When to Visit
The American Academy of Pediatric Dentistry has recommended that children first see the dentist six months after the first tooth erupts, or no later than their first birthday. After that, kids should have a dental checkup and cleaning every six months to prevent tooth decay and proactively treat problems.

Establishing a Dental Home
Establishing a dental home for children at a very young age can provide preventive care beginning with the child’s first tooth. A one-year-old child is much more manageable than an apprehensive three-year-old. It is much easier to do a quick exam and educate parents on oral hygiene for a one-year-old than treat an uncooperative three-year-old with dental cavities. The goal of the child dental visit are to:

• To provide education relevant to the child’s age.
• Give the family a place to turn if they have a question about oral health or if the child sustains an oral injury and needs immediate attention.
• Allow a place for immediate attention other than the hospital emergency room which can become very stressful and costly. This emergency room experience could likely characterize the child’s first dental experience with pain and anxiety rather than a benign examination.
• Hopefully reduce the amount of dental treatment they will need in the long run.

The infant’s first visit should be a pleasant experience that will positively influence your child’s attitudes about future oral health care.

What can you expect at the first dental visit?
An examination and cleaning on a small child doesn’t involve many teeth and can be done very quickly. The most effective and comfortable position for patient, parent, and dentist is the lap to lap position. Dr. Dunlop and parent sit opposite each other with knees touching. The child sits on the parents lap facing the parent with their legs embracing them. The child then lies backward until the head rests in Dr. Dunlop’s lap while the parent holds the patient’s hands. This creates a stable base and a cradling effect for your child as they lay down with their head resting on our lap while they see you, their loving parent. The teeth are then cleaned and examined by Dr. Dunlop.

Research has shown that dental decay has decreased over the past few decades however is still the number one cause of child illness in the United States. The best method for reducing tooth decay is still prevention and one of the major resources is the exposure to fluoride.

Fluoride is a mineral that can be found in all naturally occurring water sources, even the ocean. Fluoride compounds have been found to significantly reduce instances of tooth decay by simultaneously strengthening the tooth structure and helping the tooth to re-mineralize after acids from bacteria have attacked the dental enamel. This re-mineralization is crucial to keeping your child’s teeth healthy and strong. If the teeth have sufficient levels of fluoride, they are more likely to stay strong, healthy, comfortable, and normal looking—all of which are important factors for small children learning to eat, drink, talk, and socialize with their peers.

Studies have shown that the period when teeth are developing are the most crucial phase for the teeth to receive fluoride, which is why dentists and pediatricians recommend that your child receive regular fluoride treatments.

The American Dental Association recommends fluoride treatments twice a year for your child’s teeth to keep them healthy and strong. Please be aware that your insurance company may only pay for this treatment once a year. If you have questions about what your insurance company covers, contact your provider. Also, because some cities choose to fluoridate their water, check your local municipality to find out what level of fluoridation your child may already receive.

Dental sealants are thin plastic coatings that are applied to the grooves on the chewing surfaces of the back teeth to protect them from tooth decay. There is no numbing or shots needed to place these sealants. Research has shown that four out of every five cavities present in children’s mouths occur on the biting surfaces of molars, which is why sealants are typically used to protect these teeth. Sealants protect these surfaces by keeping germs and food particles out of these grooves. By applying dental sealants, you can significantly decrease the chances of your child getting cavities. For this reason, most pediatric dentists recommend sealing 6-year and 12-year molars.

Tooth decay is the number one chronic childhood illness, with 42% of children ages 2-11 suffering with cavities. Unfortunately, many of these early cavities go undiagnosed and untreated. In fact, 23% of children within the same age group have untreated cavities, leading to even more discomfort and decay.

Since children aren’t likely familiar with the tell-tale signs of a dental cavity, many parents overlook them. Instead of complaining about a sore tooth, your kids might suddenly develop an aversion to eating, drinking, or speaking properly. This is even more of a problem when cavities occur in the molars or in between the teeth, where they are difficult to see. Since dental disease in kids has also been tied to dangerous systemic diseases such as diabetes and pneumonia, it is crucial to bring your child in for their normal dental exams and checkups. The type of restoration will be determined by Dr. Dunlop based on the prognosis of the tooth.

Fillings
Dental fillings are designed to patch the hole in the tooth. Without fillings, food, plaque, and bacteria could easily collect in the space again, causing deeper and more painful damage.

After the dentist numbs the area with a local anesthetic, the decay is removed with a gentle dental drill. Next a tooth-colored composite resin filling is used to fill in the cavity. The surface is smoothed and the tooth is polished, leaving a strong, healthy tooth once again.

Crowns
Stainless steel crowns are silver caps that cover the whole tooth. Porcelain crowns are tooth colored. Dental crowns for children are generally completed in one visit, and will usually last until the tooth falls out at around the age of 10 to 12. We place crowns on first and second baby molars that have large decay in between the teeth, or on teeth which are too damaged to be repaired with fillings.

