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Pediatric Dentistry

Colored Dental Tooth Fillings

“Your child has a cavity.”

Not many parents want to hear those words, especially if their child has dental anxiety.

Last summer, I saw a three year old child who needed to have a filling on one of his upper molars.

Green Colored FillingThe only reason he sat still in the chair long enough for us to remove the decay and get a filling put in was because we told him we were going to give him a yellow colored filling.

He loved tractors, and wanted it to be yellow like his toy tractor. When he was all done, we took a picture of it and gave it to him so he could show his friends and family.

I’ve found that giving children a colored filling (along with some other things we do to make the comfortable), helps them to sit in the dental chair and get their needed dental work completed.

Find out why baby teeth need to have fillings if they just fall out.

Colored Fillings

Pink Colored FillingColored fillings are made of the same composite materials as tooth-colored fillings, they simply have more exciting coloring added to them.

At our office, we have five colors to choose from: blue, green, yellow, orange, and pink.

To the right, you can see how the pink filling looks on a tooth – it’s what most of the girls end up choosing.  That filling, as well as the green one above, was placed to fill in a cavity that formed between the teeth, which is one of the more common places you can get a cavity.

While we can do a colored filling to repair most cavities in baby teeth, nobody has had us do one on a front tooth yet!

Double Tooth Photos

Since starting Oral Answers, many people frequently email me photos that would be useful to share with everyone here on Oral Answers to illustrate a particular dental condition.  Since many parents end up coming to Oral Answers via the page on double teeth, I thought it would be appropriate to start a collection of double tooth photos.

This double tooth photo collection will start out with the three photos below.  If your child has a double tooth (either gemination or fusion), a photo of your child would benefit other parents who come to this site searching for photos and information.

To get your photo below, simply use this contact form or simply send them to OralAnswers [at] gmail [dot] com, replacing the bracketed words with the normal email symbols.

Double Tooth Photos

This first photo is the one I featured on the original post that discusses double teeth.  It is Rachel’s son, who has gemination:

Double Tooth Gemination

The following two photos are from Tiffany.  At first glance, her son appears to have a gemination tooth on the opposite side as Rachel’s son in the photo above:

Double Tooth from Tiffany

Here’s a close-up of the tooth pictured above:

Double Tooth Tiffany

Here’s an updated photo of Tiffany’s son now that he’s two years old:

Double Tooth 2 Years Old

Submit Your Photos

I would love it if you would submit your photos of a double tooth to help parents gain a better knowledge of what double teeth can look like.  Please use this contact form or simply send them to OralAnswers [at] gmail [dot] com, replacing the bracketed words with the normal email symbols.

If you have any questions or comments, feel free to leave a comment in the comments section below.  Thanks for reading!

More Likely to Get Cavities

Many people come into the dental school and tell us things like, “I just have bad teeth” and “My parents and grandparents all had soft teeth – and my teeth are soft too, so I get lots of cavities.”

Cavity In a ToothWhile it may be true that some people do have teeth that are more susceptible to cavities, there is usually another reason that these people have cavities.

As dentists, we can remove the tooth decay and make your tooth look shiny and new again, but we can’t prevent you from getting cavities in the future – that’s up to you.

The tooth pictured probably doesn’t look too glamorous.  Since most people don’t see what their dentist sees, I thought I’d put this picture up so you can see what an extensive cavity looks like.

If you’ve had a lot of cavities and want to know why, the following list just might give you some answers!

25 Risk Factors for Getting Cavities

1 – Cavities

I listed cavities first because if you’ve had cavities in the past, that’s usually one of the best predictors of whether or not you’ll get cavities in the future.  It makes sense that if you already have lots of cavities, that you’re more likely to keep getting cavities until you make some changes.

Also, if you have white spots on some of your teeth that have recently appeared, that could be the sign of a beginning cavity, which also puts you at risk for getting a cavity.

2 – Having Lots of Cavity-Causing Bacteria

There are millions of little bacteria in your mouth that eat your food every time you eat.  They make acid and smear it on your teeth.  The acid eats away at your tooth until a cavity develops.

Needless to say, if you have an abundant amount of cavity-causing bacteria in your mouth, you’re at a high risk for getting a cavity.

3 – Eating Sugar Frequently

If you eat sugar a lot, you give the bacteria exactly what it wants to eat: fermentable carbohydrates.  The more often you feed them, the more cavity-causing acid that they will produce.

Learn more about What Happens In Your Mouth Every Time You Eat or Drink.

4 – Bad Crowns and/or Fillings

If you have a poor quality filling or crown in your mouth, it may actually cause you to get a cavity by allowing plaque to hang out where you can’t reach it with routine brushing and flossing.

5 – Bad Oral Hygiene

If you don’t brush away the bacteria often, you will allow them to grow and destroy your teeth.

6 – High Acidic Foods Intake

Eating or drinking acidic foods can eat away at the hard, outer layer of your teeth known as the enamel.  Since the enamel is the layer of your teeth that is most resistant to cavities, if you wear it down, you will be putting yourself at risk for cavities.

