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Dental Health

Why Good Dental Health is Important

Innumerable studies and research have concluded on the importance of starting children early in their lives with good dental hygiene and oral care. According to research, the most common chronic childhood disease in America is tooth decay, affecting 50 percent of first-graders and 80 percent of 17-year-olds. Early treatment prevents problems affecting a child’s health, well-being, self-image and overall achievement.

The National Institute of Dental & Craniofacial Research estimates that children will miss 52 million hours of school each year due to oral health problems and about 12.5 million days of restricted activity every year from dental symptoms. Because there is such a significant loss in their academic performance, the Surgeon General has made children’s oral health a priority.

Parents are responsible for ensuring their children practice good dental hygiene. Parents must introduce proper oral care early in a child's life—as early as infancy. The American Dental Hygiene Association states that a good oral hygiene routine for children includes:

  • Thoroughly cleaning your infant’s gums after each feeding with a water-soaked infant cloth. This stimulates the gum tissue and removes food.
  • Teaching your child at age 3 about proper brushing techniques with a small, soft-bristled toothbrush and a pea-sized amount of fluoridated toothpaste and later teaching them brushing and gentle flossing until 7 or 8 years old.
  • Regular visits with their dentist to check for cavities in the primary teeth and for possible developmental problems.
  • Encouraging your child to discuss any fears they may have about oral health visits, but not mentioning words like “pain” or “hurt,” since this may instill the possibility of pain in the child’s thought process.
  • Determining if the water supply that serves your home is fluoridated; if not, discussing supplement options with your dentist or hygienist.
  • Asking your hygienist or dentist about sealant applications to protect your child’s teeth-chewing surfaces and about bottle tooth decay, which occurs when teeth are frequently exposed to sugared liquids.

About Teeth

Throughout your life, you will have two sets of teeth: primary (baby) teeth and secondary (permanent) teeth. The primary teeth appear around ages 6-8 months, and all 20 are in place by age 3.

Permanent teeth will begin to grow around age 6, and with the exception of wisdom teeth, are all present between ages 12 and 14. The next teeth to grow in are the 12-year molars and finally the wisdom teeth. Wisdom teeth typically begin breaking through from age 17 and on. The total number of permanent teeth is 32, though few people have room for all 32 teeth, which is why wisdom teeth are usually removed.

Your front teeth are called incisors. The sharp “fang-like” teeth are canines. The next side teeth are referred to as pre-molars or bicuspids, and the back teeth are molars. Your permanent teeth are the ones you keep for life, so it is important that they are brushed and flossed regularly and that periodic check-ups by a dentist are followed.


Early Dental Care

Teething

A baby's first tooth typically erupts between 6 to 12 months of age. Gums are sore, tender and sometimes irritable until the age of 3. Rubbing sore gums gently with a clean finger, the back of a cold spoon or a cold, wet cloth helps soothe the gums. Teething rings work well. While your baby is teething, it is important to monitor the teeth for signs of baby bottle decay. Examine the teeth, especially on the inside or the tongue side, every two weeks for dull spots (whiter than the tooth surface) or lines. A bottle left in an infant's mouth while sleeping can cause decay. This happens because sugar in the liquid mixes with bacteria in dental plaque, forming acids that attack the tooth enamel. Each time a child drinks liquids containing sugar, acids attack the teeth for about 20 minutes. When awake, saliva carries away the liquid. During sleep, the saliva flow significantly decreases and liquids pool around the child's teeth for long periods, covering the teeth in acids.

Preventing Baby Bottle Tooth Decay

Tooth decay in infants can be minimized or totally prevented by not allowing sleeping infants to bottle-feed. Infants that need a bottle to comfortably fall asleep should be given a water-filled bottle or a pacifier.

Infant's New Teeth

Primary (baby) teeth play a crucial role in dental development. Without them, a child cannot chew food properly and has difficulty speaking clearly. Primary teeth are vital to development of the jaws and for guiding the permanent teeth into place when they replace the baby teeth around age 6. Since primary teeth guide the permanent teeth into place, infants with missing primary teeth or infants who prematurely lose primary teeth may require a space maintainer, a device used to hold the natural space open. Without a maintainer, the teeth can tilt toward the empty space and cause permanent teeth to come in crooked. The way your child cares for his/her primary teeth plays a critical role in how he/she treats the permanent teeth. Children and adults are equally susceptible to plaque and gum problems—hence, the need for regular care and dental check-ups.

