Pediatric Dentistry

Why are primary teeth important?

Primary teeth, sometimes called “milk teeth”, are important to your child’s health and development and should be cared for just like permanent teeth. Primary teeth serve critical functions as a child learns to eat and speak. They are important for the normal growth and development of the face. In addition, they maintain space on the jaws and guide the formation of permanent teeth. While some primary teeth are typically replaced around age 6, the back teeth (molars) can remain in until age 12 or 13. Without proper care, these teeth can decay and possibly cause toothaches, gum disease, and serious health problems.

What is dental caries?

Dental caries is an infectious disease process that causes tooth decay or “cavities” and bad breath. If untreated, caries can lead to severe pain, local infection, tooth loss, and even serious recurring infections.

Caries in children:

Teeth, which are primarily made of minerals, are in a constant state of back-and-forth de-mineralization and re-mineralization. When your child eats and drinks, certain types of bacteria create acid from the foods and fluids left on the teeth. The acid de-mineralizes and weakens the tooth enamel. In healthy mouths, the time between meals allows, minerals from the saliva to become incorporated into the teeth, recoating the enamel and reversing the damage from the acid. The tooth essentially heals itself.

However, in unhealthy mouths where there is an abundance of bacteria and a high frequency of juice, sugary drink or snack consumption, the enamel never re-mineralizes and the tooth develops decay. Therefore, parents who incorporate healthy oral routines, use appropriate amounts of fluoride and space out food and drink consumption will have healthier little smiles in their family photos!


Fluoride is one of the most effective caries prevention agents. Dental caries is caused by acid-producing bacteria that collect around the teeth and gingivae (gums) in a sticky, clear film called plaque. Without good oral hygiene and regular dental visits, teeth become more vulnerable to caries. Brushing twice a day and flossing help remove plaque. Regular dental examinations and cleanings also are important for keeping the teeth healthy.

Another key to good oral health is fluoride, a mineral that helps prevent caries and can repair teeth in the very early, microscopic stages of the disease. Fluoride can be obtained in two forms: topical and systemic. Topical fluorides are applied directly to the tooth enamel. These include fluoride toothpastes and mouthwashes, as well as fluoride treatments in the dental office. Systemic fluorides such as community water fluoridation and dietary fluoride supplements are effective in reducing tooth decay. These fluorides provide topical as well as systemic protection because of the fluoride present in saliva.


If you, or a family member, are at a moderate to high risk of developing caries, a professional fluoride treatment can help. The fluoride preparation used in our dental clinic is of much stronger concentration than that in available fluoride toothpastes or mouthwashes. Professional fluoride treatments generally take just a few minutes. The fluoride may be in the form of a solution, gel, foam or varnish. Adults can benefit loads from professional fluoride treatments as well. Call for an appointment at our south Delhi clinic today!

Fluoride Gels/ Foams

Gels and Foams are used for individuals who are at risk for caries, orthodontic patients, patients having undergone head and neck radiation, patients with decreased salivary flow, children whose permanent molars should, but cannot be sealed and children with newly formed permanent teeth.

The gel or foam is applied through a tray which is held in the mouth by biting down on it. Application generally takes about one to four minutes and patients should not rinse, eat or drink for at least 30 minutes after application.

Fluoride Varnish

Fluoride varnish has practical advantages over gels in ease of application and a non-offensive taste. It is especially useful for younger children and toddlers as it causes minimal discomfort and sets within seconds. After the treatment, it is advised not to eat or drink for at least 30 minutes to allow the teeth to absorb the fluoride and help repair microscopic caries-inflicted areas.

Depending on the oral health status, fluoride treatments may be recommended every three, six or 12 months. Our dentists may also recommend additional preventive measures if your child or you are at a moderate to high risk of developing caries. These measures may include over-the-counter or prescription therapeutic products such as fluoride mouthwashes, gels, tooth mousses (minerals for teeth) or antibacterial mouthwashes.

Dental Sealants

Dental sealants act as a barrier to prevent cavities. They are a plastic material usually applied to the chewing surfaces of the back teeth (premolars and molars) where decay occurs most often. Thorough brushing and flossing help remove food particles and plaque from smooth surfaces of teeth, but toothbrush bristles cannot reach all the way into the depressions and tiny crevices extract food and plaque. Sealants protect these vulnerable areas by "sealing out" plaque and food. Sealants are easy for your dentist to apply and usually need only visit. The sealant is painted onto the tooth enamel, where it bonds directly to the tooth and hardens. This plastic resin bonds into the depressions and grooves (pits and fissures) of the chewing surfaces of back teeth. The sealant acts as a barrier, protecting enamel from plaque and acids.