Learn more about acidic drinks in the article,  Nine Drinks that Can Dissolve Your Teeth.

Another source of acid in your mouth is gastric reflux or even vomiting intentionally, which occurs in those with bulimia.

7 – Not Getting Enough Fluoride

Fluoride makes the enamel of your teeth stronger.  You can get it by brushing your teeth longer or using a fluoride mouthwash.

Curious about how fluoride works?  Learn about the three ways fluoride protects your teeth.

8 – Nursing Too Long (Bottle and Breast)

If you weren’t weaned from the breast or bottle until you were a toddler, this could have put you at a higher risk for getting cavities.  Most research points to the bottle, but I have heard conflicting reports regarding prolonged breastfeeding.

9 – Cavities Under Fillings

Getting a cavity under a filling means that there was a problem with the filling (age, done incorrectly, fractured, etc.) or that you weren’t taking very good care of the filling.  Either way, if you get a cavity under a filling, it puts  you at high risk for getting cavities in other teeth.

10 – Bad Family Dental Health

If your family has bad dental health, chances are that you will as well.  This could be related to lack of oral hygiene being taught in the home, genetic abnormalities in the teeth, or high numbers of the bad bacteria in your mouth.

11 – Exposed Root Surfaces

Receding gums will expose the root of the tooth, which does not have a protective enamel covering.  Consequently, the dentin that makes up the roots of your teeth dissolves at a higher pH than the enamel.  That means that weak acids that wouldn’t affect your enamel can eat away at the roots of your teeth and cause a cavity.

12 – Defect In Your Enamel

If you have a defect in your enamel, it could make you more susceptible to cavities.  Some examples might be enamel that didn’t form correctly, congenital defects like amelogenesis imperfecta, or a defect in enamel formation that can happen to a permanent tooth when its corresponding baby tooth gets knocked out.

13 – Having a Disability

If you have a disability, it can be more difficult for you to take care of your teeth.  Also, many caregivers may not pay very much attention to the oral hygiene of those under their care.

14 – Dry Mouth

When you don’t have enough saliva in your mouth, it is known as dry mouth or xerostomia.  Saliva helps your teeth in several ways.  If you suffer from dry mouth, your dentist may be able to help by prescribing you medication to help increase your salivary flow.

Are you taking one of these 348 medications that cause dry mouth?

15 – Genetic Abnormality of Your Teeth

The anatomy of a tooth can vary greatly.  Some people have deeper grooves in their biting surface that are hard to clean.  Some people’s enamel may not completely cover the whole tooth.  This can create pockets where bacteria can hide out and cause cavities.

There are many other genetic abnormalities that can affect the teeth, such as localized microdontia, which can make some teeth smaller than others and possibly make them harder to clean.

16 – Having Lots of Large Fillings

Many large fillings can put you at risk for developing cavities.  Having lots of large fillings increases the amount of tooth:filling interfaces that are present in your mouth.  If bacteria get in between the filling and the tooth, they can be nearly impossible to clean out and can cause cavities.

17 – Chemotherapy and Radiation Treatment

Having chemotherapy or radiation treatment in the head and neck area can reduce salivary flow and cause other oral problems which increase the risk of getting a cavity.

18 – Eating Disorders

Eating disorders can increase the risk of a cavity in a couple of ways.  Those with eating disorders tend to not have a very balanced diet, which may contribute to cavities.  Also, bulimics bathe their teeth in acid each time they purge.  This wears away the tough enamel surface of the tooth which makes the tooth mores susceptible to cavities.

19 – Drug and/or Alcohol Abuse

Those that abuse drugs and/or alcohol put themselves at a greater risk for developing cavities.

Take a look at what drug abuse can do to your teeth.

20 – Irregular Dental Care

By not going to the dentist regularly, you avoid learning about the condition of your mouth.  The dentist can point out small problems before they turn into cavities.  By avoiding your checkups, you lose out on the opportunity to take care of small problems before they become big.

21 – Not Knowing What Plaque Is

Many people don’t know what plaque is.  If you don’t know what’s happening inside of your mouth, you probably won’t do anything about it.

Avoid this risk factor by reading: What Every Human Needs to Know About Plaque and How Plaque Disclosing Tablets Can Help You Brush Better.

22 – Not Knowing How to Remove Plaque

Even if you know what plaque is, if you’re not removing it then you will probably end up getting some cavities.

Learn about these 12 Weapons of Plaque Destruction.

23 – Being Poor

People with a lower socioeconomic status tend to get more tooth decay.  There are exceptions to this rule, but this is one of the main reasons that so many states provide free dental care to low-income children.  Unfortunately, these programs haven’t eliminated the gap in dental health between the rich and the poor, and many poor parents simply don’t find the time to take their kids to the dentist.

Interestingly, our computer software at my dental school tells us to ask each patient if they have a “low socioeconomic status.”  It can be an awkward question, and almost everyone skips over it.

24 – Dental Anxiety

If you have a dental phobia, chances are that you will neglect getting dental work done.  If you want to try to understand your dental phobia, take a look at these 15 common reasons people are scared of the dentist.

