What do I do if my child knocks out a Permanent Tooth?

If possible, find the tooth.  Handle it by the crown, not by the root.  You may rinse the tooth with water only. DO NOT clean with soap, scrub or handle the tooth unnecessarily.  Try placing the tooth back in the socket. Have your child hold the tooth in place by biting on a gauze. If you cannot reinsert the tooth, place the tooth in a cup containing the patient’s saliva or milk.  Then call your Pediatric Dentist at 813-907-3100.

What do I do if my child knocks out a Baby Tooth?

Contact Pettinato Children’s Dentistry during business hours at 813-907-3100.  Unlike a permanent tooth, the baby tooth should not be replanted due to possible damage to the developing permanent tooth.  This is not usually an emergency, and in most cases, no treatment is necessary.

What do I do if my child chips or fractures a permanent tooth?

Contact Dr. Pettinato at 813-907-3100 immediately.  Rinse the mouth with water and apply cold compresses to reduce swelling.  Quick action can save the tooth, prevent infection and reduce the need for extensive dental treatment.

What do I do if my child has a toothache?

Rinse the mouth thoroughly with warm water and use dental floss to Gently dislodge any food caught between the teeth.  If the pain still exists, contact Pettinato Children’s Dentistry at 813-907-3100.

What do I do if my child has a cut or bitten tongue, lip or cheek?

Clean the area gently with water and apply ice or a cold compress to the injured areas.  If there is bleeding, apply firm but gentle pressure with a gauze or cloth. If bleeding cannot be controlled by simple pressure, call a doctor or visit the hospital emergency room.

Cold or canker sores

Over-the-counter medications will usually provide temporary relief. If the source persists, call our office on the phone.


General Information


How Do I Brush My Teeth?

Use a toothbrush with soft bristles. Use the appropriate amount of fluoridated toothpaste for the child's age. From age 6 months to 35 months they should use a smear, or grain of rice size of toothpaste. From 36 months and up they should use nothing more than a pea-sized amount.

Place the toothbrush at a 45° angle aiming towards the gums. Move the toothbrush back and forth gently in short tooth wide strokes. I like to tell the kids to pretend that it's a marker and to make sure to color all the surfaces of the teeth front and back and top.

The AAPD most recent guidelines recommend that we try not to rinse with water after brushing to allow the fluoride vitamins to soak into the enamel of the teeth. The key to this is using less toothpaste as described above. By using a whole lot of toothpaste as the TV commercials show us we end up having to rinse with water because we gag otherwise. Finish by brushing the tongue to help freshen breath and remove bacteria.

Brushing Technique by Colgate


How do I Floss my Teeth?

For areas between the teeth that the toothbrush can't reach, dental floss is used to remove food particles and plaque. For older kids that won't suck or chew  on the dental flosser we recommend the flosser by Reach. When purchasing dental floss make sure to purchase the thicker floss types, the thinner the floss is, the more it stabs the gums when you're flossing. Try it yourself, it really does. It is important to floss behind every tooth. I recommend when flossing that the dental floss go all the way down to the gum line and hug each side of the tooth and then to pull the floss out at an angle. more food comes out this way than if you pull the dental floss straight up. Remember to make sure you are flossing before going to bed! At night our mouth is more dry and the food left between our teeth causes more damage.

Daily Flossing Technique by Colgate


Why Are the Primary Teeth Important?

It is very important to maintain the health of the primary teeth. Neglected cavities can and frequently do lead to problems which affect developing permanent teeth. Primary teeth, or baby teeth are important for proper chewing and eating, providing space for the permanent teeth and guiding them into the correct position, and permitting normal development of the jaw bones and muscles. Primary teeth also affect the development of speech and add to an attractive appearance. While the front 4 teeth last until 6-7 years of age, the back teeth (cuspids and molars) aren’t replaced until age 10-13.


Eruption Of Your Child's Teeth

Children’s teeth begin forming before birth. As early as 4 months, the first primary (or baby) teeth to erupt through the gums are the lower central incisors, followed closely by the upper central incisors. Although all 20 primary teeth usually appear by age 3, the pace and order of their eruption varies.

Permanent teeth begin appearing around age 6, starting with the first molars and lower central incisors. This process continues until approximately age 21.

