Over the last year, we’ve had the privilege of coming to you each month with topics related to pediatric dentistry through our Ask Dr. Bob series. We’ve learned a lot together, haven’t we?! So it was no surprise when our Q & A with Dr. Christopher Bob of Dr. Bob Pediatric Dentist was one of the most popular segments of our recent Birthday Bash.
So ICYMI here is an in-depth recap of questions from Miami moms like YOU that were answered by Miami Mom Collective’s favorite pediatric dentist. Let’s jump in!
At what age should I start introducing my child to the dentist?
The recommendation by the American Academy of Pediatric Dentistry (and by Dr. Bob!) is by age 1. This first appointment is important because it not only includes a cleaning, but educates parents on what to do, what to expect, and how to take care of their child’s teeth. Dr. Bob and his team strive for prevention and the first appointment is crucial to achieving that goal.
What is your office doing to stay prepared during COVID?
Dr. Bob and his team have gone to great lengths to make their office as safe as possible. The staff wear face masks and face shields and are screened daily (temperature checks, etc.) upon arrival. Additionally, Dr. Bob has installed HEPA filters, barriers, UV light, and even got certified to use a hospital-grade sterilizer to fog the office daily. They’ve reduced the number of patients they see in a day and allow 1 parent per patient to reduce the volume of people in the office.
You can read more about safety protocols and what to expect when you return to the dentist here.
My 4-year old twins brush their teeth morning and night but they’re still yellow. Is that normal?
Some people are simply born with a different colorization to their teeth. But yellowing of the teeth could also be a result of improper brushing. Dr. Bob explained that there is a big difference between brushing and brushing properly. When you brush, you want to angle to toothbrush at a 45-degree angle into your gums and do little circles everywhere for 2 full minutes at a time. This is true for children and adults!
When is it okay to start flossing and using mouthwash for kids?
Most mouthwash has added fluoride, which Dr. Bob is really stringent on. It’s important that children are able to spit it out and not ingest it before they begin to use it. Toothpaste is different as you’ll see below.
As far as flossing, the recommendation is to begin when the 2nd baby molars have come in. The sooner we begin flossing our children’s teeth, the less scary the process is going to be. Anterior (or front) teeth typically have more space between them, so it’s most important to start in the back. You want to start flossing those molars around 2.5/3 years of age when they come in.
My 8-month old has no teeth– should I be doing anything? Gum care?
Yes, you should be doing gum care. Be sure to wipe the extra milk (breastmilk or formula) off the gums, especially before bedtime. You can do this by wiping them with a warm washcloth.
Be sure to check out this post about establishing good oral hygiene for infants, too!
Do you take insurance and are you still accepting new patients?
Yes! Dr. Bob Pediatric Dentist is still taking new patients, and they accept all major PPO plans. You’re welcome to contact the office to discuss your specific coverage or schedule an appointment. They’re always happy to help!
How early should we start brushing?
The second there’s a tooth in the mouth, you need to start brushing it. Start with a fluoridated toothpaste the minute that 1st tooth appears with an age-appropriate amount of toothpaste. For infants and toddlers 0-3 years of age, use a grain of rice-sized amount, and for children 3 and above use a pea-sized amount. It’s important to use enough toothpaste for all of the teeth, but also an amount that’s safe enough to be ingested before they’re able to spit the toothpaste out.
We missed our checkup in the fall, and then COVID hit. We’re high risk for COVID–how long can we wait for our follow-up appointment?
Ideally, you shouldn’t really wait and your child should be seen every 6 months. But understandably, COVID can change that. Dr. Bob Pediatric Dentist is totally supportive of parents to make the best decision they feel comfortable with but encourages patients to return to the dentist as soon as possible.
You can read more about their in-depth safety protocols here.
My daughter is 12 and was told that she has an overbite. For the last 4 years, we were told that she’d need braces and then were told recently that she might not need braces because her jaw will expand in puberty. Is this true? Should I get a second opinion?
It all depends, and every patient is different. Dr. Bob and his team routinely evaluate for orthodontic concerns and then refer patients to be evaluated by a board-certified orthodontist at an appropriate time.
What is best practice for toothbrushing when your 1-year old likes to bottlefeed or nurse to sleep, but you don’t want to leave milk on their teeth?
Dr. Bob and his wife went through this with their son, and can completely relate! You definitely need to brush after the milk. You don’t need to wake your child up and take them to the bathroom, but you can go in and brush after they’re done nursing/bottle feeding while they’re asleep. Use a grain of rice-sized amount of fluoridated toothpaste if a tooth/teeth are present, or wipe their gums with a washcloth. Sadly, they see tons of cavities caused by milk residue remaining on children’s teeth overnight; but it can be prevented!
