Dr. Pamela Singletary - Pediatric Dentist, Cedar Park, TX

dental topics 

For more information concerning pediatric dentistry, please visit the website
for the American Academy of Pediatric Dentistry.

General Topics

What Is A Pediatric Dentist?

The pediatric dentist has an extra 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, 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 best qualified to meet these needs.

Pediatric dentists also receive extensive training in the care of children with special health care needs. They are trained in hospital dentistry, in office sedation and minor orthodontic procedures.


Why Are The Primary Teeth 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, or baby teeth are important for:

  1. proper chewing and eating

  2. providing space for the permanent teeth and guiding them into the correct position

  3. permitting normal development of the jaw bones and muscles

  4. in diction and speech development. This is especially important in the early ages of 18months to 2 years of age when speech is developing

While the front 4 teeth last until 6-7 years of age, the back teeth (cuspids and molars) aren't replaced until age 10-13.

Eruption Of Your Child's Teeth

Children’s teeth begin forming before birth. As early as 4 months, the first primary (or baby) teeth to erupt through the gums are the lower central incisors, followed closely by the upper central incisors. Although all 20 primary teeth usually appear by age 3, the pace and order of their eruption varies.p>

Permanent teeth begin appearing around age 6, starting with the first molars and lower central incisors. This process continues until approximately age 21.

AdAdults have 28 permanent teeth, or up to 32 including the third molars (or wisdom teeth).






Pediatric Dentist - Look! My Tooth is Loose!

Look! My Tooth is Loose!
(with 16"x22" poster and stickers)
By Patricia Brennan Dermuth
Illustrated by Mike Cressy


Dental Emergencies

Pediatric Dentist - Dental EmergenciesIn case of a dental emergency please call our office at 512 401-8888 and our answering machine will immediately put you in touch with the doctor on call. If you are unable to reach the doctor on call please feel free to call Dr. Singletary on her cell phone at 512 826-8521.

As a parent it is not always easy to determine when a child needs immediate attention. If you have any questions, don't hesitate to call our office. Please contact us at 512-401-8888 for instructions on reaching the doctor on call. If you are unable to reach the doctor on call please feel free to contact Dr. Singletary on her cell phone at (512) 826-8521. Dr. Singletary will give you advise over the phone or assist you in the office as needed.

Generalized Dental Pain

Pain from a tooth ache can range from a minor gum irritation to a severe tooth infection. If significant facial swelling develops as a result of a tooth infection immediate action must be taken. This may involve the use of an oral antibiotic and pain medication or in some severe cases need to be addressed with an intramuscular antibiotic injection from the emergency room or pediatricians office.

As a general rule,pain needs to be addressed quickly if the following occurs:

  1. it happens spontaneously
  2. it keeps your child awake at night
  3. it doesn't respond to pain relievers
  4. facial swelling develops

Cut Lip, Cheek or Bitten Tongue

You should apply cold compresses to injured areas to help control swelling and bleeding. A frozen bag of corn or peas can act as a excellent compress. You may also wish to place ice in a zip lock bag. A frozen popsicle can be used as an excellent compress on a tongue laceration. The key is to apply firm pressure for at least 5 to 10 minutes. If bleeding cannot be controlled by simple pressure, call our office or take your child to a hospital emergency room.


The Dos and Don'ts of Dental Trauma

When your child needs emergency dental care your pediatric dentist is always ready to help. Please keep Dr. Singletary's emergency number in a convenient location at home or on your cell phone in the event you need it.

QUESTION #1: What should I do if my child's BABY tooth is knocked out?

ANSWER: See Dr. Singletary a soon as possible. DO NOT ATTEMPT TO RE-IMPLANT THE TOOTH.

QUESTION #2: What should I do if my child's ADULT tooth is knocked out?

ANSWER: Please follow these steps if your child knocks out there PERMANENT FRONT tooth:

  1. Locate the tooth and rinse it gently in saline solution (for example contact solution) or milk or cool water.
    IMPORTANT: Do NOT hold the tooth by its root--there are important fibers on the root that we do not want to damage. Try to hold the tooth by the crown (or the portion of the tooth that is normally seen when your child smiles)

  2. Next you will have one of 2 options to follow

    Option #1: Attempt to re-implant the tooth back into the socket and hold it with a clean gauze or towel while you transport your child to the dental office. At the office Dr. Singletary will see about re-implanting the tooth and stabilizing it.

