Posts for tag: pediatric dentistry
Have you heard about dental sealants? These preventive treatments have been available for many decades, and more and more children are taking advantage of them. The National Institutes of Health (NIH) estimates that around 30% of kids from 6 to 11 years of age have had sealants applied to their molars (back teeth). Sealants are designed to reduce the incidence of cavities by filling in or eliminating the pits or crevices found in all molars, where decay-causing bacteria can hide and your brush can't reach. But do they really work?
Now, the research is in, and the answer is clear — YES!
Two major studies, each of which reviewed the results of thousands of patients over several years, recently came to the same conclusion: Dental sealants are effective at reducing cavities, and their benefits can last for four years (or more) after application. In general, the studies showed that kids who didn't get sealants were twice, three times, or even more likely to get cavities, compared to kids treated with sealants.
Sealants themselves are protective coatings made of plastic resins or glass-like materials. They are applied in liquid form, and then hardened by a special light. When “painted on” to the chewing surface of a molar, sealants fill in the tiny crevices, or “pits and fissures,” that are found there. Uneven tooth surfaces form a perfect breeding ground for the bacteria that cause tooth decay; worse yet, the bristles of a tooth brush can't usually reach them. That's what makes these areas highly susceptible to tooth decay.
Applying sealants is a quick and painless procedure that doesn't require any numbing shots or drilling. Many kids start getting sealants when the first permanent molars come in, around age 5 to 7; they may have more sealant treatments when additional molars emerge, between the ages of 11 and 14.
Sealants are recommended by the American Dental Association and the American Academy of Pediatric Dentistry, and have only a modest cost per tooth. On the other hand, having a cavity filled generally costs substantially more, and may result in more trouble (and expense) down the line — so sealants can make sense economically, as well as preventively. This is especially true for those at high risk for tooth decay.
If you have questions about dental sealants, please contact us or schedule a consultation. You can read more in the Dear Doctor magazine article “Sealants for Children,” and “Top 10 Oral Health Tips for Children.”
Cavities can happen even before a baby has his first piece of candy. This was the difficult lesson actor David Ramsey of the TV shows Arrow and Dexter learned when his son DJ’s teeth were first emerging.
“His first teeth came in weak,” Ramsey recalled in a recent interview. “They had brown spots on them and they were brittle.” Those brown spots, he said, quickly turned into cavities. How did this happen?
Ramsey said DJ’s dentist suspected it had to do with the child’s feedings — not what he was being fed but how. DJ was often nursed to sleep, “so there were pools of breast milk that he could go to sleep with in his mouth,” Ramsey explained.
While breastfeeding offers an infant many health benefits, problems can occur when the natural sugars in breast milk are left in contact with teeth for long periods. Sugar feeds decay-causing oral bacteria, and these bacteria in turn release tooth-eroding acids. The softer teeth of a young child are particularly vulnerable to these acids; the end result can be tooth decay.
This condition, technically known as “early child caries,” is referred to in laymen’s terms as “baby bottle tooth decay.” However, it can result from nighttime feedings by bottle or breast. The best way to prevent this problem is to avoid nursing babies to sleep at night once they reach the teething stage; a bottle-fed baby should not be allowed to fall asleep with anything but water in their bottle or “sippy cup.”
Here are some other basics of infant dental care that every parent should know:
- Wipe your baby’s newly emerging teeth with a clean, moist washcloth after feedings.
- Brush teeth that have completely grown in with a soft-bristled, child-size toothbrush and a smear of fluoride toothpaste no bigger than a grain of rice.
- Start regular dental checkups by the first birthday.
Fortunately, Ramsey reports that his son is doing very well after an extended period of professional dental treatments and parental vigilance.
“It took a number of months, but his teeth are much, much better,” he said. “Right now we’re still helping him and we’re still really on top of the teeth situation.”
If you would like more information on dental care for babies and toddlers, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “The Age One Dental Visit” and “Dentistry & Oral Health for Children.”
While they're resilient, your child's teeth aren't invincible. Daily hygiene and regular dental visits are important, but you should also be alert for problems and take action when they arise.
Here are 4 areas that could cause problems for your child's teeth, and what you should do — or not do — if you encounter them.
Teething. This is a normal experience as your child's first teeth erupt through the gums. The gums become tender and painful, causing constant gnawing, drooling, disturbed sleep and similar symptoms. You can help relieve discomfort by letting them bite on a chilled (not frozen) teething ring or a cold, wet washcloth. Pain relievers like ibuprofen in appropriate dosages can also help — but don't apply ice, alcohol or numbing agents containing Benzocaine directly to the gums.
