Frequently Asked Questions
Are you accepting new patients?
Always. Please call our office at (425) 392-4048 to schedule your child’s first visit with us, to schedule a tour of the office for your child, or simply ask a question.
Our office is located at 185 NE Gilman Blvd in Issaquah, WA. (map)
What is a pediatric dentist?
A pediatric dentist is like a pediatrician that specializes in the oral health of infants to teens and those with special health care needs, the growth and development of the mouth and face, prevention of dental disease and care for a child's mouth, teeth and gums throughout a child's life. One may chose to become a pediatric dentist because of their love of children, interest in being a part of a lifelong program of optimal oral health or simply because children are fun, silly, easily amused, full of life and energetic.
A pediatric dentist is required to successfully complete dental school and then obtain two years of specialized education and training in: overall child development; growth and development of the face and mouth; behavior management including the use of sedation and general anesthesia, management of traumas to the face and mouth; and the delivery of quality dental care to children. To further their commitment to the treatment of children, some pediatric dentists elect to become Board Certified.
What is a board certified pediatric dentist?
To become Board Certified, pediatric dentists are evaluated by a panel of their peers, the American Board of Pediatric Dentistry or the ABPD. The process that Drs. Liu, Lombardi and Quinby participated in to become Board Certified involved taking a written examination which evaluated their basic knowledge of pediatric dentistry, being observed while providing dental care to patients and reviewing examples of dental care previously provided to patients. The ABPD certifies that the dental care being provided is based on standards of excellence that lead to high quality oral health care for infants, children, adolescents and patients with special health care needs. Certification by the ABPD provides assurance to the public that a pediatric dentist has successfully completed accredited training and a voluntary examination process designed to continually validate the knowledge, skills and experience necessary to the delivery of quality patient care.
Drs. Liu, Lombardi and Quinby are Board Certified Pediatric Dentists committed to providing the best oral health care to their patients.
What do DDS, DMD and MSD mean?
DDS (Doctor of Dental Surgery) and DMD (Doctor of Dental Medicine) are the degrees awarded when one has successfully completed the requirements necessary for graduation from a dental school. The education received and the requirements needed to be met for graduation are the same for schools that offer either a DDS or DMD degree.
For most dental schools, one needs to complete at least three years of undergraduate studies before being accepted into dental school and then it takes four years to complete requirements for graduation.
Following completion of dental school, those students that decide to specialize in one aspect of dentistry will spend a number of years receiving additional training. Specialty programs offer certificates in that specialty and the opportunity for students to obtain a Masters Degree.
MSD is a Master of Science in Dentistry. A master’s degree is obtained from a college or university after receiving a bachelor’s degree. It can take a number of years to complete the degree depending on the courses required. A master’s degree recognizes a heightened expertise in a field of study. It is required to complete a master’s thesis before being awarded the degree.
Why should I take my child to a pediatric dentist?
As pediatric dentists, we know that many young children may have opinions about their first dental visit. Our additional training and experience has made us quite comfortable with young dental patients. The first visit at age one allows for you and your child to develop a relationship with us. You will have a place to turn to if you have a question or if your child should suffer a dental trauma.
We have training that allows us to evaluate the oral health and development of the mouth and face for children of all ages. We will make recommendations regarding timing for orthodontic care and for other appropriate intervention, establish relationships, provide education and identify problems.
When and how often should I take my child to a pediatric dentist?
Both the American Academy of Pediatric Dentistry and the American Academy of Pediatrics recognize early childhood cavities as a health problem affecting a significant number of children. We recommend that a child sees a dentist at one year of age or 6 months after the first tooth comes into the mouth. Establishing a relationship with a pediatric dentist, or a dental home, allows for parental education, early identification and treatment of tooth related problems which will minimize the potential for lengthy and costly treatment in the future.
If your child is older than one year of age, this is a great time to schedule the first dental visit. We will often recommend that your child have dental check-ups every six months, but we will tailor this time frame based on your child’s specific needs
What happens during my child’s first dental visit?