25 – Braces

Although braces can straighten your teeth and make them look great, they do increase the risk of getting cavities.  Braces make it harder to brush your teeth and make it nearly impossible to floss.  In order to floss with braces, you have to use a floss threader to get under the wire – I know I didn’t do that when I was a teenager!

I hope you enjoyed the list and it helped you pinpoint the cause(s) of your cavities.  I compiled the above list from my own experience as well as information from the following textbooks:

Do You Have a Lot of Cavities?

Did anything on this list ring a bell for you?  Although I tried to include everything I could think of that would cause cavities, I may have missed something.  I’d love to hear about what you think is causing your cavities whether it’s on the list or not.  Feel free to leave a comment in the comments section below.

Thanks for reading!

Cavities In Baby Teeth: Do They Need Fillings?
©Ilya Andriyanov/

A lot of parents wonder if it’s really necessary to have their children get fillings in their baby teeth.  Since baby teeth just end up falling out, why not let the cavity fall out with the baby tooth rather than paying to have a dentist remove the cavity?

Many people assume that baby teeth aren’t that important since they quickly get replaced by permanent adult teeth as a child grows.

Fillings Baby TeethEven though they do end up falling out, baby teeth are important!  When they’re healthy, they can help children eat healthy foods.  When baby teeth get infected, they can damage the permanent teeth developing under them and in severe cases they can cause brain infections.  If you missed my earlier article, you can read it to learn five reasons why baby teeth are important.

Now that you understand why baby teeth are important, let’s talk about whether or not baby teeth need fillings.

Should You Get Cavities in Baby Teeth Filled?

When thinking about getting cavities in baby teeth filled, there are a couple of main things to think about: How much use your child will get out of the filling and how big the cavity is.

First, let’s talk about how much use your child will get out of the filling.  The book Pediatric Dentistry by Pinkham says, “A carious primary molar in a 6-year-old is a problem; a loose carious mandibular incisor may not be if it is about to exfoliate.”

If a tooth is about to fall out (or exfoliate if you want to speak in fancy dental terms), then your child probably wouldn’t get much use out of a filling in that tooth.

The other main factor to look at is how big the cavity is.  Although dentists recommend treating cavities when they are small, sometimes a cavity can be so small that it can repair itself under the right circumstances!

In the book Paediatric Dentistry, the authors discuss the question of whether or not to treat baby teeth.  One of their points supporting not getting fillings in baby teeth says, “Remineralization can arrest and repair enamel caries. It has long been known that early, smooth surface lesions are reversible. In addition, it is now accepted that the chief mechanism whereby fluoride reduces caries is by encouraging remineralization, and that the remineralized early lesion is more resistant to caries than intact enamel.”

If the cavity is small and has just started, there is a chance that it can repair itself through the process of remineralization.

Keep in mind that this repair will probably NOT occur unless your child’s diet and oral hygiene dramatically improve!  There’s a reason that your child started to get a cavity and if nothing is done to change the habits that started the cavity, then the cavity will probably get worse.

If you don’t think you will alter your child’s diet or oral hygiene, then it’s probably a good idea to have the dentist put a filling in the baby tooth while the cavity is small so that the cavity doesn’t get bigger.

On the other hand, if the cavity is small and you are willing to work really hard at improving your child’s diet and oral hygiene, then the cavity can remineralize.  In this case, there there’s no need to get a filling in your child’s baby tooth.


When considering a filling in your child’s baby tooth, it is important to think about how much longer the tooth will be in the mouth and the size of the cavity.  If the tooth will be falling out soon, it may not be necessary to get a filling.  If the tooth won’t fall out for a couple of years, then it’s probably a good idea to get a filling in your child’s baby tooth.

Most dentists will be able to give you a good idea as to whether or not your child would benefit from a filling in a baby tooth or if it’s really not necessary.

Do you have any questions or comments about fillings in baby teeth?  I’d love to hear them in the comments section below. Thanks for reading!

Baby Teeth and Adult Teeth Differences
©Timothy W. Stone/

Have you ever noticed that baby teeth look like they’re whiter than adult teeth?  Or maybe you knocked out a baby tooth when you were a child, but when you had a similar accident when you were older, your permanent tooth got chipped rather than getting knocked out.

The two scenarios above can be explained by the differences between adult and permanent teeth.

Baby Teeth and Permanent Teeth Comparison

There are many differences between baby teeth and permanent teeth, but before I get into all of the differences, take a look at the photo above of the little girl swimming.

Now, take a closer look at her teeth in the photo below:

Baby Teeth and Permanent Teeth Comparison

In the picture to the left, there are six permanent teeth that are visible.  Can you spot them?

They are the two top front teeth, the two bottom front teeth, and the two molars on the bottom in the very back of her mouth.

These permanent teeth stand out in more ways than one.  I’ll cover all these differences between baby teeth and permanent teeth below.

As you read, feel free to refer back to this picture to get a visual representation of some of the more noticeable differences that I talk about below.

