FAQ - JEFFREY GINSBERG, DMD - Pediatric Dentistry, Yorktown Heights, NY -Tel. 914-245-1670

Ideally, we like to first see a child when the first tooth is erupting in the mouth (see "First Tooth-First Visit" section). This usually occurs between 6 to 12 months of age. We then like to check your child at age 1, followed by a clinical examination at age 2. (see "What to Expect" section). By age 3, most children have all their primary or "baby" teeth present and are emotionally ready to have a full examination, cleaning, and fluoride treatment. From that point on we will schedule a recall exam at least every 6 months for your child. Prevention is the key!

While it is true that your child will lose all their baby (primary) teeth, this will happen over a very long time period. There are baby teeth present in your child’s mouth until sometime between 11 and 15 years old. The baby teeth are essential for your child’s eating and speaking, visual appearance, as well as for laying the foundation for the proper growth and development of their permanent teeth. If a baby tooth is lost prematurely, the other teeth can shift and move and not allow the new teeth to grow in properly. An untreated cavity can lead to an infection in your child’s mouth causing pain, swelling, and possibly damage the permanent tooth.

Teeth need to be brushed and cleaned as soon as they erupt in the mouth. In my practice, we have many children under age 3 with cavities. Most children under 3 do not like anything or anyone in their mouth except for food (and of course, small objects that you do not want in their mouth)!

To make tooth brushing a little more palatable (no pun intended!) I often advise parents to move it out of the bathroom and into the living room or family room with music or a video playing as a distraction. The best way is to sit the infant or child on one parent’s lap and lay his or her head back on the other parent’s lap. One parent can hold the child’s hands and amuse the child while the other parent brushes the teeth. Don't worry, it is perfectly normal for a 16-month-old to cry and squirm when you are brushing his/her teeth. In fact, it is perfectly normal for a 16-month-old to cry when you are simply looking in his/her mouth! If this is hard to do, have the child hold a toothbrush with a parent’s hand guiding the brush while reading a story or watching a video. Teeth should be cleaned twice a day; in the morning and especially before the baby is put to bed for the night. If the wrestling match is becoming too much for you, make sure you brush at least once a day before bedtime. I cannot stress enough how important this is for the health of you and your baby.

The most common cause of early decay is from sleeping at night with a bottle containing milk, juice, or formula. I have had infants as young as 6 months old showing signs of Baby Bottle Tooth Decay (Nursing Caries). The best way to prevent this is to brush daily and not give your child juice or milk right before bedtime. If your child likes a bottle or breast, try to give it prior to brushing and then offer a bottle of water before bedtime. As soon as the teeth appear in a baby’s mouth, they must be cleaned daily. When a baby falls asleep with a bottle, the sweet liquids bathe the teeth all night long. The tongue protects the lower teeth but the upper teeth will often show lots of severe decay. Such decay often requires many fillings or even, crowns (caps)!

How do you handle a “difficult” child or a child that requires special emotional or physical support?

A “difficult“ child in a general practice setting is not always problematic in a pediatric setting. We provide a unique “kid friendly” physical environment along with our specially trained staff. In most cases, this produces a positive and cooperative response from the child. However, there are times that a child is simply too afraid to cooperate. There are two schools of thought on how to handle this issue. One way is to sedate or place the child under general anesthesia to complete the work. An alternative approach (which I prefer) is to use some form of physical restraint to avoid the use of sedation. I have been very successful treating unmanageable patients in my office with the use of a papoose restraint complemented with 2 well-trained team members assisting during each case. We allow the parent(s) in the room and with the use of a papoose restraint and mouth prop, all the required restorations are completed in one visit. Nitrous oxide analgesia, topical and local anesthesia, is used to very safely complete the required treatment. I have performed thousands of cases in this manner. Several of my best and cooperative patients, who are now grown, were treated with a papoose when they were younger. I feel very confident and truly believe that we are providing the safest and best possible care for these “difficult“ patients that cannot tolerate conventional treatment.

I have not utilized sedation or general anesthesia in over 20 years of private practice, though I have extensive experience in its use. During my pediatric post-graduate training, I performed many sedations and procedures under general anesthesia at Beth Israel Medical Center. The chance of a child undergoing permanent damage or dying from these procedures is minimal, but does exist. Every year in this country, there are a number of children who die under sedation or general anesthesia for dental treatment. I cannot comfortably rationalize putting a child’s life at risk for dental decay.

Fluoride is an essential element in preventative dentistry. It is important for your child’s growth and development. It works in two different ways. Internal fluoride, which we get from water that is fluoridated or by taking fluoride vitamins, is incorporated into the enamel of teeth that are forming. Fluoride makes them harder and more resistant to decay. The current recommendation by the American Academy of Pediatric Dentistry is for supplemental fluoride to be provided for children from 6 months of age until 16 years old. External fluoride that we get from our toothpaste, fluoride rinses, and fluoride treatments in our office, help strengthens the teeth that are already present in our mouth and fight decay. External fluoride is very important for healthy teeth but we want to prevent ingesting this external fluoride as much as possible. Excessive amounts of either internal or external fluoride can be unhealthy for your child. (Also remember, not all tap water in our homes contain enough fluoride.) In our office, I prescribe the correct dosage of fluoride for your child. My staff and I will also discuss with you the proper ways to prevent giving your child too much fluoride. If we can be pro-active, we can reduce a lot of decay!

There are several factors that cause a tooth to decay, or get a cavity. One factor we have no control over is genetics. There appears to be an inherited component to decay. When a child has a high decay rate, almost always one of the parents has a history of “bad teeth”. While the average 4 year old has 4 cavities in our country, we see many young children without any cavities as well as young children with many more than 4 cavities. But don't fret… with regular check-ups and maintenance we can keep your child’s potential decay hopefully to a minimum.