    Option #2: Store the tooth in a clean container of milk or saline solution and come straight to the dental office for the dentist to re-implant the tooth and stabilize it.

QUESTION #3: Is time of concern in a situation where the permanent tooth is knocked out?

ANSWER:The answer to that question is YES! Time is a very important factor as to the long term prognosis of the tooth's longevity. If the tooth is re-implanted with in 30 minutes the survival rate of the tooth is 90 %. For a periods longer (60mins) the survival rate is 75% and less. The tooth will need to be stabilized by Dr. Singletary as soon as possible. Following this she will discuss with you the long term follow up needed regarding this type of tooth injury.

Before and After a Chipped Tooth

QUESTION #4:What do I do for a chipped or broken tooth?

ANSWER: Rinse the mouth with clean cool water. If there is bleeding to the site or soft tissues apply direct pressure to the bleeding area with a clean cloth. If swelling is present apply a cold compress. Call Dr. Singletary as soon as possible for further direction as to the treatment needs for your child. If the fracture is small sometimes it can be taken care with in a day or two. If the fracture is large and there is a nerve exposure then the tooth may need to be taken care of immediately.

QUESTION #5: What do I do for my child's toothache?

ANSWER: Call Dr. Singletary. Do NOT put heat or aspirin on the tooth that is causing the pain. Give your child the pain reliever you normally give (that may be Tylenol or Motrin (Ibuprophen) and plan to see Dr. Singletary as soon as possible.

QUESTION #6: What If I suspect a broken jaw?

ANSWER: Do NOT move the jaw. Secure the jaw in place by tying a handkerchief or shirt around the jaw and over the top of the head. Go straight to the hospital or call your pediatric dentist.

QUESTION #7: What do I do if my child receives a severe blow to the head?

ANSWER: Immediately take your child to the nearest hospital emergency room. They will evaluate your child for a concussion or other head trauma.

QUESTION #8: How can I prevent dental injuries?

ANSWER: In today's fast paced society of multiple activities and professional sports it is not surprising that we see as many dental injuries as we do. Children are frequently in professional sports before or after school whether it be soccer, baseball, softball, basketball, football, gymnastics, swimming, cycling, lacrosse, professional dance or cheer. These high impact activities can result in significant dental traumas. Not to mention the every day accidents we see from just children tripping, falling, hitting objects and kids being kids. The following the steps listed below may help prevent injuries to the teeth, jaw and face:

  1. Reduce oral injuries in sports by wearing a mouth guard when ever possible. Helmets should be worn for any sports that offer the use of a helmet. This includes just riding the bicycle, scooter or skate board down the side walk. Talk to Dr. Singletary about having a custom mouth guard made for your child if they do not currently have one.

  2. Always use a car seat or a seat belt for your child in the car.

  3. Child proof your home.

  4. Have a starting point. By this we mean having a base line of your child's dental development and dentition present. It is best to have routine and regular dental visits with your pediatric dentist every 6 months. When age appropriate, it is important to have a "base line" x-ray of your child's teeth to have as a comparison in case a traumatic injury does arise. An x-ray taken at a routine examination during a cleaning visit can be very beneficial as a guide when comparing the teeth following an x-ray taken after the traumatic injury.

Dental Radiographs (X-Rays)

Radiographs (X-Rays) are a vital and necessary part of your child’s dental diagnostic process. Without them, certain dental conditions can and will be missed.Pediatric Dentist - Dental Radiographs (X-Rays)

Radiographs detect much more than cavities. For example, radiographs may be needed to survey erupting teeth, diagnose bone diseases, evaluate the results of an injury, or plan orthodontic treatment. Radiographs allow dentists to diagnose and treat health conditions that cannot be detected during a clinical examination. If dental problems are found and treated early, dental care is more comfortable for your child and more affordable for you.

The American Academy of Pediatric Dentistry recommends radiographs and examinations every 6 months for children with a high risk of tooth decay. That means if your child is prone to cavities they may need x-rays more frequently. On average, most pediatric dentists request radiographs approximately once a year. Approximately every 3 years , it is a good idea to obtain a complete set of radiographs, either a panoramic and bite wings or periodical and bite wings. These x-rays aid in the diagnosis pathology (cysts), extra or missing teeth, and the correct erupt of permanent teeth.

