What to do in an emergency from Pediatric Dental Specialists

Emergency Care
When your child needs urgent dental treatment, your pediatric dentist stands ready to help. Please keep the emergency number available and convenient.

Q: What should I do if my child's baby tooth is knocked out?

A: Contact your pediatric dentist as soon as possible.

Q: What should I do if my child's permanent tooth is knocked out?

A: 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. Get to the pediatric dental office immediately. (Call the emergency number if it's after hours.) The faster you act, the better your chances of saving the tooth.

Q: What if a tooth is chipped or fractured?

A: Contact your pediatric dentist immediately. Quick action can save the tooth, prevent infection and reduce the need for extensive dental treatment. 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.

Q: What about a severe blow to the head or jaw fracture?

A: Go immediately to the emergency room of your local hospital. A blow to the head can be life threatening.

Q: What if my child has a toothache?

A: Call your pediatric dentist and visit the office promptly. 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.

Q: Can dental injuries be prevented?

A: Absolutely! First, reduce oral injury in sports by wearing mouth guards. Second, always use a car seat for young children. Require seat belts for everyone else in the car. Third, child-proof your home to prevent falls, electrical injuries, and choking on small objects. Fourth, protect your child from unnecessary toothaches with regular dental visits to Pediatric Dental Specialists.

All About Fluoride From Pediatric Dental Specialists

Scientific research in the United States on Fluoride has been ongoing for over 60 years.

Fluoride is a naturally occurring mineral that is found in well water, streams and lakes to one extent or another.

In the early 50’s, fluoride was found to be beneficial for developing permanent teeth in children. Children in communities that had higher amounts (around 1 part per million [1ppm] of water) showed lower or no cavities, whereas, children in communities with very little fluoride in the water had a higher incidence of tooth decay. Fluoride has been closely studied since then.

The proper (optimal-1PPM) amount of fluoride is deemed to be beneficial and amounts over 1.4 may cause an enamel condition called mild Fluorosis.

Some areas of the country such as Colorado and Texas have higher concentration of naturally occurring fluoride and children may get the “chalky” white spots or even some brown staining. There is a different condition that looks the same as Fluorosis but is Enamel Hypoplasia (Incomplete development of enamel).

Fluoride may be given systemically (supplements or drinking water with fluoride) or topically, such as at dental visits or toothpaste with fluoride.

Supplementation is provided by prescription by a physician or dentist after an assessment of how much fluoride may already be ingested, is completed.

In our practice, supplementation by fluoride tabs is generally discontinued after age 8. Of course the need for supplementation, its use and disuse is prescribed by the treating dentist on a case-by-case basis.

In 2007, the Metropolitan Water Company has fluoridated the drinking water so that clients from Los Angeles south to San Diego benefit form the use of fluoridated drinking water (Tap).



Frequently asked questions about fluoride:
1. Is fluoride good for my teeth, or bad for my teeth?

The proper amount of fluoride has been found to be beneficial for developing permanent teeth (in children).

2. When I was younger my dentist told me to use fluoride, do I still need to use it as a teen? As an adult?

No harmful effects will occur if we drink fluoridated water as a teen or as an adult.

3. How much fluoride should I be using each day?

The optimal amount of fluoride is 1part per million of water with 10-15 oz of water ingestion per day for children 5 and under and approximately 20-30 oz. for children 5-10 years old.

4. Many toothpaste says that fluoride is an ingredient, is this enough or do I still need a rinse in addition to brushing and flossing?

It is recommended that starting at age 2, a fluoridated toothpaste (a smear or pea-size amount) be placed by the supervising adult be used twice daily for oral hygiene. Unless prescribed by a dental professional, No other over-the-counter (OTC) fluoride rinse needs to be done.

5. Are there any at-home remedies (such as baking soda and peroxide) that I can use instead of fluoride?

There is no substitute for fluoride. The use of baking soda or peroxide is generally not recommended for children unless recommended by the treating dentist.