Your child’s first dental visit with our office will be an experience that we tailor to your child’s needs. If it is their first ever dental visit at a young age, the visit typically consists of an examination, discussion of findings and any treatment needs, demonstration of proper hygiene techniques and education for the parent regarding proper oral health and hygiene.
If you feel that your child will do better with preparation prior to the visit, please call our office at (425) 392-4048 for the most age appropriate guidance.
If your child has experienced dentistry in another office and this is the first visit with us, depending on your child’s needs, we will plan on cleaning the teeth, discussing hygiene and, when necessary, provide tips to improve hygiene, x-rays, examination and discussion of findings and any treatment needs.
We invite parents into the treatment area. If you would prefer to stay in the reception area, we will take great care of your child.
What treatment options are available for an anxious, fearful, or special needs child?
To help make your child comfortable, we will first use a ‘tell-show-do’ technique which helps us introduce your child to the dental tools. If treatment is necessary, we can utilize this same technique and when appropriate and necessary consider sedation or hospital dentistry.
How should I clean my child’s teeth?
We will demonstrate to you the best approach to cleaning your child’s teeth during your child’s visit. It is best that when brushing with a toothbrush, it is one that has a small head and soft bristles. It is best to floss any teeth that are in contact with one another to prevent cavities. Your child’s behavior may prevent you from putting forth your best effort. Once your child has accepted brushing, begin to introduce them to flossing.
We recommend that parents assist children with brushing until their hand dexterity matures. Often, this occurs for school aged children that have begun writing. After you have given your child the responsibility of brushing, we recommend that you still check to see that it is being done effectively.
What is the difference between toddler/child’s toothpaste?
Toddler toothpastes may also be known as training toothpastes. These toothpastes typically do not contain fluoride and are completely safe for your child to swallow. Please read the label for the toothpaste you have purchased to be sure it is safe to swallow. Most children’s toothpastes do contain fluoride. When a toothpaste contains fluoride, you want to be sure to use a pea size amount or enough to add a little color to the tips of the bristles on the toothbrush. If a young child receives too much fluoride whether it be from supplements, toothpastes, mouthwashes or from processed foods, it can result in fluorosis. Fluorosis can cause discolored or malformed enamel of the permanent teeth, but is not the only reason your child may have discolored or malformed enamel.
How can I help my child with the teething stage?
While teething, you may find your child to be mildly irritable, cry, have a low grade elevation in temperature (not greater than 100°F), have increased salivation, a desire to chew on hard things and a change in appetite. These behavior changes usually begin a few days before the tooth erupts and subside a few days after. The best treatment is time, but you can try rubbing or massaging the gums, having your child chew on a teething ring or a frozen washcloth, and use pain medication as necessary. Please do not place sweet liquids on a teething ring or pacifier.
When can I expect my child to get their first tooth?
Everyone has a different time table for teeth to come into the mouth so do not become concerned if your child’s teeth come in a little earlier or later. Typically, the lower front teeth will erupt around 6 months of age and a total of 20 teeth are usually in place by 3 years of age.
Your child will then begin losing teeth beginning around 6 years of age. There will be 8 teeth lost over the next 2-3 years while at the same time getting the first permanent molars. Between 10 - 13 years of age, your child will lose a dozen teeth (if all of the permanent teeth are present). During this time, the 12 year old molars will come into the mouth. This leaves the wisdom teeth, if present, to come into the mouth in the later teen years and early 20’s.
My child’s permanent teeth have come in, but the baby teeth have not come out. What should I do?
It is very common for children to have a permanent tooth enter into the mouth without a baby tooth falling out first. This is most common for the two lower center teeth, but can happen anywhere in the mouth. We will encourage you or your child to ‘wiggle’ on the baby tooth to help get them out of the way of the permanent tooth. In the case of the lower front teeth, the tongue will help reposition the teeth if there is enough room available.
What causes tooth decay?
There are a host of factors that are responsible for cavities to develop. If the delicate balance between these factors is disturbed, a cavity is likely to result. These factors include: your child’s diet and frequency of eating/drinking, the type and amount of saliva, the amount and type of bacteria in the mouth, hygiene frequency and effectiveness, and genetics.
