The First Dental Visit

Your child should visit the dentist by his or her 1^st birthday. You can make the first visit to the dentist enjoyable and positive. Your child should be informed of the visit and that the dentist and her staff will explain all procedures and answer any questions. Please convey good feelings to your child about the dental visit and remind him or her it is an important part of growing up.

It is best if you refrain from using words around your child that might cause unnecessary fear, such as: needle, pull, drill, or hurt. Our staff makes a practice of using different words that convey the same message, but are pleasant and non-frightening to your child. Do not bribe your child our use the dental visit as a form of punishment.

Please arrive early if you need to fill out the paperwork. If there is late arrival to your child’s appointment, the appointment will need to be rescheduled, due to the nature of the appointment. The forms can be downloaded from this site. Our staff will review your child’s health history with you at this visit. Then, they will explain the benefits of good oral health and the importance of preventing tooth decay-using language that children can comprehend. Each child will learn the advantages of proper diet and the correct way to brush and floss. The dentist will then complete a dental exam and cleaning on your child. Radiographs (x-rays) may be taken according to your child’s age.  This first appointment usually takes about an hour, including the parent consultation with the dentist.  Please feel free to ask questions concerning your child’s dental treatment at any time.

After the dental exam, if any dental treatment is needed, it will be scheduled for a later appointment. If your child was referred to our office we will still need to perform an initial exam prior to any dental procedures. This is mandatory to thoroughly assess and discuss treatment options and obtain any additional information that may better serve your child.

We welcome parents back into the treatment area for their child’s first visit to see our dental facility and treatment procedures. However, in order to establish a trusting relationship with your child, we ask that parents remain in the waiting room during future visits.  Our staff is highly experienced in helping children overcome anxiety.  Separation anxiety is not uncommon in children, so please try not to be concerned if your child exhibits some negative behavior. This is normal and will soon diminish. Studies and experience have shown that most children over the age of three react more positively when permitted to experience the dental visit on their own. Nevertheless, if it is apparent that your child is too young or to anxious to tolerate separation, parental assistance is welcomed and encouraged at our discretion.

Scheduled Appointments

The office attempts to schedule appointments at your convenience and when time is available. We like to schedule preschool children in the morning because they are fresher and we can work more slowly with your child for their comfort. School aged children with a lot of treatment to be done should be seen in the morning for the same reason. We are aware of school policies that make it difficult for children to be out of school for any reason. However, please, remind the schools that medical and dental appointments are excused absences.

• Arriving 15 minutes late or more for any appointment may require rescheduling so other patients are not kept waiting. This is considered a broken appointment.

Since appointed times are reserved exclusively for each patient, we ask that you please notify our office 24 hours in advance of your scheduled appointment time if you are unable to keep it. Another patient who needs our care could be scheduled if we have sufficient time to notify them. We realize that unexpected things can happen, but we ask for your assistance in this regard.

• If for any reason you fail to come or cancel an after school appointment, the missed appointment will be rescheduled during school time.
• We reserve the right to charge a missed appointment fee for excessive broken or missed appointments. Please remember that a broken appointment affect many people not just you.

We make every effort to maintain our appointment schedule, and generally do. Occasionally, we treat emergencies (such as traumatic injuries) which demand immediate attention. Please understand that you would wish us to treat your child immediately in a similar situation.

Dental Emergencies

Who do I contact in case of an emergency?

Appointment times are available everyday during normal business hours for both new and existing patients with dental emergencies.

Only our established patients who experience an after hours or weekend dental emergency involving trauma, swelling, infection, pus and/or pain should contact the doctor. Only true dental emergencies will be attended after hours.  All after hours treatment is subject to an after hours fee.

In the event of an emergency for an established patient, Dr. Harris-Echols, or the dentist on call may be reached at any time, 24 hours a day, at the following telephone number (404) 482-1038.

My child is not a patient with your office, but he or she has a dental emergency after hours. What should I Do?

After hours and weekend dental emergency treatments are only for established patients. If your emergency occurs after our office hours and your child is not an existing patient, we advise that you go to an emergency room to be examined. Dental and facial infections can be serious and sometimes life threatening if left untreated. When in doubt, go to the ER.

