A very frequent question indeed, and one which you will likely be relieved by the answer! This is a very common situation and is usually at its worst between the ages of ten and twelve, depending on the child. It is so common in fact, that it has been given a name by orthodontists. It is called the “ugly duckling” phase of dental development.

Most times, the gap will resolve on its own once the permanent canine teeth come completely in ( around age eleven). This gap is caused by the canine teeth pushing on the roots of the front teeth as they make their way down into the mouth. This pressure pushes the teeth in the front apart temporarily and will start to close as the canines come further into the mouth. It can be a little embarrassing for teens until it resolves. So, reassure them that many of their other friends are likely to go through it also, and that it usually goes away on its own.

Occasionally, however, the gap remains slightly. This will depend on the skeletal and dental relationship of your child. If the canines have come in, and have been in for awhile but the gap still remains, talk to your dentist or orthodontist. There are many options for treating this if your child is unhappy with the final appearance of their smile. Some of those options may include anything from a small, tooth-colored filling placed to widen the appearance/close the gap, to brace or other appliances. Each child and situation is unique.

This is a sticky situation to be in. I will be very honest with you, as a mother I want to be privy to everything that goes on with my children. I understand the natural parental instinct that makes you want to protect your children at all costs. We want to shadow doctors and dentists to be sure that they are taking care of our kids the way that they would their own. However, the dentist side of me will tell you that most of the time children do MUCH better when parents are not in the room during treatment. Many of our mini-sized manipulators (including my own) play the “Dr. Jekyll and Mr. Hyde” game while at the dentist.

It is pretty amazing to see how a child is polite and well behaved in my dental chair until the moment a parent walks in the room. Once the parent enters, there is usually a plethora of temper tantrums and a refusal to open their mouths. When mom and dad leave the room, it is back to cooperation with a smile. However, some children actually will do better with a parent in the room, or even while sitting on the parent’s lap during treatment. I would suggest trying it without the parent first unless you know that your child will in no way go for it. We want them to have a good experience, so whatever it takes is what needs to be done.

If a dentist is good with kids and speaks their “language,” often they will let you do most dental work without much hesitation. Of course, that doesn’t apply to all kids, which is why man invented sedation. I very strongly discourage parents from coming back in the treatment room. I never refuse to allow them back and I personally don’t feel that it is appropriate to do so. If a child does well with a parent in the room, then there really isn’t any reason to have them leave. However, leaving the room can often give mom or dad a little “quiet time” and break from the daily grind. I’ll be the first to admit that those little breaks are some of the best opportunities for me to recharge before tackling the remainder of the day!

The dentist side of me also feels very strongly that a parent should not be allowed to compromise a child’s dental experience or dental treatment. So, if a child is unmanageable while a parent is in the room and the parent refuses to attempt treatment with them out of the room, then I simply decide that this is not a patient relationship that I feel comfortable continuing. As dentists, we are providing medical care to your child and so, it is very important that we have a very open line of communication and trust with you. If that relationship does not exist, then perhaps a relationship with another dentist would better suit the needs of both parties. Another thing that can be difficult about having a parent in the room is that is can be very distracting to the dentist, dental assistant and even the child.

As parents, we have a natural curiosity for the process of things and also to help soothe our children. With such a short attention span from children, it makes it very difficult to work quickly and accurately while a parent is asking questions or talking to the child (obviously if the child is asking you a question, that is does not apply). If you decide to stay in the room during treatment, I would recommend trying to be very quiet and keep questions and conversation to a minimum. Try to save questions either before treatment or after and let the staff attempt to soothe the child first. Too many people talking to the child distracts and upsets them. And please, whatever you do, avoid the trigger words that panic children, like “needle,” “shot,” “drill, “hurt,” “pain,” and the list goes on. It truly is in the best interest for your child’s care and their overall experience. Treating children is very much like playing a game of chess in the middle of a preschool classroom. It already takes a lot of concentration to get the moves right in a quiet setting, much less in the midst of noise and physical chaos! Remember, they are a moving target for us, all while we attempt to do procedures at an almost microscopic level, with materials which have to stay completely dry, with instruments that can cause tissue damage. And, all of this is done in a dark, wet place, about the size of pool ball, with a “trap door” that opens and closes without warning. Wow, I am exhausted just thinking about it!

I am sure that different states have different laws pertaining to the refusal of allowing a parent in the room, so check with your state accordingly. However, if you feel you need to check on the law, then it might be prudent to examine the relationship you have with your current dentist, as I am guessing it is not one built on trust or communication. Of course, there are special situations when refusal to allow parents back in the room is acceptable, such as legal guardianship issues and court orders (for example, restraining orders). If you have any questions regarding these specifically, always seek the advice of your attorney. Remember, try to make the experience a good one for your child. One hundred percent of my adult patients who are terrified or fearful of the dentist tell me they are so because they had a bad childhood experience. It just shouldn’t be that way! If all of your efforts still prove fruitless, then sedation may be the best option for your child.

Some of the more serious causes of yellow teeth are genetic disorders, high childhood fevers, or damaged or dying teeth. These types of discolorations can be more difficult to treat but most of the time they can be treated effectively by a dental professional. In fact, I recommend going to the dentist for an evaluation prior to starting any tooth whitening or tooth bleaching system. Starting treatment with a healthy mouth is extremely important. Attempts at self treatment with over the counter products can result in unwanted reactions if not treated appropriately. If you get an A+ at your dental check up, then most dentists will recommend trying over-the-counter products first if you meet the recommendations.

Children can suffer from yellow teeth as well. Most parents will notice that when their child gets their first set of permanent teeth, they appear more yellow than the “baby” or toddler teeth. This is normal and is usually nothing to worry about. However, many genetic disorders such as amelogenesis imperfecta, and several others can cause yellow teeth. Have your child’s teeth evaluated and hopefully it will provide you with relief that all is normal. Whether they are normal or determined to be truly yellow, treating children’s yellow teeth will be different from adults.