Pediatric dentists are particularly careful to minimize the exposure of their patients to radiation. With contemporary safeguards, the amount of radiation received in a dental X-ray examination is extremely small. The risk is negligible. In fact, the dental radiographs represent a far smaller risk than an undetected and untreated dental problem. Lead body aprons and shields will protect your child. Today’s equipment filters out unnecessary x-rays and restricts the x-ray beam to the area of interest. High-speed film and proper shielding assure that your child receives a minimal amount of radiation exposure.


What's The Best Toothpaste For My Child?

Tooth brushing is one of the most important tasks for good oral health. Many toothpastes, and/or tooth polishes, however, can damage young smiles. They contain harsh abrasives, which can wear away young tooth enamel. When looking for a toothpaste for your child, make sure to pick one that is recommended by the American Dental Association as shown on the box and tube. These toothpastes have undergone testing to insure they are safe to use.

Remember, children should spit out toothpaste after bruising to avoid getting too 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 a fluoride free toothpaste, using no toothpaste, or using only a smear amount of toothpaste. A smear is smaller than a pea size amount of tooth paste.

Does Your Child Grind 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 the child grinding on their teeth during sleep. Or, the parent may notice wear (teeth getting shorter) to the dentition. One theory as to the cause involves a psychological component. Stress due to a new environment, divorce, changes at school; etc. can influence a child to grind their teeth. Another theory relates to pressure in the inner ear at night. If there are pressure changes (like in an airplane during take-off and landing, when people are chewing gum, etc. to equalize pressure) the child will grind by moving his jaw to relieve this pressure. Many children grind if they have sinus drainage or if they are teething, especially when they are sleeping.

The majority of cases of pediatric bruxism do not require any treatment. If excessive wear of the teeth (attrition) is present, then a mouth guard (night guard) may be indicated. The negatives to a mouth guard are the possibility of choking if the appliance becomes dislodged during sleep and it may interfere with growth of the jaws. The positive is obvious by preventing wear to the primary dentition. Night guards are commonly recommended when all the permanent teeth are erupted. We do not typically recommend a night guard for primary teeth as we do not want to restrict jaw growth

The good news is most children outgrow bruxism. The grinding decreases between the ages 6-9 and children tend to stop grinding between ages 9-12. If you suspect bruxism, discuss this with your pediatrician or pediatric dentist.


Thumb Sucking

Pediatric Dentist - Thumb SuckingSucking is a natural reflex and infants and young children may use thumbs, fingers, pacifiers and other objects on which to suck. It may make them feel secure and happy, or provide a sense of security at difficult periods. Since thumb sucking is relaxing, it may induce sleep.

Thumb 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 a child sucks on fingers or thumbs will determine whether or not dental problems may result. Children who rest their thumbs passively in their mouths are less likely to have difficulty than those who vigorously suck their thumbs.

There are 3 items we look at when assessing the thumb habit and they are intensity, duration and frequency. These 3 items have a direct impact as to whether your child will have significant skeletal deviations due to the sucking habit. The intensity (how hard your child is sucking), the duration (how long your child is sucking) and the frequency (how often your child is sucking) all have a direct correlation or link on the amount of open bite that will be present and the developing skeletal changes that will potentially occur.

Encourage your child to stop the sucking habit as soon as possible. This can be a difficult task when dealing with a very young child. Especially when there are infants and younger siblings in the household who have the same habit. We preferably like to see the habit ceased no later than age 3 to 4. However, there are exceptions to this rule. We become more concerned about this habit around the age of 5 to 6, as this is when the permanent teeth start to erupt. This prolonged sucking habit, into the time in which permanent teeth are erupting, can result in distortion of the bite. For this reason we say that children should cease thumb sucking by the time permanent front teeth are erupting. Peer pressure may cause many school aged children to stop. Most children break themselves of the habit and do not need intervention. If you are concerned about this we will check to see if intervention is necessary for your child at there dental examination.

