Patient Experience

What to do before and after your visit

Before Your Appointment

You do not need to be at Kangaroo Smiles for long to know that we use kid-friendly language and use examples that all kids can understand.  We often replace words which can potentially scare children with friendlier ones. For Example:

Shot / Needle– These words can quickly turn a happy cooperative child into a child that is fearful. We either say nothing at all or that we are using “sleepy drops” to help the sugar bugs fall asleep. We explain that they may feel “cold” and “hard” next to the tooth.

Drill–  We use the term “water whistle”, because of the loud whistling noise and water that “helps the sugar bugs come out”

Pulling, or Extracting a tooth– We often replace this by explaining that we have to “help wiggle your tooth out because the tooth fairy wants it back”

Laughing Gas –  We call this “ice cream air” because of its sweet smell. We work with kid’s imaginations by allowing them to pick whatever flavor they want. We also explain that the air will make them feel “floaty or tickly”.

Post Extraction Tips

After having a dental extraction, it is important to remember a few things to help keep your child comfortable.


  1. Avoid straws, sippy cups, or “sucking” motions
  2. Popsicles or anything cold will help reduce any discomfort
  3. Maintain a soft diet, for example: soup, Jello, pudding
  4. An over the counter pain medication can be given for pain
  5. Continue to brush your child’s teeth like normal. The cleaner their mouth, the faster the healing.
Post Local Anesthesia Info

The local anesthesia “sleepy drops” used will make your child’s lip, cheek, and tongue numb for about 3 hours. Watch that your child does not bite, suck, or pinch any part of their mouth.  Maintain a soft diet (for example: jello, pudding) to help prevent injury.


Signs/Symptoms that your child may have injured their mouth:

  • Red, white, yellow, or dark discoloration.
  • Swelling both inside and outside of the mouth.
  • Difficulty eating/drinking, or speaking.
  • Pain and discomfort.


What to do if you feel that your child has injured their mouth:

  • An ice pack will help reduce swelling.
  • An over the counter pain medication will help with pain. Be careful to follow the directions on the bottle to prevent possible overdose of medication.  Continue to give your child the medication until they are able to eat/drink comfortably.
  • Warm salt water rinses will help with healing.
  • Avoid hot or spicy foods.
  • Continue to brush your child’s teeth to maintain a clean oral environment.
  • Encourage your child to drink water to keep hydrated.
  • It will take several weeks for complete healing to occur.
Space Maintainers

When baby teeth are lost before they are supposed to naturally come out, a space maintainer can help prevent the teeth from shifting. They can help prevent space lose so the adult teeth have room to come in normally.

These appliances are cemented into your child’s mouth. At your routine checkups, we will evaluate the space maintainer, and we will let you know when is the right time to remove it.

Children usually adapt very quickly to their space maintainers, and after a short period, they forget it is there.  It’s important to brush and keep the area around the space maintainer clean, just as you would any other tooth.

To prevent the space maintainer from coming loose, avoid foods that are sticky such as gum, caramel, and laughy taffy.  Foods like this can loosen the band or pull the appliance off. Also, please remind your child not to play with it, push on it with their tongue, or try to pull it out of their mouth. If the space maintainer comes loose or if your child tells you something has changed, then make an appointment so we can evaluate it.

New mom info

When should my child first see a dentist?

“First visit by first birthday” sums it up. Your child should visit a pediatric dentist when the first tooth comes in, usually between 6 and 12 months of age. This visit will establish a dental home for your child. Early examination and preventive care will protect your child’s smile now and in the future.

Why so early? What dental problems could a baby have?

The most important reason is to begin a thorough prevention program. Dental problems can begin early. A big concern is Early Childhood Caries (formerly known as baby bottle tooth decay or nursing caries). Once a child’s diet includes anything besides breast-milk, erupted teeth are at risk for decay. The earlier the dental visit, the better the chance of preventing dental problems. Children with healthy teeth chew food easily and smile with confidence. Start your child now on a lifetime of good dental habits.

How can I prevent tooth decay from nursing or using a bottle?

At-will breast-feeding should be avoided after the first primary (baby) teeth begin to erupt and other sources of nutrition have been introduced. Children should not fall asleep with a bottle containing anything other than water. Drinking juice from a bottle should be avoided. Fruit juice should only be offered in a cup with meals or at snack time.

When should bottle-feeding be stopped?

Children should be weaned from the bottle at 12-14 months of age.

Should I worry about thumb and finger sucking?

