Pediatric Dentistry of Round Rock
Kelsey Bookmyer D.D.S
Board Certified Pediatric Dentist

Frequently Asked Questions 

How can I deal with my child's dental anxiety?
Nitrous Oxide (Laughing Gas)

What is Nitrous Oxide (N2O)? 
Nitrous oxide is a blend of two gasses, nitrous oxide and oxygen (N2O -O2 ). It is inhaled through a mask that rests on your child's nose (it is scented to smell like bubblegum or strawberry). When it is inhaled it produces a calming or euphoric effect.

What are the advantages to N2O?
The calming and euphoric effect that N20 produces is the primary benefit. This allows your child to tolerate sometimes uncomfortable procedures better, such as an injection with local anesthesia, or having your mouth open for an extended period of time. By relaxing your child, it also decreases the restlessness that young children experience when asked to be still for an extended period of time. In addition it decreases the gag reflex and thus makes it easier to treat the back teeth.

Is N20 safe for my child? 
Yes it is very safe. There have been no reported cases of hypersensitivity or allergic reactions to N2O.
It is easily accepted by most children, and is quickly eliminated by the body. Therefore there are no lingering aftereffects once your child leaves the office. Your child remains fully conscious during treatment, and is in a relaxed state not a sedated state. Children do sometimes sleep once relaxed but are easily awoken.

Are there any special instructions? 
First, give your child little or no food before their dental visit. (Occasionally nausea or vomiting occurs when a child has a full stomach). Second, let Dr. Bookmyer know of any colds or respiratory conditions
before their appointment. Having a stuffy nose can make breathing through the nasal mask difficult. Third, inform Dr. Bookmyer if there has been any change in medications since your child's first visit.

Will N2O work for all children? 
No it will not work for all children. Dr. Bookmyer evaluates each child on an individual basis. Children with severe anxiety and/or extensive treatment are often more comfortably treated with alternate methods. Our overall goal is to provide dental treatment in the most comfortable and pleasant manner for your child.

Oral Sedation
Dr. Bookmyer offers in-office conscious sedation. This can be helpful to children who can not cooperate for treatment due to age, dental anxiety/fear, or extensive treatment needs.

Is there anything that can be done to avoid being "numb"?
Some dental procedures can be done without using local anesthetic (getting a shot) with the help of N2O (laughing gas).
Other procedures do require being numb. The "numb" feeling lasts about 1 1/2 hours on most patients. We do offer a reversal called Oraverse, if this is given it cuts the amount of time you have that "numb"feeling by about half.
Why should I be concerned about the bottle/sippy cup?

Why is discontinuing the bottle so important?
 The frequency that your child has his or her teeth in contact with sugars/fermentable carbohydrates (basically everything except water) is really the key. The bottle or the sippy cup, due to the way it is placed, puts the milk or juice right next to the teeth. And since kids "suck" on these liquids they are in contact with the teeth for long periods of time. This creates a situation that is literally like soaking the teeth in sugar. Primary (baby) teeth frequently and rapidly decay under these situations. The teeth that start to decay first are the front top teeth, because they are closest to the liquid and they are the teeth that have been in the mouth the longest.

When is it recommended to stop the bottle? 
The American Academy of Pediatric Dentistry recommends discontinuing the use of the bottle by the age of 1. By this age children have the upper front teeth present and usually some molars. The longer these teeth have been present with your child, the more they are at risk for early caries (cavities). Also by the age of 1 children usually can drink out of a cup. When using the bottle, remove it from your child's mouth when finished drinking. And most important, never let your child sleep with the bottle, especially through the night.

When using the bottle how do I keep my child's teeth/mouth clean? From the very beginning your child's mouth needs to be kept clean, yes even before they have teeth. Begin with a small terry cloth towel. They sell some that fit over your index finger. Rub and clean the gums every day. This removes bacteria and stimulates healthy gum tissue. It also gets your child used to the idea, and creates less anxiety and fighting from your child when you need to begin brushing. When teeth begin to erupt you can begin using an infant toothbrush. Do not use a fluoride toothpaste until your child is 3, or unless Dr. Bookmyer recommends doing so earlier. Your child's teeth/mouth should be cleaned and brushed more than once a day, but the most important time is at night before bedtime. Should you have any additional questions please give us a call: (512) 733-5311.

