Search Results for:

Dr. Proia

 

Dr. Proia was born and raised in Sarnia, Ontario, attended Western University for her undergrad and then went to Boston University for dental school and completed her pediatric dentistry residency in Brooklyn, NY. For the past 1.5 years she has been working in a private practice in the GTA.

Dr. Proia is looking forward to moving closer to her roots so she can serve and give back to the surrounding communities. She and her husband recently welcomed their daughter, Karina, into their world this past August and since having a child, Krizia feels she is better able to appreciate pediatric dentistry from a different perspective.

MOLAR INCISOR HYPOMINERALIZATION

Molar Incisor Hypominerilization

Molar Incisor Hypomineralization (MIH) is a common developmental condition affecting primarily one or more first permanent molars. The central incisors may be affected as well, but this usually occurs to a lesser extent

Currently, the etiology of MIH is still unknown. Some correlations with prenatal, perinatal and postnatal illness, exposure to antibiotics or chemicals such as dioxin, bisphenol A and polychlorinated biphenyl have been described, but sufficient evidence is still lacking.

 

Symptoms:

  1. Hypersensitivity and decreased response to local anesthesia
  2. Rapid caries progression
  3. Posteruptive breakdown

Clinical management of MIH is challenging due to:

  1. Hypersensitivity and rapid development of dental caries in affected teeth
  2. Difficulty in achieving anesthesia
  3. Limited cooperation of the young child
  4. Repeated marginal breakdown of restorations
  5. Often, an increased number of dental visits is required
MIH

Teething

Tips for soothing sore gums

Is your teething baby keeping you up at night? Understand how to soothe sore gums and care for your baby’s new teeth. Drooling, crankiness and tears can make teething an ordeal for babies and parents alike. Here’s information to help ease the pain — for both of you. Now go out and try to get some sleep! 

What’s typical? Again nothing is really typical but this should act as a guideline for information. Please do not compare your children or friends’ kids as everyone teethes differently and develops differently. 

Although timing varies widely, babies often begin teething by about age 6 months. Many times we think it is teething when in fact it is not. I have three girls who did not get teeth until 10 months to 14 months. Each was different and each had different issues. The two bottom front teeth are usually the first to appear, followed by the two top front teeth.

Classic signs and symptoms of teething include:

Excessive drooling

Chewing on objects

Irritability or crankiness

Sore or tender gums

Slight increase in temperature — but no fever

I have also noted diarrhea but many doctors don’t believe that is a sign. For me it is anecdotal but still, it happens. 

Many parents suspect that teething causes fever and diarrhea, but researchers say these symptoms aren’t indications of teething. I will beg to differ on this contrary to popular beliefs.  If your baby has a rectal temperature of 100.4 F (38 C) or diarrhea, talk to the doctor.  If you are not sure then please call your physician and perhaps have a visit to ensure that you are correct.  

What’s the best way to soothe sore gums?

If your teething baby seems uncomfortable, consider these simple tips:

Rub your baby’s gums. Use a clean finger or wet gauze to rub your baby’s gums. The pressure can ease your baby’s discomfort.

Keep it cool. A cold spoon or chilled — not frozen — teething ring can be soothing on a baby’s gums. To avoid cavities, don’t dip these items in sugary substances. Many parents do this and this can only contribute to issues later on. Self-soothing is great and can work. 

Try an over-the-counter remedy. If your baby is especially cranky, consider giving him or her infants’ or children’s over-the-counter pain medications such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others).

What treatments should I avoid?

To keep your baby safe, avoid using:

Over-the-counter remedies, including homeopathic teething tablets. The benefits of topical gels and teething tablets haven’t been demonstrated. In recent years, lab analysis of some homeopathic remedies found greater amounts than labeled of the ingredient belladonna, which can cause seizures and difficulty breathing.

Teething medications containing benzocaine or lidocaine. These pain relievers can be harmful — even fatal — to your baby.

Teething necklaces, bracelets, or anklets. These items pose a risk of choking, strangulation, mouth injury, and infection. I can not emphasize this enough. I am not a fan of these necklaces and yes I am neurotic so I do not want any choking or strangulation happening.  My children can discuss all their issues in therapy as they get older if need be. LOL.

Do I need to call the doctor?

Teething can usually be handled at home. Contact the doctor if your baby seems particularly uncomfortable or if teething seems to be interfering with his or her eating or drinking. Don’t panic but don’t disregard symptoms.  Especially if this is your first child.  I believe better safe than sorry and would not want to miss something. 

How do I care for my baby’s new teeth?

Run a soft, clean cloth over your baby’s gums twice a day — after the morning feeding and before bed. The cleansing can keep food debris and bacteria from building up in your baby’s mouth.

