Pediatric Dentistry

Everything a growing smile needs, from the first tooth through the teen years: gentle checkups and cleanings, fluoride treatments and protective sealants, cavity prevention and tooth-colored fillings when needed, and friendly guidance so both kids and parents know what to do at home. Visits are kept short, calm and positive.

By the first birthday, or within six months of the first tooth appearing. That first visit is deliberately short and mostly about familiarity: a lap exam with the child facing you, a look at the teeth and gums, and a conversation with the parent about brushing, bottles and what comes next.

Nobody expects a one-year-old to sit obediently in a dental chair, and the visit is not a failure if there are tears. The point is that the child learns the place is ordinary and safe before anything needs doing. Children whose first visit is an emergency at five, in pain, learn the opposite lesson and often carry it into adulthood.

As children get older the visits grow with them: sitting in the chair alone, counting teeth, a polish, then X-rays when the back teeth start touching and fluoride varnish at the end. Each new thing is introduced before it happens, in words a child understands.

Yes, more than most people assume. Baby teeth hold the space for the adult teeth forming above them, guide those teeth into position, and are needed for chewing and speech. A baby tooth lost early to decay lets neighbors drift into the gap, which causes crowding later.

Decay in baby teeth also hurts in exactly the way it does in adults, and the nerve is proportionally closer to the surface, so a cavity reaches it sooner. An abscessed baby tooth can additionally damage the permanent tooth developing directly underneath it.

The last baby teeth are not lost until around age twelve, so a back baby tooth filled at six is doing a job for another six years. That is the honest answer to whether it is worth treating.

By going at their pace and never springing a surprise. We explain each step in plain words before it happens, let the child hold and feel the instruments, keep the first visits short and positive, and stop if they need a break. Nothing builds fear faster than something happening without warning.

Parents can help more than they realize, mostly by what they do not say. Words like hurt, needle, drill and shot are worth avoiding even in reassurance, because "it will not hurt" plants the idea. Describing a visit as something to be brave about does the same thing. Treating it as unremarkable works far better.

It also helps to book a young child for the morning, when they are rested, and to avoid promising a reward for being good, which frames the visit as an ordeal. If your child has had a bad experience somewhere else, tell us before the appointment rather than in the waiting room, so we can plan a slower first visit with nothing clinical attempted.

Brush twice a day with a fluoride toothpaste in the right amount for their age, supervise until around age seven or eight, keep sweet drinks to mealtimes, and seal the permanent molars when they arrive. Those four things prevent the large majority of childhood decay.

1. Toothpaste amount. A smear the size of a grain of rice under three; a pea-sized amount from three to six. Encourage spitting rather than rinsing.
2. Supervise the brushing. Children do not have the manual control to brush effectively until around seven or eight. Let them go first, then you finish the job.
3. Drinks are the usual culprit. Juice, squash and sports drinks sipped through the day are a constant acid attack. Water and milk between meals.
4. No bottle in bed. Milk or juice pooling around the upper front teeth overnight causes a distinctive and severe pattern of early decay.
5. Sealants on the new molars. Placed around six and twelve, when the grooves are deepest and brushing least reliable.
6. Keep the checkups. Six-monthly for most children, more often if they are high risk.

Thumb-sucking is normal in infancy and usually harmless if it stops by around age four; beyond that it can push the front teeth forward and change the bite. Teething is managed with cold and gentle pressure rather than gels. For any contact sport, a custom mouthguard is the single best protection.

On teething: a chilled, not frozen, teething ring and a clean finger rubbed on the gum help more than numbing gels, some of which are not recommended for infants. Mild irritability and disturbed sleep are normal; a high fever is not teething and should be checked by a doctor.

On sports, a store-bought boil-and-bite guard is better than nothing but fits poorly and is often not worn because it is bulky and hard to talk through. A custom guard is made from a model of the child's mouth, fits properly, and therefore actually gets worn. Given what replacing a knocked-out front tooth involves over a lifetime, it is among the best value dentistry there is.

Around age seven, when the first permanent molars and front teeth are in place and the shape of the bite becomes readable. Most children need nothing at that point. A minority have a crossbite, severe crowding or protruding front teeth where guiding growth early makes later treatment shorter or unnecessary.

We check this at ordinary checkups rather than making it a separate event, so by the time a decision is needed you have been hearing about it for a while instead of being presented with a surprise. Our orthodontics page explains early treatment, aligners and braces in more detail.

Because a child who is not afraid of the dentist becomes an adult with healthy teeth. Our team is patient with nervous little ones, focuses on prevention and education rather than drilling, and treats the whole family under one roof, so a parent’s checkup and a child’s first visit can happen the same morning.

Our warm, patient team knows how to put little ones at ease. We focus on prevention and education, helping your child build great habits early — and we welcome the whole family under one roof.

Being a general family practice also means continuity. The same team that sees your child at three sees them at thirteen and at thirty, with one record of how their mouth has developed. Dr. Sean Sayyar has practiced in the Richmond area since 1998 and holds Mastership of the Academy of General Dentistry. The office is at 5231 Hickory Park Drive, Suite E, Glen Allen, with free parking directly outside.