My Dentistry Blog
Posts for tag: pediatric dentistry
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.”
What do young saber tooth tigers, which have been extinct about 10,000 years, have in common with human kids today? At first glance, not a lot. Smilodon fatalis, the big cat of North America, reached adulthood at around age three and weighed up to 600 pounds. But these ice-age mammals are probably best known for their dagger-like canine teeth, which (as shown by many well-preserved skeletons) grew up to 7 inches long. And that’s where the comparison between kids and kitties gets interesting.
The toothy felines had primary (baby) teeth and adult teeth, which developed in a similar way to human dentition. The primary teeth came in first, persisted during the young cat’s development, and shared space in the mouth as the adult teeth were erupting (growing in) — with one big difference. According to a recent study reported in the academic journal PLOS ONE, those colossal canines grew at an astonishing rate: up to 6 millimeters per month! By comparison, human primary teeth emerge from the gums at around 0.7mm per month, while permanent teeth may grow up to 2mm per month.
It’s understandable why those tiger teeth developed so rapidly: Life in the Ice Age was hard, and predators needed every advantage just to stay alive. But while human baby teeth take longer to develop (and to go away), they, too, are vitally important.Â For one thing, the primary teeth let kids bite, chew, speak (and smile) properly, until they are replaced by adult teeth — a process that isn’t usually finished until a child reaches the age of 12-13. So those “baby” teeth allow kids to have good nutrition — and positive social interactions — for a significant part of childhood!
There’s another important thing primary teeth do before they’re gone: They help ensure that the succeeding teeth come in properly, by holding a space in the jaw that will later be filled by a permanent tooth. If baby teeth are lost prematurely, those spaces can close up, resulting in permanent teeth that emerge too close together, or in the wrong places. This condition, called malocclusion (bad bite), can usually be corrected by orthodontics. But it’s better to avoid the inconvenience (and cost) of braces, if possible.
That’s why it’s so important to take care of your child’s baby teeth. Even though they won’t be around forever, they have a vital role to play right now. So be sure proper attention is paid to your child’s oral hygiene: That means avoiding sugar, and remembering to brush and floss every day. And be sure to come in regularly for routine exams, cleanings, and needed care. It’s the best way to keep those little teeth from “going extinct” too soon!
If you have questions or concerns about your child’s baby teeth, please call our office to schedule a consultation. You can read more in the Dear Doctor magazine articles “Importance of Baby Teeth” and “Early Loss of Baby Teeth.”
Even though a child’s primary (“baby”) teeth eventually give way, it’s still important to treat them if they become decayed. Primary teeth serve as guides for the emerging permanent teeth — if they’re lost prematurely, the permanent tooth may come in misaligned.
If the decay, however, affects the tooth’s inner pulp, it poses complications. A similarly decayed adult tooth would be treated with a root canal in which all the pulp tissue, including nerve fibers and blood vessels, are removed before filling and sealing. Primary teeth, however, are more dependent on these nerves and blood vessels, and conventional filling materials can impede the tooth’s natural loss process. It’s better to use more conservative treatments with primary teeth depending on the degree of decay and how much of the pulp may be affected.
If the decay is near or just at the pulp, it’s possible to use an indirect pulp treatment to remove as much of the softer decay as possible while leaving harder remnants in place: this will help keep the pulp from exposure. This is then followed with an antibacterial agent and a filling to seal the tooth.
If the pulp is partially exposed but doesn’t appear infected, a technique called direct pulp capping could be used to cover or “cap” the exposed pulp with filling material, which creates a protective barrier against decay. If decay in a portion of the pulp is present, a pulpotomy can be performed to remove the infected pulp portion. It’s important with a pulpotomy to minimize the spread of further infection by appropriately dressing the wound and sealing the tooth during and after the procedure.
A pulpectomy to completely remove pulp tissue may be necessary if in the worst case scenario the pulp is completely infected. While this closely resembles a traditional root canal treatment, we must use sealant material that can be absorbed by the body. Using other sealants could inhibit the natural process when the primary tooth’s roots begin to dissolve (resorb) to allow it to eventually give way.
