Pediatric Dentist FAQ - Vero Beach, FL
Choosing a dentist for your child comes with a lot of questions - about timing, training, what’s normal, and what’s not. Below, Dr. Andrew Nickel answers the questions parents ask most often at Nickel Pediatric Dentistry in Vero Beach. If your question isn’t here, please give us a call at (772) 494-6010 - we’re always happy to talk through it before your visit.
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What is a pediatric dentist, and how is one different from a general dentist?
A pediatric dentist is a specialist who has completed at least two additional years of advanced residency training after dental school, focused entirely on the oral health of children - from infants through adolescence, including children with special healthcare needs. That additional training covers child development, behavior management, sedation safety, and the way growing teeth and jaws interact with overall health. It’s the dental equivalent of the relationship between a family doctor and a pediatrician: both are qualified, but one has built an entire career around treating children well.
When should my child have their first dental visit?
The American Academy of Pediatric Dentistry (AAPD) recommends scheduling a child’s first dental visit by age 1, or within six months of the first tooth coming in - whichever comes first. Early visits aren’t just about checking the teeth that have erupted. They give us a chance to look at jaw and airway development, walk you through brushing technique, talk about feeding habits, and - most importantly - give your child a positive first experience with the dental chair before they ever need real treatment.
Are all pediatric dentists board certified?
No. Pediatric dentists are licensed to practice as soon as they finish their residency. Board certification through the American Board of Pediatric Dentistry (ABPD) is a separate, voluntary distinction - earned only after passing a multi-day exam and committing to ongoing continuing education. According to the ABPD, nearly 80% of pediatric dentists today pursue board certification, but it remains an additional credential. Dr. Nickel is a Diplomate of the ABPD; you can verify his certification at abpd.org, or read more on our board certification page.
How often should my child see the dentist?
For most children, a check-up and cleaning every six months is the right rhythm - the same cadence recommended for adults, and the schedule the AAPD endorses. Some children benefit from more frequent visits if they have a history of cavities, are in active orthodontic treatment, or have specific medical conditions that affect oral health. We’ll let you know at your child’s first visit if a different schedule makes sense for your family.
Why are baby teeth important if they’re going to fall out anyway?
Baby teeth do far more than chew food. They hold space for the adult teeth coming in behind them, guide jaw development, support clear speech, and shape the smile your child shows the world. When a baby tooth is lost too early to decay or trauma, the surrounding teeth can drift into the empty space - leading to crowding and orthodontic complications years later. Treating baby teeth well is one of the simplest investments you can make in your child’s adult smile.
Are dental X-rays safe for kids?
Yes. Modern pediatric dental X-rays use digital sensors that emit a small fraction of the radiation of older film X-rays, and we cover your child with a leaded apron and thyroid collar during every exposure. We also follow the AAPD’s image-when-needed guidelines - we don’t take X-rays on a fixed schedule, only when there’s a clinical reason to (such as checking between teeth that are touching, or assessing growth and tooth eruption). For most children, that means X-rays once a year or less.
Does my child need dental sealants?
For many kids, yes. Sealants are a thin protective coating applied to the chewing surfaces of the back teeth - where deep grooves can trap food and bacteria that toothbrushes can’t always reach. The CDC has consistently identified sealants as one of the most effective cavity-prevention tools available. We typically recommend them once the first permanent molars have erupted (usually around age 6) and again when the second molars come in (around age 12).
How much fluoride does my child actually need?
Enough to strengthen developing enamel - but not so much that it becomes harmful. For most children, that means a fluoride toothpaste used twice daily (a rice-grain smear under age 3, a pea-sized amount from age 3 onward), plus the fluoride present in most municipal tap water. We may also recommend a professional fluoride varnish at preventive visits, especially for children at higher cavity risk. If your home uses well water or filtered water, let us know - we’ll check whether supplemental fluoride is appropriate.
Can a pediatric dentist evaluate or treat a tongue-tie or lip-tie?
Yes. As a board-certified pediatric dentist, Dr. Nickel evaluates for tongue-tie (ankyloglossia) and lip-tie during routine exams - and treats them when treatment is appropriate. A frenectomy is the procedure used to release a restrictive frenum that’s interfering with feeding, speech, or oral development. Not every tight frenum needs treatment, and the right age and approach depend on the child. If you’re concerned your infant or older child may have a tongue-tie, please bring it up at your visit.
My child broke or knocked out a tooth - what should I do?
Call us immediately at (772) 494-6010. Our emergency line is available 24/7. While you’re on the way, here’s what to know:
- Knocked-out permanent tooth: Pick it up by the crown (not the root), rinse gently if dirty, and place it in milk or in the cheek (older children only - never in younger children’s mouths due to swallowing risk). Time matters - get to us as fast as you safely can.
- Knocked-out baby tooth: Do not try to put it back in. Bring it with you so we can confirm what was lost.
- Broken or chipped tooth: Save any pieces, rinse your child’s mouth with warm water, and call us. Treatment depends on the extent of the damage - options can include bonding, a crown, or, in severe cases, extraction. Extraction is always a last resort with baby teeth, because preserving the space matters for adult tooth development.
Does Dr. Nickel offer sedation for nervous or special-needs children?
Yes. Dr. Nickel completed his pediatric residency at the University of Southern California, with rotations across three major children’s hospitals where sedation training is part of the daily clinical environment. At Nickel Pediatric Dentistry, we offer a range of options - from nitrous oxide (“laughing gas”) for mild anxiety to deeper sedation pathways for children who need it. The right approach depends on your child’s age, anxiety level, medical history, and the treatment planned. We’ll always walk through the options with you before any sedation appointment.
My child sucks their thumb. When should I worry?
Thumb sucking is normal, comforting behavior - and most children stop on their own between ages 2 and 4. The concern is when the habit continues past age 4 or 5, when permanent teeth begin to come in. Persistent thumb sucking at that stage can affect how the upper and lower teeth fit together and how the roof of the mouth develops. If your child is still sucking their thumb past age 4, mention it at your next visit and we’ll talk through age-appropriate strategies to help them stop.
My child grinds their teeth at night - should we be worried?
Probably not. Nighttime teeth grinding (bruxism) is common in kids, and most outgrow it as their permanent teeth come in and their bite settles. We’ll watch for unusual wear at every check-up. In the rare cases where grinding is causing pain, headaches, or visible damage to the teeth, we may recommend a custom nightguard or look into airway-related causes that sometimes contribute to bruxism in children.
Does my child need a mouthguard for sports?
If your child plays a sport where contact is possible - football, basketball, soccer, baseball, hockey, lacrosse, even skateboarding - yes. A custom-fitted mouthguard from our office fits more comfortably and protects more reliably than the boil-and-bite versions sold at sporting goods stores. We’ll often suggest a custom mouthguard once permanent front teeth are in and your child is in organized play.
Do you accept new patients? What does a first visit cost?
Yes - we’re accepting new patients of all ages. First visit costs depend on your insurance and what your child needs at the appointment (a routine exam and cleaning is different from a problem-focused visit). We accept most major PPO dental insurance plans and will verify your benefits before you arrive. For more on insurance, payment plans, and what to expect financially, see our financial information page.
How do I schedule an appointment?
Call (772) 494-6010 or request an appointment online. We’ll confirm your appointment time within one business day and let you know what to bring. Our office is at 2145 Indian River Blvd, Suite B, Vero Beach, FL 32960, with easy access from US-1, SR-60, and I-95.
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Still have a question?
We’d rather answer it now than have you wonder. Call us at (772) 494-6010 during office hours, or send your question through our appointment form and we’ll get back to you within one business day.
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