Mandy went to her appointment with a children's dentist yesterday. Everything went smoothly, and she didn't have any cavities. In fact, the dentist said her teeth looked great. When she met her mother back in the waiting room, she said, "That was easy, Mom. You really should go to the dentist yourself. It's no big deal."
Mandy went to a specialist in dental care for kids -- a pediatric dentist. What's a checkup with this kind of dentist like? Let's ask Dr. Don Forrester, who is the chairman of the Department of Pediatric Dentistry at Children's Hospital National Medical Center. In addition to treating patients, Dr. Forrester teaches other dentists how to care for children.
If you're going to see your dentist for the first time, he or she will probably send you a brochure or even call you up at home to talk to you before you get there, Dr. Forrester says. Mandy's dentist did that, and it made her feel less scared about going.
"The first visit is designed to introduce you to the dentist and the dental routine," Dr. Forrester says. "You and the dentist get a chance to size each other up."
When Mandy arrived at her dentist, she was surprised that the assistant asked if she wanted her mom to go in with her. At her old dentist, they had told her mom to wait outside. Mandy thought about it, but she decided to go by herself. "I am 9," she thought. "I'm grown up."
After the dentist asks his patient to sit in the chair -- and perhaps demonstrates how the chair goes up and down -- she or he will show the child the dental equipment. Mandy's dentist let her hold and look at the little mirror he uses to reflect light into the mouth.
"I always show a child my dental tools," says Dr. Forrester. "In addition to a very small mirror, we use a 'tooth feeler.' It looks sharp, but don't worry. It's used to look for defects on your teeth, not in the gums."
Now it's time for the oral examination. "The dentist may put on a pair of rubber gloves," Dr. Forrester says. "That's to protect the child and the dentist so we don't hand germs back and forth. Some dentists wear a mask, too."
With his fingers, the dentist checks the child's mouth, gums and tongue. He'll count the number of teeth and look at the "bite" -- the way the upper and lower jaw meet. Then he'll go through the mouth tooth by tooth, checking for any defects. "I use a tooth blower to dry off the surface of each tooth as I go," Dr. Forrester says.
At some point during the first exam, the dentist will take dental X-rays. "X-rays let me look in between those places where the teeth meet each other," Dr. Forrester says. "When you get X-rays, we drape a very heavy apron over the tummy," says Dr. Forrester. "That's a lead apron to protect from extra X-rays. The ones you're getting won't hurt you. But it's like going out in the sun. If you do it over and over and over again, you'll end up with too much exposure."
Dr. Forrester lets his patients help develop X-rays. "Our patients help us feed the film of their teeth into an automatic film development machine. Then they can see it come out at the other end."
Mandy helped develop her X-ray portrait. The best part about it was that she got to get out of the chair and walk around and see what was going on. She liked that better than sitting in the chair by herself wondering what was going to happen next.
Now it's time for tooth cleaning. "This gets rid of that hard yuck called plaque," says Dr. Forrester. "I use a paste-like material with fluoride and a very fine abrasive. It's like a tooth version of a kitchen sink cleanser."
The last thing the dentist will do is apply a fluoride treatment. He or she will offer a variety of flavors -- "Bubblegum flavor goes fast around here," Dr. Forrester says. The gel also comes in cinnamon, strawberry, Hawaiian punch and other flavors. It comes in little trays that you bite down on. It'll make your mouth water like crazy, Dr. Forrester says. "A suction tip goes in your mouth to suck up the extra saliva," he adds. "It's like a straw that's attached to a machine to suck the wetness away."
The gel stays in the mouth about four minutes. "After about a minute, you'll feel a little tingling on your gums," Dr. Forrester says. "It's like holding a mouthful of bubbles."
The appointment is almost over. Finally, the dentist will give you some instructions on how to care for teeth until the next time you come in. "The dentist will probably tell you to brush each time you eat," says Dr. Forrester. "That's not too realistic."
One study in Iowa showed that children of 9 or 10 put food in their mouths 22 times a day!" It's great to brush after every meal, Dr. Forrester says, but the most important time to do it is before you go to bed at night. That's when you should do a really good job. Rinsing with a fluoride rinse is a good idea, too. That way, you have a better chance of avoiding cavities altogether, like Mandy did.
Tips for Parents
"Children shouldn't necessarily only go to a kids' dentist," says Dr. Donald Forrester, chairman of the Department of Pediatric Dentistry at Children's Hospital National Medical Center. "However, they will provide more efficient, more effective, more contemporary methods of treating children than would a general practitioner."
Children's Hospital has a comprehensive (including orthodontics) Pediatric Dentistry Service staffed with pediatric dentists and specialists, as well as a formal training program for pediatric dentistry. Preventive, routine and 24-hour emergency care is offered at the outpatient dental clinic at the hospital at 111 Michigan Ave., NW, Washington, D.C. 20010. This spring, dental services will also be available at the CHNMC Clinic in Shady Grove, Md.
Catherine O'Neill is a children's writer in Silver Spring.