Children’s Dentistry: Then Vs. Now

This article is sponsored by Little Dental Studio. Thanks to Dr. Angela Austin for contributing this article!

One of my very first patients at my office in 2011 recently came in and it led me down a nostalgic road. Looking at this picture made me think about how grateful I am to have been able to watch children grow up right before my eyes. It also had me thinking about how children’s dentistry has changed over the years.

dentist and patient

A little background about me: My name is Dr. Angela Austin, and I’m a Board-Certified Pediatric Dentist.  I own three offices in Alexandria, Virginia: Alexandria Children’s Dentistry and Little Dental Studio. I opened my first office 12 years ago!

I thought it’d be fun to merge the past, present, and future of pediatric dentistry in a discussion circling about My Advice as a Pediatric Dentist in 2011 vs. My Advice in 2023.

Let’s get into it.

Home Oral Health Care


My recommendations were to ensure children were keeping up with their oral hygiene by brushing their teeth two times a day, flossing, incorporating a mouthwash when appropriate, and visiting the dentist two times a year.

Age One dental visits were encouraged, and fluoride toothpaste (a small rice grain amount) as soon as the first tooth came in was recommended.


Not much change there! I still encourage the same above practices! One difference from then and now is… I am a mom! A mom of three children: ages 9, 6 and 4.

dentist and family

Being able to relate to other parents when it comes to a “not one size fits all” approach has been very comforting to parents. My pivoting skills are top tier!

For example: some parents rather not start using fluoride at the age I recommend. How can we merge their desires with my expertise? As a practitioner, it’s important to be able to switch from a more authoritarian approach to a solution-based approach.

In 2023, I now recommend other types of toothpastes that have hydroxyapatite in them (examples: RisewellBoka) if a parent is not fond of fluoride. These toothpastes have wonderful properties that remineralize teeth and have prevention properties similar to fluoride.

Discussions at a Normal Hygiene Visit


We were truly prevention driven and we’d fix cavities when a child presented with them. We’d do fillingscrowns, or whatever the tooth needed. We were big on education and on prevention (great oral health care at home, sealants, nutritional counseling, regular routine visits).

Once we got the patient back on the right track, our goal was to continue for the child to be cavity free and have great oral health.


While all the above strategies still reign true today, I’ve done a big shift in my practice by practicing children’s dentistry in a more functional way.

I now look at the patient’s airway and whether they have restrictions (such as tongue ties and lip ties). We now know that speech issues, ADHD, sleeping and learning disorders can sometimes have to do with the child’s airway, and/or their face structure. We know there are ways to help children in ways we never realized before.

We’ve also shifted to a team approach if we notice a problem: we collaborate with speech therapists, ENT physicians, lactation specialists, chiropractors, and myofunctional therapists.

While not every child has an issue outside of a cavity here and there, there are more and more children that deserve to get answers that their parents have been so desperately searching for.

We know that many functional disruptions can contribute to oral hygiene issues, orthodontic problems, and even speech concerns. And as a pediatric dentist, I’m able to help alleviate these functional oral problems.

Restorative Dentistry


When we saw a child, and the child presented with a cavity; very traditionally we’d go over oral hygiene tips, nutrition recommendations, genetic predispositions, and we’d schedule the child to come back for a filling.

Traditionally the child would come back, and we’d work our magic. We used a technique called Tell Show Do:

  • Tell the children what we’d like to accomplish
  • Show them in a non-threatening manner
  • Then Do the procedure

We may or may not have used nitrous oxide (laughing gas), and we usually would need to numb them to get the procedure done.


The Dental Laser! This has been revolutionary in children’s dentistry.

child with dentist

I started using our CO2 Solea Dental Laser in 2018 and it’s been wonderful. We use the laser to fix cavities without getting the children numb. So, you guessed it….no needles (although we don’t like to use that word as pediatric dentists!).

The biggest benefit for children is that they are not numb, and this leads to less post-operative complications and also the ability to reduce the amount of visits if the child has more than a few cavities. Honestly, the benefits are endless.

I still use many of the same techniques as I did in 2011: a gentle approach, Tell Show Do, but I use more mindfulness approaches and take great care in using a parent-patient-provider team method. I offer free yoga classes to our patients and I’m very much in tune with what children need beyond dentistry.

yoga at dentist studio with kidsThe Future of Pediatric Dentistry

I’d say the biggest shift in pediatric dentistry is that we are not solely focused on our patients’ teeth, oral hygiene, and prevention. These practices are still very important and will never stray away from this.

But while we are still focused on their teeth, we are also focused on a whole lot more. We’ll be playing an active role with an interdisciplinary team of professionals to help our children eat better, breathe better, and smile more. I’m also hopeful that more dentists consider mindfulness techniques and also the involvement of our patients and their parents more in our treatment approach. These are trends I’m most ecstatic about!

children's dentistry doctor and patient

To learn more about Dr. Angela Austin and Little Dental Studio, please visit our website:, give us a call at: 703-495-3565, or visit us on our social media accounts:@littledentalstudio.

We offer complimentary tours and happy visits to get acquainted with our children’s dentistry team and our office.