Category Archives: Early Dental Care

Here’s how to know if your child has it, how to treat & prevent it.

First of all, what exactly is gingivitis?  Gingivitis, is caused by excessive plaque buildup. If plaque is not removed, it produces toxins that can irritate the gum tissue causing gingivitis.

5 indicators that your child has gingivitis:

1 – Gums that bleed during or after brushing.  

2 – Gums that are red, swollen, painful or tender to the touch.

3 – Gums that recede or pull away from the teeth. 

4 – Bad breath that doesn’t go away. 

5 – Teeth that are loose without injury

Treating Gingivitis in Children

The first step in treating gingivitis in children is to improve oral hygiene habits.  Depending on the severity of the gingivitis, antibiotics, a deep cleaning or even restorative surgery may be necessary. 

Preventing Gingivitis

The best way to prevent gingivitis is to thoroughly floss in between teeth every day and brush for two minutes twice daily making sure to get all tooth surfaces. 

Teens should be extra careful in paying close attention to their oral hygiene as they are especially at risk for gingivitis as hormonal changes in their bodies can increase gum sensitivity.  

If you’d like more information on gingivitis in children please reach out to our experts at Pediatric Dental Associates of Randolph 973-989-7970.

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How they impact your baby and when to have them corrected

Often when a baby’s ability to feed and thrive is compromised it is a result of a Lip and/or Tongue Tie requiring a revision.   A Lip Tie is caused by a piece of tissue behind the upper lip, called the frenulum, being too thick or too stiff which prevents the upper lip from moving freely.  When the upper lip is unable to move easily a baby’s ability to feed is significantly reduced.  A Tongue Tie results when an unusually short, thick or tight band of tissue, called the lingual frenulum, tethers the bottom of the tongue’s tip to the floor of the mouth.  This condition effects the tongue’s range of motion and also compromises feeding as it makes it difficult for a baby to suck properly and for a more difficult time eating from a spoon or even eating finger foods.  

In addition to the immediate concerns of a baby’s ability to gain proper weight, Lip and Tongue Ties can impact health and development in other ways.  Speech development can also be affected by the tongue’s limited mobility and significant challenges with other oral actions can occur such as licking one’s lips, eating an ice cream cone, kissing or playing a wind instrument.  Another significant complication of a Lip or Tongue Tie is that it often results in poor oral hygiene and can contribute to tooth decay and gingivitis. 

Tongue and Lip Ties often occur in tandem, are more common in boys than girls, and tend to run in families. Parent’s concerned that their baby might have a Lip or Tongue Tie need not to worry as they are easily corrected and can be done right in the comfort of our office at Pediatric Dental Associates of Randolph.  A frenectomy is the procedure used to correct a Lip or Tongue Tie.  During this quick procedure one of our Pediatric Dentists uses a laser to neatly sever the membrane connecting the lip to the gums and/or the tongue to the lower palate.  Aside from being a swift correction, it is virtually painless with no recovery and babies can feed immediately afterward with greatly improved results.

If you think your child has a Lip or Tongue Tie and you would like more information on this procedure, or if you have any questions on the procedure used to correct Lip and Tongue Ties, please don’t hesitate to reach out to our team of Pediatric Dentists at Pediatric Dental Associates of Randolph 973-989-7970.

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Losing their baby teeth and being paid a visit from the Tooth Fairy has always been a very big deal to kids.  As a pediatric dental office, we experience the excitement of losing teeth with our patients on a regular basis.  Seeing as though we are immersed in all things related to kids’ teeth, who better to delve into the mystery of the Tooth Fairy than the experts in children’s teeth at Pediatric Dental Associates of Randolph.   So, we took on this very important challenge and reached out to area parents with a survey on social media to see how the mystical flying princess of tooth procurement is welcomed by families throughout the area.

So how do kids learn about the Tooth Fairy anyway?

What we found out is that most kids learn about it through discussions with their parents or from older siblings, friends or relatives over the years leading up to their first lost tooth.  Our apologies to children’s book authors, but

  • Just 5% of respondents said they introduced the Tooth Fairy to their children through a story book.

As a patron of the winged princess of lost teeth, we were relieved to learn from each and every parent, that all of their children were quite familiar with this fantastical flying fairy. 

Another thing we learned from our survey is that there are a lot of old baby teeth stashed away in homes throughout New Jersey

  • More than 60% of respondents say they keep lost teeth after the Tooth Fairy visit.

Where do they keep these castoff teeth, and more importantly, what are they saving them for?  That is a question for another time. 

Does the Tooth Fairy always remember to show up?

  • An impressive 70% of parents who responded to our survey said the Tooth Fairy has never forgotten to come to their home the night a tooth is lost.