At what age can children brush their teeth on their own?
The textbook answer is when a child can tie their own shoes they have the manual dexterity to brush their own teeth (typically around age 5). But Dr. Bob prefers not to go by that. He often sees 7, 8, 9, 10, 12… even 15-year olds that don’t brush their teeth very well.
For the first couple of years up until age 5, let them start brushing their teeth to help them develop the manual dexterity to handle a toothbrush. Then a parent/caregiver needs to go over and brush really well afterward. When they’ve done enough supervised brushing and you feel like they’re actually doing a really good job, at that point you can let them go off on their own. Because everybody’s different, this will happen at different ages for different children.
My 18-month old brushes twice a day but inevitably ends up swallowing the toothpaste. At what age is it an issue? When do we switch over from a non-fluoride to fluoride toothpaste?
As soon as there’s a tooth in the mouth, you want to use a fluoridated toothpaste. Use a grain of rice-sized amount until age 3, and then a pea-sized amount. Age-appropriate amounts of fluoridated toothpaste are not enough to cause any systemic problems. Fluoridated toothpaste at age-appropriate amounts is recommended by both the American Dental Association (ADA) and the American Academy of Pediatric Dentistry (AAPD). Fluoride is actually the #1 thing that reduces caries (cavities) in children.
How can you help your child stop sucking on their fingers?
This is a tough one that many parents can relate to! The absolute best way to help your child stop sucking their fingers or thumb is positive reinforcement. Using a reward system, set up a calendar with the goal of reaching 30 days without sucking the thumb/finger(s). If the fingers or thumb go into the mouth at any point during those 30 days, the 30 days start over again. Dr. Bob has some super helpful calendars and other learning tools on his website that you can print off and use at home.
That being said, one of the biggest issues is that children often suck their thumbs/fingers when they’re falling asleep/during sleep. When they’re doing it subconsciously it’s just not possible to practice positive reinforcement. There are a lot of products on the market (bitter nail polish, T-guards, etc.) that parents can try. According to the literature, these methods are not effective. But there is a lot of anecdotal evidence to support them. One pro tip Dr. Bob shared is sewing the cuff of a pajama or long-sleeved shirt shut so that children can’t get to their fingers to suck.
Worst case scenario, if kids haven’t been able to break the habit by age 6/7, there’s an appliance that can be placed in the mouth to help them stop. But obviously, the goal is to break the habit by then.
For daytime thumbsucking, straight-up bribery worked for me.
My 9-year old wants to know if she has to get a shot to have her canines removed. How can I prepare her for this?
For an extraction, she will need local anesthesia. When preparing your child for a dental procedure, Dr. Bob recommends that we avoid the word shot. The best thing is to let the dentist talk with your child and explain what they’re going to feel and experience, rather than what the dentist is going to be doing. For children, it’s all about feelings and experiences as opposed to scientific explanations. At Dr. Bob Pediatric Dentist, they’re not there to simply treat cavities but to treat the psychology of their patients.
My 8-year old grinds her teeth while she’s sleeping. Is there anything I can do to help her?
Nighttime tooth grinding is common and completely normal. At this age, children are in the mixed dentition stage–they have both baby teeth and permanent teeth. The leading theory as to why children grind their teeth is that they don’t all fit together properly. Though this grinding can be really loud, Dr. Bob stresses that 99% of the time it causes zero damage to permanent teeth. It’s still a good idea to get checked up just to be sure there isn’t any abnormal wear on the permanent teeth, which is something that he regularly checks for during routine exams.
Do you have a best toothbrush that you recommend?
As long as you’re following the proper toothbrushing technique, it doesn’t matter whether it’s manual or electric. But it must be soft-bristled. The modified Bass toothbrush technique is best–holding the toothbrush at a 45-degree angle into the gums and rising in small circles everywhere for a full 2 minutes of brushing.
One advantage of an electric toothbrush for kids is that it’s a cool toy, which motivates kids to use it. Most electric toothbrushes will have a timer with lights, songs, etc.) which make brushing fun but also help them brush for 2 minutes.
How many times a day should a child be brushing their teeth?
At LEAST twice a day–in the morning and at nighttime, with nighttime being most important.
Read more about maintaining healthy oral habits and routines, especially in the midst of COVID and relaxed summer schedules.
Contact Dr. Bob Today
Dr. Bob Pediatric Dentist is open Monday through Friday and conveniently located in South Miami. For questions or to schedule an appointment, you can contact Dr. Bob’s practice via the website or by phone at 305-397-8214. You can also keep up by following Dr. Bob Pediatric Dentist on Instagram and Facebook.
Dr. Bob and his team are more than happy to help you and are committed to providing the exceptional care your child deserves. Find out for yourself why he’s the dentist your kids will beg to see!