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  • Many parents don’t realize how early oral care needs to start.

    Many parents don’t realize how early oral care needs to start.

    By Melinda Wenner Moyer


    If you hear blood-curdling screams coming from my house at 7 a.m. or 7 p.m., don’t fret: I’m just brushing my 2-year-old’s teeth. It’s a traumatic endeavor for us both, and I admit that I’ve sometimes wondered: Is this really worth it? Baby teeth are just, like, temporary teeth, right?

    Then I saw some statistics on cavities in young kids and spoke with a couple of pediatric dentists, and was surprised to discover that caring for your wee one’s teeth isn’t optional—it’s essential. So is taking kids to the dentist at a very young age. Don’t worry; you can learn from my mistakes, because I’ve been doing pretty much everything wrong.

    Let’s start with the stats: Numbers of cavities among kids have been going down in general, but cavities in baby teeth have become more common over the past 20 years. Today, a whopping 60 percent of 5-year-olds have had at least one cavity; many have had five or even 10. Dental decay in kids isn’t just a nuisance—it can cause a lot of pain, and decayed teeth often have to be repaired or pulled using general anesthesia, which, as I’ve previously reported, isn’t risk-free. And when baby teeth are pulled, they can no longer do the important job of holding space for the budding permanent teeth—some of which don’t come in until age 12—so the American Academy of Pediatric Dentistry recommends that dentists fit “space maintainers” in their stead when baby teeth are lost early. Cavities in baby teeth can also harm the permanent teeth directly, if the tissue in the central portion of the baby tooth gets infected.

    There is good news, though: “Dental decay is preventable,” says AAPD president Jade Miller. When dentists see a cavity forming, they can actually reverse the process—which is in part why the organization recommends that parents bring their children to the dentist when they get their first tooth or by the time they turn 1, at the latest. (If these recommendations don’t mesh with what you’ve heard, that’s probably because the American Academy of Pediatrics used to recommend the first dental visit by age 3. But since 2003, the AAP and the AAPD have both recommended this timeline.)

    To understand how dentists work their magic, you first need to know how cavities are formed. Bacteria in the mouth feed on the sugar and carbohydrates your kids eat, releasing acid in response. This acid breaks down tooth enamel and leads to tooth decay, explaining why dentists aren’t fond of kids consuming candy and juice; sugary foods provide feasts for mouth bacteria and lead to a buildup of cavity-causing acid. (Whole fruit, though, is fine: Chewing it stimulates saliva production, which helps to keep teeth clean, and its fibrous texture stimulates the gums.)

    One way pediatric dentists can reverse burgeoning cavities is by applying a fluoride varnish to kids’ teeth, which causes fluoride to be released when the pH of the tooth drops as a result of the acid. The fluoride then helps rebuild the tooth enamel. When I finally brought my daughter to a pediatric dentist last week—those statistics on cavities really rattled me!—he didn’t even try to clean her teeth, because (surprise!) she was so uncooperative. But he did apply a quick fluoride varnish. Fluoride from drinking water and toothpaste can also get incorporated into the tooth enamel itself as it grows, thereby protecting it from future decay.

    Of course, pediatric dentists do more than just deal with cavities in young toddlers; they can determine whether kids are doing things that might put them at risk for future cavities. For instance, if you’re letting little Jaden take a bottle of milk or juice into the crib with him at night, that’s a red flag for future cavities, and a dentist would likely tell you to stop. (This is so common it has its own name: baby bottle tooth decay.)  The dentist can also check kids for signs of bigger dental or jaw problems. I got a talking-to about my daughter’s pacifier use, which is causing her to develop a gap between her upper and lower teeth. He advised me to nip her pacifier and periodically trim it more, to make it less damaging and appealing and hopefully prompt her to stop reaching for it.

    Infant visits also give dentists the chance to educate parents on what to expect during teething and how best to care for kids’ teeth. If I had taken my daughter in when she got her first tooth, I might not be suffering through daily tooth-brushing battles, because I would have been told to wipe her teeth with a washcloth each day as an infant (which I didn’t do) and to start brushing with a toothbrush at age 1 (didn’t do that either). These are habits that establish oral care as a routine early on, making kids more compliant when they hit the terrible twos. Other important advice you might not have heard: brush your kid’s teeth for them at least once a day until they turn 8 or 9—oops, my 5-year-old son has been brushing solo for at least a year!—because the fine motor skills that make for good brushing “don’t really develop until about the age when a child can begin to tie shoes or write in cursive,” Miller explains; and start flossing when your child’s teeth no longer have space between them, because then the toothbrush isn’t able to reach plaque and debris between the teeth. (Yup, cavities can form between teeth, too.)

    OK, but what if you, like me, have a kid who just won’t let you near her pearly whites? Jessica Lee, a pediatric dentist at the University of North Carolina at Chapel Hill School of Dentistry, suggests experimenting with different types of toothbrushes—maybe little Anna would prefer an electronic toothbrush to a manual one, or vice versa. IPad apps like Brusheez, a brushing timer with characters and music, may also make the task more fun. Or, try letting your kid brush your teeth while you’re brushing hers. If you still can’t get in there for more than a few seconds, Lee suggests that you put a rice grain–size amount of fluoride toothpaste on the brush or your finger and at least just get a little bit of fluoride on her teeth. (Generally, a child shouldn’t use fluoride toothpaste until she knows not to swallow it, but it’s OK, Lee says, to use a tiny amount in this way.)