The Differences Between Permanent Teeth and Baby Teeth

1 – The enamel and dentin are thinner in baby teeth, and the pulp is bigger relative to the rest of the tooth. This means that if your child gets a cavity, it will travel much faster to the nerve of the tooth. This is one more reason why it’s important to take your child to the dentist before they turn one year old and get routine checkups thereafter.

Not sure what enamel, dentin, and pulp are?  Read my previous article about the anatomy of a tooth.

2 – Permanent teeth are more yellow than baby teeth. Take a quick look at the picture above and you’ll see that the six permanent teeth that are visible  don’t look nearly as white as the other baby teeth.

3 – Baby teeth have shorter roots – because of this they aren’t anchored as well into the bone and may fall out more easily if your child falls on a hard step or hits their mouth on the coffee table.  The shorter roots also give the permanent teeth more room to develop underneath the baby teeth and make it easier to dissolve the roots of the baby teeth when the permanent teeth are ready to come into the mouth.

Find out what to do when a baby tooth gets knocked out.

4 – Baby teeth fall out – If you take good care of your adult teeth you can keep them for your entire life.  Just because baby teeth fall out, it doesn’t mean that they aren’t important.  If you’ve been staying up late at night pondering this question, click the following link to find out why baby teeth are important.

5 – Permanent teeth have mamelons.  Mamelons are the small bumps that give the permanent incisors a serrated look when they first come into the mouth.  If you look closely at the girl in the picture above, you can see the little bumps on the edges of her four permanent front teeth.  Mamelons quickly wear away as long as the teeth fit together properly.

Learn more about what mamelons are and what to do if you still have them as an adult.


As you can see, there are definitely some differences between adult and permanent teeth. These differences can not only affect the appearance of the teeth, but can also affect what happens to a tooth when you suffer an injury to the mouth.

Do you have any questions about baby teeth or permanent teeth? I’d love to hear what you have to say in the comments section below! Thanks for reading.

What to Expect at Your Child's First Dental Visit
©Khakimullin Aleksandr/

A couple of weeks ago I wrote about the age when your child should go to the dentist for the first time.  Many people think that taking your child to the dentist before they are one year old is too early.  They wonder what a dentist could possibly do with such a young child.

First Dental VisitOne of the main reasons that we like to see children at such a young age is so that we can catch small problems before they turn into large catastrophes.  The American Academy of Pediatric Dentistry has said, “Unrecognized dental disease can result in exacerbated problems which lead to more extensive and expensive care, whereas early detection and management of oral conditions can improve a child’s oral health, general health and well-being, and school readiness.”

I think some of the reasons that parents don’t bring their children into the dentist by age 1 is because they don’t know why they should and they have a fear of the unknown.  Hopefully this article will provide information to alleviate both of those concerns.  If you’re wondering what a dentist will do at your child’s first dental appointment, you’ve come to the right place!

What to Expect at Your Child’s First Dental Visit

The first dental visit can be composed of a few different parts, depending on how your dentist conducts appointments with children on their first dental visit.  A few things that your child’s dentist is sure to do is to look inside of your child’s mouth, introduce the child to the dental environment, and give oral health information to the parents.

Your Child’s First Dental Visit: Looking Inside the Mouth

Your child’s dentist will be able to take a quick look inside of your child’s mouth.  The dentist probably won’t use the dental chair.  An often-used method of examining very young children is to have the child lay down in the parent’s lap with the child’s head resting in the dentist’s lap.

During this brief examination, the dentist will look for a variety of things, including making sure that:

  • All of your child’s teeth are coming in properly and at the right time.
  • The tongue and tissues inside of the mouth are developing properly.
  • There are no early problems with the temporomandibular joint (TMJ)
  • Your child’s teeth are healthy and cavity-free (Now may be a good time to make sure that you’re not causing cavities on your child’s teeth!)
  • There are no developmental anomalies with any dental structures (such as extra teeth or fusion and gemination)

Your Child’s First Dental Visit: Introducing Your Child to the Dental Office

Pediatric dentists are specially-trained in the area of helping children become acquainted with the dental office.  They know how to help your child get comfortable with the unfamiliar sights and sounds of the dental office.

Also, the dentist will note any behavior issues that your child may have in the dental office so that the dentist can be helpful and accommodating at future dental visits.

Your Child’s First Dental Visit: Getting Oral Health Information

Your child’s dentist will be able to give you valuable information regarding the oral health of your child.  This can include discussing your child’s diet and pinpointing any foods or feeding habits that can be detrimental to your child’s dental health.  Your child’s dentist may let you know how “at risk” your child is to develop cavities based on you kid’s oral hygiene and diet.

Also, if you haven’t been getting enough Oral Answers in your life, then your child’s dentist can help you understand why baby teeth are important.

Lastly, your child’s dentist is here to help you!  If you have any questions at all about caring for your precious little one’s baby teeth, your child’s dentist will be able to answer them for you.

Questions About Your Child’s First Dental Visit?