When your baby’s first teeth appear, use a small, soft-bristled toothbrush to clean his or her teeth twice a day. Until your child learns to spit — at about age 3 — use a smear of fluoride toothpaste no bigger than the size of a grain of rice. Then switch to a pea-sized dollop as your child approaches 2 to 3 years of age.

It’s also time to think about regular dental checkups. The American Dental Association and the American Academy of Pediatric Dentistry recommend scheduling a child’s first dental visit at or near his or her first birthday.

Remember, regular childhood dental care helps set the stage for a lifetime of healthy teeth and gums.

This below maybe a great form for you to use and to reprint or post 

When teething starts

Generally speaking, most babies begin teething somewhere between 4 and 7 months of age. But some children may begin teething earlier or later than this window.  Please do not compare your children. Everyone does things at their own pace. Eventually, they all catch up. Let’s not be competitive either. 

How to tell if it’s teething pain-causing nighttime trouble

Typically, you’ll know if your baby’s nighttime restlessness is due to teething because they’ll be exhibiting other common teething symptoms. Along with difficulty sleeping, these symptoms usually include: 

irritability/fussiness

excessive drooling

chewing

But if your baby is experiencing a rash (other than a drool rash), fever, or diarrhea, something other than teething may be the cause of their discomfort. In that scenario, you should speak with your child’s pediatrician. You should all have chosen a dentist and dental home for your children by age one. If you are not sure I would first check with the dentist and then the Pediatrician if need be. Both doctors can have varying opinions and I like to seek out the advice of both if need be.

1. Give a gum massage

Your baby’s gums are irritated and sore, which can explain the nighttime fussiness. So when they wake up crying, try offering them a cooling gum massage with a durable teething ring. 

With teething toys, make sure that they’re solid plastic rather than gel-filled, and store them in your fridge or freezer. Inspect the teething ring after every use to ensure that there aren’t any broken pieces that could pose a choking hazard.

Also, avoid teething jewelry such as necklaces and bracelets made from amber, marble, silicone, or even wood. The Food and Drug Administration (FDA)Trusted Source warns against them because they pose a choking risk.

2. Offer a cooling treat

Sore gums can really benefit from a cooling sensation. This trick is easy to use and doesn’t require any special equipment — just the foresight to keep a few washcloths prepped in the freezer so you’re not scrambling at 2 a.m.

Take a clean washcloth, soak it in water, and then place it in the freezer for at least 30 to 60 minutes. While you should make sure that there aren’t any rips or strings, these washcloths can serve a dual purpose. Along with instantly cooling your baby’s sore gums, your little one can also gnaw on them as long as they like. I also like to take a piece of a bagel, place it in the microwave, and time it for 30 seconds. It comes out soft but will then harden in a few minutes after that and it will let the child gnaw on it and soothe the pain.  

3. Become your baby’s chew toy

Depending on whether this is their first tooth or not, you might let your baby gum at your fingers. Just make sure that your fingers are clean before you let them have fun. For added comfort, dip your fingers in cool water to help calm their gums.  Babies also like to chew on a toothbrush but please make sure it is one that if the child is walking and falls the toothbrush will not go to the back of the throat and not create a major problem. they do make a toothbrush that will only be able to go back no further than the second primary molars 

Make sure your hands are clean before you stick them in your baby’s mouth, but use your fingers to apply gentle pressure on your baby’s gums. Sometimes simply rubbing the gums will be enough to give your baby sweet relief from teething pain. 

5. Wipe and repeat

While most people don’t associate drool with being uncomfortable, letting your baby sit around with a wet face all day can contribute to rashes, which adds to the discomfort at night.

Even though you can’t catch every dribble, make sure your little teether is as dry as possible during the day so they go into the night more comfortably. This would be a great time to invest in durable bibs that don’t let drool soak through to the clothes beneath them. 

6. Try a little white noise

Sometimes all you need is a bit of distraction to help redirect your baby’s attention elsewhere. While this might not work for every baby, adding a white noise machine to your baby’s nursery can help them drift off to la-la land despite discomfort.

Some white noise machines also serve as night-lights or can be controlled remotely. 

7. Consider medicine

This tip should be more of a last resort as opposed to your first soothing technique. But sometimes, if your baby is struggling to sleep, some over-the-counter medicine might be the trick you need.

 Please talk with your baby’s pediatrician first before you give it to your baby so you can confirm the proper dosage. But baby acetaminophen (Tylenol) given roughly 30 minutes before bedtime can help to block mouth pain and help your little one drift off to sleep. 

However, avoid teething tablets and topical numbing medications designed to be used on a baby’s gums. 