    This article originally appeared on 7/29/16,

    To schedule an appointment or for more information, please visit, We have two Portland area locations to serve you.

    Baby Pacifiers: Pros and Cons

    Picture2A common question new parents are often faced with:  should you give your baby a pacifier? Using a pacifier comes with both pros and cons, according to the Academy of Pediatric Dentistry (AAPD).

    On the positive side, pacifiers provide a source of comfort to infants and can teach self-soothing. Pacifiers can also assist in reducing the incidence of sudden infant death syndrome (SIDS), according to the AAPD and American Academy of Pediatrics (AAP). While the reason why this is true is not completely understood, it is believed that because babies with pacifiers sleep less deeply than those who sleep without pacifiers, they can be aroused from a deep sleep that could result in the stopping of breathing.  Also, the bulky handle of the pacifier makes it uncomfortable for babies to accidently bury their faces into their mattresses and as a result, restricting their airways.

    On the other hand, pacifiers can affect and change the growth and development of the mouth, jaw bones, and teeth. Prolonged pacifier use can cause changes in the shape of the roof of the mouth, the width of the upper jaw, prevent proper growth of the mouth and create problems with tooth alignment. If you do choose to give your child a pacifier, these tips can help reduce its harm:

    • Restrict pacifier use to only when the infant needs to fall asleep.
    • Look for a pacifier with ventilation holes in the shield, as they permit air passage. This is important if the pacifier accidentally becomes lodged in the child’s throat.
    • Always clean the pacifier before giving it to a child.

    Breaking the pacifier habit

    The AAPD recommends that children stop using pacifiers by age two. (Up until that age, any alignment problem with the teeth or the developing bone is usually corrected or will relapse to close to the normal position within six months after pacifier use is stopped.)

    Breaking the habit is not always easy. Here are a few suggestions for helping a child wean from the pacifier:

    • Dip the pacifier in white vinegar.
    • Pierce the top of the pacifier or cut it shorter every fews days to reduce sucking satisfaction.
    • Eliminate “cold turkey”…choose an appropriate date that works for your family and get rid of the pacifiers in the house and consider replacing with a lovie or other special animal for bed time. Usually after 2-3 nights the child has adapted to their new comfort item.
    • For older children, the “Binky” or “Paci” Fairy can come and “gather up all the pacifiers to give to the new babies being born.” Make it a fun and special story, even having child go to the store to pick out a special prize that the Fairy leaves in exchange for the pacifiers.

    Always throw away a used pacifier; it is not sanitary for another child to use or to save.

    Brushing Baby Teeth – Demo

    Dr. Michelle Stafford of World Of Smiles Pediatric Dentistry in Portland, OR demonstrates brushing on a 1 year old.

    Advice on Nursing from a Pediatric Dentist

    Dr. Michelle Stafford of World Of Smiles Pediatric Dentistry in Portland, OR gives some advice to nursing mothers.

    Summer Newsletter

    Happy (almost) Summer!

    With the Summer Solstice fast approaching, we hope you are soaking up some sunshine whenever you can.

    • This Issue at a Glance:
    • Summer Schedule
    • Baby Ski + CONTEST!
    • Got Grocery bag?
    • Baby Ender gets a tooth
    • Laser Frenectomy

    Summer Schedule
    These will be the office hours for the summer:
    Monday, Wednesday, Thursday 8 – 4
    Tuesday 9 – 6
    Friday 8 – 3

    Our office will be closed July 4th and 5th for the holiday. We hope you get to enjoy some fireworks!

    Ski Baby

    In baby news, our own Dr. Ski has revealed that she is expecting a baby boy. Look for the little Ski this fall – we’ll be sure to post some photos of the bouncing babe. And now you can enter our Baby Ski contest! Go HERE to enter by guessing the arrival date and baby’s birth weight!

    Yellow Bags

    Have you seen the World Of Smiles reusable grocery bags? We will be handing one out to all new and returning patient families throughout July and August! They are very big, bright yellow, and quite sturdy. And they might just help you to remember to brush and floss!

    Ender’s first tooth

    Dr. Stafford is beyond thrilled to announce that baby Ender cut his very first tooth in May.  For all the dental nerds, his first tooth was the lower right central incisor, #P. Normally babies get their first tooth between 6-8 months of age so he is on the later end. But that’s okay as all children develop at their own rate and those “norms” are just based on averages. As a reminder, when the first tooth shows up it is a good idea to wipe the mouth out with a xylitol wipe or something similar. This should be done after the baby finishes his last meal before falling asleep for the evening. Dr. S reports that the tooth next door is seriously threatening to cut through any day – let the flossing begin!

    Laser Frenectomy

    Dr. Stafford is pleased to announce that she will now be offering laser frenectomies in the office. A fren-ect-a-what you say?! This simple procedure refers to the removal of a flap of tissue called a frenum that prevents an organ or tissue from achieving free range of motion. Dr. Stafford is most concerned with the frena in the upper lip and the one beneath the tongue. A baby with a tight frenum under their tongue is described as “tongue tied”. Untreated, both of these situations can contribute to difficulties with breast feeding, speech and oral cleansing. Please call for more information!


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