Posts for: November, 2016
“What can I do about my child's teeth grinding habit?”
It's a common question we get from many concerned parents. Their exasperation involves more than having to wake every night to the annoying sounds coming from their child's bedroom: they're also worried about any potential damage occurring to their teeth.
Teeth grinding and similar habits fall under the umbrella term “bruxism.” In basic terms, bruxism is the involuntary movement of the teeth and jaws not engaged in regular functions like chewing, speaking or swallowing. Bruxism is actually common among pre-adolescent children, considered by many healthcare professionals as normal behavior like thumb sucking.
It's not fully known why children grind their teeth, especially during sleep. Stress can play a part, but many believe it could also be related to immaturity on the part of the neuromuscular system that controls chewing. In some cases it could be linked to sudden arousals from sleep, particularly if the child is prone to airway obstruction causing sleep apnea. And there may be a link with certain medications, especially for hyperactivity disorders like attention deficit hyperactivity disorder (ADHD).
Most children eventually outgrow the habit. If it persists, though, it can contribute to teeth problems. Teeth can withstand a lot of biting force, but when chronically exposed to the higher than normal forces produced during teeth grinding they can begin to wear. Sodas, fruit juices, sports drinks or similar acidic beverages complicate matters because they increase mouth acid that can soften enamel. And besides dental issues, teeth grinding can also cause jaw problems, ear pain and headaches.
If symptoms begin to appear, we can take steps to reduce the effect of teeth grinding, such as a mouth guard worn at night to reduce biting forces and protect against wear. We can also look at curbing consumption of acidic foods and beverages, addressing possible airway obstructions, changing medications or counseling for psychological stress.
As with thumb sucking, there's no cause for immediate alarm if your children grind their teeth. But if it continues on into their later childhood years or begins to affect their health and well-being, we'll need to intervene to prevent further harm.
If you would like more information on teeth grinding and similar 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 “When Children Grind their Teeth.”
People often put a premium on appearance when deciding whether or not to replace a missing tooth. There's more motivation to replace one in the “smile zone,” where the teeth are more visible, than one that's not.
But even if your missing tooth is in the back out of sight, there are still good reasons to replace it. That's because even one lost tooth can have a cascading ill effect on other teeth, the underlying bone or eventually your entire facial structure.
The chief problems caused by a missing tooth occur first with the bone. The act of chewing generates pressure around the teeth. The teeth transmit this pressure through the roots to the bone, which stimulates the bone to grow and remain strong in support of the teeth. When you lose a tooth, the bone no longer receives this growth stimulation.
In time, the replacement rate for older bone cells will slow down and cause the bone volume to decrease. It's possible to detect a change just months after losing a tooth: you can lose an estimated 25% of bone width in the first year.
As the bone diminishes, the jaw loses height and then more width. The gum tissues will also gradually decrease. As a result you may not be able to chew or even speak as well as you once could. Depending on the number of teeth you've lost, the foundational portion of the jawbone — the basal bone — may also decline. The distance between nose and chin may decrease and the cheeks sink in. Without bone support in the rear, the bite can collapse and push the teeth forward out of their normal position.
The best way to avoid this debilitating spiral is to replace a tooth as soon as practical. There are many options, but perhaps the best choice is a dental implant: not only will it provide a life-like appearance, but its affinity with bone will stop bone loss and even encourage new growth.
So, don't neglect replacing that “invisible” tooth if it's lost. Your mouth and ultimately your appearance will be better for it.
If you would like more information on tooth loss and restoration options, 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 “The Hidden Consequences of Losing Teeth.”
There's no doubt about it — dentures have changed your life. Now you can eat and speak normally, and smile again with confidence. But if you're going to continue to benefit from your dentures, you'll need to take care of them. One of the best things you can do is not sleep with them in.
There are a couple of important reasons why you should take your dentures out when you go to bed. First, dentures tend to compress the bony ridges of the gums that support them. This contributes to the loss of the underlying bone, an occurrence common with missing teeth. Wearing dentures around the clock can accelerate this bone loss, which eventually loosens your denture fit.
Constant denture wearing also contributes to mouth conditions conducive to dental disease. You're more likely to develop tongue and denture plaque (a thin film of bacteria and food particles) that can cause gum inflammation or yeast development. The presence of the latter could also trigger a chronic response from your immune system that might make you more susceptible to other diseases.