Another factor that contributes to tooth decay is diet. We all know that candy, sweets, soda, and junk food are bad for our teeth. But any starch, sugar, or carbohydrate, can cause cavities. There are many healthy foods and drinks, for example, milk, juice, fruits, and pasta, that have sugar and carbohydrates. These too, can cause decay in your child’s tooth. So apart from limiting the amount and frequency of eating and drinking sweet treats, diet is also hard to control. Of course it is important to still enjoy your favorite yummy foods! It is unreasonable to think that we can give up all starches and sugars. The factor that we have the most control over is oral hygiene, or cleaning our teeth. Teeth must be brushed before bed to remove all the plaque and starches from a long day of eating and drinking. Teeth should also be cleaned in the morning, when your child wakes up. And of course, you should be taking your child to our office at least every six months for an examination, cleaning, fluoride treatment, and diagnostic X-rays. When teeth are not cleaned, and these sugars sit on them, the bacteria that we all normally have in our mouth digest the sugars, make acids, and break down the teeth and cause cavities.

The most important part of a healthy diet is balance. Your child should eat a balanced diet of meat, fish, chicken, fruits, vegetables, and starches. Children tend to eat a diet heavy in starches so try your best to balance it out. Another important factor in a healthy diet for your child’s general health and their teeth is drinking lots of water. Water is really the only true sugar-free liquid that not only will not damage the teeth but will actually clean them.

The best way to try to help your child remain cavity-free is very simple. Try to have your child snack in moderation. Pay special attention to what food is being eaten and how often it is consumed. Brush effectively, at least twice a day, with fluoride toothpaste (or at least before bedtime for young infants). Take advantage of fluoride through mouthwashes and supplements, if necessary. Have sealants applied to the chewing surfaces of permanent back teeth soon after they come in for a dental visit. Visit our office at least twice a year. Follow these guidelines and your child will have the best chance of a happy and healthy smile!

Sealants are a thin, plastic coating painted and bonded on to the chewing surfaces of the back teeth. They are a good way of protecting the biting surface of a tooth from ever getting a cavity. Our back teeth, called molars and premolars, have very deep grooves where food, bacteria, plaque and sugars can get stuck. The sealant protects this groove so the sugars won't break down the hard surface of the tooth and form a cavity. Getting sealants put on is simple and painless. They are painted on as a liquid and hardened with a special light. We use a tinted white sealant so they blend with your child’s teeth yet can be checked at your child’s recall visit. Sealants generally last for several years and they have been proven to be successful at reducing cavities in children for over 20 years. But remember, Sealants are only as good as your child's brushing and diet. Sealants are an aid just like fluoride, it helps prevent decay. If your child doesn't brush or has a poor diet, he/she can get cavities in teeth that were sealed.

The tooth on the left has Sealant applied.

Why do you use digital imaging instead of traditional x-ray imaging for dental diagnosis?

We have replaced traditional X-ray films primarily to reduced radiation exposure to your child by up to 90% by utilizing the Scan X Digital Imaging system in our office. Scan X uses phosphor storage plate technology with computer enhanced digital imaging. This cutting edge technology is also easy to use with your child’s small mouth, gives us superior image quality for excellent diagnosis in addition to the smallest radiation exposure for your child available today.

An orthodontist is a special dentist that corrects your child’s mal-positioned teeth and bite with braces. We do some interceptive orthodontics (early orthodontic treatment to correct a specific problem) in our office. Most children are ready for full braces, if needed around 11 years old. However, there is a wide range of readiness with some children; ranging from those that are ready at 9 years old while others are not ready until 13 or 14 years old. We will follow your child’s growth so that we can recommend to you when your child is ready, if at all, for an orthodontic consultation. There are several good orthodontists that we work with in the area.

Glad you asked! We are located in Westchester County in Yorktown Heights, New York. A map and general directions can be found in our “Location” section.

Absolutely! We currently offer our Registration Forms and Payment Plans.
Click here for a list of available forms.

The office has established a number of flexible payment options for our patient’s families to utilize. We accept cash, check, Visa, MasterCard, American Express or Discover. We also offer an outside billing company for families who wish to break their payments up over a period of time.

We also work with Care Credit.
With Care Credit you can choose to pay your bill in either 6 or 12 payments without any interest charge. This program is paid for by our office and you can fill out forms either on line with this link http://www.carecredit.com or when you come into our office.

Dr. Ginsberg’s office is an out-of-network provider with many different dental insurance companies. Insurance is submitted after each visit. We have several options for families with insurance. You may either pay in full at your visit (and receive a courtesy discount!) or you may pay your approximate co-pay and our office will wait for your insurance reimbursement. Once we have received the check from your insurance company, you will be responsible for any unpaid balance. Please call our office to discuss the details of your specific insurance plan since each company works differently.

What to do in an emergency?

If your child has a dental emergency Dr. Ginsberg is available 24 hours a day. Simply call the office (Tel. 914-245-1670) and if it is closed, you will be given an emergency number to page Dr. Ginsberg. He will call you back as soon as possible

Do Children Still Get Cavities?

Yes they do! There is a common misconception that with all the prevention we have today with fluoride, sealents, and oral hygiene that cavities have been eliminated. Actually the opposite seems to be true with the decay rate, especially for young children on the rise (CDC article on increased dental decay). Although we do have many patients that come in every 6 months and do not have cavities, we also see many children that do still get cavities. This is why it is so important to have checkups every 6 months!