Often, numbing gels don’t provide sustaining relief because your baby is drooling so much that the medication is washed away. Teething tablets can contain belladonna and numbing gels can contain benzocaine, both of which have been linked with dangerous side effects in babies, says the FDA. 

8. Maintain baby’s regular bedtime routine

This might sound like a tall order, but teething — much like many other periods in your baby’s life — is a temporary situation. No matter how tempting it might be to let teething disrupt your baby’s regular bedtime routine, don’t do it.

As much as possible, stick to the routine you’ve already established and try to keep your little one as comfortable as possible so that they can fall asleep. 

9. Stay calm and carry on

Rest assured, you’re not the first parent to deal with this. And no matter how stressful it might seem, you’ll get through it! Try to maintain perspective, keep your little one comfortable, and give them extra cuddles.

The takeaway

Teething is one of those baby milestones that most parents have a love-hate relationship with. On the one hand, it’s exciting to see your little one grow and develop. But on the flip side, those first few teeth are usually when teething symptoms are at their worst and nighttime sleep is most disrupted.

Fortunately, there are things you can do to ease the discomfort and make sleep possible for both you and your baby. And if you notice a fever or rash, call your pediatrician — there may be something else going on.  Old family or home remedies have been around for ages so if you choose to use one please investigate the pros and cons of them.  Now relax and don’t stress. It is only a short period of time that this happens and kids never remember. Only parents do.   Be safe and healthy and don’t forget the dental home by age one for any advice you may need.  

 

 

About Us

What we Offer

All children, including those with special needs, are greeted and treated as unique persons and, in consultation with their parent/care giver, an individualized treatment approach is developed. Our child centred philosophy offers a range of treatment to work with anxiety including the use of sedation or General Anaesthetic dependent upon an individuals needs.

Referring Doctors

Your FIRST VISIT

Children should be seen for their first dental visit by the age of one as recommended by both the Canadian Dental Association and Canadian Academy of Pediatric Dentistry. By seeing children and infants at an early age, we can assess their risk for developing dental disease and teach good oral care to encourage a life time of oral health.

  • You will be requested to complete a questionnaire that helps us determine the best approach to care.
  • You and your child will first be seen in a family-friendly room where you will have an opportunity to discuss any concerns or questions.
  • Dr. Friedman/Dr. ARI may request that x-rays or photos be taken.
  • We are committed to providing you with the best dental care available and by providing preventative care we can help you to lower the cost of oral care.

Programs and services

We offer a range of specialized programs which go beyond just filling holes and include:

Risk Assessment and Individualized Intervention Program
Patient Guided Sensory Integration Program for Persons with Special Needs
Laser Dentistry
Sedation – General Anaesthesia
Orthodontic Assessment and Referral
Oro Myofunctional Therapy
Infant Oral Care

Our goal is to help you identify what risk factors may be contributing to developing dental disease and what measure can be taken to reduce that risk…

Pediatric Oral Health & Dentistry

389 Hyde Park Road
London, ON N6H 3R8
Tel:519-679-9860
Fax: 519 657-9984
e-mail:mail@dentistryforkids.ca

Sedation General Anaesthesia

Nitrous Oxide (Laughing Gas)

Pediatric dentists know that all children are not all alike! Every service is tailored to your child as an individual. Sometimes, however, a child feels anxious during treatment. Your child may need more support than a gentle, caring manner to feel comfortable. Nitrous oxide/oxygen is a safe, effective technique to calm a child’s fear of the dental visit.

Nitrous oxide is very safe. Nitrous oxide/oxygen is perhaps the safest sedative in dentistry. It is non-addictive. It is mild, easily taken, and then quickly eliminated by the body. Your child remains fully conscious and keeps all natural reflexes when breathing nitrous oxide/oxygen. Our staff will give you any specific instructions concerning eating or any other specifics concerning the visit. Please inform our staff about any respiratory condition that makes breathing through the nose difficult for your child. It may limit the effectiveness of nitrous oxide/oxygen. Also inform us if your child is taking any medication on the day of the appointment.

Nitrous oxide/oxygen is not effective for some children, especially those who have severe anxiety; nasal congestion, extensive treatment needs, or discomfort wearing a nasal masks. Our doctors have comprehensive specialty training and can offer other sedation methods that may be right for your child.

Sedation Dentistry

Pediatric dentists recognize that there exists a patient population for whom routine dental care using non-pharmacologic behavior management techniques or nitrous oxide alone are inadequate due to their need for extensive treatment, acute situational anxiety, uncooperative age-appropriate behavior, immature cognitive functioning, disabilities or medical conditions.

In these situations, our doctors and staff will discuss with you the option of sedation dentistry. 

