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Puget Sound Pediatric Dentistry
Puget Sound Pediatric Dentistry

Teeth 101: A Child's Teeth.

Smiling child with 2 teeth, who takes good care of them thanks to information provided by his pediatric dentist at Puget Sound Pediatric Dentistry.

What is a pediatric dentist?

Some of my colleagues in general and family dentistry would say, "A crazy person." The American Academy of Pediatric Dentistry (AAPD) defines Pediatric dentistry as an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. That means, we see ALL children and can provide all restorative and preventative care for your child. In doing so, my goal as a dentist for children in Marysville, Monroe, and Lake Stevens, is to create wonderful patients who will have lifelong positive dental experiences.

When should I take my child to the dentist for their first check-up?

We see children from birth to eighteen years of age. The AAPD suggest that children should receive their first dental exam at their first birthday. I would suggest the best time to get the first dental exam is when a child has four upper and lower front teeth, with the initial eruption of the first molars. That is usually between twelve and sixteen months of age; if you have a concern about your child, we suggest an immediate visit to address the issue. Early evaluation can prevent many major costly and painful dental issues.

Is fluoride necessary for kids?

Short answer: YES. The long answer is: fluoride is a safe and effective adjunct in reducing the risk of caries and reversing enamel demineralization. Studies within the last half-century indicate reductions in caries of 55 to 60% and recent data still shows caries reduction of approximately 25%, without significant enamel fluorosis when adequate amount of fluoride is given to children in either public drinking water, toothpaste, or a supplement. The key is adequate, and there is too much of a good thing. We have recently been decreasing the amount of fluoride given to children due to an increase in fluorosis seen in the last 10 years. Only your dentist or health care provider can determine the "adequate" amount of fluoride your child should receive.

When should I start brushing my baby's teeth?

Short Answer: as soon as your child has teeth. Our dentists for children recommend a soft tooth brush with water for the first couple of months. Training toothpaste is fine, but an added expense that will not provide much benefit to cavity prevention. We recommend a gently circular brushing motion of both the teeth and gums when teething begins. This may alleviate some of the pain associated with teething, and will allow for the establishment of a good oral hygiene routine.

That sounds wonderful in theory, but in real life, our children can become very difficult to brush over the first few years of life. Establishing independence, and "fighting" you every step of the way can be so challenging. At Puget Sound Pediatric Dentistry we will give you techniques to win the battle at the sink.

What should I use to clean my baby's teeth?

Initially, parents and caregivers should gently brush the gums with a soft tooth brush. We provide all new patients with a small headed soft toothbrush. I am not a fan of the rubber finger brushes, and find they provide very little mechanical removal of "gunk" from the newly erupting teeth. During teething, I suggest warm water with the tooth brush, removing the plaque that is built up on the brush. At this time, the gums will bleed. That is NORMAL. Brushing will strengthen the gums, and allow for a better teething experience. When you come in for your first visit, we can determine when it is appropriate to start using fluoride toothpaste.

Are baby teeth really important?

Baby teeth are wonderful reminders of our misspent youth, and offer the tooth fairy a means to give our children money and gifts. Additionally, the "baby teeth" or primary dentition serves several important functions. They allow us to eat, speak, give us a winning smile, and most importantly provide space holders for permanent teeth. Many of the back baby teeth are "long term" teeth that will remain until age 12. So, if a child needs teeth removed due to cavities, there is a chance they will need extensive orthodontic treatment in the future due to space loss. Baby teeth are EXTREMELY important and should be maintained to avoid future issues.

When should my child start using toothpaste?

Spitting and opposable thumbs are some of the attributes that separate us from other animals in the wild. We recommend starting this lifelong journey of individualism / spitting by starting to use fluoride toothpaste at one year of age. This can begin with evening brushing with toothpaste, and morning brushing with warm water. As children progress in age, we can determine their needs for additional fluoride exposure. We've noticed that the warnings on the back of these tubes are quite extensive and concerning to parents. At Puget Sound Pediatric Dentistry, we are concerned as well and want to decrease cavity formation without creating other health issues, including something called fluorosis. Please feel free to discuss this with our staff and we can help you decide about fluoride use and administration. I would be happy to give spitting demonstrations upon request.

Is teeth whitening safe for kids?

Once only available to royalty and very rich movie stars, whitening was considered the finishing touch to a complete body makeover. Now, no longer costing your first born child, anyone with a Costco membership or access to the Internet can order prescription strength "bleach" for your teeth. Classic bleaching requires custom made trays that can hold dental whitening agent for minutes to hours. That process is usually completed by a dentist. The over the counter whitening strips provide similar treatment with easy application strips that dissolve or need to be removed at the prescribed time. This is a cost effective and easy process, which can provide excellent results. Whitening relies on chemicals to change the stain patterns in teeth, and these chemicals can be very harsh to developing teeth.

WE NEVER RECOMMEND whitening for baby / primary teeth. The youngest age for adult teeth should be when root development is completed on the treated teeth. Some doctors start kids as early as 10 years old. My personal recommendation is usually 12, but I would wait until orthodontics treatment is completed if that process has not started. Consulting us prior to "self" treatment is advised due to possible harmful reactions that can damage your teeth.

Is my child ready for braces?

