Posts for tag: pediatric dentistry
When your baby’s first teeth come in, you might not think it necessary yet to worry about tooth decay. But even infants can develop this common dental disease. In fact, it has a specific name in children 6 and under: early childhood caries (ECC).
About one-fourth of U.S. children have ECC, and poor or minority children are at highest risk. Because of primary (“baby”) teeth’s thin enamel layer, ECC can spread to healthier teeth with unnerving speed, causing extensive damage.
While such damage immediately affects a child’s nutrition, speech development and self-esteem, it could also impact their future oral health. Permanent teeth often erupt out of position because of missing primary teeth lost prematurely, creating a poor bite. And children with ECC are more likely to have cavities in their future permanent teeth.
While there are a number of effective treatments for repairing ECC-caused damage, it’s best to try to prevent it before damage occurs. A large part of prevention depends on you. You should, for example, begin oral hygiene even before teeth come in by wiping their gums with a clean, damp cloth after feeding. After teeth appear, switch to daily brushing with just a smear of toothpaste.
Because refined sugar is a primary food source for decay-causing bacteria, you should limit it in their diet. In the same vein, avoid sleep-time bottles with fluids like juices, milk or formula. As they grow older, make sure snacks are also low in sugar.
You should also avoid spreading your own oral bacteria to your baby. In this regard, don’t put their eating utensils or pacifier in your mouth and don’t drink from the same cup. Avoid kissing your baby on the lips. And above all, take care of your own oral health to prevent your own encounter with dental disease.
Finally, start regular dental visits on or before your baby’s first birthday. Regular cleanings and checkups increase the chances for early decay detection, as well as provide for treatments and prevention measures that can reduce the disease’s spread and destruction.
ECC can be devastating to both your baby’s current and future dental health. But with vigilance and good dental practices, you may be able to help them avoid this serious disease.
It’s important for your child’s current and future health that we watch out for tooth decay. Taking x-rays is a critical part of staying one step ahead of this common disease.
But while x-ray imaging is commonplace, we can’t forget it’s still a form of radiation that could be potentially harmful, especially for a child whose tissues are rapidly developing. We must, therefore, carefully weigh the potential benefits against risk.
This concern has given birth to an important principle in the use of x-rays known as ALARA, an acronym for “As Low As Reasonably Achievable.” In basic terms, we want to use the lowest amount of x-ray energy for the shortest period of time to gain the most effectiveness in diagnosing tooth decay and other conditions.
A good example of this principle is a common type of radiograph known as a bitewing. The exposable x-ray film is attached to a plastic devise that looks like a wing; the patient bites down on it to hold it in place while the x-ray exposure takes place. Depending on the number of teeth in a child’s mouth, an appointment usually involves 2 to 4 films, and children are typically spaced at six months apart. Frequency of x-rays depends on your child’s tooth decay risk: lower risk, less need for frequent intervals.
Each bitewing exposes the child to 2 microsieverts, the standard unit for radiation measurement. This amount of radiation is relatively low: by contrast, we’re all exposed to 10 microsieverts of background radiation (natural radiation occurring in the environment) every day or 3,600 microsieverts annually. Even two appointments of four bitewings each year is a fraction of a percent of the background radiation we’re exposed to in the same year.
This conservative use of x-rays is well within safe parameters for children. As x-ray technology continues to advance (as with the development of digital imaging) we anticipate the exposure rate to diminish even more. Prudently used, x-rays remain one of our best tools for ensuring your child’s teeth are healthy and developing normally.
If you would like more information on the use of x-rays with 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 “X-Ray Safety 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 caviÂties. 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.Â 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.”
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.”
For most people, raising kids is an expensive proposition. (A recent estimate by the U.S. Department of Agriculture puts the average tab at almost a quarter of a million dollars before they turn 18.) But if you’ve been keeping up with parenting news lately, you may have come across an even more jaw-dropping fact: According to a survey by the Sunstar group, a maker of oral hygiene products, when the tooth fairy makes a pickup in New York City, she (or her parental surrogate) leaves an average of $13.25 per tooth!
That compares to $9.69 per tooth in Los Angeles, $5.85 in Chicago and $5.02 in Boston — and it’s a far higher rate than most other polls have shown. But it brings up a good question: What's a baby tooth really worth? Ask a dentist, and you may get an answer that surprises you: A lot more than that!
A child’s primary (baby) teeth usually begin coming in around the age of 6 to 9 months, and start making their exits about the time a child reaches six years; by the age of 10 – 13, they’re usually all gone. But even though they will not last forever, baby teeth are far from disposable — and they deserve the same conscientious care as adult teeth. Here’s why:
Primary teeth play the same important roles in kids’ mouths as permanent teeth do in the mouths of adults: they allow kids to bite and chew effectively, speak normally and smile brightly. Their proper functioning allows children to get good nutrition and develop positive social interactions as they grow toward adolescence — and those are things it’s difficult to put a price tag on.
But that’s not all baby teeth are good for. Each one of those little pearly-whites serves as a guide for the permanent tooth that will succeed it: It holds a space open in the jaw and doesn’t let go until the grown-up tooth is ready to erupt (emerge) from beneath the gums. If primary teeth are lost too soon, due to disease, decay or accidents, bite problems (malocclusions) can develop.
A malocclusion (“mal” – bad; “occlusion” – bite) can result when permanent teeth don’t erupt in their proper locations. “Crowding” is a common type of malocclusion that can occur when baby teeth have been lost prematurely. The new, permanent teeth may come in too close together because neighboring teeth have shifted into the gap left by the prematurely lost tooth, creating an obstruction for the incoming teeth. In other cases, the permanent teeth may emerge in rotated or misplaced positions.
Bite problems make teeth harder to clean and thus more prone to disease; they may also cause embarrassment and social difficulties. The good news is that it’s generally possible to fix malocclusion: orthodontists do it every day. The bad news: It will almost certainly cost more than $13.25 per tooth. Alternatively, baby teeth in danger of being lost too soon can often be saved via root canal treatment or other procedures.
We’re not advocating giving big money to toddlers — but we do want to make a point: The tooth fairy’s payout: a few dollars. A lifetime of good checkups and bright smiles: incalculable.