As long as the sealant remains intact, the tooth surface will be protected from decay. Sealants hold up well under the force of normal chewing and may last several years before a reapplication is needed. During your regular dental visits, your dentist will check the condition of the sealants and reapply them when necessary. The likelihood of developing pit and fissure decay begins early in life, so children and teenagers are obvious candidates. But adults can benefit from sealants as well. Consult our specialists at our south Delhi clinic.

About X-rays/Dental Radiographs

Radiography is the use of X-rays to view hard-to-see areas in the mouth and inside tooth structure. It is a necessary part of the diagnostic process. Radiographs are needed to detect dental decay, inspection of newly forming teeth on the jaw bone, diagnose bone diseases, evaluate the results of an injury and plan orthodontic treatment. With contemporary safeguards such as high-speed film, digital enhancement, equipment filtering, and proper shielding, the amount of radiation received in a dental X-ray examination is extremely low and nothing to worry about.

Advice about Brushing and Flossing:

Parents should brush the teeth of infants, toddlers and preschoolers, and help school children with brushing until the age of 7 or 8. The best times to brush are before breakfast and before bedtime. The best toothbrushes for children have soft round ended bristles that clean while being gentle on the gums. Along with brushing, parents should floss children’s teeth where any two teeth touch. Flossing removes the plaque between teeth, where toothbrushes cannot reach.

We recommend using a small amount of toothpaste and suggest placing the paste across the width of the brush’s bristles instead of the length. By applying the paste in this manner, a consistent, pea-sized amount will be delivered to your child and the risk of ingestion is reduced. Regardless of the brand your child uses, always have them spit out the excess toothpaste if possible rather than swallowing it.

Pediatric FAQs:

Q. At what age should I take my child to first dental appointment?

A. We recommend that children should see a dentist definitely by their first birthday. It is important to have this first dental visit for several reasons:

  • Dental caries is the number one bacterial infection in children. For this reason, it is important to clean the teeth as soon as they erupt to disrupt the bacterial plaque development, and reduce the amount of bacteria in your child’s mouth.
  • An early professional assessment of your child’s oral health condition helps you to better plan for his future care.
  • Early information about your child’s dental care can better prepare you to: Clean your child’s teeth properly; Decide which foods help or hurt your child’s teeth; Take precautions to prevent dental trauma within your home; Take positive action if your child has a dental emergency.

We believe this appointment is important because early information is the best way to prevent severe problems later. Nip it in the bud!

Q. Why is it important to have Continuing Care appointments every three months?

A. Visits to the dentist for continuing care will help keep your child’s gums and teeth healthy, and the examinations help early discovery of problems and facial irregularities. Early detection means an easier solution!

Q. Why every three months?

A. Studies confirm that 6 months is the average time for plaque and tartar to develop on teeth and 3 months for tooth decay to be evident. At each continuing care visit, our pediatric dentist will:

  • Check for signs of Early Childhood Caries (ECC).
  • Examine the child’s mouth for indications of possible vitamin deficiencies and other recurring diseases.
  • Guide you about the treatment of any detrimental habits like thumb sucking, tongue thrusting, breathing through the mouth, etc.
  • Note any irregularities in the facial structure, bite, arch form, and teeth spacing.
  • Check for gum inflammation and pockets.
  • Clean the teeth of plaque, tartar and stains.
  • Apply appropriate fluoride to the teeth and treat potential or reversible carious lesions.
  • Recommend dietary modifications if necessary and recommend other preventive treatments like sealants, etc.
  • Show you and your child how to best clean their teeth.
  • Encourage your child to practice good dental hygiene habits.

Since you will only see us about 4 times a year on average, please never hesitate to ask for our guidance on healthy oral practices. Your family’s good oral health is our first priority.

Q. Is it a problem if my child grinds his teeth at night?

A. Teeth grinding or bruxism in children is not uncommon and is usually not related to stress, just like in adults. In children, bruxism is typically related to the anatomy of the immature jaw joint, and it normally stops once permanent teeth develop and the jaw joint matures. Most children grow out of this habit and no intervention is needed.

Q. Is there anything that can be done to make sure that my child’s teeth form straight?

A. A complete evaluation of your child’s dental alignment, including space maintenance, arch development and eruption guidance, is part of each continuing care visit. Early treatments may be recommended and can be effective in allowing for the normal eruption of the permanent teeth. If needed, braces can be recommended to straighten the teeth once the cycle of eruption of permanent teeth is complete.

