Tiny Texans Pediatric Dentistry

Frequently Asked Questions (FAQs)

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Finding the right pediatric dentist for your child is a big decision. We realize you will probably have a lot of questions to ask before you can decide which dentist is right for your family. At Tiny Texans Pediatric Dentistry, Dr. Christina and her entire team appreciate questions—and we look forward to providing you with answers.

There are some questions we tend to hear over and over, so we have compiled some of those here for your convenience. If you have a question that is not listed here, we invite you to give us a call. We look forward to discussing the dental needs of your little ones. 

Child-Friendly Environment

General dentists do not have the extra two to three years of training on infant- and pediatric-specific issues that a pediatric dentist has. This specialized additional training includes managing and treating a child’s developing teeth, physical growth and development, child behavior, and otherwise meeting the unique requirements of a child at the dentist. Children with special needs will also benefit from seeing a pediatric dentist.

With a pediatric dentist, even the office is set up specifically for children to keep them happy and entertained. From our comfortable and inviting waiting room to noninvasive treatment options, we take care of your child’s teeth while helping them feel at ease. Our open and communicative approach involves explaining each procedure to our young patients in terms they can understand. When your child visits our dental practice, it is our goal that they will leave wanting to return for their follow-up visit.

Dr. Christina Ramirez is a board-certified pediatric dentist offering children's dentistry services centered around each child’s comfort. We believe that pediatric dental care should be stress-free, and so we offer a welcoming, child-friendly environment with an emphasis on gentle dental care. When you need the very best for your child’s smile, let Tiny Texans be your first choice.

Conservative Dentistry

Over-retained baby teeth are common, particularly in the lower front area of the mouth. In some cases, it looks like your child has two rows of teeth.

In most cases, the baby tooth is already loose but needs your child to wiggle on it more so it falls out, leaving room for the adult tooth to move into place.

Sometimes, the adult tooth comes in too far back from the baby tooth so that the root of the baby tooth is left intact and a dentist needs to remove it. We recommend that you come in and allow us to evaluate the baby tooth if it does not seem loose and the adult tooth is already erupting behind it.

In some cases, a baby tooth is over-retained because there is a missing adult tooth. This can be caused by trauma, obstructions, or late eruption—or the adult tooth is simply not there. It is just one of the reasons it’s so important to bring your child to the dentist from an early age for regular examinations. If your child needs treatment for over-retained baby teeth, Dr. Christina can make recommendations that are best for your child’s overall oral health and smile.

If you suspect your child has a cavity, you should contact our office immediately to set up an appointment. In the meantime, reduce high-sugar drinks like juice and soda, limit candy and other junk food, and keep the suspect area as clean as possible until the tooth can be evaluated by a dentist. If the tooth is causing any pain with eating or sleeping, please notify us about that when you call.

When you bring your child in, we will examine the area to determine whether or not it is a cavity. An x-ray might also be recommended. It if is decay, we will review treatment options, even if the cavity is in a baby tooth. A baby tooth cavity that is left with an untreated cavity runs the risk of spreading into the bone and gum, and it can even impact the adult tooth below it.

The dental process for kids is very similar to the way it works for adults. After the tooth is numbed, Dr. Christina will gently remove the decayed portion of the tooth, then sterilize the area. She will fill the spot with a tooth-colored composite to keep the decay from spreading. If the decay has already spread into the nerve chamber, the infected nerve will be cleaned, medicine placed, and the tooth covered with a silver crown. Sometimes cavities are too deep to be cleaned and saved, and an extraction could be recommended.

Dr. Christina has a way with children that helps them stay comfortable during the entire procedure. 

You can also talk to us about silver diamine fluoride as a treatment for cavities.

Emergency Services

Dr. Christina Ramirez is trained to treat dental emergencies that can occur to children. Most trauma to baby teeth does not need immediate care, but we do recommend calling us to schedule an evaluation to assess the damage. If a dental emergency happens after hours, call the emergency care line at 512-777-0301. Dr. Christina will walk you through what to do next and may have you send photos of the area to help diagnose the injury. If there is damage to an adult tooth, the timing of treatment is more critical. If an adult tooth is ever knocked out, put it in milk within 60 minutes and call us immediately to replant it. 

It is important to contact a pediatric dental office such as Tiny Texans Pediatric Dentistry the minute your child starts to mention tooth pain. Until the tooth can be evaluated by a dentist, try to limit very hot or cold foods and drinks, stick to soft foods, and minimize chewing in the area causing tooth pain. Other the counter pain medication such as ibuprofen can also help with the pain associated with an infected tooth.

A dental emergency is when there is continuous tooth pain or a severe injury to the mouth. The most common cause of a dental emergency for children is a traumatic dental injury. With baby teeth, it is more common for a tooth to be knocked loose or out of place. With adult teeth on children, it is more common for a front tooth to be chipped or broken. 

Frenectomies

Some hospitals will check newborns at birth for signs of a lip or tongue tie, others will not. The first symptom of a lip or tongue tie is usually difficult or abnormal pain with breastfeeding.

For older children, challenges with speech, eating and swallowing can be signs that there is a restrictive tongue frenum.  Sometimes you can see a large gap between the child’s two front teeth if the lip frenum attachment is too low, thick or tight. If you suspect your child may have a restrictive tie, it is best to schedule an evaluation with a training doctor immediately.