That was especially significant to this author as her own children have been stood up by the Tooth Fairy on more than one occasion.  After all, when too many children all lose teeth on the very same day the Tooth Fairy can be delayed, just like an Amazon package at holiday time.  Right? 

How and where is the tooth left for the Tooth Fairy?

While the concept of the Tooth Fairy is fairly simple.  A child loses his or her tooth and places it under their pillow for the Tooth Fairy to exchange it for something much more exciting.  We found that nearly everyone who responded has a slightly different way of leaving the baby tooth under the pillow. 

  • Placing the lost tooth in a Zip-lock bag seemed to be very common, as you can imagine, those tiny baby teeth can be very difficult to find in the dark.
  • Some families really stepped up their game with a special tooth pillow. Many parents who were really in the game procured a monogrammed pillow for this occasion. 
  • Other children left the tooth under their pillow wrapped in the tissue it was placed into when it fell out.
  • Some sprinkled the tooth with fairy dust in tribute to the tiny lady who was to retrieve it.
  • Some parents of light sleepers don’t take any chances and have convinced their kids to forgo the leaving of the tooth under the pillow for the enhanced option of the top of their dresser or even the bathroom counter where the Tooth Fairy won’t make the mistake of disturbing light sleeping children.
  • Notes exchanged with the Tooth Fairy, were also fairly common. In her response, and much to our delight, often the Tooth Fairy would remind those in her charge to take good care of their new adult teeth by brushing and flossing regularly.

Tooth Fairy Payouts

Now that you’ve all gotten this far into the summary of our survey responses, you will be rewarded with the results you’ve really been searching for: guidance on Tooth Fairy payouts.  This is by far the most important and anticipated result.  No Tooth Fairy wants to shortchange their disciples, nor do they want to overpay for a discarded bicuspid.  After all, kids will lose 20 baby teeth before they are done and that has the potential to get very expensive.

  • Almost 10% of responders said the Tooth Fairy leaves $5.00-$7.00
  • Nearly 40% reported that their children received between $1.00 and $4.00 per tooth.
  • Some children apparently score big from the Tooth Fairy as 10% receive over $7.00 per tooth.
  • 10% of responders also indicated that the Tooth Fairy was not particularly consistent, as their children received whatever happened to be on hand when the tooth was lost.

Above all, what we learned in our research is that in celebrating the milestone of childhood lost teeth, the Tooth Fairy is alive and well in New Jersey.  She is a joyful symbol of the innocence of childhood.  Payouts, notes, saved teeth or not, parents hold tight this right of passage for their children and at Pediatric Dental Associates of Randolph we honor and celebrate the Tooth Fairy for her partnership with us in caring for children’s teeth.

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There are few more important things a parent can do to enhance their child’s opportunity for a lifetime of good oral health than to help your child develop a mindset that brushing and flossing are a fundamental part of taking care of their body.

Below are six steps to get your child on the path to making oral care routines easy in your home.


An essential part of teaching your child anything, involves modeling the behavior you want them to emulate.  If your toddler has always seen you brushing and flossing, they will want to do it as well.  Let your child take a turn at doing it themselves so they feel invested in the routine, but until they are old enough to get all parts of their mouth properly, you should also take a turn before or after to make sure it is done properly.


There is so much of a child’s life that they have no control over.  Letting your child select their own toothbrush and toothpaste is an excellent way to make them feel invested in their oral hygiene.


Two minutes can seem like a long time to brush for a child.  To help them understand how much time that actually is, there are a variety of methods you can use to help put the amount of time in perspective for your child.  Use a timer so they can see how much time they have brushed and how much time is left.  Play or sing a 2-minute song.  Some of our favorites can be found here:


Next to watching a parent brush and floss, one of the best ways to learn how to properly brush and floss is to watch yourself doing it in a mirror.  This way your child can actually see their teeth as they follow their oral hygiene routine. 


One of the worst things a parent can do to sabotage compliance with oral hygiene and to create fear of the dentist is by threatening your child with a bad dental check-up, or worse yet, by telling them they will have a painful experience getting cavities filled. Oral care should always be viewed with a positive attitude and not with fear.


To develop good oral hygiene habits in your children, it is important that brushing and flossing become part of your child’s daily routines.  Morning teeth brushing should become part of their waking and getting dressed routines.  In the evening, flossing and then brushing should be incorporated into their bedtime routine.  Once oral hygiene becomes a pattern in their day, children are much more likely to eagerly take ownership of this very important part of their care.

You are now prepared with some tools to help your child develop great oral hygiene habits.  If you have any questions about these techniques or about your child’s oral care, please don’t hesitate to reach out to the experts at Pediatric Dental Associates of Randolph.

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What to watch for after your little one has dental treatment.