When Will My Baby Teeth Come In by the American Dental Association


Thumb Sucking

Child sucking thumb Sucking is a natural reflex and infants and young children may use thumbs, fingers, pacifiers and other objects on which to suck. It may make them feel secure and happy, or provide a sense of security at difficult periods. Since thumb sucking is relaxing, it may induce sleep.

Thumb sucking that persists beyond the eruption of the permanent teeth can cause problems with the proper growth of the mouth and tooth alignment. How intensely a child sucks on fingers or thumbs will determine whether dental problems may result. Children who rest their thumbs passively in their mouths are less likely to have difficulty than those who vigorously suck their thumbs.

Children should cease thumb sucking by the time their permanent front teeth are ready to erupt. Usually, children stop between the ages of two and four. Peer pressure causes many school-aged children to stop.

Pacifiers are no substitute for thumb sucking. They can affect the teeth essentially the same way as sucking fingers and thumbs. However, use of the pacifier can be controlled and modified more easily than the thumb or finger habit. If you have concerns about thumb sucking or use of a pacifier, consult your pediatric dentist.

A few suggestions to help your child get through thumb sucking:

Children often suck their thumbs when feeling insecure. Focus on correcting the cause of anxiety, instead of the thumb sucking.

Children who are sucking for comfort will feel less of a need when their parents provide comfort.

Reward children when they refrain from sucking during difficult periods, such as when being separated from their parents.

If these approaches don’t work, remind the children of their habit by bandaging the thumb or putting a sock on the hand at night. Your pediatric dentist may recommend the use of a mouth appliance.


Bad Breath

There are a number of reasons you might have dragon breath. While many causes are harmless, bad breath can sometimes be a sign of something more serious.

What causes bad breath? By the American Dental Association


Does Your Child Grind His Teeth At Night? (Bruxism)

Parents are often concerned about the nocturnal grinding of teeth (bruxism). Often, the first indication is the noise created by the child grinding on their teeth during sleep. Or, the parent may notice wear (teeth getting shorter) to the dentition. One theory as to the cause involves a psychological component. Stress due to a new environment, divorce, changes at school; etc. can influence a child to grind their teeth. Another theory relates to pressure in the inner ear at night. If there are pressure changes (like in an airplane during take-off and landing, when people are chewing gum, etc. to equalize pressure) the child will grind by moving his jaw to relieve this pressure.

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 negatives to a mouth guard are the possibility of choking if the appliance becomes dislodged during sleep and it may interfere with growth of the jaws. The positive is obvious by preventing wear to the primary dentition.

The good news is most children outgrow bruxism. The grinding decreases between the ages 6-9 and children tend to stop grinding between ages 9-12. If you suspect bruxism, discuss this with your pediatrician or pediatric dentist.


How do I Prevent Cavities?

It is much simpler and less expensive to prevent tooth decay than to repair or replace a decayed tooth. What we eat and how often we eat are crucial factors in limiting the exposure of decay causing acid on our teeth.

Brush your teeth at least two times a day with a fluoride toothpaste and floss between your teeth at least once daily, preferably before bedtime.  Eat a healthy diet, limiting snacking and sipping on sugary drinks. See your dentist for regular checkups. Have dental sealants applied to your teeth.  See your dentist for professional fluoride applications along with prescription fluoride toothpaste and supplements. Sugar-free candies and gum containing xylitol help neutralize plaque acids and kill tooth decay causing bacteria.  It is recommended to eat these after meals when you are unable to brush and floss or throughout the day for added help.

*Keep xylitol containing candies away from your family dog it can kill your dog if ingested in large quantities. Dogs cannot digest xylitol.*


My child has a permanent tooth growing in behind his/her baby tooth.

This is a very common occurrence with children, usually the result of a lower, primary (baby) tooth not falling out when the permanent tooth is coming in.  In most cases if the child starts wiggling the baby tooth, it will usually fall out on its own within two months. If it doesn't, then contact Pettinato Children’s Dentistry at 813-907-3100, where we can easily remove the tooth.  The permanent tooth should then slide into the proper place. 


Pettinato Children's Dentistry
5252 Village Market
Wesley Chapel, FL 33544
Phone: 813-461-5772
Fax: 813-907-3110
Office Hours

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