Toothache. Tooth pain could be a sign of decay, so you should see us for an examination. In the meantime you can help relieve pain with a warm-water rinse, a cold compress to the outside of the face, or appropriately-dosed pain relievers. If the pain is intense or persists overnight, see us no later than the next day if possible.
Swollen or bleeding gums. If you notice your child's gums are red and swollen or easily bleed during brushing, they could have periodontal (gum) disease. This is an infection caused by bacterial plaque, a thin film of food particles that build up on the teeth. You can stop plaque buildup by helping them practice effective, daily brushing and flossing. If they're showing symptoms, though, see us for an exam. In the meantime, be sure they continue to gently brush their teeth, even if their gums are irritated.
Chipped, cracked or knocked out tooth. If your child's teeth are injured, you should see us immediately. If part of the tooth has broken off, try to retrieve the broken pieces and bring them with you. If it's a permanent tooth that was knocked out, pick it up by the crown (not the root), rinse it with clean water and attempt to place it back in the socket. If you can't, bring the tooth with you in a container with clean water or milk. The sooner you see us, the better the chances for saving the tooth — minutes count.
As a parent, you have plenty of questions about your child’s health. One we hear quite often is when dental care should begin for a child.
The short answer is when their first tooth comes in, usually at six months to a year of age: that’s when you should begin brushing at home. But there’s also the matter of when to begin your child’s regular dental visits: we recommend the first visit around the child’s first birthday. Here are 4 reasons why this is the right time to start.
Prevention. First and foremost, starting visits at age one gives your child the best start for preventing tooth decay through cleanings, topical fluoride or, in some cases, sealants. Preventive care for primary teeth may not seem that important since they’ll eventually give way to the permanent teeth. But primary teeth also serve as guides for the next teeth’s ultimate position in the mouth — if a primary tooth is lost prematurely, it could affect your child’s bite in later years.
Development. Early dental visits give us a chance to keep an eye on bite and jaw development. If we notice a developing malocclusion (bad bite) or conditions favorable for it, we can refer you to an orthodontist for consultation or interventional therapy to reduce the possibility or extent of future treatment.
Support. Your child’s regular dental visits can also help you as a parent. We can advise you on all aspects of dental care, including brushing and flossing techniques, nutrition dos and don’ts, and how to handle situations like late thumb sucking.
Familiarization. Dental visits starting at age one will help your child become familiar and comfortable with visiting the dentist that might be more difficult to achieve if they’re older. Dental visit anxiety is a major reason why many people don’t maintain regular visits later in life. Children who come to realize that dental visits are a normal, even pleasant experience are more likely to continue the practice into adulthood.
Caring for your child’s teeth is just as important as other aspects of their health. Getting an early start can head off brewing problems now and set the course for healthy teeth and gums tomorrow.
If you would like more information on pediatric dental care, 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 “Age One Dental Visit.”
While pediatric dentistry has made great strides in making young patients’ dental visit experiences more relaxing, some children and teenagers still have difficulty with anxiety. Their anxiety in turn can make necessary care much harder to provide.
For difficult cases, many dental providers for children now incorporate a technique known as conscious sedation to help ease anxiety. With this technique, they’re able to perform procedures like cavity-filling or tooth-extraction that are more difficult with an anxiety-prone patient.
While general anesthesia creates a total loss of consciousness, conscious sedation uses precise medications to suppress consciousness at different levels ranging from light to deep suppression, and create a relaxed state for the patient. A child under sedation can still breathe normally and respond to certain stimuli, including touch and verbal commands. For only a light or minimal effect, a dentist normally administers the sedation drug as a pill the child takes orally. For deeper sedation, the medication is most likely delivered through a vein (intravenously).
Sedation reduces fear and anxiety but not necessarily pain, so it’s often accompanied by some type of anesthesia, either a local anesthetic delivered by injection to the procedure site or with a nitrous oxide/oxygen gas combination that’s inhaled through a mask worn by the patient.
Even though the child isn’t completely unconscious, one of the dentist’s staff will monitor vital signs (heart and respiration rates, blood pressure and blood oxygen level) throughout the procedure. This continues even after the treatment is over until the child’s vital signs return to pre-sedation levels. Once released, they will need a ride home and should rest for the remainder of the day. They can then return to school and resume other normal activities the next day.
With the advent of newer and safer drugs, conscious sedation is becoming a more widespread technique in both medicine and dentistry. Using it to ease a child’s anxiety increases the chances they’ll receive all the dental care they need without unpleasant memories of their visit that could follow them into later life.
If you would like more information on the role of conscious sedation 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.”