What is considered an after-hours emergency?

If your child experiences severe trauma, pain, pus or swelling, it is considered a true dental emergency. Unless causing one of the previously mentioned symptoms: chipped teeth, fillings that fall out, broken retainers, or crowns that come off may be inconvenient, but do not require emergency after hours treatment. Contact our office during regular hours for an evaluation.

My child knocked out a tooth. What do I do?

If a permanent tooth is knocked out, find it. Handle the tooth by the crown, not the root portion.  Inspect it for root fractures. You may gently rinse, but DO NOT scrub the tooth under water. If it is sound, try to reinsert it in its socket. Have the patient hold the tooth in place by biting on gauze or washcloth.  If this is impossible, place the tooth in a glass of milk or the patient’s saliva (make sure the tooth is covered by the milk or saliva).  Contact us immediately and come to the office as soon as possible. Time is a critical factor in saving a permanent tooth.

If a baby tooth is knocked out, DO NOT reinsert the tooth into the socket.  Attempt to control the bleeding with gauze or a washcloth by placing it firmly over the site. Allow your child to bite down and hold in place for fifteen minutes. Place your child on a soft food diet and age appropriate pain medicine (i.e. Tylenol or Motrin). Contact our office for an evaluation.

My child has a toothache. What should I do?

Clean the area of the affected tooth thoroughly. Rinse the mouth vigorously with warm water or use dental floss to dislodge impacted food or debris. DO NOT place aspirin on the gum or on the aching tooth. If the face is swollen apply a cold compress and contact your dentist immediately.

My child had an accident and cut, bit, bruised; their tongue, cheek, lip, or gums?

Apply ice to bruised areas. If there is bleeding, apply firm but gentle pressure with a gauze or cloth. If bleeding does not stop after 15 minutes or it cannot be controlled by simple pressure, take your child to the hospital emergency room.

Frequently Asked Questions

What is a pediatric dentist?

A pediatric dentist has an additional two to three years of specialized training after dental school, and is dedicated to the oral health of children from infancy through the teenage years. The very young children, pre-teens, and teenagers all need different approaches in dealing with their behavior, guiding their dental growth and development, and helping them avoid future dental problems.  The pediatric dentist is the best qualified to meet these needs. She also provides a very child friendly setting for treatment and to reduce the anxiety of both patients and parents.

Why are baby (Primary) teeth so important?

It is very important to maintain the health of the primary teeth. Neglected cavities can and frequently do lead to problems which affect developing permanent teeth. Primary teeth are important for (1) proper chewing and eating, (2) providing space for the permanent teeth and guiding them into the correct position, and (3) permitting normal development of the jaw bones and muscles. Primary teeth also affect the development of speech and add to an attractive appearance. While the front four teeth last until 6-7 years of age, the back teeth (cuspids and molars) aren’t replaced until age 10-13.

How do I prevent cavities?

Good oral hygiene removes bacteria and left over food debris that combine to create cavities.  For infants, use a wet gauze or clean washcloth to wipe plaque from the teeth or gums. Do not put your child to bed with a bottle or Sippy Cup filled with anything other than water.

For older children, brush their teeth at least twice a day.  Juices and other beverages are recommended at meal or snack time. Children should not be exposed to sweet beverages in their Sippy Cups all day, substitute water if it’s not meal or snack time.

What is Pulp Therapy?

The pulp or nerve is the inner central core of the tooth. The purpose of pulp therapy in pediatric dentistry is to maintain the affected primary tooth, so the tooth is not lost prematurely.  Dental caries (cavities) and traumatic injury are the main reasons for a tooth to require pulp therapy. Pulp therapy is often referred to as a “nerve treatment”, “children’s root canal”, or “pulpotomy”.

The pulpotomy removes the diseased pulp tissue within the crown portion the tooth. Next, an agent is placed to prevent bacterial growth and to calm the remaining nerve tissue. This is followed by a final restoration, usually a stainless steel crown.

What are the advantages and disadvantages of Composite Fillings?