6. I’ve heard that fluoride can actually stain teeth or leave behind spots. Is this true? How can I avoid staining my teeth but still keep them healthy? If my teeth become stained or spotted, how can I fix this?

Fluoride will not spot teeth nor produce brown spots unless it is ingested in excessive amounts for a prolonged period of time and only on developing teeth. Staining of teeth may be caused by different factors. See the dentist for a diagnosis and treatment.

7. Should I drink water with fluoride or without? How much fluoride should there be in the water I drink? How can I tell if there is enough fluoride in my water?

If no supplementation has been prescribed by the pediatrician or dentist, drinking fluoridated water is recommended for children. No harmful effects have been noted for adults who drink fluoridated water.

8. Do you recommend fluoride for all your patients? Should certain people avoid using fluoride?

Ingestion of fluoride is recommended for the proper development of permanent teeth and topical (on surfaces of erupted teeth) fluoride for children and adult patients who may be susceptible to tooth decay or who have sensitivity of the roots of teeth. There is no known allergy to fluoride and it will not be harmful for people who ingest the recommended amount of it.

9. Is it best to use over-the-counter fluoride or to have a prescription? If I use over-the-counter fluoride, what brand do you recommend?

Fluoride is prescribed by a physician or dentist and is not sold over the counter in therapeutic dosages. There are over the counter products, such as many toothpastes that have fluoride in them but will always be at lower levels than the prescribed fluoride. For children over 2 years old, a fluoridated toothpaste under supervision of a responsible caretaker may be given. Only a “smear” or “pea-size” amount should be placed on the toothbrush.

Bottled Water, What's It Missing? -- Pediatric Dental Specialists

As more families turn to bottled water and away from the tap, they may be missing out on one important ingredient that most brands of bottled water fail to include: fluoride.

As of 2005, bottled water is second only to soft drinks as the most popular drink in the United States, beating out milk, juice, and – more significantly – tap water. Between 2001 and 2006, the amount of bottled water sold in the U.S. rose an average of 10% per year. And many dental health specialists point to bottled water’s increased popularity as the culprit behind rising rates of cavities.

Because fluoride helps strengthen teeth, it is an important component of maintaining good oral health. The benefits of fluoride were noticed in the early part of the twentieth century, when researchers found communities with low levels of tooth decay. It turned out that these towns had measurable levels (around 1 part per million) of fluoride in their drinking water.

Beginning in the 1940s, communities have fluoridated their water supplies, and dentists have seen a significant decline in cavities ever since. The American Dental Association endorses both community water fluoridation and the use of fluoride-containing products as a safe means of preventing tooth decay. Between tap water and toothpaste, most of us get sufficient amounts of fluoride.

But if your family avoids fluoridated tap water in favor of ever-more-popular bottled water, you could be missing out on the levels of fluoride necessary to make a difference in your oral health.

If bottled water is your water of choice, check the label to make sure that your brand contains fluoride. As of a 2006 decision, the FDA allows bottled water containing .6 to 1.0 milligrams per liter of fluoride to carry a label stating that fluoridated water may reduce the risk of dental cavities or tooth decay. The ADA has backed this decision.

Of course, simply drinking fluoridated water is not a magic ticket to perfect teeth. To keep your choppers in tip-top shape, it’s important to brush and floss daily and avoid sugary sweets, in addition to maintaining your fluoride intake. And come see us at Pediatric Dental Specialists every six months for a professional cleaning and exam.

Beware the "Toothworm": Managing a Modern Toothache - Dr. Santos Cortez

As long as there have been humans, there have been toothaches. Throughout various cultures in ancient times, people believed that the pain in their teeth was caused by a toothworm – a literal worm that found its way into their mouth and bored deep into their teeth. In the eighteenth century, the myth of the toothworm died out, and today we understand the exact causes of toothaches and how to treat the pain involved.

