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First Visit

What is a Pediatric Dentist?

A pediatric dentist is a dentist who has received an additional 3 to 4 years of advanced specialty training in meeting the dental needs of children from infancy to adolescence. Pediatric dentists, during the course of their post graduate, train extensively in child development and psychology, behavior management, caring for children with special needs, methods of handling oral/facial trauma, anesthesia and sedation methods. They also develop a comprehensive understanding of facial growth and dental needs of every child at every stage of development. Our Manhattan pediatric dentist truly enjoys working with children and strive to make each of their dental care visits a positive one.

When should I bring my child in for a first visit?

According to the American Dental Association parents are advised to have their baby around the time of their first birthday! This early first visit is a very important one. We examine the mouth and teeth to make sure that everything is developing normally and we also teach parents how to care for their babies’ teeth, help with tooth brushing technique, and answer any questions. It also gives our patients and their families a chance to get to know us and become familiar with our clinic.

When will my child’s first tooth appear?

Your child’s first teeth will start to appear in the 6 to 12 month range. While this is an extraordinary milestone, you need to be aware that your baby may find the experience a little bit uncomfortable. Teething can make them feel irritable. They may be fussy, have trouble sleeping, not want to eat, and be drooling quite a bit. While you are powerless to speed up the process of teething, there are a few things that you can do to soothe your baby as their new teeth are erupting into place. Common approaches to helping your baby feel more comfortable while getting their new teeth include teething rings or a cold spoon or moist gauze rubbed over their gums. Even for these few new teeth, it is important to establish an oral healthcare regimen for your baby. For information on when your baby’s first set of teeth will erupt into place, consult this time line from the American Dental Association.

How can I prepare my child for their first visit?

You can prepare your child by explaining that the visit will start by having one of our friendly team members provide a tour around our super fun space. This will allow you and your child to become oriented and familiarized with the clinic. Your child will get to pick his/her favorite flavour of toothpaste from our menu, pick a toothbrush and get to watch his/her favorite Netflix show overhead. Dr Carolina will count your child’s teeth and check for sugar bugs. Of course, there will be stickers to choose from, and no appointment will be complete without a token and trip to our prize chest!

Can I stay with my child during the appointment?

Definitely! In fact, we encourage it! You are welcome to sit in the chair with your child until he/she is comfortable enough to sit alone. Once your child is calm and relaxed, you can sit back and relax in our Dental Lounge.

Do I need a referral?

We are always happy to see new patients and a referral is not necessary.


My Child is starting Kindergarten and still sucking their thumb, will this habit affect their new teeth?

Some children persist in sucking their thumbs or fingers beyond their preschool years. For these children the activity continues to be a source of comfort, relaxation, and security. It may even help them fall asleep at night. However, it is important as parents to be aware that if your child’s thumb or finger sucking habit is still present when their permanent teeth come in, there is a greater chance of developing a bad bite. This means that if the activity has not ceased by the age of five or six years, you need to constructively and gently help your child stop the habit. It is also a good idea to have a comprehensive evaluation at this time. Your pediatric dentist can assess if there are any habit related alterations to the alignment of your child’s teeth or jaws, or if it is affecting their speech or swallowing patterns. They can also discuss habit control strategies with you, as well as follow your child’s bite and facial development as they grow. If there are recommendations that interceptive appliances or corrective orthodontic care is required, the pediatric dentist will discuss these with you.

How often should I brush my toddler’s teeth?

Teeth should be brushed at least twice a day. After breakfast and before bed are the ideal times to brush. You should assist your child with brushing until your child can eat with a fork and a knife. We are happy to provide you with some helpful tips!

Should I use toothpaste?

Before a child can spit (usually at around 2.5-3 years old), plain water and a toothbrush should be sufficient, unless your child is at high risk for cavities in which case we may advise brushing with a fluoridated toothpaste sooner. Once your child can spit, we recommend brushing with a small amount of fluoridated toothpaste.

How often should I bring my child to the dentist?

We like to see most kids every 6 months for a re-care visit which includes a check up and a cleaning. If children are at high risk for cavities or tend to accumulate plaque and tartar quickly, we may recommend more frequent visits.

If I don’t want my child to have fluoride, is it still OK to come to your office?

While home and in-office fluoride treatments have been shown in many studies to prevent cavities, we understand and respect that some families may prefer to use fluoride-free products. If you prefer to avoid fluoride during your child’s dental visit, please let us know at the beginning of the appointment.

Are routine dental X-Rays necessary?

For kids, one of the main reasons we take x-rays is to look for cavities in between teeth. These are cavities that we can’t detect just by looking in the mouth. Early detection of cavities is important because if they are caught and treated early, the treatment involves a quick and easy procedure. If left undetected and untreated, cavities tend to grow (relatively quickly in baby teeth!) and treatment is generally more involved and more complicated. Teeth can look completely normal and healthy clinically but cavities can be hiding in areas that can only be seen on xrays.