The best way to prevent cavities is to get started on a good home oral health program at a young age. Try to brush at least twice daily and floss once daily. Snacks should be nutritious. Try to limit snacks that are high in sugar and starches. When appropriate, begin to incorporate products containing fluoride and/or xylitol. Consider sealants for your child’s teeth. Be sure to keep regular dental visits.
What is early childhood caries? (also known as nursing caries, baby bottle tooth decay, bottle rot or bottle mouth)
Early childhood caries (ECC) can be the result of frequent nursing either from the bottle or breast. Breast milk does contain a higher percentage of sugar than cow’s milk. ECC will typically affect the four top front teeth first, followed by the first baby molars, then the canines and the second baby molars. Last to be affected are the lower front teeth which are protected by the tongue and lip.
With frequent feeding/nursing, the tongue side of the top front teeth are continuously bathing in milk and acid produced by the bacteria. In the absence of good oral hygiene, the enamel on the tongue side of these teeth can begin to breakdown. When cavities are noticed on the lip side of the top front teeth, the cavities are usually at an advanced stage.
It will be best to avoid bottle and breast feeding in bed. Try to make sleeping and feeding two separate events. If feeding occurs close to bedtime or during the night, wipe the mouth out with a wet cloth. Try to give bottles at meal times and try to avoid using them as a pacifier. Try to avoid placing juice in the bottle. Children should be taught to drink from a cup around 1 year of age.
What is acid erosion?
When the teeth come in contact with acid, the enamel begins to lose some of its minerals (demineralization). Most of us have spit that can neutralize the acid and help remineralize the teeth. The process can be assisted by the use of fluoride and/or xylitol.
The acids that come into contact with teeth are in some of the beverages that we drink, such as fruit juice, sports drinks, diet and regular sodas and energy drinks and then from the by-products of the bacteria fermenting the sugars in these and other foods and drinks.
Athletes, at times, may have heavy mouth breathing which will reduce the amount of spit available to neutralize the acids found in the beverages consumed to maintain hydration.
When consuming beverages known to have a low pH or high acid content and/or are high in sugars, you can reduce the chance of acid erosion of the teeth by rinsing with water, using a straw, not consuming sodas or juices at bedtime and not brushing for at least 2-3 hours after consuming acidic beverages. Be sure to read food and beverage labels, practice good oral hygiene habits at home and see us regularly.
Why does my child have bad breath?
Bacteria are constantly breaking down proteins found in the mouth, airway, esophagus and stomach. Some bacteria degrade sulfur containing amino acids producing volatile sulfur compounds which smell like rotten eggs. Aromatic chemicals such as methyl mercaptan, hydrogen sulfide, putrescine are absorbed from the bowel into the bloodstream and are then excreted through the lungs. Ninety percent of bad breath originates from the mouth but the list of possible causes is vast. Talk with us if you feel your child has bad breath.
What about fluoride?
Fluoride is a mineral that can be found naturally in our water or is added to our water to help strengthen the teeth and prevent or reverse early stages of cavity development. Water fluoridation is considered by the Center for Disease Control to be one of the top ten great public health achievements of the 20th century. It is the most cost effective way to protect people of all ages from cavities. Not all areas have fluoride in the water, please contact your water district for the most accurate information of whether your water has fluoride and how much is in the water. Your child may benefit from fluoride supplements if you live in an area that does not have fluoride placed into the water supply and your child is not using a toothpaste which contains fluoride. The amount of fluoride your child should receive is based on your child’s age. We can discuss with you the correct amount of fluoride for your child.
What are canker sores?
Canker sores are round to oval shaped ulcers that can be found on the cheeks, gums, lips and tongue. These ulcers have a red ‘halo’ and a yellow center lasting for about a week. The pain tends to be inversely proportional to the size of the ulcer and is most intense in the first 3-4 days. Canker sores can be confused with a herpes infection or cold sore. 20-60% of the population suffer from canker sores. Females and those in higher socioeconomic classes tend to get canker sores more often. Unfortunately, there is no known cause for canker sores.
