Howard W. Schneider, DDS, PC


Answers from the Tooth Fairy

Infant and Toddler Dental Care

Q When should my child first see a pediatric dentist?

Your child’s first dental visit should be scheduled by their first birthday. These early visits allow you to get an important start on preventive dental care that will yield a lifetime of good health. Our office offers complimentary “well baby” dental visits for children less than 24 months to help you get started.

Q Why is taking care of “baby teeth” so important?

Primary teeth (baby teeth) serve important functions in your child’s normal growth and development.

Primary teeth:

• Help maintain good nutrition by allowing proper chewing.
• Are involved in proper speech development.
• Maintain space for the permanent teeth and aid in proper jaw development.
• Aid in the development of good self-esteem by giving your child a healthy smile.

Q When do children naturally lose their primary teeth?
A Most children will begin to lose their bottom, front, primary teeth between 5 ½ and 6 ½ years old. The last back primary molars do not usually get replaced till between 12 and 13 years old.
Q What is Early Childhood Caries (Nursing Decay Syndrome) and how can I prevent it?
A Early Childhood Cariesis a serious form of tooth decay among young children that can completely destroy their teeth if left untreated. It can start affecting the teeth as soon as they start to erupt and is caused by frequent and/or long exposure of an infant's teeth to liquids that contain sugar, such as: milk (including breast milk), formula, fruit juice and other sweetened drinks.
Early Childhood Caries is completely preventable with a few easy steps.
• Avoid at-will breast feeding once the first primary teeth start to erupt.
• Only use water in night-time and nap-time bottles.
• Most children should be weaned from the bottle by 12-14 months of age.
• Juice should be given in a Sippy-Cup and only at meals or snack time.
• Starting from birth, clean your baby’s gums and teeth after each feeding with a soft infant toothbrush or cloth.
Q When should I start cleaning my baby’s teeth? Should I use toothpaste?

You should start cleaning your baby’s gums before they even have teeth. Use a soft infant toothbrush or clothand water. Once the first tooth erupts, start brushing at least twice a day with a soft infant toothbrush and a non-fluoridated infant toothpaste. Continue to use a non-fluoridated infant toothpaste until your child can reliably rinse and spit. Once they can reliably rinse and spit you should start using a pea-size amount of fluoridated toothpaste. It is your responsibility to clean your child’s teeth during their first several years and to oversee the process though late childhood.


Dental Care for Young and School-Age Children

Q What do you do at a preventive dental visit?
A At these visits our dental team will:
• Clean and polish the teeth to remove any debris that has built up.
• Check that the gum tissue and other oral soft tissues are healthy.
• Check the teeth for cavities and any developmental defects.
• Check if the bite (occlusion) is developing normally.
• Review home care and oral hygiene instructions.
• Apply fluoride to help strengthen the teeth’s enamel surface.
• Take radiographs (x-rays) if indicated.
• Devise a treatment plan to treat any problems found.
• Review everything with you and your child.
Q How often do you take radiographs (x-rays)?
A Our office is very conservative in our use of radiographs and we only take them when we expect that they will provide important information that will impact on your child’s dental health. Frequency is determined by each child’s individual needs. If you have recent radiographs from another dentist we will be glad to use them instead of taking new ones. We will always discuss the need for radiographs with you before any are taken.
Q How safe are dental radiographs?
A Dental radiographs are very safe and are a much smaller risk then undetected and/or untreated dental problems. To further reduce any unneeded radiation exposure we use lead aprons and the latest digital x-ray technology. Digital radiographs use less x-ray radiation then “old-style” radiographs, and arealso better for the environment as they do not require use of toxic developing chemicals.
Q What type of fillings do you use?
A Our office has made a commitment not to use amalgam (mercury containing) restorations with our patients. We use white, bonded, composite restorations for most of the teeth we restore. Occasionally a back tooth may be so severely damaged that it requires covering with a stainless steel crown. While these crowns are silver-colored, they do not contain mercury.
Q What are sealants and how do they work?
A Even with good brushing and flossing it is difficult, almost impossible, to clean the grooves and pits on certain teeth. Food and bacteria can build up in these areas and lead to cavities. Sealants help solve this problem. Sealants are the same type of material as a bonded composite filling, but in a more liquid form. After the tooth is specially cleaned, the sealant is “painted” into any deep grooves and crevices. The sealant fills in these areas so that food and bacteria cannot get stuck there, thus lowering the risk of decay.
Q Which teeth do you seal?
A First and second permanent (grownup) molars are the most common teeth that benefit from sealants, as they usually have deeper crevices on the chewing surfaces. For some children the tongue side of their upper front permanent teeth and their premolars may also form with deep pits, in which case they should be sealed as well.Less frequentlywe may also find deep crevices that require sealing on primary (baby) molars.
Q How often should my child see the Pediatric Dentist for preventive dental visits?
A The American Academy of Pediatric Dentistry recommends that most children be seen for preventive dental visits every six months. Some children who have: an increased risk of tooth decay, poor oral hygiene, unusual growth patterns, and/or are undergoing orthodontic treatment may require more frequent visits.
Q How will my child benefit from regular preventive dental visits?
A Children with healthy mouths have a better chance of overall good general health. Studies show that children with dental pain have decreased school performance, poorer social skills, and decreased success later in life. Pleasant childhood dental visits help keep them cavity free, help ensure we catch any potential problems early, and help promote the establishment of trust and confidence that will last a lifetime.