Do your products contain bisphenol-A (BPA)?

All of our products are BPA-free!

Why do baby teeth need to be filled?

Baby teeth are important teeth! They help with chewing, speech and appropriate spacing of the adult teeth. If a child has a cavity that is left untreated, it will grow and can eventually cause pain, infection, swelling and tooth loss. If a baby tooth is lost early, an appliance called a spacer may be needed to hold the space for the adult tooth to erupt.

We have a dental emergency, what should we do?

Dental emergencies in children can arise for a number of reasons. Recognizing the fact that children have active lifestyles, means there is always a chance an accident involving a hit or blow to the mouth or teeth can occur. These traumatic injuries can happen at home, in the playground or on the playing field. Common injuries to the teeth and oral cavity seen in a pediatric dental office include everything from soft tissue lacerations of the lips, cheeks or tongue to chipped, fractured, dislodged or “knocked out” teeth. Equally frequent reasons for children to require urgent dental care are painful toothaches, dental infections, and mouth ulcerations. Whatever the dental emergency may be, prompt and effective care is required to alleviate a child’s discomfort and to prevent more serious consequences to their oral health and overall well-being. 

Pediatric dentists are trained in all facets of dental care for children and are well equipped to handle a wide range of dental emergencies. They provide skilled and compassionate care, helping children to feel comfortable and safe while restoring their oral health and function.

During office hours: call the clinic at (646) 374-1804 and we will do our best to accommodate you. 

Outside of clinic hours, you can take your child to the Emergency Dentist NYC at 100 E 12th St, NY (SE Corner of 12th and 4th Ave) 212-600-4275 or go to the Emergency Department at your nearest Hospital. 

Tongue and Lip Tie

Here are some of the most frequent questions related to tongue tie and the tongue tie procedure.

What is tongue tie?

Tongue Ties come in many different shapes and sizes.

The medical definition of tongue tie is: An embryological remnant of tissue in the midline between the undersurface of the tongue and the floor of the mouth that restricts normal tongue movement. It affects around 20% of the population.

What does that mean to you or I? A small band of tissue underneath the tongue is preventing the tongue from moving left to right, extending out of the mouth, and lifting to the roof of the mouth.

Types of tongue ties

Tongue ties are rated on their location under the tongue.  Some tongue ties are considered anterior, or near the front of the tongue, while others are considered posterior or near the back of the tongue.  It is important to note that ALL levels of tongue tie are significant.  Remember, we consider a person tongue tied when the tongue is not able to function properly due to the restriction. The two types are:

1   Anterior Tongue Tie: Even though this tongue is able to lift some, the back of the tongue is not able to elevate to the roof of the mouth.

2   Posterior Tongue Tie: Even though the frenulum is not visible, the tongue is not able to elevate to the roof of the mouth.

It is important to note each person’s anatomy is different. Only a professional specializing in tongue tie can give an accurate diagnosis of the type of tongue tie and the degree that it affects normal tongue function.

How does tongue tie affect infants?

Although it is often overlooked or dismissed by some medical professionals, a tongue and lip-tie can very often be an underlying cause of feeding problems that not only affect a child’s weight gain but lead many mothers to abandon breastfeeding altogether. Very often, after releasing the tongue and/or lip, mothers report immediate relief of pain and a deeper latch.

The symptoms of reflux and colic often disappear and weight gain occurs rapidly. The sooner the tongue-tie is addressed the better the child will learn to use his or her tongue correctly. Noticeable symptoms include, but are not limited to:

  • Poor latch, suck
  • Poor weight gain, excessive weight loss
  • Fussy baby, colic, frustrated
  • GERD (reflux)
  • Clicking on the breast
  • Frequent latching and unlatching on the breast
  • Sleepy, tired baby on the breast
  • Excessive air intake, dribbling mouth from milk
  • Gumming, chewing the breast
  • Unable to hold pacifier, Shoots pacifier
  • Poor bottle feeding, leaking
  • Long feedings, lasting up to an hour, frequent feedings, insatiable baby
  • Thrush

How does tongue tie affect breastfeeding?

In addition to the effects noted above, breastfeeding moms experience:

  • Poor milk supply or Oversupply
  • Severe pain when breastfeeding
  • Bleeding, cracked or blanched nipples
  • Nipple vasospasms
  • Nipple “flattening” post-breastfeeding
  • Mastitis
  • Clogged ducts
  • Nipple thrush
  • Breast lumps
  • Frustration and anxiety associated with breastfeeding
  • Problems bonding with the baby

How do tongue/lip/buccal ties affect an older child?

Untreated or undiagnosed tongue tie can present different symptoms in toddlers and older children.  Tongue tie can cause food aversions due to not being able to properly manipulate food in the mouth.  Tongue ties can also cause speech issues, specifically pronouncing the ‘r’, ‘k’, and ‘l’ sounds.  This is because the tongue cannot properly elevate to the roof of the mouth.