Any pain originating inside the tooth indicates that the nerve of the tooth is irritated. The most common source of this kind of toothache is a cavity, or a hole in the outer layer of the tooth caused by decay. Other common sources of toothache include a broken or cracked tooth, an abscess, an exposed root, an impacted tooth, an erupting tooth, temporomandibular jaw disorder (TMJ), and gum disease. In rare cases, a toothache can be a symptom of a problem outside of the mouth, such as an ear infection, a sinus problem, or even heart disease.

Toothache pain can range from sharp and brief to dull and extended. It may be intensified with exposure to hot, cold, sweet or sour foods. For temporary relief until you can make it in to our office, try the following:

* Rinse your mouth with warm water to clean it out
* Carefully remove any particles from between your teeth with dental floss
* Take aspirin, ibuprofen or acetaminophen to ease the pain (Important: never put aspirin, ibuprofen or acetaminophen directly in contact with your gums; this can damage your gum tissue)
* Avoid extremely hot, cold, sweet, or sour foods
* Apply an over-the-counter numbing gel to the tooth
* Soak a cotton ball or swab in clove oil (available in most pharmacies) and bite down on it

A toothache is a symptom of a dental or other kind of medical problem, so make an appointment with us immediately. We can conduct a complete examination, including x-rays if necessary, to determine the cause of your toothache.

Because cavities are a very common cause of toothache, the best way to avoid one is to maintain your oral hygiene with daily brushing and flossing and regular visits to our office for professional cleanings and examinations.

At Pediatric Dental Specialists, we take the anxiety out of dentistry and orthodontics. But don’t take our word for it, see what our patients have to say!My son is very comfortable with the doctors, they have an extremely kid friendly atmosphere
-Michael K.

I love Dr. Cortez and how he provides information that I am able to understands. I have referred so many people over to Dr. Cortez, because I know that they will love his work. He takes pride in working with children. He makes you feel welcome
-Ryan K.

My kids are taken care of by specialists in an environment where they are looking out for them--not trying to figure out how to charge me for more things. The staff is very kind and polite with all of us!
-Martha G.

It is a very comfortable environment for both me and my son, who is 2 1/2. I trust the staff and they are all very friendly.
-Michael E.

The office is able to work with children with special needs. The staff takes the time to explain things when I have questions. I like the personalized book they gave my children when they were new patients.
-Sean A.

Dr. Cortez makes my daughter excited about dental care. She loves coming for her appointments.
-Sonora O.

Very kid friendly office and staff with an excellent reputation for being one of the best.
-Dawn S.

Dr. Cortez and his staff have always been great! I have been coming here since I was a little tyke and it is always great. In two words: THEY ROCK !!!!!
-Andrew T.

Dr. Santos is incredible. I have recommended him to several friends.
-Micha C.

I'm new and was very impressed by the atmosphere and the friendly staff and dentist. But, the most important thing was that my daughter felt comfortable. This website is just the icing on the cake! Great idea...
-Lori M.

Scheduling Your Appointment with Pediatric Dental Specialists

Our office makes every effort to accommodate your schedule. However, we strongly recommend that preschool and young children be seen in the morning because they are usually more rested, cooperative and attentive. School-aged children that require extensive dental treatment should also be seen in the morning for the same reasons.

Please be advised that a dental appointment is an excused absence. When possible, we will schedule older children and teens first thing in the morning or after school. We realize that as parents you do not want your children to miss an excessive amount of school so we also offer appointments during some school holidays and vacations.

Meet the Staff of Pediatric Dental Specialists!

Our staff is a strong team of compassionate and highly trained individuals who are committed to life-long oral health for our patients. You will find each of them caring and knowledgeable.

This team is made up of clerical and clinical staff. The clinical staff members are registered dental assistants and are certified with coronal polishing and x-ray licenses by the Department of California- Department of Consumer Affairs. They take over 25 hours of Continuing Education to renew their licenses in a variety of topics, including Cardiopulmonary Resuscitation and Infection Control. Our staff, besides having the professional training, also possess the practical experience of being parents.