• Lindi J. Ezekowitz, D.D.S.
  • Rosalyn M. Sulyanto, D.M.D., MS

7 Graf Road
Suite 2A
Newburyport, MA 01950

(978) 462-2227

Pediatric Dentistry: Common Questions


Your Child’s Teeth

Dental Caries (Cavities or Tooth Decay):

Tooth decay is the most common childhood illness and it is also the most preventable!!!(American Academy of Pediatric Dentistry). Tooth decay is a progressive disease of the teeth resulting from the interaction of bacteria that naturally occur on the teeth, sugars in the everyday diet, and time. The healthy human mouth contains a multitude of bacteria many of which are beneficial in everyday processes such as digestion. Sugar often causes bacteria to produce acids that break-down the minerals in teeth, forming a cavity or hole in the tooth. Dentists remove the decay that caused the cavity, and then fill the space in the tooth left by the cavity using a variety of materials; the tooth is thus restored to a healthy state.

Deep decay can unfortunately result in damage to the nerve in the tooth. Once the decay has progressed into the nerve, and is subsequently removed by the dentist from the tooth, there is often little tooth structure left from the damage caused by the decay; in such an instance, a filling cannot be placed into the tooth because there is little tooth left to hold the filling. When this scenario occurs, the dentist will place a crown to protect the tooth.

A crown on a primary or baby tooth has a similar function to a crown placed on an adult tooth; the purpose of a crown is to cover a tooth to increase the tooth’s strength. There are some important differences between crowns for permanent teeth and crowns for primary teeth, and your dentist can review these differences for you. In general a crown for primary teeth, also referred to as a cap, is made of stainless-steel for back teeth and of an esthetic bonding-material for front teeth.

Preventing decay simply requires strict adherence to a good dental hygiene regimen: brushing and flossing twice a day, regular dental checkups, diet control, and fluoride treatment. Practicing good hygiene avoids unhealthy teeth and costly treatment.


Tooth decay is often preventable with the correct diet. Your child should avoid any sticky foods such as fruit snacks, raisins, sugar gum, and sticky candy. These foods get stuck between the teeth and on the biting surfaces of teeth, frequently leading to cavities. Prolonged consumption of sports drinks, juices, or soda can also create cavities.


The grooves and depressions that form the chewing surfaces of the back teeth are extremely difficult (if not impossible) to clean of bacteria and food. Sealants protect the grooves and depressions of the back teeth by preventing bacteria and food particles from residing in these areas. Sealants typically last for several years but need to be maintained and evaluated at every recall appointment.


BabyWtoothbrushFluoride is a substance that helps teeth become stronger and more resistant to decay. To determine if your home’s water has appropriate fluoridation, you may have your well tested or your town can provide information about the public water supply in your area. If necessary, supplements (usually in tablets or drops) can be prescribed for children with developing teeth. If your child is able to swish and spit without swallowing, a fluoride mouth rinse can be extremely valuable for prevention of tooth decay on erupted teeth–even if your water supply is fluoridated.

We DO NOT recommend bottled water with fluoride because the concentration of fluoride in bottled water is neither controlled nor regulated. It is important for us to be able to track the amount of fluoride your child receives. Consequently, with fluoridated bottled water we cannot determine whether your child is getting enough fluoride or even too much. If your child must drink bottled water it is better to drink bottled water without fluoride and then give your child a supplement with the appropriate amount if necessary. Your dentist will review your child’s fluoride status with you and help to determine the right amount of supplementation needed, if any.

Thumb or Finger Sucking:

Sucking is a natural reflex that comforts babies and toddlers.

Children typically stop sucking their thumbs between the ages of 2 and 4 years when the permanent front teeth are becoming ready to erupt. If thumb sucking behavior persists beyond the eruption of adult teeth, this habit can cause improper growth of the mouth and misalignment of the teeth. If you notice prolonged and/or vigorous thumb sucking behavior in your child, talk to your dentist. Here are some ways to help your child outgrow this habit:

  • DO NOT scold a child when thumb sucking behavior is observed.
    Instead, praise your child when he or she refrains from thumb sucking, especially during difficult times.
  • Focus on eliminating the cause of anxiety—thumb sucking is a comfort device that helps
    children cope with stress or discomfort.
  • For older children, try placing a bandage on the thumb or a sock on the hand at night.


Questions about Dental x-rays

(American Academy of Pediatric Dentistry)

digital x-rays_caption

How often should a child have dental X-ray films?

Since every child is unique, the need for dental X-ray films varies from child to child. Films are taken only after a complete review of your child’s health, and only when they are likely to yield information that a visual exam cannot.

In general, children need X-rays more often than adults. Their mouths grow and change rapidly and children are more susceptible to tooth decay than adults. The American Academy of Pediatric Dentistry recommends X-ray examinations every six months for children with a high risk of tooth decay; children with a low risk of tooth decay require X-rays less frequently.

Why should X-ray films be taken if my child has never had a cavity?

X-ray films detect more than cavities. X-rays may be needed to survey erupting teeth, diagnose bone diseases, evaluate the results of an injury, or plan orthodontic treatment. X-rays 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 often more successful, comfortable and affordable.

Will X-ray films be taken routinely?

No. X-ray films are recommended only when necessary to protect your child’s dental health. The frequency of X-ray films is determined by your child’s individual needs.

How safe are dental X-rays?

Pediatric dentists are particularly careful to minimize the exposure of pediatric patients to dental x-rays.. With the contemporary safeguards our office has in place, the amount of radiation received in a dental X-ray examination is extremely small and the risk of dental X-ray related disease is negligible. Dental X-rays, in fact, represent a far smaller risk to a child than an undetected and untreated dental problem.

How will my child be protected from X-ray exposure?

Lead body aprons and shields will protect your child. Today’s advanced X-ray equipment filters out unnecessary X-rays and restricts the X-ray beam to the area of interest. High-speed film and proper shielding also assure that your child receives a minimal amount of radiation exposure.