If you have anything to say about this article or have any questions about your child’s first dental visit, please feel free to drop me a line by filling out the comment form below.  Thanks for reading!

When Should Child Go to Dentist for First Time?
©Khakimullin Aleksandr/

It has been said that although your baby may not be ready for a dental visit at one year of age, your baby’s teeth are ready.

However, even if you take your child to the dentist on their first birthday, you may be taking them later than is recommended by the American Academy of Pediatric Dentistry and the American Dental Association.

At What Age Should You Take Your Child to the Dentist for the First Time?

Age When Baby First Goes to DentistAt my dental school, we follow the guideline from the American Dental Association that a child should have his or her first dental visit within six months of getting their first tooth, or before they turn 1.  Whichever comes first. So if your little girl gets her first tooth at 4 months, it is recommended that she visit the dentist no later than six months later, which would be at 10 months.

I have included the official statements below from both the American Dental Association and the American Academy of Pediatric Dentistry on when a child should visit the dentist for the first time.

The American Dental Association on When a Child Should First Visit the Dentist

Here’s what the American Dental Association has to say on the topic of when a child should first visit the dentist:

The Association urges parents and guardians, as a child’s first tooth erupts, to consult with their dentist regarding:

1 – Scheduling the child’s first dental visit. It is advantageous for the first visit to occur within six months of eruption of the first tooth and no later than 12 months of age, and

2 – Receiving oral health education based on the child’s developmental needs (also known as anticipatory guidance).

The American Dental Association recommends that a child visit the dentist within six months of getting their first tooth, but definitely before their first birthday.

The American Academy of Pediatric Dentistry on When a Child Should First Visit the Dentist

First Dental VisitThe American Academy of Pediatric dentistry recommends that a child should first see the dentist by their first birthday.  Here’s what they say on their website:

“First visit by first birthday’ sums it up. Your child should visit a pediatric dentist when the first tooth comes in, usually between 6 and 12 months of age. This visit will establish a dental home for your child. Early examination and preventive care will protect your child’s smile now and in the future.

The American Academy of Pediatric Dentistry’s policy is similar to the American Dental Association’s statement.  The AAPD ‘s policy says to go by the first birthday or when the first tooth comes in.  Pretty much any time between 6 and 12 months is a good time for your child to visit the dentist for the first time.

What Will the Dentist Do at the First Dental Visit?

The dentist will simply examine your child and give you advice on how to better take care of your child’s oral health at the first dental visit.  Of course, the exam does depend on how comfortable and cooperative your child is.

One of the best methods of examining children is to have the parent and dentist sitting down facing one another.  The parent then holds the child’s body in his or her lap and the dentist holds the child’s head in his or her lap.  This is known as “knee-to-knee dentistry” and has proven to be a good method to put children at ease while allowing the dentist to check for early cavities and oral developmental problems.

What Should You Do If Your Dentist Won’t See Your Child This Early?

As you can imagine, some dentists are comfortable with toddlers and some dentists aren’t.  When I eventually graduate and become a dentist, I plan to treat patients of all ages and will refer extremely complicated patients to pediatric dentists, who are trained in the behavioral management of young children.

I found a really interesting letter written by Milton Houpt, the chair of the Department of Pediatric Dentistry at the New Jersey Dental School.  It was a letter to the editor in the dental journal Pediatric Dentistry.

In it he talked about how his granddaughter recently turned one and needed to find a pediatric dentist.  Rather than seeing her himself, he decided to find a younger pediatric dentist so that his granddaughter could develop a good relationship with her dentist.  Upon calling the office, he was rather disappointed.  Here’s how he relates what happened:

What I thought would be a routine call became, to my dismay, a great disappointment.  This is what I was told: “We don’t see children until they are at least two and a half or three years of age.  The parents in my practice are upscale.  They would not let me examine their children if they were crying.  And if I wouldn’t examine the child, how could I charge a fee?  I couldn’t charge just for giving advice.  And I am not going to see infants free of charge.

As this case demonstrates, not all dentists are willing to see children before their first birthday.  They may not be comfortable seeing and charging for a dental visit for young children (as in the above case) or they simply may be stuck in the way they’ve always done things, which is to wait until the child is between the ages of 3 and 6 to first see them.

I believe the case above is an exception to the rule.  From what I have read on the internet in various forums, it does seem that there are some dentists who are not willing to see a child until they turn 2 or 3 years old.  If this is the case, it might be a good idea to find a pediatric dentist in your area that specializes in oral health care for children.

Conclusion – Should a Baby Really Go to the Dentist Before They Turn One?

All of the major organizations in the United States that have a vested interest in the oral health of children (the ADA, AAPD, and the AAP) recommend that a child go to the dentist before age one.  This wasn’t always the case — up until around 10 years ago, I believe that the American Academy of Pediatrics still recommended age 3, but they have since changed their policy to more closely mirror that of the two dental associations.

If you’ve made it this far, you’re probably wondering if YOU should really take your baby to the dentist.  From what I have observed, most 12 month-old kids that come to my dental school are the ones whose parents are taking good care of their teeth.