Thumb sucking is perfectly normal for infants; many stop by age 2. Prolonged thumb sucking can create crooked teeth or bite problems. If the habit continues beyond age 3, a professional evaluation is recommended. Your pediatric dentist will be glad to suggest ways to address a prolonged thumb sucking habit.

When should I start cleaning my baby’s teeth?

The sooner the better! Starting at birth, clean your child’s gums with a soft infant toothbrush or cloth and water. As soon as the teeth begin to appear, start brushing twice daily using fluoridated toothpaste and a soft, age-appropriate sized toothbrush. Use a “smear” of toothpaste to brush the teeth of a child less than 2 year of age. For the 2-5 year old, dispense a “pea-size” amount of toothpaste and perform or assist your child’s toothbrushing. Remember that young children do not have the ability to brush their teeth effectively.

From six months to age 3, your child may have tender gums when teeth erupt. Many children like a clean teething ring, cool spoon or cold wet washcloth. Some parents swear by a chilled ring; others simply rub the baby’s gums with a clean finger

Frequently asked questions

Why are primary (baby) teeth so important?

Although they will all eventually fall out, primary (baby) teeth are important for:


• Proper chewing and eating
• Keeping space for the permanent teeth and guiding them into the correct position
• Allowing normal development of the jaw bones and muscles
• Development of speech
• Giving your child the self-confidence they need to succeed in school and other activities

Cavities in baby teeth can cause sensitivity, pain, and sometimes even serious infections. In some situations, they can also directly affect the development of your child’s permanent teeth.

I think my child has a cavity, what should I do?

Often times, cavities develop without any pain or other symptoms. That is why it is so important to schedule your child for regular, routine visits with our office. Small cavities that are not painful are always easier to fix than large cavities.

Left untreated, cavities can lead to more serious problems for your child, such as infections in the nerve of the tooth, swellings, and possibly needing to have the tooth removed. Some common symptoms of a larger cavity may include:

1) A painful toothache or swollen gums
2) Pain when chewing or eating hot or cold foods
3) The presence of white spots, tooth discolorations, or holes in teeth

What are dental radiographs (x-rays), and why does my child need them?

We use dental radiographs, or X-rays, in the dental exams of children of all ages, because many problems with the teeth and surrounding tissues cannot be seen by the naked eye.


X-rays can reveal:
• Small cavities between teeth
• Deep cavities
• Infections in the jaw bones
• Abscesses or cysts
• Developmental problems such as missing teeth

At Kangaroo Smiles we use digital X-rays. Digital X-rays are not only more comfortable and accurate than traditional X-rays, but also faster and better for the environment. With no sharp X-ray film and no lengthy chemical processing required, the images can be seen on our computer screen within seconds. Studies have also found that digital X-rays emit up to 90% less radiation than conventional X-rays!

What do I do if I have an emergency?

Dr. Mona is very familiar with the phrase, “Accidents happen.”


If your child experiences a dental accident that causes him or her any amount of dental pain, call us immediately. We can talk you through the situation and help relieve your stress. If needed, we will schedule a same-day emergency appointment.

Common conditions

Teeth Grinding
Teeth grinding is normal for a lot of young children. Most children do not even realize they are doing it, and it usually does not cause any discomfort. Often times parents say they can hear their children grinding their teeth from down the hall at night.

Teeth grinding usually stops as children start to develop adult teeth, and for that reason, we generally monitor this. However, if the grinding is getting worse over time, or if we start to see wearing down of the adult teeth, Dr. Mona may recommend treatment.

Over time teeth grinding can cause wearing away of the chewing surfaces of teeth. This can lead to teeth that look shorter than normal or have dents, jaw pain, as well as headaches. Some older children and adults grind their teeth because of stress or anxiety. In older children that have all of their adult teeth in, Dr. Mona may recommend a special mouth guard that can be worn while sleeping.

Canker Sores/Cold Sores
Canker sores occur inside the mouth, and cold sores usually occur outside the mouth, usually on or near the lips. Whether they occur inside or outside of your mouth, they can be very annoying!

They tend to appear when children are sick, when the seasons change, or can even happen due to some food allergies. These sores are very common and for some people they recur often, depending on genetics.

Unfortunately there is no quick fix that will eliminate these sores right away. These sores usually heal in about two weeks. In the meantime, Dr. Mona recommends a mild/bland diet that can help reduce discomfort while eating. Foods that are too hot, spicy, or crunchy can be very irritating. The most important thing to remember is to keep your child hydrated. Your child may not be eating or drinking like normal, and we do not want them to become dehydrated.

