Common questions

A child should see a dentist by their first birthday, or within six months of the first tooth coming in, whichever happens first. This is the recommendation of the American Academy of Pediatric Dentistry and the American Dental Association.

That feels early to most parents, and the first visit is genuinely short. What it buys you is a baseline: we can spot early decay while it is still reversible, check that the jaw and bite are developing normally, and give you specific instructions for the teeth your child actually has. Families who start at one tend to avoid the emergency visit at four.

A first visit at Brightburrow takes about 40 minutes and includes a full exam, a gentle cleaning, fluoride varnish if you consent to it, and time for your questions. For children under three, the exam is usually done knee-to-knee, with your child lying back across your lap facing you.

Nothing happens without warning. We show your child every instrument before it is used, and we say what it does in plain words. If your child is not ready for part of the visit, we skip that part and note it for next time. No child has ever been held down in this office.

Yes. A parent or guardian is welcome in the treatment room for any appointment, at any age, and you never have to ask permission. Our operatories have a parent chair in them for exactly this reason.

The one thing we will ask is that you let us do the talking during the exam. Children take their cues from the adult in the room, and phrases meant to reassure, like “it won’t hurt” or “be brave,” introduce the idea that it might. If we need you to hold a hand or a phone, we will say so.

Yes. Dr. Julia’s residency at Nationwide Children’s was largely spent treating children with developmental and medical complexity, and we take referrals from general dentists who are not set up for it.

Practical things we can do, if you tell us in advance: schedule the first appointment of the day or the first after lunch, when the office is quiet; turn off the overhead music; skip the sunglasses; let your child sit in the chair on a previous visit without any treatment happening; run through the exact sequence of the visit ahead of time so you can practice at home. Tell Rosa what works and what does not when you book, and it goes in the chart so you do not have to explain it again.

We ask for one business day’s notice to cancel or reschedule. There is no fee for the first two late cancellations or missed appointments in a calendar year. After that we charge $45, and we will always call you before applying it.

Sick children are never charged, for any reason, on any number of occasions. If your child has a fever, has vomited in the last 24 hours, or has hand-foot-and-mouth, please keep them home and call us. We would rather move the appointment than have it move through the waiting room.

Most children need a cleaning and exam every six months. Children at higher risk for cavities, including those with a history of decay, orthodontic appliances, dry mouth, or certain medical conditions, are often seen every three or four months instead.

We set the interval per child rather than by policy, and we tell you which one your child is on and why. If your child is on a three-month schedule, that is a clinical decision we will explain, not an upsell.

Children under three should use a smear of fluoride toothpaste the size of a grain of rice. Children three and older should use a pea-sized amount. Both should be supervised, and both should spit rather than rinse afterward, because rinsing washes away the fluoride that is doing the work.

Brush twice a day, and make the second time the last thing before bed with nothing to eat or drink after. Most parents are surprised by how much that one change matters. Keep brushing for your child until they can write their name in cursive, which is a rough but reliable proxy for the fine motor control brushing requires.

Most children benefit from sealants on their permanent molars. Sealants reduce cavities in the chewing surfaces of back teeth by about 80 percent in the first two years, and the deep grooves on those molars are where the large majority of childhood cavities start.

The timing that matters is soon after the tooth comes in, which is around age six for first molars and age twelve for second molars. A sealant placed before a groove starts to break down works; one placed after does not help as much. We check them at every cleaning and repair them for free if they chip.

Usually yes. Baby teeth hold space for the permanent teeth behind them, and an untreated cavity in a baby tooth can cause pain, infection, and damage to the permanent tooth developing underneath it. A back molar that comes in at age two is not lost until age ten to twelve, so it has to last.

There are exceptions. A small cavity in a front baby tooth that is already loose in a six-year-old may not be worth treating. We will tell you when that is the case. When a tooth does need work, we will show you the photo or the x-ray on the screen and explain what we are seeing before you decide.

Yes. We use digital sensors, which cut radiation by roughly 80 percent compared with the film systems most adults remember, and we use a leaded apron and thyroid collar on every child. A set of two bitewing x-rays delivers less radiation than a one-hour flight.

We take x-rays when there is a reason to, not on a fixed schedule. For most children with no history of decay and visible spacing between the back teeth, that means the first bitewings around age five or six. If your child’s teeth touch tightly, we may need them sooner, because that is where cavities hide.

The American Association of Orthodontists recommends a first orthodontic evaluation by age seven. At seven, enough permanent teeth have come in to reveal crowding, crossbites, and jaw growth problems, while enough growth remains that some of them can be guided rather than corrected later.