Some children with tongue tie also experience sleep apnea as the restriction of the tongue does not allow for the airway to be blocked off while sleeping, resulting in the tongue slipping down the throat and occluding the airway.

 Untreated tongue tie can also lead to malocclusion of the teeth and improper jaw development.  The proper placement and movement of the tongue is instrumental in proper jaw growth and development.  When a tongue is restricted, proper pressure is not placed on the upper or lower jaw to allow for expansion, resulting in small jaws and necessity for orthodontic care that may involve removal of adult teeth and braces to properly align teeth.

How does tongue tie affect adults?

Emerging research suggests that adults with untreated tongue ties often experience: TMJ symptoms, tension headaches, neck and shoulder pain, and sleep apnea. The reason for these symptoms is that the jaw has improperly formed over time resulting from the tongue not being able to elevate to the roof of the mouth to create a seal.  The result, specific to sleep apnea, is mouth breathing which can result in the tongue slipping down the back of the throat, occluding the airway while sleeping.

What is a lip tie?

A lip tie is medically defined as an attachment of the upper lip to the maxillary gingival tissue. Just as a tongue-tie is a small piece of tissue under the tongue, the lip tie is a small piece of tissue between the upper lip and the gums.  This piece of tissue prevents the lip from flanging out correctly during breast and bottle feedings.

There is some research suggesting lip ties are also associated with improper jaw development and adult tooth placement.

Research presented at the Academy of Breastfeeding Medicine 2016 Conference suggests that unresolved lip ties are associated with reflux and increased gas in infants.  The reason for this association is that the lip tie prevents a perfect seal from being formed around the breast or bottle resulting in air being drawn and swallowed during feedings.

What is a buccal tie?

A buccal tie is an atypical mucosal tether that extends from the cheek to gingiva.  Buccal ties contrast from upper ties, which extend from the midline upper lip to the gingiva.  Buccal ties are asymmetrical; some have ties on both right and left, some only on one side.

They can have effects across a person’s life span:  Difficulty breastfeeding, can effect smile, can cause discomfort as the cheek lifts, possible food entrapment depending on severity.

Do all lip and buccal ties require correction?

No. Just as with tongue ties, lip and buccal ties are not corrected unless they present functional problems.  It is unnecessary to put a child through an unnecessary procedure if there will be no benefit. Check with an expert to see if your child is in need of this procedure.

Should tongue, lip, and buccal ties be corrected at the same time?

Typically, yes.  If multiple ties are noted, all ties should be corrected at the same time to allow for proper movement of the bones and muscles.  Assessment is not solely based on anatomy, but also on function.  Dr. Carolina approaches each family with an open mind and takes into account the totality of the symptoms before making a final recommendation.

How are tongue ties treated?

Correction of a tongue tie means that the tissue is released to allow better mobility of the tongue.  Tongue tie clipping can be performed with scissors, diode lasers, erbium lasers, CO2 lasers, and electrocautery.

Dr. Carolina uses a Light Scapel CO2 laser to perform all tongue and lip tie procedures.  In our experience, we have found that the CO2 laser results in less scar tissue and reattachment of tissue post procedure.

What if I choose not to correct my baby’s tongue tie?

Going through with a tongue tie procedure is a very personal choice.  We try to present you with all of the information, but the decision is ultimately up to you and your family.  We 100% support you in your decision-making process and know that you will make the best choice for your baby and your family.

Will the tongue tie procedure hurt my baby?

The tongue tie procedure will cause discomfort.  We sometimes use a topical anesthetic.  Afterwards, there can be discomfort caused by inflammation of the tissue as well as inflammation in the muscles of the jaw, neck and shoulders.

 We recommend using baby Tylenol and Arnica to treat the pain.  Most babies require Tylenol and Arnica for 12- 48 hours post procedure, though we do see a range of discomfort.  Some children need one dose of medication and others may need as many as 5.  Every baby is different. It is important to follow guides outlined by your Doctor and also follow your baby’s cues.

Dental Insurance and
Financial Information

Do you accept Dental Insurance?

We will complete and submit all insurance claim forms electronically on your behalf. Payments are made at the end of each appointment, and you will be reimbursed directly by your insurance company, usually within a few days.

What insurance do you accept?

While we accept most dental insurances, including the ones below, please contact us to check if we accept your dental insurance.

If we are not covered by Dental Insurance, what methods of payment do you accept?

We accept Visa, Master Card, American Express, cash and Debit.

What if I need to make a change to my appointment?

We reserve a block of time for each child. We kindly ask for at least 48 hours notice to make any changes to an appointment so that we may provide care for another child who is waiting to be seen.

Location, Parking,
Hours of Operation

Where is the clinic located?

We are located at 535 Hudson Street #1C, New York, NY 10014 (ring the buzzer upon arrival). Call us if you need directions: (646) 374-1804. We are easily accessible by subway (E train).

Where should I park?

There is ample street parking to both east and west of the building.

What are hours of operation?

The dental clinic is open from 8:00am-5:00pm Monday – Friday

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