Using the most advanced dental technology possible is just as important as staying up-to-date on the latest treatment techniques. Because our practice is dedicated to providing you with the safest and most convenient treatment options available, we utilize advanced digital X-ray technology in our office. Digital X-rays provide several advanced imaging options designed to save time, provide clearer dental photos, and expose patients to 90% less radiation than with traditional Xray technology.

Most children start to lose their baby teeth by the time they are 6 or 7, but every child is different. Some children lose teeth earlier than they are supposed to because of illnesses, accidents, decay, or other injuries. Although losing teeth early might not seem like a serious problem, complications can occur if the baby teeth aren’t in place for as long as they should be.

Baby teeth play the crucial role of holding a space available for incoming permanent teeth. Unfortunately, if baby teeth fall out early, the other teeth might shift or spread differently, which could leave the permanent tooth without a place to go. Dr. Dunlop will evaluate your child to see which space maintenance device works best for the patient.

Upon examination, Dr. Dunlop and Dr. Shieh will work together to determine not only the oral health of your child but also the adequacy of space and alignment. During each checkup, they are observing healthy teeth and gums, completing an oral cancer screen and checking eruption patterns and space for growth.

When is the best time to begin orthodontics?
The American Association of Orthodontists recommends that the initial orthodontic evaluation should occur at the first sign of orthodontic problems or no later than age 7. At this early age, orthodontic treatment may not be necessary, but vigilant examination can anticipate the most advantageous time to begin treatment.

What are the benefits of early orthodontic evaluation?
Early evaluation provides both timely detection of problems and greater opportunity for more effective treatment. Prudent intervention guides growth and development, preventing serious problems later. When orthodontic intervention is not necessary, the doctors can carefully monitor growth and development and begin treatment when it is ideal.

What are the advantages of interceptive treatment

Some of the most direct results of interceptive treatment are:

• Creating room for crowded, erupting teeth
• Creating facial symmetry through influencing jaw growth
• Reducing the risk of trauma to protruding front teeth
• Preserving space for unerupted teeth
• Reducing the need for tooth removal
• Reducing treatment time with braces

Are you a candidate for orthodontic treatment?
Orthodontics is not merely for improving the aesthetics of the smile; orthodontic treatment improves bad bites (malocclusions). Malocclusions occur as a result of tooth or jaw misalignment. Malocclusions affect the way you smile, chew, clean your teeth or feel about your smile.

Why should malocclusions be treated?
According to studies by the American Association of Orthodontists, untreated malocclusions can result in a variety of problems:

• Crowded teeth are more difficult to properly brush and floss, which may contribute to tooth decay and/or gum disease.
• Protruding teeth are more susceptible to accidental chipping.
• Crossbites can result in unfavorable growth and uneven tooth wear.
• Openbites can result in tongue-thrusting habits and speech impediments.

Ultimately, orthodontics does more than make a pretty smile – it creates a healthier patient.

Our goal at South Shore Smiles is to create an enthusiastic and supportive environment that fosters a positive dental attitude. We want your child to be excited about his or her visit! Our team is trained in a variety of techniques that help ease an anxious or fearful child. Commonly used behavior guidance tools include:

Tell-Show-Do
Although very simple, tell-show-do is one of the most effective behavior guidance techniques. With this technique, a team member tells your child about the appointment using age appropriate terms and descriptions, shows your child related sounds/smells/tactile aspects of the appointment, and then completes the appointment without deviation from the explanation and/or demonstration. Our team members utilize this technique with all anxious patients.

Distraction
As any parent knows, distraction helps to redirect a child’s attention and behavior. Our team members will engage your child in conversation/song/questions to help alleviate anxiety. Our treatment areas are also equipped with radios and televisions to help distract your child during longer or more difficult appointments.

Nonverbal Communication
Gestures and facial expressions convey a great deal of information to children. A simple smile, high-five, or fist bump combined with a relaxed posture at your child’s level will help to relieve anxiety.

Positive Reinforcement
Rewarding desired behavior is essential to strengthen its recurrence. Our team members utilize verbal praise, stickers and end-of-appointment prizes to help shape good behavior. We also encourage patients to demonstrate their good behavior to siblings in an effort to reinforce positive appointments.

Advanced Behavior Management
Occasionally children require more advance behavior guidance techniques in order to complete dental treatment. These advanced techniques include protective stabilization, conscious sedation and hospital treatment under general anesthesia. Protective stabilization is the use of a blanket, wrap, mouth prop, parent, and/or team member to restrict a child’s movement in order to decrease the risk of injury while allowing for the safe completion of treatment. Our office is trained in the correct use of such techniques, and we will never use protective stabilization without your consent. If our doctors recommend protective stabilization, sedation, or hospital treatment, additional information will be provided at your child’s appointment.

Nitrous Oxide
Commonly referred to as laughing gas, nitrous oxide is a safe and effective way to reduce anxiety and improve communication. It is easily administered through a comfortable nose mask, and its effects are quickly reversible. Nitrous oxide helps to relax patients and provides a small degree of amnesia for those “less than pleasant” aspects of a dental treatment. Our doctors will only administer nitrous oxide with your consent, so please ask for details.

