Posts for tag: pediatric dentistry
A baby’s teeth begin coming in just a few months after birth—first one or two in the front, and then gradually the rest of them over the next couple of years. We often refer to these primary teeth as deciduous—just like trees of the same description that shed their leaves, a child’s primary teeth will all be gone by around puberty.
It’s easy to think of them as “minor league,” while permanent teeth are the real superstars. But although they don’t last long, primary teeth play a big role in a person’s dental health well into their adult years.
Primary teeth serve two needs for a child: enabling them to eat, speak and smile in the present; but more importantly, helping to guide the developing permanent teeth to erupt properly in the future. Without them, permanent teeth can come in misaligned, affecting dental function and appearance and increasing future treatment costs.
That’s why we consider protecting primary teeth from decay a necessity for the sake of future dental health. Decay poses a real threat for children, especially an aggressive form known as early childhood caries (ECC). ECC can quickly decimate primary teeth because of their thinner enamel.
There are ways you can help reduce the chances of ECC in your child’s teeth. Don’t allow them to drink throughout the day or to go to sleep at night with a bottle or “Sippy” cup filled with milk, formula, or even juice. These liquids can contain sugars and acids that erode enamel and accelerate decay. You should also avoid sharing eating utensils with a baby or even kissing them on the mouth to avoid the transfer of disease-causing bacteria.
And even before teeth appear, start cleaning their gums with a clean, wet cloth right after feeding. After teeth appear, begin brushing and flossing to reduce plaque, the main trigger for tooth decay. And you should also begin regular dental visits no later than their first birthday. Besides teeth cleanings and checkups for decay, your dentist has a number of measures like sealants or topical fluoride to protect at-risk teeth from disease.
Helping primary teeth survive to their full lifespan is an important goal in pediatric dentistry. It’s the best strategy for having healthy permanent teeth and a bright dental health future.
If you would like more information on tooth decay in children, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Do Babies Get Tooth Decay?”
Dental disease doesn’t discriminate by age. Although certain types of disease are more common in adults, children are just as susceptible, particularly to tooth decay.
Unfortunately, the early signs of disease in a child’s teeth can be quite subtle—that’s why you as a parent should keep alert for any signs of a problem. Here are 3 things you might notice that definitely need your dentist’s attention.
Cavities. Tooth decay occurs when mouth acid erodes tooth enamel and forms holes or cavities. The infection can continue to grow and affect deeper parts of the tooth like the pulp and root canals, eventually endangering the tooth’s survival. If you notice tiny brown spots on their teeth, this may indicate the presence of cavities—you should see your dentist as soon as possible. To account for what you don’t see, have your child visit your dentist at least twice a year for cleanings and checkups.
Toothache. Tooth pain can range from a sensitive twinge of pain when eating or drinking hot or cold foods to a throbbing sharp pain. Whatever its form, a child’s toothache might indicate advancing decay in which the infection has entered the tooth pulp and is attacking the nerves. If your child experiences any form of toothache, see your dentist the next day if possible. Even if the pain goes away, don’t cancel the appointment—it’s probable the infection is still there and growing.
Bleeding gums. Gums don’t normally bleed during teeth brushing—the gums are much more resilient unless they’ve been weakened by periodontal (gum) disease (although over-aggressive brushing could also be a cause). If you notice your child’s gums bleeding after brushing, see your dentist as soon as possible—the sooner they receive treatment for any gum problems the less damage they’ll experience, and the better chance of preserving any affected teeth.
Helping your infant or toddler develop good dental habits is one of the best head starts you can give them toward optimum oral health. But even after they’ve matured enough to handle hygiene tasks without you, they still need your guidance.
This is especially true in the “tween” and teen years. Although they’re beginning to flex their independence muscles, they’re still vulnerable at this age to peer pressure urging them to try things that, among other outcomes, could hurt their oral health.
Here are 3 areas where your input and guidance could save your older children and teens from oral health problems.
Sports activities. As children mature, they may also become involved with various physical activities, including contact sports. Years of diligent hygiene and dental care can be undone with one traumatic blow to the mouth. You can help avoid this by urging your child to wear a mouth guard during sports activity. While there are some good choices on the retail market, the most effective mouth guards are custom-created by a dentist to precisely fit your child’s mouth.