Good oral hygiene is just as important with dentures as with natural teeth. Besides removing them at night, you should also take them out and rinse them after eating and brush them at least once a day with a soft tooth brush. And be sure to use regular dish or hand soap (especially antibacterial) or denture cleanser — toothpaste is too abrasive for denture surfaces.
It's also a good habit to store your dentures in water or, better, an alkaline peroxide solution. This will help deter plaque and yeast development. And don't forget the rest of your mouth: brush your tongue and gums with a very soft toothbrush (different from your denture brush) or clean them off with a damp cloth.
Taking care of your dentures will ensure two things. You'll lower your risk for disease — and you'll also help extend your dentures' life and fit.
You can't go wrong with an early start caring for your child's teeth and gums. In fact, dental care should begin in earnest when their first tooth appears.
You should begin by gently cleaning your infant's gums and new teeth after each feeding with a clean, water-soaked washcloth or gauze pad. Once they start eating solid food, you should transition to a soft-bristled brush with just a smear of fluoridated toothpaste. Around age 2, you can increase that to a pea-sized amount and begin teach them to brush for themselves.
The next important element in your child's dental care is beginning regular dental visits around their first birthday. There are good reasons to begin visits at this time. There primary teeth should now be erupting in earnest and you'll want to begin prevention measures against tooth decay if needed. You'll also want to get them used to going to the dentist early in life: if you wait a year or two later, they may not respond well to the unfamiliar surroundings of a dental office.
There are also a number of things you can do to support hygiene and dental visits. You should not allow your child to sleep with a pacifier covered or a bottle filled with anything but water. Milk, juices and other sugar-containing liquids will raise the risk of tooth decay. And speaking of sugar, limit their consumption to meal times: snacking constantly on sugar can create an environment ripe for decay.
Of course, dental disease isn't the only hazard your child's teeth may face. Accidents can happen and your child's otherwise healthy teeth could be injured. So, make sure they don't play too close to hard furniture or other features around the house they could fall on. If they should begin playing contact sports, invest in a custom mouth guard — avoiding an injury is well worth the cost.
Getting into dental care with your children as soon as possible will set the foundation for good oral health. And the example you set will stick with them as they take on their own dental care when they're older.
If you would like more information on caring for your child's 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 “Top 10 Oral Health Tips for Children.”
Like many other families, you may use formula instead of breast milk as a safe and healthy alternative to feed your infant. But, if you use a powdered form that you mix with water your child may be taking in more fluoride than they require.
Fluoride is a natural chemical that can strengthen tooth enamel and help prevent decay. After decades of study it's also been shown to pose no serious health risks. Because of fluoride's benefits and safety, many water utilities add tiny amounts to their drinking water supply.
But it can have one side effect called enamel fluorosis. If a child ingests too much fluoride during early development it can cause discoloring mottled spots or streaking in permanent teeth. Although it doesn't affect their health, the teeth can be unattractive and require cosmetic attention.
That's why it's best to keep fluoride consumption to a healthy minimum for children. That, however, is often easier said than done, since we can encounter hidden fluoride in a variety of places. Besides hygiene products and fluoridated drinking water, you may find fluoride in prepared juices and other beverages, bottled water or in foods processed with fluoridated water. There are no labeling requirements for fluoride, so you'll have to research to find out if a product contains fluoride.
There are, however, some things you can do to control your child's fluoride intake. First, know as much as you can about known sources your child may encounter like your water supply. You can find out if your utility adds fluoride and by how much by contacting them or visiting My Water's Fluoride online at https://nccd.cdc.gov/DOH_MWF/.
If you use fluoride toothpaste apply only a “smear” on the end of the brush for children under two and a pea-sized amount for older children. If you have fluoridated drinking water, consider breastfeeding your infant, use ready-to-feed formula or mix powdered formula with bottled water labeled “de-ionized,” “purified,” “demineralized” or “distilled.”
And, do feel free to discuss your concerns with us during your child's regular checkup. We'll help you adjust their diet, water intake and hygiene habits to be sure they're receiving the right amount they need for developing strong teeth — and no more.
If you would like more information on appropriate fluoride levels 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 “Tooth Development and Infant Formula.”