Pain, pain, go away, please don’t even come another day….!

Pain is not just an unpleasant sensory, but also an emotional experience that is subjective and individual to every child who experiences it.  The subjective nature of pain makes it hard to assess in children, especially those who are nonverbal.  No one wants a child to experience pain.  Often there are simple techniques such as; distraction, breathing and imagery that can be used to help children lessen the discomfort; however, these techniques may not be applicable in more invasive procedures and are hard for all children to comply with.  Some children are unable to understand directions or unwilling to follow them.

Some children require special care during dental treatments due to their young age, excessive fear, inability to cooperate and/or extensive treatment needs. Parents often question about why general anesthesia or sedation is necessary for children undergoing dental procedures, which may be painful or uncomfortable.  General Anesthesia and conscious sedation are management techniques that use medication to help children relax so they are less stressed and anxious, and are better able to cooperate during dental treatment. Minimal patient movement during dental treatment helps prevent injury and enables the dentist to work more efficiently, keeping the dental experience positive.

Your children remember more than you think! Especially when it comes to pain.

The brains of children, especially those of age 3 and under, undergo substantial changes and have twice as many synapses as in adulthood.  Early stages of a child’s development are not only affected by genetic factors,  but also environmental factors such as early childhood experiences that stimulate neural activity in the brain. If a child experiences a high level of pain and anxiety,  like an unsuccessful dental procedure, when he is young,  it is possible that they run the risk for post-traumatic stress. The child may experience flashbacks, bad dreams or frightening thoughts that can occur in his everyday life or a similar situation later on in life.  Research studies showed that if a child has a traumatic experience or has a great deal of pain, especially when they are very young, the experience may lead to changes in neurologic development and his overall development.  If there are repeated stimuli, such as pain, the synapses in the brains may be altered which ultimately affects learning, memory and cognitive abilities.  Children are vulnerable to negative influences in early life.  It is important that health-care professionals work together with parents to bring positive early childhood experience that better shape their future.

little crying boy close-up portrait

References: Joseph 2012; Urban Child Institute  2013; Canadian Mental Health Association, 2013

Copyright 2013 The Children’s Oral Care Centre

Our New Pediatric Dentistry Satellite Practice in Whitehorse!

I have great pleasure announcing the opening of my Pediatric Dental Practice in Whitehorse.   When I first went to work in Whitehorse I was drawn in by wonderful, friendly people and the remarkable scenery.  The dental community showed immense hospitality towards me and made our team feel very welcome.  I am excited to join the Whitehorse community and look forward to being of service to children in the Yukon area.

I completed a PhD in Oral Biology alongside with my specialty degree in pediatric dentistry at the University of California, Los Angeles.  Previous to this experience, I undertook the pediatric dentistry residency at BC Children’s Hospital in Vancouver, British Columbia.   I am very grateful for my training, especially in the area of conscious sedation and behavior guidance of children.  These skills have allowed me to have great success in my own practice in Abbotsford, British Columbia and I hope to bring these skills to serve the children in the Yukon and surrounding territories.

We are located with the Whitehorse Dental Specialists Clinic. (Please click here to for  addremap)

 If you are interested in getting more information about us,

 please visit our website at or

 simply call us at (867)336 1360

    to make an appointment today!

We look forward to meeting you and provide positive dental experience to all your children.

Yours sincerely,

Phoebe Tsang DMD, PhD, FRCD(C)

Certified Specialist in Pediatric Dentistry

Diplomate, American Board of Pediatric Dentistry

You are what you eat! A gluten-free diet may give your child a healthier life and a healthier smile!

Celiac disease is a form of gluten intolerance that is known to affect the small intestine.  Gluten is a collection of proteins that are found in wheat, rye and barley and are present in many foods we eat that we wouldn’t even know have it!  Since there is a range of non specific symptoms for celiac disease including: anemia, diarrhea, weight loss and depression, it can be tricky to diagnose right away or at all.  If this disease is left untreated, it can lead to osteoporosis, vitamin and mineral deficiencies and increased risk for cancers.    

Studies have shown that dental problems are common in individuals with celiac disease.    The possible explanations are:

  1. autoimmune responses from the celiac disease affecting tooth development

  2. malabsoprtion of nutrients (calcium/vitamin D) preventing healthy tooth enamel

Awareness of the connection between oral health and celiac disease is crucial for both dentists and parents because often times, oral manifestations are the only clues to prompt the diagnosis.  Individuals with celiac disease may presented with rough textured tooth enamel with yellow or brown spots.   Recurrent canker sores and delayed eruption of  teeth can also be signs indicating celiac disease.    Other symptoms in children that are not dentally related, including delayed growth and puberty, vomiting and irritability are also worth monitoring.  

Although celiac disease can present at any age,  it is especially important to catch it early in children since enamel defects only occur when teeth are forming.  If a child is diagnosed early and be put on a gluten-free diet before majority of his adult teeth are fully formed,  he is less likely to end up with tooth enamel defects.  Teeth with enamel defects are irreversible and are prone to significant tooth decay.   So a gluten free diet may help prevent drastic treatment like crowns or pulling of the teeth!  

Dentists may play a vital role in early diagnosis of this condition by noticing the changes in a child’s tooth enamel and the presence of recurrent canker sores when children present for their routine dental examinations.   Please don’t be surprised if our pediatric dentists at the Children’s Oral Care Centre are prodding a little further about your family history and assessing the tooth for structural defects such as: deep horizontal grooves and large pits or irregularly shaped teeth.  We are also happy to talk to your family physicians as well if further testings are needed to confirm the diagnosis of celiac disease.

Enamel defects
Enamel defect

Aphthous ulcers
Aphthous ulcer












Copyright 2013 The Children’s Oral Care Centre