Oral Sedation
If your child is nervous, oral sedation may be used. It is taken by mouth. This type of medicine will make your child a little drowsy, and will keep him or her relaxed and calm during the procedure. The medicine usually begins to work within 20 minutes. Your dentist will have your child take the medicine once you arrive at the appointment. If your child is having sedation, he or she should have nothing to eat or drink after midnight the night before the appointment.

General Anesthesia
Some children require deeper anesthesia to manage their dental anxiety or uncontrollable movements. General anesthesia might also be recommended if your child has extensive dental issues, such as baby-bottle tooth decay or deeply rooted infections.

General anesthesia is administered through an IV to help put your child to sleep. This deeper form of anesthesia can affect other systems of the body, so your child’s breathing, heart rate, and other vital signs will need to be carefully monitored. The general anesthesia can be either performed in office or at the hospital. Dr. Dunlop holds hospital privileges for treatment under general anesthesia at Community Hospital in Munster, IN and at St. Catherine Hospital in East Chicago, IN. Dr. Dunlop also works with a board-certified dentist anesthesiologist, Dr. Zak Messieha, if your child is better suited in an in-office setting. He has specialized training using various medications to safely put a child patient to sleep. All the dental work can be completed in one visit.

Dr. Dunlop also works with a board-certified dentist anesthesiologist, Dr. Zak Messieha, if your child is better suited in an in-office setting. He has specialized training using various medications to safely put a child patient to sleep. All the dental work can be completed in one visit.

A toothache can be caused by a cavity, lost filling, loose tooth, or injury. If your child has a toothache without any noticeable swelling or fever, we recommend an over-the-counter pain medication (Tylenol or Advil) combined with a soft, room-temperature diet. It’s best to have any toothache evaluated by the dentist to determine the cause and treat if necessary. Please contact our office during business hours to schedule an appointment.

If your child has a severe toothache with swelling and/or fever, please contact our office or after-hours number immediately. A severe toothache that prevents sleeping or causes swelling/fever signals the spread of infection. You can provide your child with an over-the-counter pain medication, but a prescription antibiotic and/or after-hours office visit may be necessary. It’s important for your child to remain hydrated, so encourage room temperature drinks. If your child develops swelling of the neck or has trouble breathing, contact 911 immediately.

If a tooth is struck or bumped, the surrounding gum tissue may bleed. This bleeding is typically mild to moderate and stops without treatment. If the tooth is slightly loose or out of position, we recommend a soft diet and over-the counter pain medication. Contact our office during business hours to schedule a follow-up appointment. If the tooth is very loose or severely out of position (your child cannot talk or close the mouth properly), please contact our office or after-hours number immediately to discuss the injury with our dentists. An after-hours appointment may be necessary to evaluate the injury and/or re-position the tooth. With all injuries, continued follow- up is necessary to ensure the vitality of the tooth.

If a tooth is chipped, try to locate the chipped portion and place it in cold milk. A chipped piece can often be reattached in the office. If the chipped tooth is pink or bleeding, contact our office or after-hours number immediately. This type of injury is often very sensitive and requires evaluation and prompt treatment. If the chipped tooth is not pink or bleeding, we recommend soft, room-temperature foods combined with an over-the-counter pain medication. Contact our office during business hours to schedule an evaluation and treatment. Depending on the size of the chip, the tooth may be smoothed for comfort or “rebuilt” using white filling material.

Permanent Tooth: An avulsed tooth can be scary but don’t panic. If the tooth can be located, gently rinse off any large debris (dirt, grass, etc.) using cool water. It’s important to hold the tooth by the crown (the portion of the tooth that is visible in the mouth) in order to protect the delicate tissue on the root surface. Reinsert the tooth into its socket using gentle finger or biting pressure OR place the tooth in a glass of cold milk. Contact our office or after-hours number immediately since treatment is time sensitive and requires prompt attention. If the tooth cannot be located, it’s still important to contact the dentist immediately for evaluation.

Baby Tooth: An avulsed baby tooth should never be reinserted in order to protect the developing permanent tooth. Instead, have your child bite down on a cold, wet towel to control any bleeding and contact the office or after-hours number. An appointment may or may not be necessary depending on the tooth and age of your child. If you are not sure whether a lost tooth is a baby tooth or permanent tooth, err on the side of caution and place it in cold milk.

**NOTE: If your child loses consciousness or complains of nausea and disorientation following trauma, seek immediate medical attention prior to contacting the dentist.

In most cases, a broken or dislodged appliance does not require after-hours treatment. Discourage your child from “playing” with a broken or loose appliance and offer soft foods and over-the-counter pain medication if necessary. Contact our office during business hours to schedule an evaluation or repair appointment. If an appliance becomes completely dislodged, place it in a small bag for safe storage and contact our office for an evaluation. The appliance will be reinserted or remade based upon its integrity and length of time outside the mouth.