Even if you take great care of your child’s teeth, it is still a good idea to take them to the dentist because it helps them get acclimated to being in a dental office and can help you discover any previously unknown oral risks (such as having pits on some teeth that could make them more susceptible to getting cavities) that your child faces.  Also, you will probably learn something new about how to take care of your child’s teeth and can find out if you’re causing your child to develop tooth decay.

Not sure why you should take care of your baby’s teeth since they fall out?  Find out why baby teeth are important!

Most parents take their child to the pediatrician a total of seven times during their first year of life (at 5 days, 2 weeks, 2 months, 4 months, 6 months, 9 months, and 12 months of age.)  These visits are routine checkups where a professional makes sure your child is developing properly and answers your questions.  A visit to the dentist before they turn 1 will be similar to these routine medical checkups, only the focus will be on your child’s teeth and gums.  And just think, you only need to take your child to the dentist one time before they turn 1 to ensure they are growing a happy, healthy smile!

Do you have any questions about your child’s first dental visit or how to find the right dentist for your child’s first dental visit?

Leave any questions or comments below in the comments section and I’ll get right back to you.  Thanks for reading!

Tooth Decay Serious Disease

Deamonte Driver was a typical twelve year old boy growing up in Maryland.  In January 2007, he complained that he had a headache to his mother, Alyce.  Then he said his tooth hurt.

Emergency RoomAlyce, his concerned mother took him to the emergency room at the local hospital where the doctors found that bacteria from decayed teeth had traveled through his blood into his brain, causing a serious infection.

Fast forward six weeks to a Saturday near the end of February.  Deamonte underwent two operations and it looked like he would recover.  His mother spent all day Saturday with her son, then went home.  The very next day the hospital called his mother and told her that he was unresponsive.  By the time she made it to the hospital, Deamonte, her son of only 12 years had passed away.

To learn more about the tragic story of Deamonte Driver you can read about it in the Washington Post or watch a video report from MSNBC.

Tooth Decay: A Serious Disease

Deamonte’s story is an extreme one.  Tooth decay doesn’t always kill people.  My purpose in sharing this story was to let you know that tooth decay is a disease and it can be serious.  It has many of the same traits as more well-known diseases.  Here are a few lesser known facts about tooth decay:

1 – Tooth decay is contagious — you have to “catch the disease.” The bacteria that cause tooth decay can easily be transmitted from one person to another.  When babies are born, their mouths are sterile.  If they had teeth, they could eat lots of sugar without any detrimental effects on their teeth.  Babies usually catch the bacteria that cause tooth decay from one of their parents or siblings.

2 – Tooth decay can cause pain. If a cavity progresses without pain, it can cause a painful toothache.

3 – Tooth decay can cause children to miss school. This can be either due to pain or multiple dental visits to take care of the diseased tooth.

4 – Tooth decay is the most common disease of early childhood! The American Academy of Pediatric dentistry has stated, “Caries is the most common chronic disease of childhood.  Approximately 60% of children experience caries in their primary teeth by age 5.”

5 – Tooth decay can cause developmental problems and nutritional deficiencies. Here’s another quote from the American Academy of Pediatric Dentistry:

Rampant caries is one of the factors causing insufficient development in children who have no other medical problems.  Children with early childhood caries (ECC) may be severely underweight because of the associated pain and disinclination to eat. Nutritional deficiencies during childhood can impact cognitive development.


Hopefully you can see that dental caries isn’t just a small problem.  It affects over half of all children under age 5!

Whether you call it tooth decay, cavities, or caries – an infection of your teeth can be a serious problem.

Do you have any questions or comments to share about dental cavities?  Please leave them below in the comments section.  Thanks for reading!

Listerine Agent Cool Blue Review
©Andrey Popov/

A lot of people think that a popular dental health product, Listerine Agent Cool Blue, will show you where the plaque is on your teeth as plaque disclosing tablets do.

Listerine Agent Cool BlueI was under the same impression myself.  I got a bottle so that my son could try it.  Unfortunately, I realized after testing it that Agent Cool Blue isn’t a plaque disclosing solution.

Listerine Agent Cool Blue tints the teeth a very slight blue color.  The product is intended to make brushing more fun for kids.  To use the solution, your child swishes the solution in their mouth before brushing, which tints their teeth blue.  Then your child brushes their teeth and checks afterward to see if any blue remains on the teeth.  In theory, this enables the child to see which surfaces of their teeth were  missed when they brushed.

On the front of the bottle it says that it is a “tinting rinse.”  As you will see below, I find it to be a very poor tinting rinse simply because it is not very noticeable and because it is so easily removed.  I also believe most people are disappointed with it simply because most people assume that Agent Cool Blue dyes plaque, like traditional plaque disclosing solutions.  To its credit, it does have a nice minty flavor and, as a safety feature, the bottle measures exactly 10 milliliters for you as you can see in the picture above.