Infant Tooth Eruption

A child's teeth actually start forming before birth. As early as 4 months of age, the primary (baby) teeth push through the gums—the lower central incisors are first, then the upper central incisors. The remainder of the 20 primary teeth typically erupt by age 3. Permanent teeth begin eruption around age 6, starting with the first molars and lower central incisors. This process continues until around age 21. Adults have 28 permanent teeth—32 including the third molars (wisdom teeth).

A Child's First Dental Visit

A child's first dental visit should be scheduled around his/her first birthday. The most important part of the visit is getting to know and becoming comfortable with the dental team. A pleasant, comfortable first visit builds trust and helps put the child at ease during future dental visits.

Good Diet and Healthy Teeth

The teeth, bones and soft tissue of the mouth require a healthy, well-balanced diet. A variety of foods from the five food groups helps minimize (and avoid) cavities and other dental problems. Children should receive healthy foods like vegetables, low-fat yogurt and cheeses, which promote strong teeth.


Stainless Steel Crown

Please Be Aware

When your child receives a stainless steel crown or "silver cap" it is important that they avoid things that can cause the cap to come off. Also please advise others such as grandparents and teachers that your child has a crown and they should avoid sticky, chewy foods or candies.

Examples of these sticky, chewy foods and candies are as follows: Tootsie Rolls, Laffy Taffy, Now and Laters, Carmel, Gummi Bears or Worms, Milk Duds, Bit O Honey, Jolly Ranchers, Sugar Babies, Sugar Daddies, etc…

Should your child’s crown ever come off please keep the crown and contact our office duirng regular hours so that we can replace it. Please be sure to bring the crown to this appointment.


Sealants

The chewing surfaces of molars have many grooves and pits, making them difficult to keep clean and prone to cavities. Dental sealants are a plastic resin applied to the groovy surfaces that act as a barrier and protect them against decay-causing bacteria and food particles. We recommend dental sealants for all six and twelve year molars, and most insurance companies cover them as part of your child’s preventative care services. When you bring your child in for their cleaning and check-up appointments, our staff will check to see if their molars are present, and if they are, they will discuss applying sealants with you.

The application process is simple and usually takes five or ten minutes. The teeth that will be sealed are thoroughly cleaned and dried, and then the chewing surfaces are roughened with an etching solution that helps the sealants adhere to the teeth. Next the sealant is "painted" onto the tooth and special curing light bonds and hardens it. Sealants can last for several years, and will be checked and touched up as necessary at your child’s future appointments at no charge. Certain deficiencies in enamel or inability to obtain a completely dry surface can cause sealants to be weaker and not as successful. Our office always guarantees the money that a parent spends out of their pocket will be reimbursed if the sealant fails.

Getting sealants is not painful and most children have no problem with the process. They just have to stay still and have their mouth propped open with a "tooth pillow" while the sealants are being applied. In children who have high dental anxiety or a strong gag reflex, nitrous oxide (laughing gas) can be administered during the sealant process to help them relax. Occasionally, a gag reflex is too strong and sealants are not an option.


Space Maintainers

Your child has received a space maintainer. A spacer will help to hold space where a tooth has been removed so that the permanent tooth will have room to erupt. The spacer consists of a ring that was custom fit to your child’s tooth at a previous appointment and a loop that stretches across the span of the spot where the missing tooth used to be, and this loop will touch the tooth in front of the space.

After placing a spacer, your child may complain that it feels tight. This can be the case if the tooth behind the space has slightly shifted forward since we took the impression for the spacer at a previous appointment. This tooth will shift back into place with the placement of the spacer. Children’s pain reliever can be administered to reduce this discomfort.

Helping your child to take care of their space maintainer is important. Your child should avoid sticky candies, a few examples of such candies include Now and Laters, Carmel, Laffy Taffy, Milk Duds, Sugar Daddies, Gummi Bears, Bit O Honey and Jolly Ranchers. Also gums containing sugar should be avoided.

Your child’s space maintainers will be checked during future routine exams to insure that they have not been loosened from the tooth, or that the tooth, which the space is being held for, hasn’t begun to come in.