Composite fillings have been used for about 35 years. The advantages  of using composite material is the color can be closely matched to your child’s natural teeth, so restorations are nearly undetectable and result in a natural-looking smile. The tooth can be restored with a much smaller filling as compared to silver (amalgam) filling, so less natural tooth structure is lost. The composite actually bonds to the tooth creating a tighter seal and aids in strengthening tooth structure.

The disadvantages of using composite materials are that, depending on the condition of the tooth, it may be contraindicated and can actually set up the tooth for future decay leading to more major treatment.  Also, the technique to place a composite filling is more difficult and requires more supplies and time. This can often be very difficult for your child to tolerate. In addition, the cost of composite material is significantly higher than amalgam thus making the overall cost of treatment higher. Most insurance benefits don’t cover the additional cost of composite fillings, so you must pay the difference.

What are Sealants and why are they important?

The chewing surfaces of teeth are the most susceptible to cavities and usually benefit the least from fluoride. A sealant is a clear or white plastic material that is designed to fill-in these unprotected grooves on the teeth.  Therefore, they can be used as a protective coating and can be applied to these areas to help serve as a barrier to prevent decay.

My child grinds his teeth at night? (Bruxism)

Parents are often concerned about the nocturnal grinding of teeth, (bruxism). Often, the first indication is the noise created by your child’s grinding during sleep.  Or, you may notice wear to the dentition (the teeth getting shorter). One theory as to the cause involves a psychological component. Stress due to a new environment, divorce, or changes at school can influence a child to grind their teeth. Another theory relates to pressure in the inner ear at night.  If there are pressure changes (i.e.  airplanes taking off and landing) the child will grind by moving his jaw to relieve and equalize the pressure.

The majority of children who grind do not require any treatment. If excessive wear of the teeth (attrition) is present, a night guard (mouth guard) may be indicated.  The downsides to a night guard are the possibility of a choking hazard as the appliance becomes dislodged during sleep or it may interfere with growth of the jaws. The positive, it prevents wear to primary teeth.

Most children outgrow bruxism. The grinding tends to became less noticeable between the ages 6-9 and children tend to stop grinding between the ages of 9-12. If you suspect bruxism, discuss this with your pediatric dentist.

What is the best toothpaste for my child?

When looking for toothpaste pick one that has the American Dental Association (ADA) seal. These toothpastes have undergone testing to insure safety of use.

Remember, children should spit out toothpaste after brushing to avoid getting to much fluoride. If too much fluoride is ingested, a condition known as fluorosis can occur. If your child is too young or unable to spit out toothpaste, consider providing them with fluoride free toothpaste, using no toothpaste, or using only a “pea size” amount on the tooth brush.

My child sucks a thumb, finger, or pacifier?

Thumb or finger sucking that persists beyond the eruption of the permanent teeth can cause problems with the proper growth of the mouth and tooth alignment. How intensely your child sucks on fingers, thumb or pacifier will determine whether or not dental problems may result.  Passive digit suckers as compared to more vigorous digit suckers are less likely to have dental complications.

My child participates in a sports activity. Why are Mouth Guards recommended?

Mouth guards help to prevent broken teeth, injuries to the lips, tongue, face or jaw.  A mouth guard or mouth protector, is an important piece of athletic gear that can help protect your child’s smile and should be used during an activity that could result in a blow to the face or mouth.

A properly fitted mouth guard will stay in place while your child is wearing it, making it easy for them to talk and breathe. Ask your pediatric dentist about custom mouth protectors.

What is “Laughing Gas”? (Nitrous Oxide)

It is a very safe way to comfort a very anxious child or help a good child have a more enjoyable visit.  In order to help relieve anxiety or to relax your child, a combination of nitrous oxide and oxygen is often used during their appointment.  The gas is administered through a “flavored nose”, which is pleasing scent that your child chooses. It is NOT designed to “put them to sleep”, but only to help relax them.

What are your procedures to ensure infection control?

All aspects of our dental office have been designed to easily adhere to our industries strict infection control procedures. All equipment, cabinetry, and floors in the treatment rooms are dental specific and were designed for complete disinfection. Our sterilization center incorporates the latest cleansing and sterilization equipment and is structured so that sterile items do not contact non-sterile items.