A few suggestions to help your child get through thumb sucking:

  • Children often suck their thumbs when feeling insecure. Focus on correcting the cause of anxiety, instead of the thumb sucking.
  • Children who are sucking for comfort will feel less of a need when their parents provide comfort.
  • Reward children when they refrain from sucking during difficult periods, such as when being separated from their parents.
  • Your pediatric dentist can encourage children to stop sucking and explain what could happen if they continue.
  • If these approaches don’t work, remind the children of their habit by bandaging the thumb or putting a sock on the hand at night. Your pediatric dentist may recommend the use of a mouth appliance. Do not use punishment or hot sauce to make your child quit his/her oral habit.
Pediatric Dentist - David Decides About Thumbsucking


 David Decides About Thumbsucking
A Story for Children, A Guide for Parents

by Susan Heitler PHD
Paula Singer (Photographer)



Pacifiers are no substitute for thumb sucking. They can affect the teeth essentially the same way as sucking fingers and thumbs. However, use of the pacifier can be controlled and modified more easily than the thumb or finger habit. You can take away a pacifier but you can not take away a thumb or finger. If you notice your child resorting to there finger or thumb after removing the pacifier then we encourage that you give the child the pacifier back until they are emotionally ready to discard the pacifier. Switching over from a pacifier habit to a thumb habit is NOT considered a success in fact it would be considered a step backward. If you have concerns about thumb sucking or use of a pacifier consult your pediatric dentist.

Getting Rid of the Pacifier: Listed below are some clever ideas we have heard about from parents and colleges regarding disposing of pacifiers. You know your child best and what will work for them best.

  1. Cutting the pacifier= You may wish to start cutting off the tip of the pacifier so that eventually the pacifier is just a nub and no longer has the soothing sensation the child desires. You may then say "we need to through this pacifier away as it it broken". Then toss it in the trash.

  2. Fair well parties= Some parents will perform elaborate ceremonies and special farewell parties for there child to send the pacifier off to the pacifier fairy, or mail it to a baby that needs a pacifier.

  3. Saving the pacifier= We have even had children that go to Build-A-Bear and place there pacifier inside the bear that is being made so they know where there pacifier is but do not have access to it.

  4. Donating the pacifier= Parents have taken their children to the hospital when visiting friends and taken them to the nursery and shown them the new babies that need pacifiers. They then leave the pacifier at the hospital when they leave.

  5. Giving away the pacifier to a younger sibling= In this case the parent makes a big deal about what a big boy or big girl the child is for giving away the pacifier to the "baby" sibling.

  6. Reward System= Some parents will develop a chart or graph for the child to follow and at the end of a set time period (you decide a few weeks or one month with out the habit) they are rewarded with a special toy or gift.

  7. Cold Turkey= Some parents just resort to throwing away all of the pacifiers on the same day and having to stop the habit immediately.

Before and After Oral Habits
Before with a habit present an open bite results   After with the habit ceased the bite is closed     

Harmful oral habits can have an undesirable effect on...

  1. primary tooth alignment
  2. permanent tooth alignment
  3. growth and development of upper and lower jaws-resulting in a constriction of the upper jaw
  4. speech- due to inappropriate positioning of the tongue from the developing open bite
  5. psyche- cosmetically an open bite can be unattractive

What Is Pulp Therapy?

The pulp of a tooth is the inner, central core of the tooth. The pulp contains nerves, blood vessels, connective tissue and reparative cells. The purpose of pulp therapy in Pediatric Dentistry is to maintain the vitality of the affected tooth (so the tooth is not lost).

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", "pulpectomy" or "pulpotomy". The two common forms of pulp therapy in children's teeth are the pulpotomy and pulpectomy.

A pulpotomy removes the diseased pulp tissue within the crown portion of 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).

A pulpectomy is required when the entire pulp is involved (into the root canal(s) of the tooth). During this treatment, the diseased pulp tissue is completely removed from both the crown and root. The canals are cleansed, disinfected and, in the case of primary teeth, filled with a resorbable material. Then, a final restoration is placed. A permanent tooth would be filled with a non-resorbing material.

What Is The Best Time For Orthodontic Treatment?

Developing malocclusions, or bad bites, can be recognized as early as 2-3 years of age. Often, early steps can be taken to reduce the need for major orthodontic treatment at a later age.