Lip biting, especially for children, has always been a potential complication of any dental treatment involving local anesthesia.  When a child’s mouth has been numbed for a dental procedure it is difficult for them to know, or even feel, if they are biting their lip or the inside of their cheek.  Not surprisingly, this complication has become more prevalent during the COVID-19 pandemic as children are wearing face masks coming and going from the dental office and it is significantly more difficult for a parent to discern whether or not their child has bitten their lip through a face mask. 

After a dental procedure involving anesthetic it is important that both children and their caregivers understand that for the next 2-3 hours, or until the numbness goes away, that children need to be very careful not to accidentally bite their lip or cheek.  No food or drink should be given during this time. To best ensure this doesn’t happen it is ideal to remain in a situation where mask wearing isn’t required so that parents can better observe their child’s mouth.

Lip Biting

If your child does bite or chew on their lip or cheek, a yellowish looking traumatic ulcer may form as the wound heals.  This may take up to two weeks to go away.  During this time, it is important to keep the area clean, maintain normal oral care of brushing and flossing, and avoid anything that might irritate the wound such as citrus juices or tomato-based foods.  If your little one is in pain, acetaminophen or ibuprofen may be given as needed.

If you have any questions or complications, please don’t hesitate to reach out to our office 973-989-7970.

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The first time you hear a grating sound coming from your toddler’s mouth it can be quite startling.  Don’t be alarmed. Teeth grinding, also known as Bruxism, is reasonably common in young children and is rarely a cause for concern.  As adults we may be more inclined to grind our teeth during times of stress, like those felt during a national pandemic, this is not the case for a toddler’s grinding. 

“We get a lot of calls to the office from parents worried about their children grinding their teeth,” says Dr. Mannella, of Pediatric Dental Associates of Randolph.  “We like to check a child’s mouth to make sure there are no underlying problems but the reality is that most kids just grow out of it without doing any harm to their teeth.” 

According to Dr. Mannella, approximately 15% of all toddlers will grind their teeth.  “Usually it first begins when a child’s upper and lower teeth cut through the gums.  Sometimes it can occur because the upper and lower jaws are growing at a different rate, sometimes it is a means for a toddler to self soothe when teething, or even from the pain of an ear infection.  And some kids just grind their teeth simply because they’ve figured out how to do it and they are curious about the sound they’ve learned to make.”

Because the enamel on baby teeth is thinner, excessive grinding can erode the enamel if a child is still grinding their teeth by the age of four or five.  When physical reasons for grinding are ruled out sometimes grinding can be a reaction to stress or anxiety, such as a new sibling, a change in daycare, or the start of a new school year. 

Around one-third of children with bruxism will still be grinding their teeth as adults.  Grinding and teeth clenching as an adult can lead to some pretty severe jaw pain and headaches, so it’s worth keeping tabs on this habit as your child gets older.

If you have concerns about your child’s tooth grinding, or any questions about your child’s oral health, Dr. Mannella and his team at Pediatric Dental Associates of Randolph are always happy to discuss any issues that matter to you.  You can reach their office at 973-989-7970 or check out the Pediatric Dental Associates of Randolph website at You can also follow the practice on Facebook and Instagram for the upcoming family events.

We follow the American Academy of Pediatric Dentistry and American Academy of Pediatrics, recommendations which state that a child’s first visit to the dentist should occur when the first baby teeth appear or by their first birthday. Our goal is to establish a Dental Home for your child, an ongoing relationship between our pediatric dentist and your child, allowing care to be delivered in a comprehensive, continuously accessible, coordinated and family-centered way. 

During this visit, our dentist and hygienist will discuss teeth eruption patterns, oral hygiene, fluoride recommendations, nutrition and diet, any habit (pacifier, thumb sucking, etc.), dental sealants and interceptive orthodontics.  We will also plan a re-care schedule to fit your child’s needs. Children will receive a thorough examination, digital images (x-rays) if needed, cleaning and a fluoride treatment. The first visit is a great time for you and your child to explore our office.  We encourage parents to accompany their children back for the initial visit.  Our staff will review the health history form and discuss proper tooth brushing technique, diet, and other age-appropriate information.

Our staff is trained to make your child’s first visit a positive experience. Please do not be upset if your child cries. Children are often afraid of anything new and different, and crying is a normal reaction to fear of the unknown. Some children may be fearful, but once a child becomes familiar with our friendly staff and the new surroundings, the fear disappears. To prepare your child for the visit, be positive in your approach and allow us explain to your child what will happen during the appointment.

Before the visit, we encourage you to talk with your child about his or her visit in an age-appropriate, positive manner.  Parental attitudes toward the dentist play a significant role in how children view the dentist.  Children are skillful at reading mom and dad, if you are anxious there is a good chance they will pick up on it.  Please do your best to remain calm and upbeat about your child’s visit.  Explain that we will count their teeth and maybe take some pictures.  Please avoid using words that may suggest unpleasantness.  All procedures will be explained in a manner in which kids can understand.  We treat all children as if they were our own.