Oral Conscious Sedation

Our doctors may recommend Oral Conscious Sedation. Often referred to as a “drink,” oral conscious sedation is a drink that your child will take in our office prior to their dental treatment. This technique is intended to induce a cooperative, yet conscious state in an otherwise uncooperative child. The medication regiment will be custom tailored to your child’s specific age, weight, and dental needs.

The goals of sedation are;

  • provide the most comfortable, efficient, and high-quality service for the patient
  • to control inappropriate behavior on the part of the patient that interferes with such provision of care
  • to thus produce in the patient a positive psychological attitude toward future care
  • to promote patient welfare and safety. For many children, oral conscious sedation is a pleasant and positive experience

For a small percent of patients, oral conscious sedation may be ineffective due to their extensive dental needs and/or inadequate response to oral sedative medications. Under these circumstances, General Anesthesia may be recommended.

General Anesthesia

For some patients with complex medical conditions, extensive dental needs or failed oral conscious sedation, it may be necessary, based on the recommendation of your child’s physician, that their treatment would best be completed in a hospital setting under general anesthesia. In this case, the Doctors would refer you to the appropriate facility.

Please feel free to contact us if you need additional information or have questions regarding General Anesthesia procedures.

Weaning from the Pacifier

Many parents are thankful for the invention of pacifiers that can help calm and soothe fussy babies. Infants often use a pacifier or suck on a thumb for comfort, security or simply as a method to make contact with the world. In fact, some babies begin to suck on their fingers or thumbs even before they are born! 

Why does this matter?

The sucking reflex is completely normal and many children will stop sucking on thumbs, pacifiers or other objects on their own between 2 and 4 years of age.  Frequent pacifier use over a longer period of time can affect the way a child’s teeth bite together and the growth of the jaw. The upper teeth may tip outward or become crooked and other changes in tooth position or jaw alignment could occur. Intervention may be recommended for children beyond 3 years of age. The earlier a child can stop a sucking habit, the less chance there is that it will lead to orthodontic problems down the road.

My child won’t give up their pacifier – what do I do?

Some parents swear by cold turkey, while others have gradually weaned their children off pacifiers. Below are some techniques that will help your infant give up the Binky for good. But no matter which route you take, remember that as the experts in little teeth, pediatric dentists will be an invaluable resource for guidance and recommendations on the best approach to quit the pacifier.

Offer an alternative

What causes your child to cry out for their beloved Binky? Once you’ve identified which situations trigger your child’s desire for a pacifier, be ready to replace it with comfort and reassurance. It can be helpful to swap out the pacifier with a transitional object such as a cuddly doll or stuffed toy. Additionally, distracting your child with a fun activity can help take their mind off the desired Binky. Be sure to offer positive reinforcement and praise when your child sleeps through the night or self-soothes without his pacifier.

Time to get creative

If you’re still running into roadblocks, it’s time to put a creative spin on the “bye-bye Binky” process. One idea is to take your child and pacifier to the store to pick out a new toy to replace their pacifier. There are many experienced store clerks who are used to this trick and are willing to play along when your child “trades in” the pacifier for a new toy of her choosing. Other parents have thrown a “Goodbye Binky” party, set out the pacifier for the Binky Fairy or donated the Binky to children who need it.

Use a countdown

If your child is resisting the idea of losing his or her pacifier, try making the process into a game. Similar to the graphic shown on this page, create a countdown game where you tell the child that over the next three to four weeks Binky will be shrinking. The first week, cut a very small hole in the top of the pacifier. Be careful to make clean cuts that do not leave any part of the pacifier hanging which could break off in your child’s mouth. Continue to cut a portion of Binky off each week until there is no longer anything left for your child to suck on. This is a great way to separate your child’s association from someone taking the pacifier away to the pacifier just breaking on its own. At the end, you can tell your child it’s time to bid Binky bye-bye.

Timing is key

Whether you decide to gradually wean or go cold turkey, make sure to time it right. Try not to take away the pacifier during life changes, major transitions or traveling so as not to put further stress on the process. Once you’ve made the plan to ditch the pacifier, make sure all caregivers are on board and stick with it! If you choose to gradually remove the pacifier, try limiting use to nap time and bed time at first. Or, let your child use the pacifier for short periods of time if you feel he particularly needs it, and gradually shorten the frequency and length of time the pacifier is used.

If you decide to go cold turkey, be sure to collect all pacifiers around the house – the last thing you need is your little one finding a pacifier the week after she gave it up and going back to square one! If you need additional ideas on how to wean your child off the pacifier be sure to ask your pediatric dentist or visit mychildrensteeth.org for further tips and a pediatric dentist locator to find a pediatric dentist near you.