Stage I - Early Treatment: This period of treatment encompasses ages 2 to 6 years. At this young age, we are concerned with underdeveloped dental arches, the premature loss of primary teeth, and harmful habits such as finger or thumb sucking. Treatment initiated in this stage of development is often very successful and many times, though not always, can reduce or eliminate the need for future orthodontic/orthopedic treatment. Some treatment options that would be present during this stage may be space maintainers including a lower lingual arch, a nance appliance, or a band and loop appliance. All of these appliances are used to hold the space until the permanent teeth erupt into the correct location. In many cases an appliance such as this can prevent extensive problems later.

Stage II - Mixed Dentition: This period covers the ages of 6 to 12 years, with the eruption of the permanent incisor (front) teeth and 6 year molars. Treatment concerns deal with jaw malrelationships and dental realignment problems. This is an excellent stage to start treatment, when indicated, as your child’s hard and soft tissues are usually very responsive to orthodontic or orthopedic forces.

Stage III - Adolescent Dentition: This stage deals with the permanent teeth and the development of the final bite relationship.


Early Infant Oral Care

Perinatal & Infant Oral Health

Pediatric Dentist - Perinatal & Infant Oral HealthThe American Academy of Pediatric Dentistry (AAPD) recommends that all pregnant women receive oral healthcare and counseling during pregnancy. Research has shown evidence that periodontal disease can increase the risk of preterm birth and low birth weight. Talk to your doctor or dentist about ways you can prevent periodontal disease during pregnancy.

Additionally, mothers with poor oral health may be at a greater risk of passing the bacteria which causes cavities to their young children. Mother's should follow these simple steps to decrease the risk of spreading cavity-causing bacteria:

  • Visit your dentist regularly.
  • Brush and floss on a daily basis to reduce bacterial plaque.
  • Proper diet, with the reduction of beverages and foods high in sugar & starch.
  • Use a fluoridated toothpaste recommended by the ADA and rinse every night with an alocohol-free, over-the-counter mouth rinse with .05 % sodium fluoride in order to reduce plaque levels.
  • Don't share utensils, cups or food which can cause the transmission of cavity-causing bacteria to your children.
  • Use of xylitol chewing gum (4 pieces per day by the mother) can decrease a child’s caries rate.

It is recommended early on, i.e. after the birth of your child, and before the eruption of even one tooth, that your child's mouth be wiped out with a wet wash cloth following feedings. From day one your child will become accustomed to you placing an object (finger with wet wash cloth) in there mouth and cleaning the gum pads. By performing this daily ritual you will instill the routine early on, of coral cleanings. When the teeth erupt your child will already be accustomed to the routine and not be averse to a tooth brush being placed in the mouth.

For infants Dr. Singletary may recommend the use of a finger brush to massage the gum pads. As your child's teeth start to erupt around 6 months of age this massaging of the gums may actually help sooth some of the pain related to the eruption pressure of the primary teeth.

Your Child's First Dental Visit-Establishing A "Dental Home"

The American Academy of Pediatric Dentistry (AAPD), American Academy of Pediatrics (AAP) and our office recommend that your child visit the dentist no later than his/her 1st birthday. This visit is intended to help guide and advise the parent of issues that will be of concern during the development of their child's teeth. The main objective is to determine the infant's risk of developing cavities.The following issues may be discussed:

  • infants fluoride exposure: The use of infant formula vs breast milk. The fluoride content of the formula (non-milk based formulas have higher fluoride content because the calcium that is added to formula contains fluoride) and the water used to reconstitute the formula may contain fluoride increasing an infants early exposure to excessive fluoride.
  •  transmission of bacteria: The transmission of the oral bacteria from the mother or care taker to the infant via sharing utensils. We will discuss with the parent on the importance of avoiding saliva-sharing behaviors (example: sharing spoons and other utensils,sharing cups,cleaning a dropped pacifier or toy with their mouth) . By decreasing these types of behaviors we can reduce or eliminate the transmission of bacteria.
  • parental history of cavities: A family history of high number of cavities can place an infant at high risk due to the genetic factors.
  • age of tooth paste use: Monitoring tooth paste to prevent ingestion of excessive amounts of fluoride at an early age.
  • oral hygiene: The proper routine to be used early on for oral hygiene.