Children’s books, such as The Berenstain Bears Visit the Dentist and Show Me Your Smile!: A Visit to the Dentist (Dora the Explorer) are a great way to prepare your child for their visit.   

For your convenience prior to visiting our office, please click on the link below to print the New Patient Forms, complete the information and bring it with you to your first visit.  

Begin cleaning your baby’s mouth during the first few days after birth by wiping the gums with a clean, moist gauze pad or washcloth.  As soon as teeth appear, decay can occur.  Brush your child’s teeth in the morning and before bed time.

For children under the age of 3 use a child-size toothbrush and fluoride toothpaste   with an amount no larger than the size of a grain of rice.

 When your child has two teeth that touch, you should begin flossing their teeth daily.

For children 3 to 6 years of age, use a pea-sized amount of fluoride toothpaste.   Until you’re comfortable that your child can brush on his or her own, continue to supervise their brushing and remind them not to swallow the toothpaste.

The selection of toothpaste at the grocery store seems to grow weekly. With a little knowledge about what’s best for your little one, you can successfully navigate this isle and make a toothpaste selection that will make you happy and your child eager to brush.

From the time the first teeth begin to erupt until all permanent teeth come in it is especially important for children to use a toothpaste containing fluoride. Fluoride in toothpaste helps to prevent cavities by strengthening teeth. Until a child is capable of spitting out toothpaste when brushing, a rice or pea sized amount should be used at this stage. While you may not love the idea of purchasing separate toothpastes for your kids, toothpastes with whiteners should be avoided as they are too abrasive for baby teeth which are softer than adult teeth.

In order to get your child excited about brushing it is a great idea to allow them input in selecting their toothpaste. Many manufacturers make kid-friendly options that taste appealing to children and are also tooth friendly as well. You may shake your head at why a 3 year old prefers bubble gum flavor over mint, but the important issue at this age is to get your child to be compliant at brushing for 2 minutes twice a day. The right ingredients are much more important than the flavor of the toothpaste.

Some great, kid friendly options available in most grocery stores today are:

Toms Of Maine

Toms of Maine makes toothpastes that contain fluoride as well as those that do not contain fluoride. The only Toms of Maine toothpastes that contain fluoride are the Fruitilicious Children’s Gel and Outrageous Orange Mango Children’s Toothpaste


Kids 2 in 1 Strawberry Smash or Watermellon Toothpaste


Toothpaste featuring Disney and Marvel characters in flavors like sparkle fun, bubble gum and minty breeze

If you have questions about your child’s toothpaste, or any issues related to their oral health, please give our office a call. Our trained professionals are always eager to provide the answers you are seeking.

Between the costumes and the candy, Halloween ranks as one of the absolute best days of the year for kids. With a little bit of care and planning parents can be more comfortable that this day of fun won’t lead to a mouth full of cavities down the road.

With Halloween candy there certainly are some that are worse for your kid’s teeth than others. So that you can purchase your candy with some insight this year, below are some examples of the many varieties of candy and the pros and cons of each.


Chocolate by itself is one of the better candy options. It melts and is more easily washed off of teeth. Dark chocolate is better than milk chocolate because it has less sugar. Chocolate becomes a less optimal option when mixed with sticky fillings.

Sticky/Gummy Candies

These types of candies represent some of the worst options for your child’s teeth. They have a very high sugar content and because they are sticky they are harder to remove from your child’s teeth and therefore give cavity-causing bacteria more time to do their job.

Sour Candy

The acids used to create sour flavors also work to erode teeth. That coupled with the high sugar content which is used to balance the tartness in the candy is a bad combination for teeth.

Hard Candy

Hard Candies have two issues working against them. Because they are hard they tend to linger in your child’s mouth coating every tooth in a sugary saliva mixture. Because they are so hard there is also a tendency to want to chew these types of candies and sometimes they can actually break teeth.


Chewing gum can be one of the best options for Halloween candy if you choose carefully. It stimulates the production of saliva, which helps clear away food, and reduces the levels of acid in your mouth that cause tooth decay. When choosing a gum look for one that contains a sugar replacement instead of natural sugar.

Regardless of what kind of candy you wind up purchasing, your kids will undoubtedly come home with way more candy than they can, or should, eat. With this in mind, Pediatric Dental Associates of Randolph will be collecting your wrapped surplus candy to be donated to the Ronald McDonald house. The kids staying at the Ronald McDonald house are all fighting difficult medical situations and are unable to go trick-or-treating at home this year. Your candy will brighten these kids day and are sure to bring lots of smiles.

We also are requesting you have your kids make cards of support to donate along with your candy. We will be accepting candy and cards in our office through 5pm on November 10th. Happy Halloween!

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