There is no known cure and no one remedy works for everyone. Time and patience are the best remedies. Some over the counter and prescribed ointments can be helpful. When an ulcer is present, try to avoid spicy, acidic and abrasive foods and use caution when brushing.
Research has looked at several possible triggers: allergies; autoimmune response; trauma; hormonal alterations; stress; certain foods such as chocolate, potatoes, gluten containing products, cheese, nuts, figs, coffee, citrus fruits; nutritional deficiencies such as iron, folate and vitamin B12; sodium lauryl sulfate (the foaming agent in toothpaste) and other chemical irritants such as pyrophosphate and sodium hexametaphosphate.
What are cold sores?
Cold sores are caused by a herpes virus and is one of the most widespread viral infections. It is VERY CONTAGIOUS. You may notice small ‘blister-like’ lesions in the mouth. Once these blisters break open, your child will have painful ulcers in the mouth and/or the skin around the lips. Before your child shows any signs of the infection, there may be a few days that your child has irritability, increase in temperature and malaise. These infections are self limiting and the ulcers usually heal spontaneously within 10-14 days.
When the ulcers are present, they are extremely painful. This may interfere with your child’s ability or interest in eating and drinking. It is very important to keep your child well hydrated while the ulcers heal.
What is a space maintainer?
When a baby molar is removed prematurely, a space maintainer is often necessary to help 'hold the space' for the permanent tooth to come in the mouth. The appliance will prevent the neighboring teeth from drifting or tipping into the empty space. The type of space maintainer made is determined by the number and position of teeth missing as well as the overall condition of your child's mouth.
Can my child get whiter teeth?
As the permanent teeth begin to erupt, you will likely notice that they are more yellow in color than the baby teeth. This is normal. As your child continues to lose the brillantly white baby teeth, the contrast in color between the baby and permanent teeth will no longer be present and the permanent teeth will be uniform in color. Please keep in mind that everyone has a slightly different natural tooth color. Tooth whitening is not recommended until at least 16 years of age. This will allow for all of the permanent teeth to be in and orthodontic treatment, if necessary, to be completed.
When should my child see an orthodontist?
The American Association of Orthodontists recommends that all children have a check-up with an orthodontist no later than age 7 so that growth-related problems may be identified and so that treatment can be commenced at the appropriate time for each patient.
Should my child wear a mouth guard?
Being safe when participating in sports and recreational activities requires the proper protective equipment. If your child is participating in sports or activities where there is a risk of falls or contact with the head or face, it is recommended that a mouth guard is worn.
Why isn’t Eastside Pediatric Dental Group a preferred provider with my insurance plan?
Drs. Liu, Lombardi and Quinby of Eastside Pediatric Dental Group have made a decision not to sign up with any insurance plans as “preferred providers” for several reasons:
1. The designation as a “preferred provider” seems to imply that the provider has been picked by the insurance company for his/her expertise or excellence in the care that he/she provides. This is the furthest thing from the truth. It simply means that the “preferred provider” has signed an agreement to discount his/her fees for the customers of the insurance plan. We’ve chosen not to discount our fees to 10% or less of our patients who have these plans.
2. By not discounting our fees for the patients who have insurance plans, we have made a commitment to our patients that we have set our fees reasonably and that they are paying a fair price for the services they receive rather then an inflated fee. Obviously, if we discount our fees to the portion of our patients with insurance, either our fees are too high or, those who pay cash are subsidizing the discount given to patients with insurance coverage. We don’t believe this is a fair way of doing business.
3. Just because we are not a “preferred provider” does not mean that you are unable to bring your child in to see us. It just means that there may be some out of pocket expenses that you will need to pay for at the time of service rather then have it all covered by the insurance plan. Our staff will continue to work with you and your insurance plan to insure that the coverage you are entitled to is recovered.
4. By going to “preferred providers”, the decision making of whom you choose as your children’s health care providers has been given over to the insurance plans. One should choose whom you bring your children to with more care and thought then to rely on an insurance company’s “preferred provider” directory.
If you have any questions about insurance plans, please feel free to call our office and speak with one of our staff.