For infants this initial exam consists of what is called a knee to knee exam (see the adjacent picture attached). The dentist and parent sit with there knees in close proximity. The parent holds the child in a hugging manner (with the child's legs wrapped around their waste) as if they are going to hug the infant and then drops the child's head into the lap of the dentist. This enables the dentist to get a good look at the oral cavity.


You can make the first visit to the dentist enjoyable and positive. Your child should be informed of the visit and told that the dentist and her staff will explain all procedures and answer any questions. The less to-do concerning the visit the better. The AAPD recommends establishing a "dental home". Children who have a dental home are more likely to receive appropriate preventive and routine oral health care. The dental home is intended to provide a place other than the emergency room for parents.

It is best to refrain from using worlds around your child that might cause unnecessary fear, such as needle, pull, drill or hurt. Pediatric dental offices make a practice of using words that convert the same message, but are pleasant and non-frightening to the child.

We invite you to stay with your child during the examination. Our highly trained, kid friendly staff will accompany you and your child through the dental experience and help answer questions that may arise. We are skilled at developing a rapport with your child in order to gain there confidence and help them overcome apprehension. We are highly experienced in helping children overcome anxiety. Our bright and airy open concept office was designed with your child in mind. The open environment is designed for children to observe others and evoke feelings of confidence as they watch other children have there teeth examined.

When Will My Baby Start Getting Teeth?

Teething, the process of baby (primary) teeth coming through the gums into the mouth, is variable among individual babies. Some babies get their teeth early and some get them late. In general, the first baby teeth to appear are usually the lower front (anterior) teeth and they usually begin erupting between the age of 6-8 months.
See "Eruption of Your Child’s Teeth" for more details.


Baby Bottle Tooth Decay (Early Childhood Caries)

Pediatric Dentist - Baby Bottle Tooth DecayOne serious form of decay among young children is baby bottle tooth decay. This condition is caused by frequent and long exposures of an infant’s teeth to liquids that contain sugar. Among these liquids are milk (including breast milk), formula, fruit juice and other sweetened drinks.

Putting a baby to bed for a nap or at night with a bottle other than water can cause serious and rapid tooth decay. Sweet liquid pools around the child’s teeth giving plaque bacteria an opportunity to produce acids that attack tooth enamel. If you must give the baby a bottle as a comforter at bedtime, it should contain only water. If your child won't fall asleep without the bottle and its usual beverage, gradually dilute the bottle's contents with water over a period of two to three weeks.

After each feeding, wipe the baby’s gums and teeth with a damp washcloth or gauze pad to remove plaque. The easiest way to do this is to sit down, place the child’s head in your lap or lay the child on a dressing table or the floor. Whatever position you use, be sure you can see into the child’s mouth easily.

Before and After Tooth Decay

sippy cupsSippy Cups

Sippy cups should be used as a training tool from the bottle to a cup and should be discontinued by the first birthday. If your child uses a sippy cup throughout the day, fill the sippy cup with water only (except at mealtimes). By filling the sippy cup with liquids that contain sugar (including milk, fruit juice, sports drinks, etc.) and allowing a child to drink from it throughout the day, it soaks the child’s teeth in cavity causing bacteria.

By filling the sippy cup with liquids that contain sugar (including milk, fruit juice, sports drinks, etc.) and allowing a child to drink from it throughout the day, it soaks the child's teeth in a cavity causing bacteria, resulting in an increased risk of developing cavities. Every time your child eats or drinks a item that is a carbohydrate the teeth are exposed to an acid bath for 20 minuets. Why 20 minuets you may ask? this is due to the fact that it takes normal saliva flow approximately 20 minutes to neutralize the acidic environment. You can see how sipping on a cup or bottle all day long exposes the teeth to an acid bath resulting in an acidic environment which breaks down enamel. A similar scenario would be if an adult sipped on a sugary soft drink all day long and never brushed there teeth This would result in extensive weakening of the enamel and leading to cavities over time.



Care Of Your Child's Teeth

Good Diet

Good Diet = Healthy Teeth

Healthy eating habits lead to healthy teeth. Like the rest of the body, the teeth, bones and the soft tissues of the mouth need a well-balanced diet. Children should eat a variety of foods from the five major food groups. Most snacks that children eat can lead to cavity formation. The more frequently a child snacks, the greater the chance for tooth decay. How long food remains in the mouth also plays a role. For example, hard candy and breath mints stay in the mouth a long time, which cause longer acid attacks on tooth enamel. If your child must snack, choose nutritious foods such as vegetables, low-fat yogurt, and low-fat cheese, which are healthier and better for children’s teeth.