Q. What be done to ensure that my child is comfortable during dental treatments?

A. First visit to the dentist is the most crucial and the most important one. A pleasant dental visit can take away the fear of dentist and prevent development of dental phobias. Our pediatric dentists are flexible and adept at handling children. Some dental treatments will definitely cause discomfort and our objective is to make your child as comfortable as we can during his/her treatment. Taking care of fearful children is our niche. The best pediatric dentists in Delhi are at your service.

We can manage comfort with topical anesthetics, local anesthetics, nitrous oxide, and oral sedation with an anesthesiologist – also called “deep conscious sedation.” You are welcome discuss the available options for your child with us to determine the course of action you are most comfortable with. We are here to help!

Q. How should I clean my infant or toddler’s teeth?

A. Use water and a washcloth or a children’s toothbrush with very soft bristles. It is recommended not to use toothpaste until he/she is able to spit it out and not swallow it. This ability is usually acquired around the age of three.

Q. Do you do early orthodontic evaluations?

A. Pediatric dentists are specialists with children’s dental development. Your child’s complete dental condition, including potential orthopedic (concerning the positioning of facial bones) and orthodontic (concerning the positioning of the teeth) conditions will be evaluated at every continuing care visit. It is normal to practice preventive or interceptive orthodontics.

Guidelines for Perinatal and Infant Oral Health

There is nothing better in the world than seeing your toddler smile at you. It is your duty to protect that smile and keep it healthy by knowing the best practices for your young one’s age. Our pediatric dentists have the unique education and training in child psychology, growth and development and preventive treatments required to care for a child’s developmental needs. Tiny smiles need to be properly cared for both in the dentist’s chair and at home.

Best Practices:

  1. Clean the infant’s mouths and gums regularly with a very soft toothbrush or cloth and water. Once the primary teeth appear, brush them at least twice daily with an age-appropriate sized toothbrush and age appropriate fluoride toothpaste.
  2. Wean infants from the bottle by 12-14 months of age. Have infants drink from a cup as they approach their first birthday.
  3. Visit our pediatric dentist before your child’s first birthday and at least four times annually following the first appointment.
  4. Avoid at-will breast feeding after the first primary tooth appears and other foods are introduced to the diet.


Care Guidelines for children of 2-5 years of age

Eruption of teeth

Your child will get his final primary teeth around age two to two and a half years. He/she will then experience a time of inactivity in the jaws during which he/she will neither gain new teeth nor lose any teeth. Children typically begin to lose their primary teeth for permanent ones around the age of six but some children may begin this as early as four years. If you have any questions regarding your child’s tooth eruption or loss, please consult with our pediatric dentist.

Preventing cavities and controlling dental caries

We recommend that parents stay diligent at controlling their child’s nutrition, snacking habits, and oral hygiene during the ages of 2 and 5. This is the age where children often increase their snacking and drinking of sugary liquids. It is no coincidence that we see a lot of tooth decay in children who drink a lot of fruit juice as it stops re-mineralization of the teeth as discussed earlier. We highly recommend that juices be limited to twice a day consumption or the child be given plain water or flavored waters with no sugar.

Also at this age, children tend to want to do more things by themselves. However, we strongly recommend that parents continue to help their child brush and floss his/her teeth until he/she is 7 or 8 years old. A good rule of thumb is that if they cannot tie their shoe laces, they can’t do an adequately good job of brushing and flossing.

Is it a problem if my child sucks his thumb or uses a pacifier?

Thumb-sucking and pacifier use in children younger than 4 is not considered a problem. Children usually grow out of this habit between the ages of 2 and 4. If this habit persists beyond 5 years, then they require an intervention. Children who suck their thumbs frequently or with great intensity after the age of 4 or 5 are at risk for dental or speech problems. It can hamper proper growth of the jaws, misalignment of teeth and misguiding shape of the dental arches. A child may also develop speech problems, including mispronouncing Ts and Ds, lisping, and tongue thrusting. Please do not hesitate to consult our pediatric dentists if your child has this habit.

Early orthodontic evaluation and treatment

The ages of 2 to 5 years often present early opportunities to correct many orthopedic (positioning of the facial bones) abnormalities and facilitate normal functioning of the jaws. The goal of intervention at this age is to aid and guide the normal formation of molars. Also, we can begin to assess crowding and bite malformations, and develop a course of action for managing the eruption of the permanent teeth.

The potential for dental emergencies

Children at 2-5 years of age are often climbing, jumping, and testing their limits. Keeping a watchful eye on them and helping them understand how to have fun while avoiding major injuries is a must. We also recommend that you have our emergency number in your cell phone. If your child experiences any facial trauma, please call the emergency number and consult our dentists immediately.