Dr. Josh Twiss and his wife Marianne live in Alamo with their two young girls Harper and Finley. Since they were first married, the Twiss family has dreamed of returning to Danville to open a practice and raise their kids near grandparents, aunts, uncles, and 9 cousins. Before opening Iron Horse Pediatric Dentistry in Danville, Josh spent three years at one of the most successful and demanding pediatric dental offices on the West Coast.
Dr. Josh successfully completed dental school at the State University of New York at Buffalo in 2010 where he was awarded “most outstanding potential in pediatric dentistry”. Following dental school, Dr. Josh completed an additional year of training earning his Advanced Education in General Dentistry (AEGD) at the University of New Mexico. The program focused on dental surgery, dental emergencies, patients with special needs, and pediatrics. During his time in New Mexico, Dr. Josh decided Pediatric dentistry was his life’s mission and completed two additional years of pediatric dental training in New York at the Women and Children’s Hospital of Buffalo. Dr. Josh is Board Certified, the highest achievement within his specialty. It has been a dream come true opening a practice in Danville where Josh can serve the community.
Your child's first visit to the dentist is an important one and it is our goal to make every visit enjoyable and positive. We understand that every parent has worries about how his or her child will behave at the dentist. Your help in preparing your child for their first appointment is important. We suggest staying positive, we want your child to develop a favorable opinion of the dentist. Please do not share with your child any anxiety you may have about dentists. Try to avoid using words that may cause unnecessary fear such as "hurt", "pain", "shot", "needle:, "drill" or "pull"; we use age appropriate and non-threatening words to explain our equipment and procedures. Reassure your child that the friendly doctor and staff will explain everything to him or her and answer all questions.
WILL MY CHILD
The first visit to the office can be a challenging and new experience for many children, especially if they have had a negative experience in another dental office. Parents should not be surprised or embarrassed if their child cries, this is a normal and age appropriate coping skill. Dr Josh and his staff are skilled at connecting with and assessing the level of cooperation of your little ones. Parenting styles vary significantly and we will do our best to accommodate your preferences. With regular dental visits, your child's confidence and comfort grows; laying an important foundation for lifelong dental health. At Iron Horse Pediatric Dentistry, our doctors and staff are specially trained in child development and behavior management. Our goal is to build lasting relationships with our patients from infancy through college and instill in them the skills and desire to have a lifetime of good oral health and habits!
Please be aware that during the first appointment, treatment such as fillings or extractions will NOT be done. We use the first visit to get to know your child and gain his or her confidence in us, to assess your child’s dental needs, and to evaluate behavior to determine the best approach to take in any necessary treatments. Parents are welcome to come to the treatment room with their child as silent observers. For the safety and privacy of all patients, other children who are not being treated should remain in the reception room with a supervising adult. Exceptions will be made for parents with infants.
We're so glad you're here! You will experience a fun, farmhouse-themed office, where you and your children will feel at ease. Our office is environmentally friendly, and state-of-the-art. We have chosen to use the most up-to-date dental materials that are mercury free, BPA free, and latex free. The x-ray technology we utilize is the safest digital technology and the most precise.
Your child’s first visit to the dentist can set the stage for a lifetime of good oral health. And as your baby grows, regular dental visits will be just as important as regular visits to the pediatrician. That's why it's crucial to find an East Bay practice that offers comprehensive baby, child, adolescent, and special-needs dentistry in a soothing, kid-friendly environment. You want your child to feel comfortable and secure when visiting the dentist, and Iron Horse Pediatric Dentistry can provide the perfect environment. We offer an array of services that will grow with your children through the years, and put them on the right path for a lifetime of good oral health.
No two children are alike, and we understand that certain patients require a specific approach. Dr. Josh is experienced with special needs dentistry, and treats these patients with the care and compassion they deserve.
Dental Cleanings & Fluoride Treatments
Restorative Care including
Root Canals (baby teeth), and Extractions
Tooth-Colored Fillings and Crowns
Minimal Sedation with Nitrous Oxide
Oral Sedation and General Anesthesia
Space Maintainers (Spacers)
Sports Dentistry including Exams
& Athletic Mouthguards
Emergency and Dental Trauma Care
Limited Orthodontic Treatment
We encourage every parent to have a basic understanding of the most important topics related to their child’s oral health at each stage of development. Click the boxes to learn more about each stage.