Post Operative Care Instructions

Care of the Mouth after Extractions

1. DO NOT scratch, chew, suck, or rub the lips, tongue, or cheek while they feel numb or asleep. The child should be watched closely so he/she does not injure his/her lip, tongue, or cheeks before the anesthesia wears off. For this reason, the child should keep the piece of cotton in his/her mouth until the numbness is gone.
2. DO NOT rinse the mouth for several hours.
3. DO NOT spit excessively.
4. DO NOT drink any carbonated beverages (Coke, Sprite, etc.) for the remainder of the day.
5. DO NOT drink through a straw.
6. KEEP FINGERS AND TOUNGE away from the extraction area.
7. BLEEDING:  Some bleeding following tooth extraction is to be expected. If unusual or sustained bleeding occurs, place gauze firmly over the area of extraction and bite down or hold in place for fifteen minutes. A WET tea bag can also be used to bite on and help stop the bleeding.  Repeat if necessary.
8. Maintain a soft diet for a day or two, or until the child feels comfortable eating normally again.
9. Avoid strenuous exercise or physical activity for several hours after the extraction.
10. PAIN:  For discomfort use Children’s Tylenol, Advil, or Motrin as directed for the age of the child. If a medicine was prescribed, then follow the directions on the bottle.

Please do not hesitate to call our office if there are any questions.

Care of the Mouth after Local Anesthetic

Your child has had local anesthetic for their dental procedure:

• If the procedure was in the lower jaw (mandible)…the tongue, teeth, lip and surrounding tissue will usually be numb or asleep.
• If the procedure was in the upper jaw (maxilla)…the teeth, lip, and surrounding tissue will usually be numb or asleep.

 

1. Please monitor your child closely for approximately one to two hours following their appointment.
2. Children do not understand the feeling of local anesthesia, and may chew, scratch, suck, or play with the numb lip, tongue, or cheek. These actions can cause minor irritations or they can be severe enough to cause swelling and major abrasions to the tissue.
3. Keep your child on a liquid or soft diet (Apple Sauce, Yogurt, Smoothie, etc.) until the anesthesia has worn off and they regain feeling.
4. Please do not hesitate to contact our office if there are any questions.
5. Discomfort: For discomfort use Children’s Tylenol, Advil, or Motrin as directed for the age of the child. If a medicine was prescribed, then follow the directions on the bottle.

Care and Maintenance of Sealants

By forming a thin covering over the pits and fissures, sealants keep out plaque and food, thus decreasing the risk of decay. Since, the covering is only on the chewing surfaces of the tooth, you must have good brushing and flossing habits to protect the sides and areas in-between the teeth.  Healthy nutrition plays an important part as well.

Your child should refrain from:

1. Eating hard candy or ice. Large cubes, especially, can cause the sealant to chip or come off.
2. Food that is sticky or chewy, such as Carmel, Taffy, Starburst, Fruit Rolls Ups, etc. (Sugar-less gum can be chewed.)

Normal retention of a sealant is up to four years. Sealants that become displaced in the first twelve months will be replaced at no charge.  After twelve months, sealants will be replaced at 50% charge.

Oral Discomfort after a Cleaning

A thorough cleaning unavoidably produces some bleeding and swelling and may cause some tenderness or discomfort. This is not due to a “rough cleaning” but, to tender and inflamed gums from insufficient oral hygiene. We recommend the following for 2-3 days after the cleaning was performed:

1. A warm salt water rinse 2-3 times per day. (1 teaspoon of salt in 1 cup of warm water)
2. For discomfort use Children’s Tylenol, Advil, or Motrin as directed for the age of the child. Please do not hesitate to contact our office if the discomfort persists more than 7 days or if there are any questions.

We offer General & Family Dentistry services, Cosmetic Dentistry and Dental Implants, Invisalign and Orthodontics, Porcelain Veneers and Porcelain Crowns, Teeth Whitening, and a wide variety of other dentistry services. Please call us now at (404)23-SMILE or Schedule An Appointment.