A wise instructor once told me, "No one has died from crooked teeth." That has always stuck in my head, especially when parents have questions about their 6 year old and tooth eruption / spacing. A major challenge in our office is determining the appropriate age for an orthodontic consultation, or if one is even needed. Straight teeth are wonderful, but my major concern is how the bite lines up, and if there are any major jaw issues from abnormal growth patterns. As a dentist for children in the Puget Sound area, I will be happy to let you know the best time to seek Orthodontic care, and who is a "quality" orthodontist in your area.

What are dental sealants?

Sealant is exactly what it sounds like, a sealer that goes in the groves of a tooth to protect it from cavities, not a freakish genetic experiment between a marine mammal and an insect (get it, SEAL – ANT). Now people think when a tooth is sealed, it is protected from cavities. Partly true, partly fairy tale. A permanent tooth has deep groves, and when sealer is placed into the groves before a cavity, it can be protected. Like clear coat on a car, wear and tear can cause it to be damaged over time, leaving the tooth vulnerable to cavities.

While patients at Puget Sound Pediatric Dentistry, we will always maintain the sealant at no charge. It is important to come for your six month checkups to make sure your child's sealants are maintained.

Can cavities spread to adult teeth?

A common myth is that cavities can spread from tooth to tooth, like grasshoppers jumping from blade of grass to blade of grass. NOT TRUE. I would consider thinking about the cavity bacteria (aka sugar bugs) as "ever present" in the mouth, like pollen in the air or sand in your car after a trip to the beach. No matter how hard you try, the bugs will remain in the mouth. The only things we can control are: how many bugs live in the mouth, and how often they are fed. Brushing with fluoride toothpaste will lessen the total number of bugs, like vacuuming the car after the trip to the beach. Decreasing your child's sugar intake will lessen the food source for the bugs, like using a pollen filter in your room during allergy season.

If the bugs are in your mouth, there is a chance you can get cavities. It is possible to live CAVITY FREE, but it requires a regular routine of brushing, FLOSSING, and six month visits to our office for a professional cleaning and fluoride treatment. Cavities that are small will not directly spread to permanent teeth that are forming in the jaw, and only the dentist can determine the risk to your child's teeth.

Are oral habits, like thumb sucking or pacifier usage, harmful to my child's teeth?

I am a person who loves to sleep, and once my children go to bed, I will do anything to keep them asleep so I can sleep. Does that sound familiar? We all want to sleep. I will never berate a parent who wants to get a good night sleep. Sometimes, children will have an oral habit that will cause them to fall asleep. Society really wants children to be done with oral habits by age one. As a dad and a dentist, I would really like children to stop an oral habit by three to three and a half. Overall, stopping earlier will decrease the chance for orthodontic correction (aka braces) and has been shown to decrease the number of colds during a flu season.

Are dental x-rays safe?

Making your child glow due to dental x-rays is not the goal of our practice. In fact, children receive more radiation by the breakdown of potassium after eating bananas during the year. Digital x-rays have made the process of getting "pictures" easier. One "old school" film x-ray is equivalent to six digital x-rays. Additionally, we use shielding to protect vital organs and areas of growth from any scattered radiation during an x-ray. On the whole, in moderation, dental x-rays provide a valuable diagnostic tool that is safe for people of all ages. Please ask for more information at your visit if there is a concern.

What Should I Do if My Child Hurts a Tooth?

Tooth pain is never normal. There are many reasons for teeth to hurt, but NONE should be taken lightly and immediate evaluation by the providers at Puget Sound Pediatric Dentistry should be scheduled. To manage most oral pain, we suggest over-the-counter pain relievers like Children's Ibuprofen or Acetaminophen. Topical anesthetics like benzocaine (active ingredient in orajel) can provide temporary relief to teething pain, but will not be effective on other types of oral infection. Please call immediately if your child is in pain. We will always make time in our schedule for your child if they are in pain.

What foods cause cavities?

Note: All foods in moderation are fine. I am a dad, and often I will give these to my children when driving away from home because they are easy to pack and dispense. If you are able to brush immediately after eating, the chance of cavity formation decreases. If not, at least try to give you children some water to rinse out the sugar and decrease the levels of "sugar bugs" forming after a meal.

•  Raisins
•  Craisins
•  Yogurt
•  Go-Gurt
•  Gold Fish
•  Fruit Leather
•  Fruit Roll-Ups
•  Gummy Vitamins
•  Candy (all forms)
•  Milk - drinking all day in bottles or sippy cups (fine at meals and snacks followed by brushing)
•  Soy milk - very sticky, high in sugar
•  Chocolate/vanilla/strawberry milk
•  Soda & energy drinks (even diet due to the level of acids in them)
•  Sugar cereals (any cereal with a character on the box)
•  Fast food - you know it's bad for you, it's not any better for your kids!
•  "100 percent natural" foods and drinks -due to high levels of sugar

We Look Forward To Meeting You

Our front office staff is happy to discuss our services with you. Our dentists are here to serve your children and teens. For more information, contact one of our multiple Seattle area offices.


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Puget Sound Pediatric Dentistry, 919 State Ave, Suite 104, Marysville, WA 98270
14090 Fryelands Blvd SE, Suite 348, Monroe, WA 98272
9421 N Davies Road, Suite A, Lake Stevens, WA 98258
7104 265th Street NW. #110, Stanwood, WA 98292, 360-659-8100, 360-863-8700, 425-367-4149, 360-339-8000,, 7/31/2021, Key Phrases: pediatric dentist Marysville WA, pediatric dentist Marysville WA,