Tom Dance is a Hayden dentist  that specializes in pediatric dentistry.

Dr. Dance’s Philosophy:

My goal is to treat each patient as I would my own children. To treat them with patience and compassion and with an understanding for what they may be thinking. I believe in a gentle approach. I am sensitive to the fear and anxiety that a child may have towards dentistry regardless of his or her age. My goal is to help kids enjoy coming to the dentist and look forward to their check-ups by providing an overall positive experience. I understand that each child is different and unique and thus may require a unique and tailored dental experience to make their experience as enjoyable as possible. When it comes to the treatment rendered as far as the decision making process goes I go out of my way to visualize and ponder the reality of “what would I do if this were my own child.  If you’re looking for a Hayden Dentist I would love to see you!

Tom Dance is a premium Coeur Dalene dentist and specializes in pediatric dentistry.

Dr. Tom Dance was born in the state of Idaho, but grew up in Bellevue Washington. He met his wife Kim in undergraduate studies where he graduated with honors from Brigham Young University in zoology. He attended the University of Washington Dental School in Seattle and graduated 4th in his class. Tom found a passion in pediatric dentistry while in dental school and furthered his studies by continuing his education at Primary Children’s Medical Center with a residency in Pediatric Dentistry.

Tom and Kim have three kids, Cameron, Braden and Jane. Together, they enjoy the outdoors and most sports. Especially soccer, running and skiing. They like to camp, hike, swim and bike. Dr. Tom also enjoys endurence sports and recently ran a 50 mile trail run. He participates in triathlons, and marathons too. Being active in the community and being social is important to them as well.

Adolescent Dentistry News
Tongue Piercing – Is it Really Cool?
You might not be surprised anymore to see people with pierced tongues, lips or cheeks, but you might be surprised to know just how dangerous these piercings can be.
There are many risks involved with oral piercings, including chipped or cracked teeth, blood clots, blood poisoning, heart infections, brain abscess, nerve disorders (trigeminal neuralgia), receding gums or scar tissue. Your mouth contains millions of bacteria, and infection is a common complication of oral piercing. Your tongue could swell large enough to close off your airway!
Common symptoms after piercing include pain, swelling, infection, an increased flow of saliva and injuries to gum tissue. Difficult-to-control bleeding or nerve damage can result if a blood vessel or nerve bundle is in the path of the needle.
So follow the advice of the American Dental Association and give your mouth a break – skip the mouth jewelry.

Tobacco – Bad News in Any Form
Tobacco in any form can jeopardize your child’s health and cause incurable damage. Teach your child about the dangers of tobacco.
Smokeless tobacco, also called spit, chew or snuff, is often used by teens who believe that it is a safe alternative to smoking cigarettes. This is an unfortunate misconception. Studies show that spit tobacco may be more addictive than smoking cigarettes and may be more difficult to quit. Teens who use it may be interested to know that one can of snuff per day delivers as much nicotine as 60 cigarettes. In as little as three to four months, smokeless tobacco use can cause periodontal disease and produce pre-cancerous lesions called leukoplakias.
If your child is a tobacco user you should watch for the following that could be early signs of oral cancer:
• A sore that won’t heal.
• White or red leathery patches on the lips, and on or under the tongue.
• Pain, tenderness or numbness anywhere in the mouth or lips.
• Difficulty chewing, swallowing, speaking or moving the jaw or tongue; or a change in the way the teeth fit together.
Because the early signs of oral cancer usually are not painful, people often ignore them. If it’s not caught in the early stages, oral cancer can require extensive, sometimes disfiguring, surgery. Even worse, it can kill.
Help your child avoid tobacco in any form. By doing so, they will avoid bringing cancer-causing chemicals in direct contact with their tongue, gums and cheek.

What is Pulp Therapy?
The pulp of a tooth is the inner, central core of the tooth. The pulp contains nerves, blood vessels, connective tissue and reparative cells. The purpose of pulp therapy in Pediatric Dentistry is to maintain the vitality of the affected tooth (so the tooth is not lost).
Dental caries (cavities) and traumatic injury are the main reasons for a tooth to require pulp therapy. Pulp therapy is often referred to as a “nerve treatment”, “children’s root canal”, “pulpectomy” or “pulpotomy”. The two common forms of pulp therapy in children’s teeth are the pulpotomy and pulpectomy.
A pulpotomy removes the diseased pulp tissue within the crown portion of the tooth. Next, an agent is placed to prevent bacterial growth and to calm the remaining nerve tissue. This is followed by a final restoration (usually a stainless steel crown).
A pulpectomy is required when the entire pulp is involved (into the root canal(s) of the tooth). During this treatment, the diseased pulp tissue is completely removed from both the crown and root. The canals are cleansed, disinfected and, in the case of primary teeth, filled with a resorbable material. Then, a final restoration is placed. A permanent tooth would be filled with a non-resorbing material.

