Posts for: May, 2017
A child with a chronic illness or condition often requires a lot of focus on care for their special needs. Other aspects of their health can often take a back seat — too often including dental care.
Proper dental care can be a challenge for special needs children if they have diminished physical, intellectual or behavioral capacities. Children with autism or attention deficit disorders may not be able or willing to perform tasks like brushing and flossing. Other conditions could make them intolerant to toothpaste in the mouth, or create an inability to keep their mouths open or to spit.
Some chronic conditions also seem predisposed to dental defects. For example, enamel hypoplasia, a lack of sufficient tooth enamel, is common with Down, Treacher-Collins or Turner Syndromes, and can greatly increase the risk of tooth decay.
But even though difficult, effective dental care isn't impossible. It begins with your dental provider.
Pediatric dentists are often excellent in this regard: they often have the training and experience to treat children with chronic conditions. Whoever you choose must be able to partner with you in caring for your child's dental needs.
Daily hygiene is also a critical factor. Your goal should be the same as with any child — to teach them to brush and floss for themselves. Depending on their condition, however, you may need to assist them for a longer term, perhaps permanently. But it is imperative — daily hygiene is their best defense against oral diseases.
You should also consider their medication and how it may impact their dental health. Antidepressants, antihistamines or drugs that assist with breathing function can cause mouth dryness. This, as well as drugs with sugar or acid compounds, can increase risk for dental disease. If they must take these types of medications, try to give them at mealtime to reduce their effect in the mouth.
Above all, pursue the same professional dental care as you would for any other child. Keep up regular dental visits beginning around their first birthday for cleanings and preventive measures like topical fluoride or sealants. By taking these measures you'll help ensure their dental health won't suffer.
If you would like more information on dental care for special needs 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 “Managing Tooth Decay in Children with Chronic Diseases.”
A half million people are diagnosed every year with oral cancer. While other cancers are more prevalent, oral cancer is among the most dangerous with only a fifty percent five-year survival rate.
A major reason for this low rate is because this fast growing cancer is difficult to detect early — diagnosis comes far too often after the disease has already well advanced. In an effort to detect cancer earlier many dentists visually screen for oral abnormalities during checkups, especially patients over fifty, tobacco or heavy alcohol users, patients with a family history of cancer or a medical history of exposure to the sexually transmitted human papilloma virus, HPV-16.
If they detect an abnormality, the dentist often refers the patient to an oral surgeon or other specialist for a possible biopsy. In this procedure the surgeon removes a sample of the abnormal tissue, which is then examined microscopically for cancer cells. A biopsy remains the most effective way to diagnose oral cancer.
Because of the disease's aggressive nature, many dentists lean to the side of caution when referring patients for biopsy. As a result 90% of oral biopsies reveal no cancer. Reducing the number of biopsy referrals is highly desirable, especially for the patient undergoing the procedure. Tissue samples tend to be large to ensure complete detection of any cancer cells. Depending on the size and location of the sample, there may be a risk for loss of function or disfigurement.
A new screening tool using a sample of a patient's saliva could help reduce the number of biopsy referrals. Besides DNA, saliva also contains dormant genes called biomarkers that activate in response to the presence of a specific disease. This particular saliva test identifies those biomarkers for oral cancer if they're present.
A sample with a low score of biomarkers indicates no cancer present (with a statistical confidence of 99%). A medium or high score indicates cancer may be present, but only a biopsy can determine for sure. Using this test, dentists might be able to reduce the number of biopsy referrals and instead be able to employ watchful waiting in certain cases. Because of its simplicity and non-invasiveness, saliva screening could help identify oral cancer earlier.
When it's time for your child to visit the dentist (we recommend around their first birthday), you may want them to see your family dentist. But you might also want to consider another option: a pediatric dentist.
The difference between the two is much the same as between a pediatrician and a family practitioner. Both can treat juvenile patients — but a family provider sees patients of all ages while a pediatrician or pediatric dentist specializes in patients who haven't reached adulthood.
Recognized as a specialty by the American Dental Association, pediatric dentists undergo about three more years of additional post-dental school training and must be licensed in the state where they practice. They're uniquely focused on dental care during the childhood stages of jaw and facial structure development.
Pediatric dentists also gear their practices toward children in an effort to reduce anxiety. The reception area and treatment rooms are usually decorated in bright, primary colors, with toys and child-sized furniture to make their young patients feel more at ease. Dentists and staff also have training and experience interacting with children and their parents to help them relax during exams and procedures.
While a pediatric practice is a good choice for any child, it can be especially beneficial for children with special needs. The “child-friendly” environment is especially soothing for children with autism, ADHD or other behavioral/developmental disorders. And pediatric dentists are especially adept in treating children at higher risk for tooth decay, especially an aggressive form called early childhood caries (ECC).
Your family dentist, of course, can presumably provide the same quality care and have an equally welcome environment for children. And unlike a pediatric dentist who will typically stop seeing patients when they reach adulthood, care from your family dentist can continue as your child gets older.
In the end it's a personal choice, depending on the needs of your family. Just be sure your child does see a dental provider regularly during their developing years: doing so will help ensure a lifetime of healthy teeth and gums.
If you would like more information on visiting a pediatric dentist for your child's dental needs, 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 “Why See a Pediatric Dentist?”
A root canal treatment is a commonly known but often misunderstood procedure. Contrary to popular belief, these treatments aren't painful — in fact, they often stop a toothache. More importantly, a “root canal” can give a tooth on the verge of loss another lease on life.
Still, if you've never experienced a root canal treatment before, you probably have questions. Here are the answers to a few of the most common.
Why do they call it a “root canal”? This is the popular shorthand term for a procedure that removes diseased tissue from a decay-infected pulp, the innermost part of a tooth and the actual root canals themselves. Root canals are the narrow, hollow channels that run from the tip of the root to the pulp and are also involved in the procedure.
Why do I need one? Once infected, the pulp's bundles of blood vessels, nerves and other tissues become diseased. This often results in a painful toothache that can also suddenly disappear once the nerves within the pulp die. But there's still a problem: If we don't clean out the diseased and dead pulp tissue, the infection could spread through the root canals to the bone and endanger the tooth's survival.
What happens during the procedure? After deadening the tooth and surrounding gums with local anesthesia, we enter the pulp through an access hole we create. Using special instruments we remove the diseased tissue and shape the root canals to seal them with a filling material called gutta percha. Sealing the access hole is then necessary to prevent re-infection. Later we'll cap the tooth with a porcelain crown to restore its appearance and add further protection against fracture or cracking of the tooth.
Who can perform a root canal treatment? In many cases a general dentist can perform the procedure. There are some complex situations, however, that require a root canal specialist with additional training, expertise and equipment to handle these more difficult cases. If your tooth is just such a case it's more than likely your general dentist will refer you to an endodontist to make sure you get the right kind of care to save it.
If you would like more information on root canal treatment, 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: What You Need to Know.”