Pediatric dentistry

Drs. Cirstea and Pistol provide quality dental care to infants, children, adolescents and those with special needs.

We emphasize the importance of early prevention, starting with the first dental visit at age 1. Our goal is to make your child’s experience as comfortable and positive as possible.

Our approach is based on a mutual cooperation between patient, doctor and parent. Thank you for helping us in making dental care unique and fun!

Pregnancy and your baby’s teeth

Since teeth begin to form in the second month of pregnancy, we recommend a balanced diet. With proper attention to diet and oral hygiene throughout pregnancy, you can prevent oral diseases. Some medications taken during pregnancy can influence your baby’s health and his/her teeth. If you are pregnant, be sure to visit Lawrence Park Dentistry regularly . Infection in your mouth or your teeth can affect your baby and untreated caries can increase your baby’s susceptibility to tooth decay.

Your child’s first visit

Please discuss the positive aspects of dentistry with your child. Prepare your child in advance that someone is going to look at his/her teeth. By putting your child in the proper frame of mind, you can make the first visit enjoyable and positive.We recommend the first dental examination by 12 months of age. We also recommend that both mom and dad come to their child’s first visit. We invite you to stay with your child during the initial examination. Please do not be upset if your child cries. Young children are often afraid of anything new and strange, and crying is the normal reaction to that fear.

Dr. Cirstea or Dr. Pistol will examine your child’s teeth, check for decay, make sure teeth are coming in the right order, screen all the oral tissues for diseases and determine proper jaw development. This early appointment is one of the best things you can do for your child. If your child is over 3 years of age and had never had a dental cleaning, we recommend a dental cleaning during the first visit. This will help to introduce all different instruments used.

There will be plenty of valuable information given about how to effectively clean baby’s teeth, nutrition and what to expect during teething. We will inform you when you should start using fluoridated toothpaste or if your child can benefit from other sources of fluoride. Since parents are often concerned about thumb and pacifier habits, we can offer some strategies on how to stop these habits.

During future appointments we suggest that parents remain in the reception room while your child is in our care with our highly trained staff. Our purpose is to gain your child’s confidence and overcome any apprehension.

Baby Bottle Tooth Decay (BBTD) also known as Early Childhood Caries (ECC) is a disease that causes severe rapid decay of baby teeth. It usually affects the upper front teeth of infants and toddlers who fall asleep with a bottle of milk, formula, fruit juices, or any sweetened liquid. Although we encourage breastfeeding, to reduce the likelihood of nursing decay, infants should be removed from the breast when they finish feeding and have their front teeth wiped with a damp cloth.

To help keep baby bottle tooth decay from affecting your child, follow these tips:

• After each feeding, wipe the baby’s gums with a clean, damp washcloth or gauze pad. Begin brushing the child’s teeth, with non-fluoridated toothpaste, when the first tooth appears and begin flossing when all the baby teeth have come in.

• Never allow your child to fall asleep with a bottle containing milk, formula, fruit juice or sweetened liquids

• If your child needs comfort between regular feedings, at night, or during naps, fill a bottle with WATER or give the child a clean pacifier. Never give your child a pacifier dipped in any sweet liquid

• Start dental visits by the child’s first birthday. Make visits regularly and verify your child gets the fluoride needed to prevent decay.

• Additionally, parents play an important role in catching decay in the earliest stages. To inspect, parents should “lift the lip” to check for white spots along the gum line of the front upper teeth. It is essential to treat decay when present since this could lead to pain and infection for your child. Also remember children with caries on their baby teeth are at greater risk of having caries on their permanent teeth.

Prevention of cavities

The following steps will help your child be cavity-free :

• Beware of frequent snacking

• Brush effectively twice a day with a fluoride tooth paste. Remember that most children under 8 years old do not have the dexterity to brush their teeth effectively. You must help them brush every night!.Fluoridated toothpaste should be introduced when a child is 2-3 years of age. Make sure the child uses no more than a pea-sized amount on the brush.

• Floss once a day

• Offer a balanced diet. Set times when your child can have a treat.Make sure you offer healthy snacks like vegetables and fruits. Cheese is also a great snack.

• Have sealants applied when appropriate. Sometimes the tiny grooves and bits on the chewing surfaces of the back teeth are very difficult to clean. A sealant can be applied on those surfaces and will fill all those crevasses preventing food and plaque from being caught there. It resembles a white plastic coating on the teeth and its application is fast and comfortable.

• Seek regular dental check-ups.

What if my child has a cavity?

Primary or baby teeth are the foundation of the permanent dentition. In other words, they are the key to healthy and well aligned permanent or adult teeth. Their position in the jaw maintains the proper place for the underlying permanent teeth. Primary teeth also help your child speak clearly and chew naturally.

• Bonded fillings are more aesthetic since they are “tooth-coloured” .

• If the cavity has spread to the nerve of the tooth, a pulpotomy (partial root canal treatment on a baby tooth) will be necessary to save the tooth. This procedure involves removing part of the nerve tissue and placing special medication on the remaining tissue so it can heal.

When a posterior tooth cannot be saved and must be extracted, a space maintainer might be required to prevent the adjacent tooth from moving into the empty space, keeping the space necessary for the eventual eruption of the corresponding adult tooth. Space maintainers are little appliances, usually made of metal, and are usually very well tolerated by children.

