Ask Dr. Matt

Is there any reason I should send my kids to a pediatric dentist instead of the dentist I go to?

You know, I always refer my patients to pediatric dentists, but like you, I’d like to find out just how they’re different from dentists who work with adults. I decided to ask a friend, pediatric dentist Jason Moffitt, just what he does.

MT: How is a pediatric dentist different from a family dentist?

JM: A pediatric dentist is different in that they have two extra years of school after dental school, focusing solely on kids. I only see kids — 6 months through about 18 years. Our office style, wordage, demeanor, attitude, colors, etc. are all about kids. Throughout their growth and development, we can mentally and physically guide the child and parents through the dental experience. We hope to set up their grown-up teeth for success by providing certain timely extractions, restorations as needed, cleanings, appropriately timed x-rays and watchful waiting — all with the idea of grooming and teaching for eventual graduation from us to the big world. One of the beauties of baby teeth is that in a sense they are a “practice” round for hygiene.

MT: Parents are often surprised when I suggest they see a pediatric dentist 6 months or so after the first tooth. I am not sure where I came up with that age, maybe a dream, but that is what I tell them — what should I tell them?

JM: That’s no dream, that’s the good stuff. Although there is not much for us to do at that age, it’s important to get parents on board as far as hygiene instructions, philosophy, and the experience we’re shooting for. There is a ton of stuff we can talk about. As a parent, I think it is important to know what to watch for and be as prepared as possible — so there will be no surprises. Technically, once a tooth erupts you can get a cavity on it — rare, but possible. However, at that age I would typically watch it, because teeth don’t like fillings. The goal is to save tooth structure, nothing better than the real deal. Anybody that’s had fillings knows that small fillings eventually get bigger, and bigger. I often hear parents ask, “Why fix baby teeth?” I say, “I hear ya. You don’t want to put the kid’s college tuition in their baby teeth.” But if they’re 3 and the tooth is going to be in there until 10, 11, 12, I’m more inclined to say, “We should probably do something about this one.”

MT: My pocketbook has a question it wants to ask you — By receiving earlier care, can kids end up not needing braces later, if preemptive action is taken with extractions, spacers, etc?

JM: Yes, it is no guarantee, but a lot of times the parents and patients are satisfied with results and hold off. An orthodontist consult really can be done at any time — my mom had braces at 40. By getting baby teeth out in a timely manner, we can “make room” for the permanent teeth to come in more straight. Teeth grow in the path of least resistance, so you can create a space and the permanent tooth will drift to the spot it should go, with the tongue and lip doing the moving. Basically you’re giving the body a chance to do what it can on its own.  There are, of course, situations (crossbites, mixed dentition, impactions, skeletal formations, etc.) that trump your cards as far as an orthodontist referral. Generally, I am just trying to buy time and see how it plays out.

MT: Do you have any tips on how to brush and floss our toddlers’ teeth? Talk about hand-to-hand combat!

JM: Good old-fashioned elbow grease. Making it a part of life. Having them watch mom and dad. How bad do you want it? The more parents do, the less we need to do — bottom line.

MT: How significant is genetics in dental health?

JM: Genes play a role, but I’m still a believer in just gettin’ ‘er done — brushing, flossing, good diet, regular checkups, kiss grandma, etc. 

MT: OK, last question. If you could only pick one of the next three, because you were on a desert island, which would be most important for a kid: brushing, flossing, or fluoride? (And you can’t say you would make a brush and floss out of bamboo and coconuts, and bring toothpaste with fluoride.)

JM: I’d take the toothbrush because it’d cover the most tooth surface, and my diet would be pretty simple, no complex sugars (other than the mai tais). I’d be able to swish with warm salt water for my gingivitis, plus with my killer tan my teeth would look white.

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