Diet & Nutrition
0-3 YEAR OLDS
Life has changed for you, but what a great change! Most babies are born without teeth, but the mouth still needs to stay clean! Gently wipe your baby's gums after feedings. Avoid the transmission of cavity causing bacteria and other sick germs by limiting behaviors where saliva is shared. This includes the sharing of utensils or cups with your baby. Teething usually starts around 6 months and continues until 2-3 years old. We do recommend using a "smear" of flouridated toothpaste when brushing your child's teeth. This is equivalent to a rice grain amount of toothpaste. Not much! It is best to establish feeding times for your baby or young child. Babies with frequent contact with formula throughout the day or who are put to sleep with bottle can develop cavities very rapidly. As babies learn to walk, injuries are common. Be sure to protect your babies teeth by placing barriers on sharp corners and hard surfaces such as brick fireplaces and bathtub faucets. Pacifier habits should be discontinued by their 2nd birthday. By age 3, you should encourage your child to discontinue any thumb or finger habit.
4-5 YEAR OLDS
This is a very fun age! Kid's imaginations are soaring and they love life. Keep their teeth clean with a "pea size" amount of fluoridated toothpaste 2 times per day. Spit out but don't rinse. Spaces will become much tighter so flossing is needed. Make brushing teeth fun! Sing songs, make noises, etc. Let them brush independently, but always brush after them to make sure the teeth are being properly cleaned, especially before bedtime. Establish a nighttime routine that includes brushing teeth. Studies show that kids sleep better with these routines that include brushing teeth. We encourage reading to your kids instead of screen time! If thumb or finger habits continue to this age, you will most likely see bony changes. Intervention may be needed depending on the child.
6-10 YEAR OLDS
Around 6 years old, permanent teeth start coming into the mouth starting with the 6 year molars. These teeth usually have many deep grooves and sealants are recommended to prevent cavities in these grooves. Studies show that kids don't have the hand eye coordination to brush properly until 7-8 years old. So be sure to brush after your kids if the plague is not properly being brushed away. Emphasize brushing in small circles around the gumline prevent gingivitis. Sometimes interceptive orthodontics is needed at this age. As your child starts their growth spurt, modifications can be made in their facial growth through oral appliances or limited orthodontics. Children also become more active in sports at this age. Mouth guards are recommended to protect your child's teeth. Ask us about our custom mouth guards.
11-14 YEAR OLDS
Kids are gaining more independence at this age and making more decisions regarding their diet and nutrition. During recall cleaning visits, we will educate your child on these decisions for their dental health and overall health. Sodas, sports drinks, energy drinks and junk food are consumed by many teens and healthier options are encouraged. By this age, kids most likely have all their permanent teeth and proper oral hygiene is demonstrated. Evaluations for orthodontics are completed at this age and referrals are given if needed.
15-18 YEAR OLDS
Evaluated for possible wisdom teeth removal occurs during this period. Proper diagnosis requires a Panoramic x-ray to confirm the positioning of the teeth and timing of removal if necessary. High school is also a critical time to touch up sealants and reinforce healthy personal oral hygiene habits before graduation.
Congratulations!I f you are pregnant or are planning to become pregnant, your oral health is very important to you and your baby. Research shows the bacteria that can cause cavities and gum disease in a mother's mouth can easily be passed to her child. Unhealthy gums and teeth have also shown negative affects in unborn children. Healthy smiles for your baby begin during pregnancy. So we encourage moms to take advantage of our free consult at Iron Horse Pediatric Dentistry to discuss steps you can take during your pregnancy to promote good oral health for mom and baby.
Here are a few recommendations during your pregnancy:
Cleanings are great during pregnancy. The best time to receive dental treatment (fillings, etc) is before becoming pregnant but treatment can still be completed safely in the 2nd trimester. This is after organogenesis is complete in the first trimester and before you start feeling uncomfortable in the third trimester. Emergency dental treatment can be completed at any time.
If you suffer from morning sickeness we recommend rinsing your mouth with 1 tsp of baking soda mixed in a cup of water to neutralize the acidic effect on your teeth.
Instead of sugary treats, try snaking on more nutrient-dense foods such as raw veggies, hummus, yogurt, nuts or fruit. It is important to continue taking a daily prenatal vitamin to ensure the baby is getting the vitamins and minerals that are crucial to fetal development.
SPECIAL NEEDS PATIENTS
Pediatric dentists are specifically trained to treat the dental needs of young individuals and adults with special needs. We realize your child may see many different doctors and specialists. Establishing a dental home is key to oral health and prevention. When making an appointment, please let us know that your child has special needs, as well as any medications, arrangements or concerns you may have. This will allow our office to prepare better for any special situations. We may recommend a site visit only. This allows your child to become accustomed to the surroundings, noises and staff of our dental office. This is also more likely to assure a happy first visit. Site visits are complementary and will be recommended by the dentist if needed.
