Scott H. Leaf Pediatric Dentistry, Burke, Northern Virginia


Frequently Asked Questions

Fluoride varnish is a coating that is applied to the outer surface (enamel) of the teeth using a small brush.  The varnish adheres to the teeth and sets after contact with saliva.  The use of varnish has become widely accepted by dentists and pediatricians alike as it easily tolerated by infants and young children, has a prolonged effectiveness, and has minimal risk of ingestion due to its immediate adherence properties.  The American Dental Association, the American Academy of Pediatric Dentists and the American Academy of Pediatricians support the use of fluoride varnish as effective for reducing the rates of dental decay in the pediatric population.  The American Dental Association has rated the scientific evidence in favor of fluoride varnish as being of the highest quality for the success of preventing and reducing dental decay in primary (baby) and permanent (adult) teeth.  

Comparison of fluoride varnish and traditional fluoride gel or foam:

Fluoride Varnish

Topical Fluoride Gel/Foam

5% Sodium Fluoride

1.23% Acidulated Phosphate Fluoride

Quick application with brush allowing infants and young children to easily tolerate product

4 minute application time with trays for maximum effect making effective use difficult or unacceptable for infants and young children.  May aggravate sensitive gag reflex

Adheres to teeth for prolonged effect throughout the day

Expectorated after application, leaving little behind for continued effect

Minimal ingestion of fluoride due to its adherence properties, making this an extremely safe method of application, especially for infants and young children

Extra fluoride can be easily swallowed if not removed with dental suction or expectoration

Child can eat and drink immediately (with the exception of hot food or drinks)

Child must wait 30 minutes to eat or drink as to minimize amount of fluoride lost

Should not be brushed off until the next morning to maximize contact with the enamel





To read more about fluoride varnish, please check out these websites:

Children’s smiles come in all different shapes and sizes. At your child’s dental visit Dr. Leaf or Dr. Nuger may talk to you about the way your child’s smile comes together. Sometimes certain discrepancies in your child’s bite can be corrected early in order to reduce the risk of future extractions, length of future orthodontics (braces), or orthodontics all together. It is important to start appliance therapy early because it works with your child’s natural growth and development to receive the best results. If you are concerned about your child’s smile please call to schedule a consultation appointment today.



An Underbite is when the lower teeth bite in front of the upper teeth. It is important to correct an under bite because it prevents proper function of the front and/or back teeth, and can contribute to future jaw joint disorders (TMJ). This type of bite should be evaluated early on as it may require more extensive treatment when the child is older.

Deep Bite

Deep Bite

A Deep Bite is when the upper teeth almost, or completely cover the lower teeth. It is important to correct a deep bite because it can lead to unusual wear of the front teeth and improper function of the front teeth. Over time it can lead to periodontal disease from the lower teeth biting into the gum tissue of the palate.



Crowding develops when there is not enough space for permanent teeth to erupt, causing them to grow at different angles, high on the gums, or through the palate. It is important to correct crowding as crowded teeth can be very challenging to keep clean and could lead to periodontal (gum) issues and cavities. In severe cases it could lead to impaction of permanent teeth and decreased function (chewing).



A Crossbite is when the upper teeth are biting on the inside of the lower teeth. It is important to correct a crossbite because it can cause premature wear of the teeth, asymmetrical jaw bone development, dysfunctional chewing patterns, and may contribute to future jaw joint disorders (TMJ).


openbite image

An Openbite is when the upper teeth do not adequately meet the lower teeth and can be caused by thumb or finger sucking or a tongue thrust. It is important to correct an openbite because it can cause premature wear on the back teeth, create dysfunctional chewing patterns, and may contribute to future jaw joint disorders (TMJ).

Pregnant and new moms should practice good oral hygiene and chew gum with xylitol three times a day.

Parents should take their children to the dentist regularly, beginning with the eruption of the first tooth. Then, the dentist can recommend a specific program of brushing, flossing, and other treatments for parents to supervise and teach to their children. These home treatments, when added to regular dental visits and a balanced diet, will help give your child a lifetime of healthy habits.

There is very little risk in dental X-rays. Pediatric dentists are especially careful to limit the amount of radiation to which children are exposed. Lead aprons and high-speed film are used to ensure safety and minimize the amount of radiation.

The most important thing to do is to remain calm. Then find the tooth. Hold it by the crown rather than the root and try to reinsert it in the socket. If that is not possible, put the tooth in a glass of milk and take your child and the glass immediately to the pediatric dentist.

Soft plastic mouthguards can be used to protect a child's teeth, lips, cheeks and gums from sport related injuries. A custom-fitted mouthguard developed by a pediatric dentist will protect your child from injuries to the teeth, face and even provide protection from severe injuries to the head.

Have your pediatric dentist evaluate the fluoride level of your child's primary source of drinking water. If your child is not getting enough fluoride internally through water (especially if the fluoride level is deficient or if your child drinks bottled water without fluoride), then your pediatric dentist may prescribe fluoride supplements.

Sealants work by filling in the crevasses on the chewing surfaces of the teeth. This shuts out food particles that could get caught in the teeth, causing cavities. The application is fast and comfortable and can effectively protect teeth for many years.

Make sure your child has a balanced diet, including one serving each of: fruits and vegetables, breads and cereals, milk and dairy products, and meat fish and eggs. Limiting the servings of sugars and starches will also aid in protecting your child's teeth from decay. You can also ask your pediatric dentist to help you select foods that protect your children's teeth.

Fluoridated toothpaste should be introduced when a child is 2-3 years of age. Prior to that, parents should clean the child's teeth with water and a soft-bristled toothbrush. When toothpaste is used after age 2-3, parents should supervise brushing and make sure the child uses no more than a pea-sized amount on the brush. Children should spit out and not swallow excess toothpaste after brushing.

A check-up every six months is recommended in order prevent cavities and other dental problems. However, your pediatric dentist can tell you when and how often your child should visit based on their personal oral health.

Avoid nursing children to sleep or putting anything other than water in their bed-time bottle. Also, learn the proper way to brush and floss your child's teeth. Take your child to a pediatric dentist regularly to have his/her teeth and gums checked. The first dental visit should be scheduled by your child's first birthday. Breastfeeding should be encouraged and continued as long as possible to enhance the child's immune defenses, including oral immune defenses.

Thumb and pacifier sucking habits will generally only become a problem if they go on for a very long period of time. Most children stop these habits on their own, but if they are still sucking their thumbs or fingers when the permanent teeth arrive, a mouth appliance may be recommended by your pediatric dentist.

First, rinse the irritated area with warm salt water and place a cold compress on the face if it is swollen. Give the child acetaminophen for any pain, rather than placing aspirin on the teeth or gums. Finally, see a dentist as soon as possible.

Though your baby's teeth probably will fall out to give way to permanent ones, proper care of baby teeth is important. Decay and loss of them lead to problems when your child is older. Your child also needs these teeth for biting and chewing for years to come and for normal speech development.

Pediatric dentists are the pediatricians of dentistry. A pediatric dentist has two to three years specialty training following dental school and limits his/her practice to treating children only. Pediatric dentists are primary and specialty oral care providers for infants and children through adolescence, including those with special health needs.

In order to prevent dental problems, your child should see a pediatric dentist when the first tooth appears, or no later than his/her first birthday.

A toothbrush will remove plaque bacteria that can lead to decay. Any soft-bristled toothbrush with a small head, preferably one designed specifically for infants, should be used at least once a day at bedtime. Begin cleaning your baby's mouth after feedings with a clean gauze pad or tooth wipes deigned for this purpose. Start brushing the baby teeth at least once a day as soon as the teeth begin to erupt.