Will my child be cooperative?

Drs. Cirstea and Pistol will always use a technique called “Tell-Show-Do” which consists in explaining to your child what is to be done, then demonstrating with instruments before the procedure is performed in your child’s mouth. We will also constantly reward desirable behaviors with compliments and praise.

What if my child grinds his teeth at night?

One theory as to the cause involves a psychological component. Stress due to a new environment or new sibling, divorce, changes at school; etc. can influence a child to grind their teeth.

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 good news is most children outgrow bruxism. The grinding gets less between the ages 6-9 and children tend to stop grinding between ages 9-12.

Oral habits

Many parents express concern over their child’s thumb sucking or use of a pacifier. Thumb, finger and pacifier sucking all affect the teeth essentially the same way. Most children outgrow thumb sucking and pacifier use by age 4. However, thumb sucking that persists beyond the eruption of the permanent front teeth can cause changes in the appearance and positioning of teeth, shape and growth of the jaws, and affect speech development. The amount of change that may occur is dependent on the frequency, duration and intensity of the habit.

If your child is having trouble giving up the pacifier or thumb sucking, we suggest gradually weaning your child. The most effective way to accomplish this is to simply explain to your child that they must do so in order for their teeth to come in straight. Drs.Cirstea and Pistol believe, the most effective way of breaking the habit is providing positive reinforcement when children don’t suck their thumb.

What should you do? First start by NOT allowing them to suck their thumb or use a pacifier during certain hours of the day.Offer them rewards when they successfully do this. Also, since thumb sucking and pacifier use are often security mechanisms, consider giving them a teddy bear or lots of hugs to, in effect, replace the pacifier or thumb sucking. Gradually increase the number of hours in which they are not allowed to use the pacifier or suck their thumb until they no longer need these habits. Remember, the time they need the pacifier the most (during bed) should be the last time period phased out. If a child’s habit is persisting after age 5, a “habit breaker appliance” may be needed to assist the child in ceasing the habit. Some helpful hints on breaking thumb sucking habit include:

• Wait until the time is right (low stress).
• Praise them when they are not sucking (positive reinforcement).
• Use a reward system like a calendar with stickers followed by reward at the end of the week/month

Early Orthodontic Treatment

Children between ages of 6 to 10 years are excellent candidates for early orthodontic care because it takes advantage of the patient’s physical growth potential at a stage when they are growing at a rapid rate. Periodic recall appointments are set in order to check the progression of jaw growth and permanent tooth eruption. For this purpose, appliances can be utilized to direct the growth of the jaws and improve teeth alignment.

Which orthodontic problems need early examination and interceptive treatment?

• Injury-prone dental protrusions or commonly known as severe “overbite” or “buck teeth”.
• Prominent or protrusive lower jaw relating in positioning of lower teeth in front of upper teeth or “under-bite”.
• Narrow upper jaw or “cross-bite” (i.e., when the upper teeth bite inside the lower teeth).
• Open-bite
• Early or late loss of baby teeth.
• Thumb or finger sucking.
• Crowding, misplaced or blocked out teeth.
• During this time many permanent teeth will erupt and guidance of this eruption can facilitated the correction of many malocclusions.
• The bones and muscles are growing rapidly and the treatment can take advantage of the patient’s physical growth potential
• Psychological development, understanding of treatment goals and patient cooperation is most improved during this time.

Tooth eruption

The first tooth can come in as early as 4 months and as late as 12 months. If the child has some discomfort, avoid using teething gels. Instead, many babies like a clean teething ring, cool spoon or cold wet washcloth while others simply like the rubbing of their parents’ clean finger. Do not give him/her teething biscuits since most of them contain sugars. Don’t forget to wipe or brush his/her teeth as soon as they come in!


What if my child has a toothache?

Call Lawrence Park Dentistry immediately. To comfort your child, rinse the mouth with water. Apply a cold compress or ice wrapped in a cloth. Do not put heat or aspirin on the sore area.

Cut or Bitten Tongue, Lip or Cheek

Apply ice to bruised areas, If there is bleeding, apply firm but gentle pressure with a clean gauze or cloth. If bleeding does not stop after 15 minutes or it cannot be controlled by simple pressure, take the child to a hospital emergency room.

What should I do if my child’s tooth is knocked out?

Find the tooth and rinse it gently in cool water. (Do not scrub it or clean it with soap — use just water!) If possible, replace the tooth in the socket and hold it there with clean gauze or a wash cloth. If you can’t put the tooth back in the socket, place the tooth in a clean container with milk, saliva, or water. Call Lawrence Park Dentistry immediately.

The faster you act, the better your chances of saving the tooth.

What if a tooth is chipped or fractured?

Contact Lawrence Park Dentistry immediately. Rinse the mouth with water and apply cold compresses to reduce swelling. If you can find the broken tooth fragment, bring it with you to the dentist.

How to prevent dental injuries?

When a child begins to participate in recreational activities and organized sports, injuries can occur. Mouthguards are highly recommended whenever your child is in an activity with a risk of falls or of head contact with other players or equipment. Custom-fitted mouthguards are provided through your dentist. They will stay in place, with no interference with speech and breathing.