Dr. Valerie Woo grew up in the local Washington, DC area and received her undergraduate degree at University of Maryland, College Park. She went on to Harvard School of Dental Medicine where she received her DMD cum laude and completed her Pediatric Dental Residency at Children’s Hospital, Boston. Dr. Woo currently practices at NOVA Pediatric Dentistry & Orthodontics, in Ashburn, VA.
This is Part 2 of the interview with Dr. Woo. If you missed the first interview, which covered brushing and flossing, you can read it here.
When should children go to the dentist for the first time?
When the child is between one year and 16 months. A nice rule of thumb is first tooth and first birthday. The American Academy of Pediatric Dentistry recommends that children have their first visit before one year.
Pediatric dentistry is all about trying to prevent anything from ever happening. It’s not just a cleaning. I’d rather not ever diagnose cavities. I did my residency in Boston and all we saw was rampant decay. We can contribute this to both the child’s diet and genetics. The food is all fast and pre-packaged. If you look at why our children are getting sick, why they are getting cavities, you go back to their diet. It’s preventative. That’s why coming to see the dentist twice a year is preventative and so important. Your insurance covers preventative services. Once you get a cavity, it will cost you more, you’ll have to get x-rays of your child’s mouth, etc.
Sometimes people forget that doctors need to examine to make sure that everything is ok. We don’t call it “just a cleaning.”
Prophylaxis is our preventative cleaning procedure. And a “sealant” is the preventive film that we put on the molars to prevent cavities. They get the plastic coating on the 6 year molars and again on the 12 year molars. For the 1 and 2 year molars, if they have very groovy teeth then we recommend them on those. I have sealed the molars of my two older kids, ages 5 and 4.
But I don’t want to give parents the preconceived notion that just because they’ve sealed their children’s teeth that they won’t get cavities. They still need their check ups every 6 months and fluoride treatments. I get that all of the time. Parents ask, can’t I just seal all of their teeth? Sealants are for molars. And it helps prevent cavities, but it does not prevent cavities.
How often should children go to the dentist?
At least twice a year. There are some patients I see 3 or 4 times a year because their parents are very proactive and if I see something in their children’s teeth, they want to bring them in more often. Once you have decay, you’re at a higher risk of decay in the future.
What do you look for when you examine a child’s teeth?
I look for whether the enamel is healthy, how the hygiene is, whether the gums are healthy. We’re always doing an oral cancer screening. We look for any possible indications where there could be difficulty in speech, eating or brushing properly. We also look for when the skin between the teeth and top lip (frenulum) don’t allow parents to properly brush their child’s front top teeth. The frenulum could also be a barrier to nursing.
What is the most common problem you see in children under 5?
Cavities. Usually the majority of my patients with cavities are under 5. Not a lot of my older patients come in with cavities. That’s because when they’re older, they do a better brushing. We also do sealants on the 6 year molars, which helps prevent cavities. Pre-school right before entering school is where we see the most cavities.
Any tips for parents to help make the dentist’s visit a positive one?
Not to make your own fears your children’s. Children are really aware of when their parents are uncomfortable. You can tell that the parent is more worried than the child at times, probably because the parent had a bad experience at the dentist. Children can sense those things.
For more information, check out Dr. Woo’s tips for parents on how to improve the chances of a positive dental office visit via her practice’s website.
What should parents do when/if a child’s tooth is knocked out?
If it’s a baby tooth and it gets knocked out due to trauma, first thing you want to do is find the tooth. Make sure that they didn’t swallow and/or aspirate it, and do not put it back in their mouth. It could look like it got knocked out, but could have gotten shoved further up into their gums. The child will need an x-ray to determine that no part of the tooth is remaining. Make sure to bring the tooth to the dentist.
If it is a permanent tooth, that’s different. If it’s a permanent tooth and it got knocked out, you need to contact your dentist immediately. If the child feels comfortable putting it back in their mouth right way, go ahead and do that and still see your dentist. If it’s dirty after the tooth got knocked out, submerge it in milk until they can get to the dentist.
What questions do you have for Dr. Woo?