In primary teeth a pulp therapy is performed to cleanse the tooth of the bacteria that was harbored inside the tooth from extensive caries or sometimes from trauma. It is a fairly effective procedure and has success rates of about 90%. With that said, it doesn’t always work, but is still a very valued treatment option based on all the benefits. (See section on importance of baby teeth)

When should my child get braces?
A Pediatric dentist is trained in early intervention for orthodontics and can do a great deal to help prevent serious orthodontic problems that sometimes lead to surgery. As a pediatric dentist I can help direct families to a local orthodontist as necessitated by the child’s growth patterns and tooth eruption phases. There is much we can do in our office as well to provide interventional treatment for orthodontic problems. As Children grow they may tend toward a certain type of bite and treatment at a very early age can help correct and promote better growth patterns.
A child’s orthodontic problems may be derived from a skeletal, or underlying bone growth problem, or it may be a more simple crowding issue where the teeth are bigger than the space provided. Sometimes it is a combination of the two. These orthodontic problems can be recognized as early as 2-3 years of age. As diagnosed early, steps can be taken to decrease the severity of the treatment rendered later on in the child’s life.
Stage I – Early Treatment: This period of treatment encompasses ages 2 to 6 years. At this young age, we are concerned with underdeveloped dental arches, the premature loss of primary teeth, and harmful habits such as finger or thumb sucking. Treatment initiated in this stage of development is often very successful and many times, though not always, can eliminate the need for future orthodontic/orthopedic treatment.
Stage II – Mixed Dentition: This period covers the ages of 6 to 12 years, with the eruption of the permanent incisor (front) teeth and 6 year molars. Treatment concerns deal with jaw malrelationships and dental realignment problems. This is an excellent stage to start treatment, when indicated, as your child’s hard and soft tissues are usually very responsive to orthodontic or orthopedic forces. Your Child has not finished growing and bones have not fused.
Stage III – Adolescent Dentition: This stage deals with the permanent teeth and the development of the final bite relationship. This is the most common stage for orthodontic needs and usually starts around ages 12 to 16. Our team can help you understand the pros and cons of orthodontic treatment and help you weigh out your decision making process of whether to pursue treatment or not.

Mouth Guards
When a child begins to participate in recreational activities and organized sports, injuries can occur. A properly fitted mouth guard, or mouth protector, is an important piece of athletic gear that can help protect your child’s smile, and should be used during any activity that could result in a blow to the face or mouth.
Mouth guards help prevent broken teeth, and injuries to the lips, tongue, face or jaw. A properly fitted mouth guard will stay in place while your child is wearing it, making it easy for them to talk and breathe. One of the most common causes of TBIs (Traumatic Brain Injuries otherwise known as concussions) is from the crashing of teeth during a head injury. Children wearing mouth guards are much less likely to get a TBI during a sports injury.
The Academy of Sports Dentistry lists some 40 sports in which mouth protection would be advantageous: Acrobatics, baseball, basketball, bando, boxing, cycling, discus, equestrian sports, field hockey, football, gymnastics, handball, ice hockey, judo, karate, lacrosse, motocross, martial arts, parachuting, horseback riding, rugby, raquetball, skiing, soccer, squash, surfing, skate boarding, shot putt, sky diving, trampoline, tennis, volleyball, wrestling, weight lifting, and water polo. This calls for more education and motivation. Mandating rules are not the answer to the problem. Athletes should be wearing these protective devices as a result of their knowledge and concern for their own safety.
Advantages of Mouth Guards
1. They prevent the tongue, lips and cheeks from being lacerated against the sharp edges of the maxillary teeth.4
2. They lessen the risk of injury to the anterior maxillary teeth by about 90%.4
3. They lessen the risk of damage to the posterior teeth of either jaw following a blow delivered to the inferior aspect of the mandible which causes traumatic closure of the mandible to occur. Such an impact can cause cusp fractures and tooth infractions.4
4. They lessen the risk of jaw fractures by absorbing the energy of a traumatic blow to the chin.2
5. They lessen the risk of concussion occurring subsequent to an impact to the mandible from either in front or below because full posterior translation of the condyles is prevented, reducing the level of force transmitted from the condyles to the base of the skull.2,4,5

Ask Dr. Dance and his Staff about custom and store-bought mouth protectors

Does Your Child Grind His Teeth At Night? (Bruxism)
Parents are often concerned about the nocturnal grinding of teeth (bruxism). Often, the first indication is the noise created by the child grinding on their teeth during sleep. Or, the parent may notice wear (teeth getting shorter) to the dentition. One theory is that of accommodation. With new teeth erupting and consistently changing the bite the kids play with these new teeth by grinding on them at night. Another theory as to the cause involves a psychological component. Stress due to a new environment, divorce, changes at school; etc. can influence a child to grind their teeth. A final theory relates to pressure in the inner ear at night. If there are pressure changes (like in an airplane during take-off and landing, when people are chewing gum, etc. to equalize pressure) the child will grind by moving his jaw to relieve this pressure.
The majority of cases of pediatric bruxism do not require any treatment. If excessive wear of the teeth (attrition) is present, then a mouth guard (night guard) may be indicated. On most children night guards are useless because they will not tolerate them and they simply spit them out soon after falling asleep. Also, a negative to a mouth guard are the possibility of choking if the appliance becomes dislodged during sleep or it may interfere with growth of the jaws. The positive is obvious by preventing wear to the primary dentition.
Just remember this…Bruxism or grinding is very common in children. It is not anything to worry about because your child is completely within the norm if he or she is grinding their teeth. Once the permanent teeth begin erupting grinding should subside. The good news is most children outgrow bruxism. The grinding decreases between the ages 6-9 and children tend to stop grinding between ages 9-12. If you suspect bruxism, discuss this with your pediatrician or pediatric dentist. Decisions will be made based on age and the ability to tolerate a mouth guard