How Do I Prevent Cavities?

Good oral hygiene removes bacteria and the left over food particles that combine to create cavities. For infants, use a wet gauze or clean washcloth to wipe the plaque from teeth and gums. Avoid putting your child to bed with a bottle filled with anything other than water. See "Baby Bottle Tooth Decay" for more information.

Enamel on baby teeth is thinner than on adult teeth so once a cavity gets started it will progress much more rapidly than on a permanent tooth. For this reason it is important to catch cavities early and to treat these areas early to prevent pain and costly dental bills.

For older children, brush their teeth at least twice a day. Also, watch the number of snacks containing sugar that you give your children.

The American Academy of Pediatric Dentistry recommends visits every six months to the pediatric dentist, beginning at your child’s first birthday. Routine visits will start your child on a lifetime of good dental health.

Your pediatric dentist may also recommend protective sealants or home fluoride treatments for your child. Sealants can be applied to your child’s molars to prevent decay on hard to clean surfaces.

Seal Out Decay

A sealant is a clear or shaded plastic material that is applied to the chewing surfaces (grooves) of the back teeth (premolars and molars), where four out of five cavities in children are found. This sealant acts as a barrier to food, plaque and acid, thus protecting the decay-prone areas of the teeth.

Sealant-Before Sealant-After

Before Sealant Applied

After Sealant Applied



FluorosisFluoride is an element, which has been shown to be beneficial to teeth. However, too little or too much fluoride can be detrimental to the teeth. Little or no fluoride will not strengthen the teeth to help them resist cavities. Excessive fluoride ingestion by preschool-aged children can lead to dental fluorosis, which is a chalky white to even brown discoloration of the permanent teeth. Many children often get more fluoride than their parents realize. Being aware of a child’s potential sources of fluoride can help parents prevent the possibility of dental fluorosis.

Some of these sources are:

  • Too much fluoridated toothpaste at an early age.
  • The inappropriate use of fluoride supplements.
  • Hidden sources of fluoride in the child’s diet.

Two and three year olds may not be able to expectorate (spit out) fluoride-containing toothpaste when brushing. As a result, these youngsters may ingest an excessive amount of fluoride during tooth brushing. Toothpaste ingestion during this critical period of permanent tooth development is the greatest risk factor in the development of fluorosis.

Excessive and inappropriate intake of fluoride supplements may also contribute to fluorosis. Fluoride drops and tablets, as well as fluoride fortified vitamins should not be given to infants younger than six months of age. After that time, fluoride supplements should only be given to children after all of the sources of ingested fluoride have been accounted for and upon the recommendation of your pediatrician or pediatric dentist.

Certain foods contain high levels of fluoride, especially powdered concentrate infant formula, soy-based infant formula, infant dry cereals, creamed spinach, and infant chicken products. Please read the label or contact the manufacturer. Some beverages also contain high levels of fluoride, especially decaffeinated teas, white grape juices, and juice drinks manufactured in fluoridated cities.

Parents can take the following steps to decrease the risk of fluorosis in their children’s teeth:

  • Use baby tooth cleanser on the toothbrush of the very young child.
  • Place only a pea sized drop of children’s toothpaste on the brush when brushing.
  • Account for all of the sources of ingested fluoride before requesting fluoride supplements from your child’s physician or pediatric dentist.
  • Avoid giving any fluoride-containing supplements to infants until they are at least 6 months old.
  • Obtain fluoride level test results for your drinking water before giving fluoride supplements to your child (check with local water utilities).


Pediatric Dentist - Mouth Guards

Mouth Guards

When a child begins to participate in recreational activities and organized sports, injuries can occur. A properly fitted 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 any activity that could result in a blow to the face or mouth.

Mouth guards help prevent broken teeth, and injuries to the lips, tongue, face or jaw. 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 and store-bought mouth protectors.

Xylitol - Reducing Cavities

The American Academy of Pediatric Dentistry (AAPD) recognizes the benefits of xylitol on the oral health of infants, children, adolescents, and persons with special health care needs.