 

Dr. Christina Ramirez uses a soft tissue diode laser for Frenectomies. For newborns and infants, the patient is swaddled and has safety goggles placed to protect their eyes from any possible laser exposure. A small amount of topical anesthetic is placed along the tissue to be released before the laser is used. The procedure takes a few minutes for each area and the baby is returned to mom immediately after to breastfeed. Most mothers are able to feel a difference in the baby’s latch immediately.

For older children, patient cooperation is a huge factor and nitrous oxide or an oral sedative like versed may be used to help with the experience. Because the tissue is usually thicker at this age, a local anesthetic such as lidocaine is used to insure patient comfort during the Frenectomy.

 

The tissue that attaches any organ to nearby tissue to prevent it from flopping around is called frenum, or frenulum. There are several frenums in the mouth, the most prominent usually being the frenum under the tongue and upper lip. When the frenum attachment is too tight or short, it can restrict the movement of the tongue or lip. In young children, this can cause normal things like breastfeeding, talking, or swallowing to become more challenging.  A Frenectomy is the corrective procedure that releases the tension on the frenum allowing better movement of the tongue or lip. At Tiny Texans Pediatric Dentistry, Dr. Christina Ramirez uses a soft tissue laser to complete Frenectomies on newborns (from days old to 6 months) and children. The earlier the tie is released, the sooner the child can learn to use their lip and tongue correctly.  Lasers are believed to have better healing and less bleeding than using a scalpel or scissors.

Each child heals differently, but you can expect some soreness around the Frenectomy area for 3-7 days. We find that over the counter medications like ibuprofen (children over 6 months only) and acetaminophen work well for soreness and should be used as needed for pain. Arnica tablets and Rescue Remedy are also more holistic options to assist with the healing process. There is sometimes some slight swelling or bleeding  around the treat area that will revolve within first 24-48 hours. Stretches will be reviewed with you before your child’s Frenectomy is completed to assist with proper healing and minimize reattachment. These stretches will be done about 4-6 times a day for about 2 weeks. A follow up appointment will be scheduled with Dr. Christina Ramirez the week after the Frenectomy to make sure the site is healing correctly.

 

Infant Oral Health

You should start brushing your child's teeth as soon as they start to come in and assist with brushing until they are old enough to tie their own shoe laces (around age 7). For children 3 and younger, try and brush for 20-30 seconds without any toothpaste first. After you see the teeth and gums look clean, you have let them take over with a rice size amount of fluoride toothpaste. Try having the child lay down (like on the changing table before a diaper change) when you brush so that you can easily see all the teeth. For children over 3 years of age, brushing should be twice a day for 1-2 minutes. This is also an ideal time to have them start flossing or transitioning to an electric toothbrush. An adult needs to check every evening before bed that the teeth and gums look clean of food or plaque. If they did not do a good job, go back and assist them with brushing, especially along the gumline. 

Good oral habits start young, so it is never too early to practice good oral hygiene habits with your child. You can start by wiping their gums with a soft, wet baby washcloth after feedings until teeth start to erupt. This habit helps remove any milk residue, gets the child used to you being in their mouth, and can help with teething pain.

Once the child has a tooth erupt (usually around six months of age), you can continue with a washcloth or start using a finger brush or infant toothbrush. Ideally, you want to brush your child’s teeth at least every night after their last meal. You don’t need to use toothpaste at this time, although there are particular kinds available specifically for children this age. Ask Dr. Christina about those if you are interested.

For infants who fall asleep nursing or with a milk bottle, try to at least brush their teeth and gums well before their last feeding and again once they wake up.

Be sure to bring your child to the dentist for his or her first appointment right around their first birthday. Dr. Christina can go over more specifics on good home oral care at this time.

We recommend your child’s first visit take place within six months of that first tooth eruption or by their first birthday. This is also the recommendation set by the American Dental Association.

Your child’s first visit to the dentist is friendly and nonthreatening. Our primary goals are to get your child accustomed to the dentist and keep him or her from ever getting a cavity. If your child is anxious, you may even sit in the dental chair with your child on your lap.

Dr. Christina will conduct a short examination, checking for signs of decay, problems with bite, and health of the gums. She will also talk to you about good oral hygiene practices to follow at home, whether a fluoride treatment is recommended, and developmental milestones. If your child is a thumb-sucker or tongue-thruster, she will help you with strategies for stopping these behaviors. Because she believes so strongly in the connection between proper eating and good oral health, Dr. Christina will also offer advice on proper nutrition.

Taking children to the dentist at an early age sets them up for a lifetime of visiting the dentist regularly. We do everything we can to make sure their experience at the dentist is as pleasant as possible!

Preventive Dentistry and Nutritional Counseling

Fluoride is a naturally occurring element that has been found to make tooth enamel stronger against acid buildup, which is one of the leading causes of cavities. The right time to start your child on daily fluoride toothpaste depends on how many teeth they have and their risk of getting cavities based on their diet, brushing habits, and family history of tooth decay.

If we find your child is at a higher risk of developing cavities, we recommend using a smear of fluoride toothpaste once a day once they reach the age of one. Otherwise, we recommend waiting until age two or three when most of their baby teeth have erupted. At this time, you can start using a rice- to pea-sized amount of fluoride toothpaste on their toothbrush. We realize most children have not learned how to spit out the toothpaste at this age, but the small amount of fluoride toothpaste is still in a safe range to swallow.

You can also talk to Dr. Christina to find out whether your child would benefit from fluoride treatments at the dental office. Children with particularly deep grooves in their back molars might also benefit from sealants, which can prevent cavities from forming in those teeth.

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