An evaluation at seven does not mean braces at seven. For most children the answer is that we watch and recheck at each cleaning. We do these evaluations here as part of a regular visit at no additional charge, and we will tell you plainly when we think you can wait.

A tongue-tie is diagnosed by function, not appearance. The signs that matter are feeding-related: a shallow or clicking latch, nipple pain or damage, a feed that takes longer than 30 minutes, poor weight gain, or a baby who falls asleep at the breast and wakes hungry twenty minutes later. A short frenulum on its own, with feeding going well, is not a problem and does not need treatment.

If feeding is difficult, start with an evaluation from an IBCLC lactation consultant. Many latch problems have nothing to do with a tie and resolve with positioning changes. When a release is genuinely indicated, Dr. Marco does the procedure here and works with the lactation consultants at Cedarfield Family Birth Center on the follow-up.

Silver diamine fluoride, or SDF, is a liquid painted onto a cavity to stop it from growing. It requires no drilling and no numbing, takes about a minute, and is useful for very young children, children who cannot tolerate a filling yet, and teeth that will fall out before the decay becomes a problem.

Yes, it stains. The treated decay turns permanently black. On a back molar nobody will see it. On a front tooth it is obvious, and we will show you a photo of what it looks like before you decide. Many families choose SDF on back teeth and a regular filling on front teeth, which is a completely reasonable answer.

Brightburrow is in network with Delta Dental Premier and PPO, Cigna DPPO, Aetna DPPO, MetLife PDP Plus, Guardian, United Concordia, Anthem Blue Cross Blue Shield Dental, and Ameritas. We also accept Ohio Medicaid through CareSource and Buckeye Health Plan.

If your plan is not on that list, we are still happy to see your child. We file the claim for you as an out-of-network provider, and Rosa will verify your benefits and quote you the out-of-pocket number before your appointment, not after it. Plans change their networks without telling anyone, so call us with your member ID and we will check rather than guess.

Yes. We accept Ohio Medicaid through CareSource and Buckeye Health Plan for children through age 20. Covered preventive care, including exams, cleanings, fluoride, sealants, and x-rays, is billed directly to the plan with no cost to you.

Medicaid appointments are scheduled the same way and in the same time slots as every other appointment. We do not keep a separate schedule for them and we do not limit how many we take per day.

Families without dental insurance can join the Burrow Club, our in-house membership plan. It covers the visits most children need in a year, exams, cleanings, fluoride, and x-rays, for a flat annual fee, and includes 20 percent off any additional treatment.

The Burrow Club is not insurance. There is no deductible, no annual maximum, no waiting period, and no claim to file. Full details, including what it does not cover, are on the membership page.

Nitrous oxide, sometimes called laughing gas, is the most widely used and best studied form of sedation in pediatric dentistry, and it is safe for healthy children. Your child stays awake and able to talk the entire time. The effect wears off within about five minutes of breathing plain oxygen at the end of the appointment.

Children go back to school the same day and can eat normally. The most common side effect is mild nausea, which is why we ask for a light meal beforehand rather than an empty stomach. Nitrous is not appropriate for children with a blocked nose, certain respiratory conditions, or a recent middle ear surgery, so we go through health history before we use it.

For nitrous oxide, give your child a light meal two to three hours before the appointment. A full stomach or a completely empty one both raise the chance of nausea. Toast, yogurt, or a banana is ideal; a large breakfast is not.

For oral conscious sedation, the instructions are stricter and different: nothing to eat after midnight, and clear liquids only up to two hours before the appointment time. We give these to you in writing at the visit where sedation is scheduled, and we call the day before to confirm you have them. If your child eats anything outside these instructions, call us before you drive over. We will reschedule rather than proceed.

If it is a permanent tooth, pick it up by the crown and not the root, rinse it briefly in milk or saline if it is dirty, put it back in the socket if you can, and call us immediately at (216) 555-0148. If you cannot reinsert it, put it in a cup of cold milk and get to us within 30 minutes. Time matters more than anything else here.

If it is a baby tooth, do not put it back in. Reinserting a baby tooth can damage the permanent tooth forming above it. Control the bleeding with gauze and call us the same day so we can check for damage to the socket and the teeth on either side.

Do not scrub the tooth, do not store it in tap water, and do not wrap it in a tissue. Tap water and dry storage both kill the cells on the root surface that make reattachment possible.

A small chip with no pain and no bleeding is not an emergency, but it should be looked at within a few days. A chip that exposes yellow or pink tissue inside the tooth, or that comes with pain, looseness, or a darkening tooth over the following weeks, needs to be seen the same day.

Call us either way and describe what you see. We hold two openings every morning for children who woke up in pain, and we would rather look at a chip that turns out to be nothing than have you wait it out.