How Listerine Agent Cool Blue Dyes Your Teeth

Here’s a quick before and after picture I took after rinsing with Agent Cool Blue (the AFTER picture was taken before I brushed my teeth):

Listerine Agent Cool Blue Test

You will notice it does NOT show you where the plaque is.  But, as you can see from the photo above, my teeth did change color slightly.   Since the product is marketed towards kids, I think the color change needs to be more dramatic to really motivate them to brush.

To see a before and after picture with regular plaque disclosing tablets, read the article How Plaque Disclosing Tablets Can Help You Brush Better.

What Agent Cool Blue Claims To Do

Listerine Agent Cool Blue InstructionsTo the right is a picture of the back of the bottle.  I noticed that they never come out and say that it will dye your plaque blue.

Technically, Agent Cool Blue does what it is supposed to do — it tints the teeth blue.

In my opinion, the color change is not enough to really be effective.  I don’t think a 6 year old is going to notice if he got all of the blue off of his teeth since the color is so faint.

The simple fact that people think it should mark the plaque on your teeth has caused Agent Cool Blue to receive some terrible reviews at Amazon.  I couldn’t find one positive review.  Below, I copied some highlights from the reviews.

What People Say About Listerine Agent Cool Blue

Here’s an excerpt from a review that PghYinzer wrote about Listerine Agent Cool Blue:

This stuff does not do what I thought it does. I thought it stuck to plaque and showed the really nasty areas. My brother and I used some red disclosing solution as kids – I thought that’s what this was. Brush your teeth, use the red stuff, see how poor a job you did.

This just dyes everything pale blue. I guess in theory you have to brush everything to get all the blue off but it comes off very easily so it really doesn’t do much good.

Very disappointing. I’m going to purchase something sold as disclosing solution instead. I squeezed all of the agent blue out and poured it down the sink – total waste of money and total waste of counter space.

A Fan “Breezy” had this to say about Agent Cool Blue:

This stuff is useless. The taste is bad and it discolors the toothbrush bristles. It seems that even after a lot of brushing, teeth still retain a slight tint of blue.

The only slightly positive review I did find was from Noname, who said:

It was so pale, I don’t think most kids would notice. Just a slight brushing will remove it. In fact, if I brush one side and not the other, the toothpaste removes it from the whole mouth…The blue tint makes them spend more time brushing, so that earns this product a bump up to three stars.

Was Listerine Agent Cool Blue Ever Recalled?

Listerine Agent Cool Blue was recalled back in 2007 due to contamination with microorganisms.  The Listerine Agent Cool Blue currently on your local shelves should be safe.

If you go to the site above that talks about the recall, you’ll notice that they describe Agent Cool Blue by saying, “the rinse makes plaque show up blue on your teeth in an attempt to encourage better brushing.”  Even The Consumerist thinks that Agent Cool Blue sticks to plaque!


In summary, I wouldn’t recommend Listerine Agent Cool Blue with so many superior plaque disclosing solutions out there.

Do you have any questions, comments, or suggestions on how to better remove the plaque from your teeth?  Leave them below in the comments section.  Thanks for reading!

Children's Medicine Sugar Teeth

A quick walk down the aisle at your local pharmacy will reveal an alarming amount of sugar.  Most medicine that we give our children is combined with a thick syrup made up of sugar and corn syrup.  For more information on the different sugars that hurt your teeth, read my article about the five sugars that damage your teeth.

Sugar in Children's MedicineWhen you give your child syrupy medicine, the sugary syrup clings to your child’s teeth.  Because the medicine is so thick, it can stay around in your child’s mouth for a lot longer than sugary drinks such as soda pop that are more easily washed away by saliva.

It’s unlikely that you’re giving your child medicine just for fun — you’re likely giving them something that they need to return to full health or to be more comfortable.  So, the most important concern you have is to get a sick child to take their medicine at all!  But since you need to give your so or daughter medicine in syrup form to get them healthy again, here’s how you can do it without causing harm to their teeth.

How to Give Children Cough Syrup Without Hurting Their Teeth

Here’s a few suggestions that you can try when giving your child medicine in syrup form:

1 – Dilute the syrup with water.  By diluting the syrup you are doing two things: you are making it less sticky, so it’s easier to get rinsed away by your child’s saliva.  You are also decreasing the concentration of the sugar in the medicine, which will provide less sugar to feed the plaque that live on your child’s teeth.  One caution: your child will still need to drink the entire amount of liquid you have diluted the medicine in to get its intended effects, so don’t dilute it too much – sick kids often have decreased appetites and once you have diluted the medicine, it will be difficult to guess how much medicine they have actually ingested.  So don’t overdo it!  Also, don’t dilute their medicine if they are having a hard time keeping other food or liquids down – in this case, just get them to take the medicine as is and try to rinse their mouth out after, as described below.

2 – Try having them drink it through a small straw.  When we drink anything through a straw, it bypasses our teeth and gets whisked to the back of the mouth and swallowed almost immediately.  By avoiding contact with most of the mouth, the syrup doesn’t have much of an opportunity to damage your child’s teeth.  Some medicines will be too thick to do this with, so use your judgment or dilute it slightly first, as mentioned above.