The use of XYLITOL GUM by mothers (2-3 times per day) starting 3 months after delivery and until the child was 2 years old, has proven to reduce cavities up to 70% by the time the child was 5 years old.

Studies using xylitol as either a sugar substitute or a small dietary addition have demonstrated a dramatic reduction in new tooth decay, along with some reversal of existing dental caries. Xylitol provides additional protection that enhances all existing prevention methods. This xylitol effect is long-lasting and possibly permanent. Low decay rates persist even years after the trials have been completed.

Xylitol is widely distributed throughout nature in small amounts. Some of the best sources are fruits, berries, mushrooms, lettuce, hardwoods, and corn cobs. One cup of raspberries contains less than one gram of xylitol.

Studies suggest xylitol intake that consistently produces positive results ranged from 4-20 grams per day, divided into 3-7 consumption periods. Higher results did not result in greater reduction and may lead to diminishing results. Similarly, consumption frequency of less than 3 times per day showed no effect.

To find gum or other products containing xylitol, try visiting your local health food store or search the Internet to find products containing 100% xylitol.

Beware of Sports Drinks

Sports DrinksDue to the high sugar content and acids in sports drinks, they have erosive potential and the ability to dissolve even fluoride-rich enamel, which can lead to cavities.

To minimize dental problems, children should avoid sports drinks and hydrate with water before, during and after sports.  Be sure to talk to your pediatric dentist before using sports drinks.

If sports drinks are consumed:

  • reduce the frequency and contact time
  • swallow immediately and do not swish them around the mouth
  • neutralize the effect of sports drinks by alternating sips of water with the drink
  • rinse mouthguards only in water
  •  seek out dentally friendly sports drinks


Adolescent Dentistry

Pediatric Dentist - Teens

Tongue Piercing - Is It Really Cool?

You might not be surprised anymore to see people with pierced tongues, lips or cheeks, but you might be surprised to know just how dangerous these piercings can be.

There are many risks involved with oral piercings, including chipped or cracked teeth, blood clots, blood poisoning, heart infections, brain abscess, nerve disorders (trigeminal neuralgia), receding gums or scar tissue. Your mouth contains millions of bacteria, and infection is a common complication of oral piercing. Your tongue could swell large enough to close off your airway!

Common symptoms after piercing include pain, swelling, infection, an increased flow of saliva and injuries to gum tissue. Difficult-to-control bleeding or nerve damage can result if a blood vessel or nerve bundle is in the path of the needle.

So follow the advice of the American Dental Association and give your mouth a break - skip the mouth jewelry.

Tobacco - Bad News In Any Form

Tobacco in any form can jeopardize your child’s health and cause incurable damage. Teach your child about the dangers of tobacco.

Smokeless tobacco, also called spit, chew or snuff, is often used by teens who believe that it is a safe alternative to smoking cigarettes. This is an unfortunate misconception. Studies show that spit tobacco may be more addictive than smoking cigarettes and may be more difficult to quit. Teens who use it may be interested to know that one can of snuff per day delivers as much nicotine as 60 cigarettes. In as little as three to four months, smokeless tobacco use can cause periodontal disease and produce pre-cancerous lesions called leukoplakias.

If your child is a tobacco user you should watch for the following that could be early signs of oral cancer:

  • A sore that won’t heal.
  • White or red leathery patches on the lips, and on or under the tongue.
  • Pain, tenderness or numbness anywhere in the mouth or lips.
  • Difficulty chewing, swallowing, speaking or moving the jaw or tongue; or a change in the way the teeth fit together.

Because the early signs of oral cancer usually are not painful, people often ignore them. If it’s not caught in the early stages, oral cancer can require extensive, sometimes disfiguring, surgery. Even worse, it can kill.

Help your child avoid tobacco in any form. By doing so, they will avoid bringing cancer-causing chemicals in direct contact with their tongue, gums and cheek.



Dr. Pamela Singletary - Pediatric Dentist, Cedar Park, TX

Pediatric Dentist Cedar Park, TX 78613, Dr. Pamela Singletary   Serving patients in the surrounding cities and areas of Austin, Cedar Park, Leander, Pflugerville, and Round Rock, Texas.>


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