We recommend brushing 2 times per day with a flouride toothpaste and flossing as soon as the contacts between teeth are tight. Be sure to use light pressure and go in slow circular motions. The angle of the toothbrush should allow you to get the plaque out from below the gums too. Even at a young age, studies have shown that the bacteria that cause cavities can start making a home in the grooves of the tongue before kids even have teeth. Therefore, we recommend cleaning the gums and tongue of your baby with a gentle washcloth. Anything you can do to make brushing teeth fun for little kids is helpful. Sing songs, make noises, talk about getting the sugar bugs out, etc.
Diet & Nutrition
A good general rule for a healthy diet is to stay to the outside sections of the grocery store. Many foods in the middle of stores are processed sugars and carbohydrates that are not good for you. For snakes instead of chips, crackers, cookies and gummy fruit snacks, it is best to give them whole fruits and vegetables, cheese, nuts and even yogurt.
Bottles should only have water, breastmilk and formula. Babies should NEVER be put to sleep with the bottle, as this causes rapid tooth decay (baby bottle tooth decay). The sippy cub should not have anything except water in it throughout the day. If you want to give you child white milk or 100% juice, then do it during meals. A good expression to remember is juice just once, milk with meals, and water whenever. These are the lifestyle choices we recommend, but there are birthday parties and times for celebration that should be celebrated!
Sports Dentistry is the prevention and treatment of oral and facial sports injuries as well as related oral diseases and their manifestations. our team highly encourages the use of a custom mouthgurad for contact sports. Studies are currently showing potential of concussion prevention with the use of custom mouthguards. While the main roll of a properly fitted mouthguard is to protect the oral structures, studies are now showing possible links to the prevention of concussions. Please come take advantage of our free sports dentistry consult to learn more.
Dr. Josh was the BEST dentist. His personality immediately put my son (and me) at ease and we walked away excited for the next visit in six months! I actually wish I could be a patient too!
Dr. Josh is wonderfully attentive and kind to both myself and my children. He is quick and efficient with his work while making sure all our questions are answered with a smile. He takes time to explain to my child, in terms they can understand, HIs approach to dental care is to make sure that my child will not be scared and nervous for any procedure, but feel safe and happy when receiving treatment.
I knew because of my medical background, I wanted a board certified dentist. But I did not expect to find my needs met in one office with having a teen and a toddler. Dr. Josh made us feel right at home, talking to my teen like she was a grown up then turning around to talk on my toddlers level. My 2yr old won't stop showing everyone her teeth since the visit!
If your child has suffered a blow to the head, has lost conscienceless, or any other life-threatening emergency, please call 911 or proceed to your nearest emergency room. If your child faces a dental emergency, call us immediately. We are always here to assist when your child’s dental health is at risk. Here are some tips on dealing with urgent dental situations:
Knocked out Teeth (Permanent)
If your child has a toothache, ask him or her what makes it hurt. If it hurts spontaneously or continuously, please make an appointment immediately. We don’t want your child to be in pain. If the pain was an isolated event, be sure there is no food debris caught between the teeth or in the gums. Give Motrin and make an appointment if any pain continues.
If you notice facial swelling or a swollen cheek, please call our office immediately. However, if facial swelling approaches the eye or is causing your child to have trouble breathing, this is a medical emergency and you need to call 911 or go to the nearest emergency room.
Broken Tooth/Filling Knocked out tooth
If your child knocks out a PERMANENT tooth, this is a dental emergency. Put the tooth in milk; not water. Call our office immediately. Try not to touch the root of the tooth. If this happens at school or a sporting event, look for an athletic trainer or a school nurse to see if they have Sav-A-Tooth Solution. This solution keeps the cells of the tooth living longer.
Knocked out Teeth (Baby)
If your child knocks out a baby tooth, we can’t put it back in the mouth. The priority is to not damage the developing permanent tooth underneath. Rinse your child's mouth and bite on a cold washcloth. Call our office to see if an appointment is needed. Find the tooth and get them excited about the tooth fairy! We hear the tooth fairy is extra generous with an unexpected tooth loss!
If your child breaks or chips a permanent tooth, try to find the pieces of the tooth, apply a cold compress to the area and call our office to make an appointment.
Cut Lip, Tongue or Cheek
If your child falls or has trauma to the lips gums or cheek, apply a cold compress to the sites that are bleeding. Inspect the mouth to see if any teeth are loose. Give Motrin (preferred) or Tylenol to reduce inflammation and pain. Call our office to see if an appointment is needed.
Loose Space Maintainer
Although rare, sometimes the cement that holds a space maintainer in place can fail. Usually this failure is related to consuming sticky candy or biting on something very hard that dislodges the the metal band. Regardless of the cause, as soon as space maintainer becomes loose it needs to be removed from the child’s mouth, cleaned, and recemented if possible. If the space maintainer comes completely out at home, try to save it as it is custom fit for your child’s tooth.
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822 Hartz Way • Suite 100 Danville, CA 94526
FAX: (925) 281-2704
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