3 – Have your child drink water afterwards, or at least rinse out their mouth after having the medicine.  This suggestion is probably the most important and most easily done.  If your child can drink some water, or rinse out their mouths and spit it out, it will remove most of the sugar that hangs out in their mouth waiting to get turned into acid by the plaque.

4 – Avoid giving the medicine right before bedtime if possible.  If you give your child a syrupy medicine and then send him or her right off to bed, your child will fall asleep with sugar-coated teeth.  When we sleep, our saliva production decreases dramatically.  Without the saliva there to wash away the syrup, it can stay on your child’s teeth all night.  This is the main reason why toddlers get lots of cavities; they drink sugary drinks right before they fall asleep, or even worse,  their parents give them a bottle when putting them to bed.

If you need to give your child a bottle to get them to fall asleep, the best thing to give them is pure water.


Cold medicine may seem like an insignificant source of sugar in the grand scheme of things but every bit of sugar your child ingests adds up.  By following these four suggestions, you can reduce the potential damage caused by these cold medicines.  Of course, the most important thing when your child is sick is to get he or she feeling better; but if your child is able to take their medicine in one of these ways it will prevent the medicines they need to take from harming their teeth.

Do you have any comments or questions about giving medicine to children and its effects on the teeth?  Leave them below in the comments section!

How Spacers Space Maintainers Look In Your Child's Mouth
©Jaimie Duplass/

A few months ago, I wrote an article detailing why it would be necessary for a child to get a space maintainer.  A space maintainer is commonly referred to as simply a spacer.

A Child That Has Lost a Tooth PrematurelyIn the picture to the left, you can see how the lower teeth of a six year old child might appear with a missing baby tooth — the first molar.  Let’s say that this kid didn’t brush his teeth a lot and ended up needing his first molar extracted because of a large cavity that couldn’t be fixed.

If the dentist simply removed that tooth and sent the child home, that kid’s permanent tooth would probably never come in!

Under normal circumstances, all of the teeth in the mouth exert pressure on each other, which holds them in their proper position. When a tooth is lost, the teeth next to the lost tooth will move into the lost space since the lost tooth can no longer exert its pressure on the adjacent teeth. Also, the teeth above the lost tooth will erupt a little more to fill in the space below.

The picture below shows what happens if a space maintainer is not placed after a baby tooth gets extracted.

Tooth Loss - The Space Fills In
When a tooth is lost, the teeth around it are eager to fill in the empty space

Why Teeth Move

Many people wonder why teeth want to move to fill in the gap when a neighboring tooth is extracted.  Here’s an analogy to illustrate why teeth move.

Large CrowdLet’s say there’s a giant crowd of people waiting in line for the chance to read the latest article on Oral Answers.  Now suppose that one person decides he’s sick and tired of waiting and decides to leave.  When he leaves, there is a small opening in the crowd where he used to be excitedly waiting.  Does the crowd leave that space open?  No!  The people that were waiting right next to the space where that guy used to be waiting move to fill it in the empty space that he left behind.

That’s pretty much how it works in the mouth.  When there’s an empty space, teeth move to fill it in.

A Space Maintainer Maintains The Old Space

A space maintainer will conserve the space left by the extracted tooth.  That way, when the permanent tooth starts to grow into the mouth, there will be lots of room for it to fit in perfectly.

Here’s a space maintainer that I made during my pediatric dentistry lab earlier this year.

A Birds Eye View of a Space Maintainer - Spacer
Here is a top view of a band and loop space maintainer.

Here’s another view:

A Dental Space Maintainer - Spacer
A side view of a space maintainer. This is how the space maintainer would look if you were sitting on the inside of your child’s cheek.


If a space maintainer is not used, the jaw may never grow to its full potential and consequently it might not have room for all of the permanent teeth, necessitating the removal of some teeth along with orthodontic treatment (braces).

Do you have any questions or comments about space maintainers (spacers)?  Leave them in the comments below and I’ll get back with you!

Spacer Space Maintainer Teeth
©Tatyana Vyc/

Whenever a tooth is lost, the teeth on either side of it move towards the empty space to try to fill it in.

SA Red Headed Boy with Baby Teethometimes this can be a good thing, like if your orthodontist has to extract a tooth due to crowding.  After the tooth is extracted, the teeth adjacent to it move together and line up perfectly to create a beautiful smile.

Other times, this movement can be a bad thing.  Let’s say a little boy named Johnny with baby teeth and his six year molars lost his baby second molar (the second tooth from the back after the six year molars have come in) because he had too many cavities in it and it was too far decayed to try to put a filling in it.  The six year molar (the last tooth – at the very back of the mouth) would move forward to fill that space.

The problem is, Johnny has a permanent tooth right under that baby second molar that may not be able to come into his mouth if the six year molar has moved forward to fill that space.  This permanent tooth may give up trying to come up into Johnny’s mouth and may never come into his mouth, but just stay lodged deep within his jaw.  It could also try to force its way out sideways and cause big problems for Johnny (and his parents who are paying the bill!)