Fluoride Supplements

Q Should my child take a fluoride supplement?

This question does not have a clear cut answer.

Fluoride in small quantities helps to strengthen teeth.  Too much fluoride prior to age 6 can sometimes cause mottling (fluorosis) of developing permanent teeth.  Like many things (such as iron, calcium, oxygen, and water) the right quantity can be helpful, but large quantities can be harmful.  The key is finding the correct balance for your child given their age, dietary habits, and oral hygiene habits.

While we have no fluoride in our water in Suffolk County, we realize that our children are ingesting fluoride from many other sources.  Dr. Schneider will help you formulate the correct fluoride usage schedule for your child based on their individual needs.



Emergency Care

Q Knocked Out Permanent Tooth
A Find the tooth. Handle the tooth by the top (crown), not by the root portion. You may rinse the tooth with cold water, but DO NOT clean or handle the root unnecessarily. Try to reinsert the tooth back in its socket. Have the child hold the tooth in place by gently biting on a clean gauze or cloth. If you cannot reinsert the tooth, transport the tooth in a cup of milk or saline. See a dentist IMMEDIATELY! Within 20 minutes is best. TIME IS A CRITICAL FACTOR!
Q Knocked OutPrimary (baby) Tooth
A Primary teeth should never be replanted because of the high risk of damaging the permanent tooth developing underneath.If the spot where the tooth came out is bleeding, fold and pack a clean gauze or cloth over the bleeding area. Have the child bite on the gauze with pressure for 15-20 minutes. This may repeated once. If bleeding persists see your child’s dentist.


Q Toothache
A Clean the area around the sore tooth gently with a soft toothbrush. Rinse the mouth vigorously with warm water or use dental floss to dislodge trapped food or debris. DO NOT place aspirin on the gum or on the aching tooth. If their face is swollen, apply a cold compress. Take Tylenol for pain, and see your child’s pediatric dentist as soon as possible.
Q Chipped or Broken Tooth
A Rinse any dirt from the injured area with warm water. If there is swelling, place a cold compress over the outside of the face in the area of the injury. DO NOT put ice directly on the tooth. Find and save any broken tooth fragments if possible. Take Tylenol for pain, and contact your child’s pediatric dentist as soon as possible.
Q Cut or BittenTongue, Lip or Cheek
A Apply ice to any bruised areas. If there is bleeding, apply firm pressure with a clean gauze or cloth. If bleeding does not stop significantly after 15 minutes or it cannot be controlled by simple pressure, call 911 or take the child to a hospital emergency room.
Q Broken Braces and Wires

If a broken appliance can be removed easily, take it out. If it cannot, cover the sharp or protruding portion with cotton balls, gauze, wax, or chewing gum. If a wire is stuck in the gums, cheek, or tongue, DO NOT remove it. Take the child to a dentist immediately. Loose or broken appliances which do not bother the child don’t usually require emergency attention.

Q Severe Blow to the Head, or Fractured Jaw
A Call 911 and seek IMMEDIATE EMERGENCY CARE. Remember an emergency medical team may be able to get to you faster than you can reach a hospital.




Useful Dental Websites

Q What are some trusted dental websites?

American Dental Association public section (website)

American Academy of Pediatric Dentistry parent section (website)