Posts for: September, 2018
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.”
Your family uses fluoride toothpaste and your drinking water is fluoridated too. So with the fluoride your child already takes in, is it really necessary for topical fluoride treatments during their regular dental visits?
The answer is most definitely. Fluoride has a unique ability to strengthen enamel, your teeth’s protective cover against decay and other diseases. It does this by infusing itself in the enamel structure and making it that much more resistant to acid attack and decay.
This infusion occurs in two ways. First, growing teeth obtain it through the bloodstream as they incorporate other minerals that make up the enamel structure. The very small amount of fluoride added to drinking water — as low as one part per million (ppm) — imparts sufficient fluoride to developing teeth. In the absence of fluoridated water, dietary fluoride supplements can achieve the same effect.
The second way is just after the teeth have erupted and are still quite young. In this case, fluoride coming in direct contact with the enamel surface is absorbed, resulting in changes to the enamel’s crystalline structure that will create added strength. This can occur to a limited degree through fluoride toothpaste or other dental products. The concentration of fluoride in these products, though, is relatively low (850-1500 ppm) as mandated by the U.S. Food and Drug Administration for safety.
Professional applications, on the other hand, are much higher — 12,300 to 22,600 ppm depending on their form. They’re applied, of course, under strict clinical guidelines to cleaned tooth surfaces, usually as a gel, foam or varnish. The latter form will often continue leaching fluoride into the enamel for a month or more.
These topical applications can greatly strengthen the teeth of children who don’t have the benefit of fluoridated water or may be at higher risk for dental disease because of socio-economic conditions. But they can still be helpful for children with adequate fluoride exposure and low risk factors for disease. At the very least, fluoride treatments can give your child an added boost of protection as their teeth continue to develop.
If you would like more information on topical fluoride treatments 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 “Topical Fluoride.”
While braces are a tried and true method for achieving a more attractive smile, they may also give rise to problems with dental disease. This is because their hardware — the brackets and bands that serve as tracks for the tensioning wires — make it more difficult to access the tooth and gum surfaces to clean away plaque. This thin film of food remnant may then become a haven for bacteria that cause gum disease or tooth decay.
One of the more common conditions to occur while wearing braces is gingivitis. This is an initial inflammation of the gum tissues caused by bacterial plaque that hasn’t been removed by brushing or flossing. As the inflammation grows unchecked, the infection could advance deeper into the tissues to become a more serious form of gum disease that threatens the survival of affected teeth.
Difficult as it may be for those wearing braces, the best way to avoid gingivitis is through more thorough oral hygiene practices. Fortunately, there are many hygiene products that can help you get around many of the access difficulties posed by braces. Smaller toothbrushes known as interproximal brushes and floss threaders, small aids that thread dental floss under braces wires, can access the spaces between teeth more readily than conventional brushes or floss. Water flossers (which use water under pressure to remove plaque between teeth) and motorized toothbrushes can further increase efficiency. We can also reduce bacterial growth in the mouth if need be with prescription-strength antibacterial mouthrinses.
If, however, gingivitis or gum overgrowth (another common occurrence during orthodontic treatment) continues to be a problem, we may need to take other actions including surgery. In extreme cases, the braces may need to be removed to adequately treat the gums and allow them time to heal before proceeding with orthodontics.
Extra care with daily hygiene and regular dental checkups and cleanings in addition to your orthodontic visits will help keep gum problems at bay while you’re wearing braces. Taking this extra care will stop or minimize the effect of disease as you continue on to the ultimate goal of your orthodontic treatment — a more beautiful smile.
Periodontal disease may start in the gums’ superficial layers, but it’s not likely to stay there. As the disease moves deeper it can wreak havoc on tooth roots and bone as well as gum tissue attachments. Teeth with multiple roots are in particular peril because of the “forks” called furcations that form where the roots separate from each other. Infected furcations can be very difficult to treat.
We primarily treat gum disease by removing its main source, a thin film of bacteria and food particles called dental plaque that builds up on teeth. To remove it we most often use special hand tools or ultrasonic equipment to vibrate it loose. As the plaque and tartar diminish, the infection begins to wane.
But we can’t be completely successful in stopping the disease if any lingering plaque deposits remain. This especially includes furcations where the infection can cause significant damage to the roots. Although cleaning furcations of plaque can be difficult, it’s not impossible with the aforementioned tools and antimicrobial substances to disinfect the area.
The real problem, though, is access—effectively getting to the furcations to treat them. We may need to perform a surgical procedure called flap surgery where we create a hinged flap in the gum tissue to move it aside and access the root area beneath. Afterward we replace the flap and suture the tissue back in place.
In some cases, the infection may have already caused significant damage to the tissue and underlying bone. We may therefore need to graft gum or bone tissues to these damaged areas to stimulate re-growth. We may also need to surgically reshape the gum attachments around a tooth to make it easier in the future to access and clean the area.
These additional treatments around furcations can be very involved and labor-intensive. That’s why the best outcomes occur if we’re able to start treatment in the early stages of an infection. So, if you notice red, swollen or bleeding gums contact your dentist as soon as possible. Treating gum disease as early as possible will help ensure your tooth roots won’t suffer extensive damage.
If you would like more information on treating gum disease, 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 “What are Furcations? Branching Tooth Roots can be Periodontal Nightmares.”
When things get unpleasant in your mouth, it’s most often related to some underlying cause. In fact, the discomfort you’re feeling is often a call to action to have it checked and treated.
The American Dental Association recently surveyed approximately 15,000 U.S. adults about their oral problems. If you have any of the top 3 problems found in this survey, it could be a “warning bell” sounding in your mouth right now.
Here, then, are the top 3 dental problems in America, what they mean and what you should do about them.
#3: Tooth Pain. About a third of respondents (more among those younger or from lower-income households) indicated pain as a problem. As a warning sign of something wrong, tooth pain could be telling you that you have a decayed tooth, a gum abscess or something similar. The best thing to do is get a checkup as soon as possible. It’s unlikely that whatever is causing the pain will go away on its own and procrastination could make ultimate treatment more complex and difficult.
#2: Difficulty Biting. A slightly higher number of people named difficulty chewing and biting as their main oral problem. As with tooth pain, chewing difficulty causes could be many: cracked, loose or decayed teeth, ill-fitted dentures, or a jaw joint disorder (TMD). Again, if it hurts to chew or bite, see a dentist. Besides the underlying problem, chewing difficulties could also affect the quality of your nutrition.
#1: Dry Mouth. Chronic dry mouth garnered the highest response in the survey, especially among older adults. This is more serious than the occasional “cotton mouth” feeling we all experience—with chronic dry mouth the salivary glands aren’t producing enough saliva to neutralize mouth acid or fight disease, thus increasing your risk for tooth decay or periodontal (gum) disease. It’s most likely caused by medications or systemic conditions, so talk with your dentist or physician about boosting saliva flow.