Santa Fe Pediatric Dentistry

Dr. Elizabeth Prishkulnik is a dentist and has answered some of the common questions Bizymoms visitors have about Pediatric Dentistry.


Q. When should parents take their children to have their first checkup?

A. According to The American Academy of Pediatric Dentistry and The American Academy of Pediatrics (through the SOPD), the first visit to pediatric dentist should be at the eruption of the first tooth or within 6 months, whichever comes first.  The first checkup should not be long past the age of 12 months.

Q. What should be used to clean a baby’s teeth?

A. There are several inventive tools to aid in cleaning a baby’s teeth.  You can readily find these at most pharmacies.  A clean, coarse washcloth will do fine before the baby has any erupted teeth.  After the eruption of the first tooth, the best tool is a soft toothbrush, using water alone or toddler (fluoride-free only) toothpaste.  Keep in mind that the time to start brushing a baby’s teeth is immediately upon the first signs of eruption (and, forever, thereafter…).

Q. What is a Pediatric Dentist?

A. (the following is paraphrased from Pediatric Dentisty Reference Manual, V 30 / NO 7     08 / 09)

 To become a pediatric dental specialist, a dentist must satisfactorily complete a minimum of 24 months in an advanced education program accredited by the Commission on Dental Accreditation of the American Dental Association (ADA). Such programs "must be designed to provide special knowledge and skills beyond the DDS or DMD training..."   The curriculum of an advanced program provides the dentist with necessary didactic background and clinical experiences to provide comprehensive primary oral health care and the services of a specialist. Pediatric dentists provide care, conduct research, and teach in a variety of clinical and institutional settings, including private practice and public health. They work in coordination with other health care providers and members of social disciplines for the benefit of children.

Pediatric dentistry encompasses a variety of disciplines, techniques, procedures, and skills that share a common basis with other specialties, but are modified and adapted to the unique requirements of infants, children, adolescents, and those with special health care needs. By being an age-specific specialty, pediatric dentistry encompasses disciplines such as behavior guidance, care of the medically and developmentally compromised and disabled patient, supervision of orofacial growth and development, caries prevention, sedation, pharmacological management, and hospital dentistry, as well as other traditional fields of dentistry. These skills are applied to the needs of children throughout their ever-changing stages of development and to treating conditions and diseases unique to growing individuals.

Q. What should a parent do if their child has a toothache?

A. Without a doubt, seek the advice of a dentist.  If this dentist does not feel qualified to treat the child, an appropriate referral should be made.  A real toothache will typically indicate definitive care, as opposed to monitoring and observation.

Q. Are thumb sucking and pacifier habits harmful for a child’s teeth?

A. Thumb sucking and similar oral habits are termed ‘non-nutritive sucking’ and may be considered normal for the first 2 years of life.  Parents are advised to observe the habit.  If it is gradually diminishing, often the child will stop the habit.  However, when the habit persists and increases in frequency past this age, adverse dental and skeletal changes can be seen.  We would like to wean the child before malocclusion (change in the structure of the child’s bite) and skeletal dysplasias (changes in the maxilla bone – upper teeth) occur.

The effect of the sucking habit on facial bones and dental arches is impacted by several factors:

-         frequency of the habit

-         duration of the habit

-         osteogenic (bone) development

-         genetic endowment, and

-         the child’s state of health.

Q. How can a mom prevent decay caused by nursing?

A. There are several evidence-based measures that nursing mothers can take to prevent decay (Early Childhood Caries, i.e, ECC) in their babies.

•   Delay of colonization: Education of the parents, especially mothers, on avoiding saliva-sharing behaviors (eg, kissing the baby on the mouth, sharing spoons and other utensils, sharing cups, cleaning a dropped pacifier or toy with their mouth) can help prevent early colonization of Mutans Streptococci (MS) in their infants.   The major reservoir from which infants acquire cariogenic bacteria is their mother’s saliva.  Infants whose mothers have high levels of MS (from untreated decay) are at greater risk of acquiring the organism (MS) than infants whose mothers have low levels of MS.

•   Xylitol chewing gums (e.g., Trident, Stride): Evidence demonstrates that mothers’ use of xylitol chewing gum can prevent dental caries in their children by prohibiting the transmission of MS.

•   Diet: High-risk dietary practices appear to be established early, probably by 12 months of age, and are maintained throughout early childhood. Frequent night time bottle feeding, ad libitum breast- feeding, and extended and repeated use of a sippy or no-spill cup are associated with, but not consistently implicated in ECC. Likewise, frequent consumption of snacks or drinks containing fermentable carbohydrates (eg, juice, milk, formula, soda) also can increase the child’s caries risk. 

•   Ad libitum breast-feeding should be avoided after the eruption of the first tooth and the introduction of other dietary carbohydrates.  Breast-feeding is more commonly implicated in ECC after other dietary carbohydrates have been introduced.

•   The gums, including all erupted teeth, should be cleaned immediately after nursing. Newly erupted teeth have immature enamel, which may be at greater risk for decay.

Q. How often does a child need to see the pediatric dentist?

A. As we said earlier, the first visit should be made at the eruption of the first tooth or at six month of age, then every six months like any other patient.
If restorative work needs to be done, additional visit may take place. 

Q. How to contact Dr. Prishkulnik if we have further questions?

A. You may call "Just for Grins" at any time 505-428-7878, additionally, you may reach us on the web at: www.just-for-grins.com when you call many times you will have a team member answering your call. All the clinical questions are referred to me. Our professional and courteous team members will be helpful and knowledgeable to answer some of the basic knowledge questions, make an appointment, or let you know who better can answer your question.