Over-the-counter topical anesthetics are never recommended. They can cause lots of irritation, stinging, and are very unsafe if too much is eaten.

Thumb or Finger Sucking and Pacifiers
Thumb and finger sucking or even pacifiers after the age of four is not recommended because it could lead to changes in the way your childs facial bones are formed.

This can cause narrowing of the upper jaw, crooked teeth, bite problems, the upper front teeth may start to tip out, or your child may develop an open bite (front teeth do not touch when biting down completely).

These habits can be very difficult for some children to break, and for that reason, it is very important that we work together to figure out what will work best for your child. For some children, a mouth appliance can be a very effective reminder to help get them through breaking the habit.

A tooth cavity is the result of bacteria in your mouth producing acid which can weaken your tooth.

Over time, this weakened tooth structure can grow, and the bacteria can start to move into the deeper layers of a tooth. Often times, the tooth can become so weakened that it causes a hole to form.


Some people are more prone to developing cavities than other people. To give your child the best chance of not getting cavities it is important to remember a few things. Anything that has sugar and sticks to teeth for a long time can potentially cause cavities. Foods such as fruit snacks, granola bars, crackers, and gummies can sit on your child’s teeth for hours. Even some healthy foods such as fruit has a lot of acid which can cause cavities The best thing to do is rinse with water, or brush the food off of their teeth after these snacks.


To help very young children not get cavities, try to avoid putting your baby to sleep with a bottle containing anything that may have sugar (milk, formula, juice). If your child needs a bottle to fall asleep, try plain water, or water flavored with a sugar free sweetener. Even breast milk has sugars that could potentially cause cavities. For children being breast fed, try to wipe their teeth after feeding to help get some of the sugars off of the teeth.

Gingivitis causes the gums to become red, swollen and easily bleed when brushing or flossing.

You may also notice persistent bad breath. Gingivitis happens when bacteria sitting on the tooth near the gums for an extended time. The best thing to do to help prevent this is to brush all of your child’s teeth where the tooth and the gums come together. This is the location where most plaque and bacteria tend to sit.

Teething - Baby Teeth
Baby teeth actually start to develop while they are still growing in their mommy’s belly.

From birth to about the age of 3, you will see the gradual eruption of 20 baby teeth (primary teeth). When babies are teething, they often have sore and tender gums. The pain usually can be soothed by gently rubbing their gums with a clean finger, or a wet gauze. A clean teething ring to chew on also may be helpful.

At around age 6, the front baby teeth on the bottom generally start to get wiggly and fall out. At the same time, the adult first molars start to grow in behind all of the baby teeth. The process of losing baby teeth and getting adult teeth usually lasts until age 12 or 13. However, every child is unique and special, so this is just a general timeline which may be very different for normal kids. Dr. Mona will let you know during each exam if she is concerned about your child’s teething pattern.


It is important for us to keep your child’s baby teeth healthy because they ultimately affect the development of your child’s permanent teeth. Baby teeth are important for eating, ensuring the adult teeth grow in normally, development of the jaw bone and muscles, speech and confidence. At Kangaroo Smiles we always encourage taking good care of your child’s baby teeth. Just as in adults, cavities and infection in baby teeth can cause a lot of pain. If your child loses a baby tooth too soon the permanent tooth may not be ready to come in. Sometimes having this extra space in the mouth can cause the other teeth in that area to start to shift. This may lead to teeth becoming crowded or crooked. In many cases, future problems can be avoided by space maintainers, which are appliances that hold surrounding teeth in place.

Teething - Parmanent Teeth
The first permanent molars begin erupting around the age of 6.

They start to grow behind all of the baby teeth. Extra care should be given to this first set of molars because they can cause a significant impact on the structure and position of future erupting teeth. From then on, children will continue to loose and gain teeth over the next few years. By about age 14, most kids have a full set of 28 permanent teeth.

Teething - Wisdom Teeth
Wisdom teeth, or third molars, typically start to develop in early teenage years, and may start to erupt into the mouth in the late teenage years.

In some people, wisdom teeth do not grow in properly and often times this can lead to infections. Wisdom teeth can also become impacted if they start to grow in the wrong direction, requiring them to be extracted. Wisdom teeth are evaluated at each visit, and sometimes Dr. Mona may choose to refer you to see an oral surgeon for evaluation and possibly to have them removed.