These all may seem like extraordinary efforts to save a tooth with such a short lifespan. But by giving primary teeth a second chance, their permanent successors will have a better chance of future good health.
If you would like more information on treating decay in primary teeth, 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 “Root Canal Treatment for Children’s Teeth.”
The arrival of your child’s first set of teeth is a natural and expected process. But that doesn’t mean this period of development, commonly known as teething, is an easy time: your baby will endure a fair amount of discomfort, and you, perhaps, a bit of anxiety.
Knowing the facts about teething can help you reduce your child’s discomfort — as well as your own concern — to a minimum. Here are a few things you need to know.
Teething duration varies from child to child. Most children’s teeth begin to erupt (appear in the mouth) between six and nine months of age — however, some children may begin at three months and some as late as a year. The full eruption sequence is usually complete by age 3.
Symptoms and their intensity may also vary. As teeth gradually break through the gum line, your baby will exhibit some or all normal teething symptoms like gum swelling, drooling and chin rash (from increased saliva flow), biting or gnawing, ear rubbing, or irritability. You may also notice behavior changes like decreased appetite or disrupted sleep. These symptoms may be a minimal bother during some teething episodes, while at other times the pain and discomfort may seem intense. Symptoms tend to increase about four days before a tooth emerges through the gums and about three days afterward.
Diarrhea, rashes or fever aren’t normal. These symptoms indicate some other sickness or condition, which can easily be masked during a teething episode. If your child exhibits any of these symptoms you should call us for an exam to rule out a more serious issue.
Keep things cool to reduce discomfort. There are a few things you can do to reduce your child’s discomfort during a teething episode. Let your child chew on chilled (but not frozen) soft items like teething rings, wet washcloths or pacifiers to reduce swelling and pain. Gum massage with your clean finger may help counteract the pressure from the erupting tooth. And, if your doctor advises it, pain relievers in the proper dosage may also help alleviate discomfort. On the other hand, don’t use rubbing alcohol to soothe painful gums, or products with the numbing agent Benzocaine in children younger than two unless advised by a healthcare professional.
If you would like more information on dealing with teething issues, 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 “Teething Troubles.”
Every February, the American Dental Association sponsors a campaign called National Children’s Dental Health Month. The purpose of this operation is to raise awareness about how important it is to get an early start on developing good dental hygiene habits — and how this can lead to a lifetime of healthy teeth and gums. So we thought this might be a good time to answer some of the most frequently asked questions about how to do exactly that:
When is it time to start cleaning my baby’s teeth?
As soon as you see one! The earlier your child gets used to a daily dental hygiene routine, the better. Baby teeth that have not fully emerged from beneath the gums can be wiped with a clean, moist washcloth after feedings. A tooth that has grown in completely should be brushed twice daily (once in the morning and once in the evening) with a soft, child-sized tooth brush and a thin smear of fluoride toothpaste. Fluoride is an important weapon against tooth decay, but you don’t want your child to swallow too much.
Can babies get cavities?
Absolutely — especially if they are allowed to fall asleep routinely with a bottle filled with anything but water. Milk, formula — even breast milk — all contain sugars that should not be left to pool around your baby’s teeth during sleep, facilitating decay. Juice is an even bigger no-no because it is not only sugary but also acidic.
Can’t I give my child sweets once in a while?
We realize total avoidance of sweets may not be realistic, as beneficial as this would be for your child’s teeth. If you are going to allow your child to have sweets once in a while, better that the treat be given immediately following a meal, and not as a between-meal snack. Soda should really be avoided completely — it’s that bad.
When should I take my child to the dentist for the first time?
The experts say: Get it done in year one. That’s right — even though your child won’t have many teeth by age 1, there’s a lot we can do at that first visit to ensure good oral health now and well into the future. We will do everything possible to make sure your little one has a positive first experience in the dental chair; this helps set the tone for the many important preventive visits yet to come. It’s also a great opportunity for you to ask any specific questions you may have, and receive hands-on instruction on how to care for your child’s teeth and gums.
If you would like more information about children’s oral health, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Taking the Stress Out of Dentistry for Kids” and “Age One Dental Visit.”