What are sealants? 
Sealants are a clear or shaded plastic material that is applied to the surfaces of teeth that have pits and grooves (primarily back molars). They protect the areas where cavities most often occur.

How do sealants work? 
Sealants work by "sealing" the tiny grooves in teeth where it is difficult to keep clean. Toothbrush bristles are too thick to reach into the tiny grooves of certain teeth, and thus food and bacteria build up in these areas, placing your child in danger of tooth decay. Sealants basically "seal out" food and plaque, thus reducing the risk for decoy.

Which teeth should be sealed? 
The teeth that are most at risk of decay, and those that a sealant will adhere to. (This depends on the likelihood of caries in your child). But in general all permanent molars (6 year & 12 year molars), and sometimes primary molars and adult premolars. Dr. Bookmyer can discuss which teeth on your child can benefit most from sealants.

How long do sealants last? 
Research shows that sealants can last for several years. With regular visits your child can be protected throughout the "most cavity-prone years". If your child has good oral hygiene and avoids biting on hard objects, the sealants will last longer. Dr. Bookmyer can easily repair or replace a last or damaged sealant. She even has a Sealant Warranty!

What is the treatment like? 
The application process is a quick and comfortable process. It only takes one visit. Each tooth is cleaned and dried first. Next the sealant material is painted on and hardened with a special blue light.
If my child has sealants, are brushing and flossing still important? ABSOLUTELY! Sealants are only one important step in the overall plan to keep your child cavity-free for a lifetime. Sealants can not protect all of the surfaces of all of the teeth. They are designed to protect the "chewing surfaces". Brushing, flossing, and regular dental visits are still essential to a bright and healthy smile.
Should I be concerned about my child sucking their thumb or a pacifier?

Why do children suck on things? 
Sucking is a normal and natural reflex for babies. It makes infants and children feel secure and happy, and helps them learn about the world around them. Young children often suck on a thumb or a pacifier to soothe themselves. For this reason sucking usually occurs at bedtime or at difficult or stressful times.

When should thumbsuckinq stop? 
Most children stop sucking on thumbs and pacifiers between the age of 2 and 3. Sucking usually stops gradually as children spend more of their waking hours exploring their surroundings. Peer pressure usually discourages thumbsucking, so kids generally stop during school hours or when they start school. The longer a child sucks a thumb, usually the harder it is to get them to stop. Thumb/pacifier sucking should be discouraged by the age of 3 or 4.

What problems can result from prolonged thumb/pacifier sucking? 
Most children that suck a thumb or a pacifier in the early years (before 2 or 3) have no long term problems. The more aggressively and the more time a child spends sucking, the more likely that problems can result. When the thumb or pacifier is in the mouth in these children, a sucking noise is often heard, and when it is removed a "popping" sound is often heard. Prolonged and intensive sucking can cause changes in the alignment of your child's teeth, and the bones surrounding them. These changes include a space between the top and bottom front teeth, the front teeth protruding outward, a crossing of the teeth in the back, and an increase in the depth of the roof of the mouth. These changes affect the permanent teeth and often need to be corrected orthodontically.
Are pacifiers less harmful to suck on than a thumb or fingers? Thumbsucking and pacifier sucking essentially affect the teeth the same way. The pacifier is better from the standpoint that it is an easier habit to break.

What can I do to stop my child's habit? 
Most children will stop on their own. Positive reinforcement and praise when not sucking is most effective. Remember that children often suck during times of insecurity. Focus on correcting the cause of the anxiety, instead of the thumbsucking. A few children need additional help to stop, in the form of a deterrent appliance. Dr. Bookmyer can discuss your child's case individually.