Preventing and Overcoming Dental Anxiety

Some children love coming to the dentist from day one and others take time to warm up. If your child gets upset during the visit, rest assured that it is normal behavior because they are in an unfamiliar situation. Please do not be alarmed or embarrassed. We are all trained to help fearful or anxious children through their dental experience, and as your child matures, we hope to encourage his or her independence and promote self-esteem.

If your child is older and has not been to the dentist yet, you should discuss the positive aspects of dentistry with them before the appointment. Try to act relaxed and at ease because if you are stressed and anxious, they will likely be stressed and anxious as well.

Please do not tell your child that the dentist will not hurt because the possibility of pain may have never entered his or her mind. Instead, reassure your child that our Doctors will be friendly and gentle. Also, avoid using words such as needle, shot, pull, or other words that could create anxiety. We will explain our procedures in ways that your child can understand and will work to decrease any fear or anxiety they may have. For example, we call the suction device "Mr. Thirsty" and cavities "sugar bugs."

A common problem that children face is being fearful about coming to the dentist because they are unsure about what will happen. It is normal to be scared of the unknown, and we work with kids every day to help them feel more comfortable so that they can establish a positive relationship with our dentists and staff.

While we welcome parents in the back, if a parent truly has a dental phobia themselves, it may be best for the child to have the parent stay in the waiting room. That fear is easily picked up on by the child. We would like them to come in and experience the dental visit without any preconceived notions about a fear of the dentist.

If you would like for your child to come for a pre-dental visit of the office, please call and ask to schedule a time to come in for a tour. We also have a tab on the website that is for Bippo Lingo. This might help parents learn our use of gentle words to describe the dental talk in a less threatening terminology.

If you have any specific concerns about your child’s first visit, we would love to talk to you about them ahead of time. Just call our office or email us at your convenience.


Abscess and Infection

A dental abscess is an infection deep in the gums and surrounding tissue that is usually caused by bacterial growth from an untreated cavity. It’s an extremely painful condition that will not resolve on its own and requires dental intervention. Left untreated, the infection can spread to other areas of the body and even become life-threatening. Typical symptoms of a dental abscess include pain, facial swelling, redness of the face, fever, a pimple-like nodule on the gums, and pus drainage. If your child has any of these symptoms, they should be brought to the dentist for an evaluation. Other more severe symptoms include nausea, vomiting, diarrhea, difficulty swallowing, and difficulty breathing.

An abscess can be diagnosed by the dentist visually or on an x-ray. If your child has an abscess on a baby tooth, the tooth will likely need to be extracted and thus the abscess will drain. If the abscess is on a permanent tooth, it will likely require a root canal with a crown in order to save the tooth. Unfortunately, even some permanent teeth cannot be saved if an abscess has persisted for a long time. He or she may also need a course of antibiotics to kill the bacteria. Our doctors try to only use antibiotics if the child has a facial swelling or has been in pain and the tooth cannot be extracted immediately.

To prevent a dental abscess, make sure your child has a good oral hygiene routine, take them to the dentist every six months to check for cavities, and have their cavities fixed promptly.


Bitten or Chewed Lips After Dental Treatment

Some dental treatments will require your child to be anesthetized (numbed). As the anesthetic wears off, your child will experience a tingling sensation in the mouth, tongue and/or cheek areas. It is important to monitor your child for the next 2-3 hours after treatment to ensure that he or she does not bite or scratch at these numbed areas. You should also avoid giving your child solid food until the numbness has worn off. Instead, opt for soft snacks such as Jell-o, frozen yogurt, milkshakes and/or smoothies. We suggest spooning these instead use of a straw.

If your child bites his or her cheek, tongue or lip, there may be swelling over the next 4-5 days. This is most common in a child under the age of 8. A soft scab may develop that looks like a yellowish white plaque or like a large traumatic ulcer. This is a normal part of the healing process. The lesion should heal over the next 10-14 days.

What you can do:

Keep the area clean, being sure to brush teeth as usual, just being as gentle as possible around affected area.

You may give your child children’s acetaminophen (Tylenol®) or ibuprofen (Motrin®) if he or she is in pain.

Avoid acidic food and drinks such as tomato based foods and sauces and citric juices. These might burn the open wound.