Dental Radiographs (X-Rays)
Taking dental radiographs on children can be a challenge at times. The film sensors are not always easy for the kids to tolerate. We will evaluate each child and assess the need for dental radiographs and the frequency needed. We will work with kids on an individual basis to make taking radiographs as easy as possible.
Radiographs (X-Rays) are a vital and necessary part of your child’s dental diagnostic process. Without them, certain dental conditions can and will be missed.

Radiographs detect much more than cavities. For example, radiographs may be needed to survey erupting teeth, diagnose bone diseases, evaluate the results of an injury, or plan orthodontic treatment. Radiographs allow dentists to diagnose and treat health conditions that cannot be detected during a clinical examination. If dental problems are found and treated early, dental care is more comfortable for your child and more affordable for you.
The American Academy of Pediatric Dentistry recommends radiographs and examinations every six months for children with a high risk of tooth decay. On average, most pediatric dentists request radiographs approximately once a year. Approximately every 3 years, it is a good idea to obtain a complete set of radiographs, either a panoramic and bitewings or periapicals and bitewings.
Pediatric dentists are particularly careful to minimize the exposure of their patients to radiation. With contemporary safeguards, the amount of radiation received in a dental X-ray examination is extremely small. The risk is negligible. In fact, the dental radiographs represent a far smaller risk than an undetected and untreated dental problem. Lead body aprons and shields will protect your child. Today’s equipment filters out unnecessary x-rays and restricts the x-ray beam to the area of interest. In our office we use digital radiography which subjects your child to even a much smaller percentage of radiation exposure than conventional film based radiography. We are using the latest and greatest in dental technology to provide the safest experience for your child.

Thumb Sucking
Sucking is a natural reflex and infants and young children may use thumbs, fingers, pacifiers and other objects on which to suck. It may make them feel secure and happy, or provide a sense of security at difficult periods. Since thumb sucking is relaxing, it may induce sleep.
Thumb sucking that persists beyond the eruption of the permanent teeth can cause problems with the proper growth of the mouth and tooth alignment. How intensely a child sucks on fingers or thumbs will determine whether or not dental problems may result. Children who rest their thumbs passively in their mouths are less likely to have difficulty than those who vigorously suck their thumbs.
Children should cease thumb sucking by the time their permanent front teeth are ready to erupt. Usually, children stop between the ages of two and four. Peer pressure causes many school-aged children to stop.
Pacifiers are no substitute for thumb sucking. They can affect the teeth essentially the same way as sucking fingers and thumbs. However, use of the pacifier can be controlled and modified more easily than the thumb or finger habit. As a parent you can take a pacifier away. It proves more difficult to take off a thumb. If you have concerns about thumb sucking or use of a pacifier, consult your pediatric dentist.
A few suggestions to help your child get through thumb sucking:
• Instead of scolding children for thumb sucking, praise them when they are not.
• Children often suck their thumbs when feeling insecure. Focus on correcting the cause of anxiety, instead of the thumb sucking.
• Children who are sucking for comfort will feel less of a need when their parents provide comfort.
• Reward children when they refrain from sucking during difficult periods, such as when being separated from their parents.
• Your pediatric dentist can encourage children to stop sucking and explain what could happen if they continue.
• The habit can be very difficult to break. Start early. It usually happens when the child decides to stop
If these approaches don’t work, remind the children of their habit by bandaging the thumb or putting a sock on the hand at night. Your pediatric dentist may recommend the use of a mouth appliance. The appliance is an effective tool and many times necessary, but it is also a last resort in our office when other methods have been tried over and failed.

Seal Out Decay
A sealant is a clear or shaded plastic material that is applied to the chewing surfaces (grooves) of the back teeth (premolars and molars), where four out of five cavities in children are found. This sealant acts as a barrier to food, plaque and acid, thus protecting the decay-prone areas of the teeth.

Usually baby teeth are not sealed. They are occasionally sealed in children with a very high caries rate or children with very deep grooves and pits.

The most frequently sealed teeth are 6 year molars. 6 year molars are the permanent teeth that erupt around age 6 and are usually the first permanent teeth in a child’s mouth. They frequently get cavities because the teeth are difficult to brush when the jaws are still very small. They often remain partly covered by the gum tissue and trap food and bacteria which can cause cavities. We like to seal the 6 year molars just as soon as they are fully erupted to all them the best chance to remain cavity free.

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