Oral piercings. While expressions of solidarity among young people are popular and often harmless, some like oral piercings and their hardware could potentially damage teeth and gums. You should especially discourage your child from obtaining tongue bolts or other types of lip or mouth hardware, which can cause tooth wear or fracture. Instead, encourage them to take up safer forms of self-expression.
Bad habits and addictions. A young person “spreading their wings” may be tempted to dabble in habit-forming or addictive activities. In addition to their effect on the rest of the body, tobacco, alcohol and drugs can have severe long-term consequences for oral health. Unsafe sexual practices could lead to the contraction of the human papilloma virus, which has been linked to oral cancer in young adults. Be sure your teen understands the dangers of these habits to both their oral and general health—and don’t hesitate to seek professional help when a habit becomes an addiction.
If you would like more information on helping your child develop great oral habits, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “How to Help Your Child Develop the Best Habits for Oral Health.”
The best way to prevent dental visit anxiety in your children is start those visits around their first birthday, and continue with them through childhood. Age One visits are the best way to ensure they're comfortable with the dentist now and that they'll continue the habit into adulthood.
But in spite of your best efforts and those of your dental provider, there's no guarantee your child won't experience dental visit anxiety at some point. If that happens, we recommend conscious sedation.
Conscious sedation is the use of certain medications to help a patient relax. It's not the same as anesthesia, which eliminates pain by numbing tissues (local anesthesia) or inducing unconsciousness (general anesthesia). During conscious sedation a patient remains awake or at the most in a dream-like state, can still respond to touch or verbal commands, and although monitored doesn't require assistance in heart or lung function.
We can induce this relaxed state in a number of ways: orally, with medication given by mouth a short time before the visit; intravenously, the medication delivered through a drip directly into the bloodstream; or by inhalation, usually nitrous oxide gas mixed with oxygen and delivered by mask.
Oral sedation is the most common. On the day of the procedure, we'll give your child one or more sedative drugs, usually in syrup form. For best results we advise they eat a low-fat dinner the night before and not eat or drink any food or liquid afterward. We typically use Midazolam and Hydroxyzine, both of which are proven safe and fast acting.
During the procedure, we'll also assign a team member to monitor their vital signs while they're under the influence of the drugs. We may also employ special positioning or immobilization equipment to keep movement to a minimum.
After the procedure, we'll continue to monitor vitals until they return to pre-sedation levels. The child should remain home the rest of the day to rest and return to school the next day.
Conscious sedation is regulated by states: providers must be trained and licensed to administer sedation drugs with continuing education requirements. Even so, the use of sedation for children is becoming more widespread and helps to safely ensure they're getting the dental care they need.
If you would like more information on comfortable dentistry for children, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Sedation Dentistry for Kids.”
Your child’s dental care wouldn’t be the same without x-ray imaging. It’s one of our best tools for finding and treating tooth decay.
But since x-rays emit radiation, is your child in any danger when they’re exposed?
X-rays, an invisible form of electromagnetic energy, will form images on exposed film after passing through the body. Because it takes longer for x-rays to pass through dense tissue like teeth and bones, the corresponding areas appear lighter on the film than less dense tissue like the gums. We can detect decay because the diseased tooth structure is less dense and thus appears darker against healthier tooth structure.
The downside of x-rays, though, is the radiation they emit could potentially alter cell structure and increase the risk of future cancer, especially with children. That’s why we follow a principle known as ALARA when using x-ray imaging. ALARA is an acronym for “as low as reasonably achievable,” meaning the doses for an x-ray session will be as low as possible while still gaining the most benefit.
Advances in technology, particularly the development of digital processing, has helped reduce the amount of radiation exposure. We’re also careful with what types of x-rays we use. The most common type is the bitewing, a device with the film attached to a long piece of plastic that the child holds in their mouth while biting down.
Depending on the number of our patient’s teeth, we can usually get a comprehensive view with two to four bitewings. A typical bitewing session exposes them to less radiation than what they’re receiving from natural environmental background sources each day.
Keeping the exposure as low and as less frequent as possible greatly reduces health risks while still getting the full benefit of early decay detection. Still, if you have concerns about your child’s x-ray exposure, we’ll be happy to discuss our approach and all the precautions we take using x-ray imaging.
If you would like more information on x-ray diagnostics and your child, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “X-Ray Safety for Children.”