Category Archives: Pediatric Dentistry

Chipped Teeth

If your child chips a tooth you should give us a call to arrange an appointment to evaluate the affected tooth and surrounding tooth structures.  Depending on the size of the chip, we may need to smoothen or repair the tooth with a white bonded filling.  Going forward, we will continue to evaluate the tooth to make sure there is no damage to the tooth’s nerve structure. 

Avulsed Tooth (Knocked Out Tooth)

The most significant injury to your child’s mouth is a tooth that is completely knocked out.  Whether it is a baby tooth or an adult tooth this is a dental emergency and requires a call to our office immediately.  Part of our mission is to be available for our patients 24/7.  If the tooth is dirty, gently rinse off the tooth with water and reinsert the tooth into the socket.  If you cannot get the tooth back into the socket, place the tooth in a cup of milk.  Call the office so we know you are on your way.  In the office we will evaluate and treat the affected tooth. 

If the tooth is a baby tooth, do not attempt to reinsert the tooth.  It is not recommended to reinsert a baby tooth because you can potentially damage the developing permanent replacement tooth.  Call the office so the tooth could be evaluated and treated.  Depending on which tooth has been lost, a space maintainer maybe needed to maintain the proper space.

Preventing Tooth Injuries

One of the most common ways teeth are injured is through playing sports.  The best and easiest way to prevent injuries to teeth while playing sports is to wear a mouthguard.  Mouthguards are inexpensive, readily available and comfortable to wear.  Our doctors believe that mouthguards should be a required piece of equipment for any team sport. 

For any dental emergency please don’t hesitate to give us a call 973-989-7970

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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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When you choose a practice, you do so with the expectation of getting the best care possible. What makes a practice truly special and stands above its competition is exceptional care and compassion from the providers and the front desk staff. The very best practices have individuals answering the phones and working their reception desks that back up excellent medical care with phenomenal customer service and a thorough knowledge base to answer any questions.

At Pediatric Dental Associates of Randolph, our Pediatric Dentists provide extraordinary care with empathy. Our hygienists have extensive experience working with kids of all ages and abilities and are adept at making every child as comfortable as possible.

Our front desk staff backs up our team of providers with comprehensive knowledge enabling them to answer any insurance questions. They get to know every parent or guardian individually and follow through on any issues or questions until they are resolved. Our front desk staff also works tirelessly to accommodate busy schedules when arranging appointments.

As the first people you see when you enter the office and the last you see as you check out, their mission is solely to make things run effortlessly, making every experience at Pediatric Dental Associates of Randolph a positive one, every single time.

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.

In our office we see far too many children with damage to teeth that could have been prevented by wearing a mouth guard.

Children who don’t wear mouth guards playing sports are 60 times more likely to harm their teeth. These injuries often result in permanent damage even after medical intervention. Yet, most parents will admit that their children do not wear a mouth guard during organized sports.  While some sports like football and field hockey require kids to wear a mouth guard, many sports such as baseball, soccer and basketball do not.  

As you ready your children for spring sports, please keep in mind that mouth guards have been proven to dramatically decrease the risk of oral injuries and they are also one of the least expensive pieces of protective sports equipment available. Not only do mouthguards save teeth, they help protect jaws and can also prevent traumatic injuries such as concussions. 

The most effective mouth guard should be comfortable, covering the teeth and depending on the patient’s bite, also the gums. It should also be durable, easily cleaned, and not restrict speech or breathing.  We believe if you start your child out wearing a mouthguard while they are young it will be a natural routine to always reach for a mouthguard when suiting up for play or practice. 

At Pediatric Dental Associates of Randolph, Dr. Mannella, Dr. Marybeth and Dr. Russo are happy to recommend the best option of dental protection for your child.  Our mission in caring for your children’s dental health goes beyond simply reminding them to brush and floss regularly.  By discussing the various types of mouthguards available, from those custom-made in our office, to ready-to-wear ones available at any sporting goods store, you can make an informed decision on how to best protect your child.

It is important to remember damaged teeth do not grow back. Our motto at Pediatric Dental Associates of Randolph is “We make smiles happen”. Protect that perfect smile – always insist that your child wear a mouthguard.

Please call our office at 973-989-7970 for an appointment to discuss the use of mouthguards or any concerns you have about your children’s dental and oral health.

As Chief of Pediatric Dentistry at Morristown Medical Center and as a Pediatric Dentist practicing in Randolph for over 25 years, I get asked a lot of questions from parents who want to make sure they are doing everything to help take proper care of their children’s teeth.  Recently I appeared with Marissa Brahney on News 12’s Mom’s Minute segment answering these frequently asked questions. 

When should I first take my child to see a dentist?

This is one of the most frequent questions I get asked.  Parents are often surprised to learn that both the American Academy of Pediatrics and the American Academy of Pediatric Dentistry both recommend that children first see a dentist with the eruption of the first baby tooth.  This is to make sure that there are no underlying issues and that the teeth are coming in properly.  At Pediatric Dental Associates of Randolph we try to make this process easy for new parents by offering free exams to all children under the age of two. 

What is the difference is between a Pediatric Dentist and a General Dentist?

A lot of people aren’t aware that Pediatric Dentists have an additional two years of training beyond that of a General Dentist.  This additional training is focused on the specific needs of working with children including developmental issues, special needs patients, pediatric dental trauma, pediatric sedation and how to recognize developing orthodontic problems.   Pediatric Dental offices like ours are also geared to be more welcoming to children.  Our office is brightly colored and decorated to appeal to children, we have a fish tank and TV’s playing children’s programming and our staff and hygienists are thoroughly experienced in accommodating the needs of children of all ages and abilities. 

Why do you need to fix decay in a baby tooth if it will fall out anyway?

Baby teeth have a very important role.  They are the place holders for the adult teeth that are forming below the gum line.  Baby teeth not only help a child with language development and are vital to eating but they also help to ensure that a child’s mouth will grow properly while maintaining space for the adult teeth that will follow. 

What are dental sealants?

Sealants are beneficial in preventing dental caries on premolars and molar teeth on children and adults.  A dental sealant is a protective barrier placed in the pits and fissures of teeth.  They seal out food and bacteria which can result in cavities.  Sealants can reduce the incidence of cavities 86% the first year and up to 58% after 4 years.   Most dental insurances cover the cost of sealants in children, sealants do not hurt and children are able to eat after the procedure.

If you have a pediatric dental question that was not answered here please feel free to call Pediatric Dental Associates of Randolph at 973-989-7970 and I will be happy to discuss any concerns you may have. 

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