PEDIATRIC DENTISTRY

What dental problems could my child have?

Some dental problems begin very early in life. One concern is baby bottle tooth decay, a serious condition caused by a child staying on the bottle (or breast) too long. Another problem is gum disease. About 40% of children 2-3 years old have at least mild inflammation of gum tissues. Oral habits (such as thumb-sucking) should also be checked. The earlier the dental visit, the better the chances of preventing problems. Strong, healthy teeth help your child chew food easily, speak clearly and feel good about his or her appearance.

Why are baby teeth so important?

Primary teeth are important because they help with proper chewing and eating, help in speech development and add to an attractive appearance. A child who can chew easily, speak clearly and smile confidently is a happier child. Healthy primary teeth allow normal development of the jaw bones and muscles, save space for the permanent teeth and guide them into place. If a baby tooth is lost too soon, permanent teeth may come in crooked. Decayed baby teeth can cause pain, abscesses, infections, and can spread to the permanent teeth. Also, your child’s general health can be affected if diseased baby teeth aren’t treated. Remember, some primary molars are not replaced until age 10-14, so they must last for years.

What should I tell my child about the first dental visit?

We are asked this question many times. We suggest you prepare your child the same way that you would before their first hair-cut or trip to the shoe store. This will not be the frightening experience you may remember from your youth. If you are nervous about the trip, then the less you say the better. You cannot hide your anxiety from a child (they have radar for these things). Your child’s reaction to his first visit to the dentist may surprise you.

What about preventative care?

Tooth decay and children no longer have to go hand in hand. At our office we are most concerned with all aspects of preventive care. We use the latest in sealant technology to protect your child’s teeth. Sealants are space-age plastics that are bonded to the chewing surfaces of decay prone back teeth. This is just one of the ways we will set the foundation for your child’s lifetime of good oral health.

What about sterilization?

Your health and peace of mind are always our primary concern; therefore, we use state-of-the-art sterilization procedures. After each patient’s visit, the treatment area is thoroughly disinfected. We ultrasonically clean and heat sterilize all non-disposable instruments. Our staff wears gloves and masks during procedures. Please feel free to ask us for information on the measures we take to ensure the safety of you and your children, or a tour of our sterilization area.


TOOTH BRUSHING

Children’s hands and mouths are different than adults. They need to use toothbrushes designed for children. Both adults and children should use brushes with soft, rounded bristles for gentle cleaning. Change to a new brush about every three months.

Wipe infant’s teeth gently with a moist, soft cloth or gauze square. As babies grow, use a child’s toothbrush with a small, pea-sized dab of toothpaste, usually non-fluoridated until your child can spit. By age two or three begin to teach your child to brush. You will still need to brush where they miss every day. We advise parents/ guardians to use a gentle, small, circular motion to remove plaque. When children are older, usually around age 7, they can switch to this method and brush independently.

Hold the brush at a 45 degrees angle towards teeth and gums. Move brush in a circular motion with gentle pressure, about a tooth wide for 2 minutes.

Brush the inside and outside surfaces of each tooth, top and bottom.
Hold the brush flat on top of the teeth and brush the chewing surfaces.
Gently brush the tongue to remove debris.
Floss between teeth daily.

THUMB SUCKING

Digit (Thumb) sucking is a habit that occurs in infants. Children usually give up digit sucking by the age of four. If the child continues past the age when their permanent teeth start to erupt, they may develop crooked teeth and a malformed roof of their mouth. This results from the frequency, duration, intensity, and position of the digit in the child’s mouth. This can also affect the position of the upper and lower jaw and can also affect speech.

Suggestions to break the habit:

  • Wait till the time is right (low stress).
  • Motivate your child (show examples of what could happen to their teeth and fingers/thumbs).
  • Use a reward system (small incentives will encourage your child to stick with it).
  • If none of these options are helpful for your child, speak with us at your dental visit or call to discuss further intervention.

TOOTH ERUPTION

The first baby teeth which come into the mouth are usually the two bottom front teeth. You will notice this when your baby is about six to eight months old. Next to follow will be the four upper front teeth and the remainder of your baby’s teeth will appear periodically. They will usually appear in pairs along the sides of the jaw until the child is about 2-1/2 years old.

At around 2-1/2 years old, your child should have all 20 teeth. Between the ages of five and six, the first permanent teeth will begin to erupt. Some of the permanent teeth replace baby teeth and some don’t. Don’t worry if some teeth are a few months early or late as all children are different.

Baby teeth are important as they not only hold space for permanent teeth, but they are important to chewing, biting, speech, and appearance.

For this reason it is important to maintain a healthy diet and daily hygiene.


BABY BOTTLE DECAY

What Causes Tooth Decay?

Several specific types of bacteria that live on the teeth cause decay. When sugar is consumed, the bacteria use the sugar and then manufacture acids that dissolve the teeth and cause an infection in the tooth. This infection is called decay.

What Is Baby Bottle Tooth Decay?

Babies who go to bed with a bottle of milk, formula, or juice are more likely to get tooth decay. Because the sugar in formula, milk, or juice stays in contact with the teeth for a long time during the night, the teeth can decay quickly.

Some Tips To Avoid Baby Bottle Tooth Decay

  • Do not put your child to bed with a bottle, unless it is of plain water.
  • Stop nursing when your child is asleep or has stopped sucking on the bottle.
  • Do not to let your child walk around using a bottle of milk or juice as a pacifier.
  • Start to teach your child to drink from a cup at about six months of age. Plan to stop using a bottle by 12 to 14 months at the latest.
  • Don’t dip your child’s pacifier in honey or sugar.
  • Brush or wipe your child’s teeth before bedtime and naps.

What Is Fluoride?

Fluoride helps make teeth strong and prevents tooth decay. If the water where you live does not have enough fluoride, your doctor may prescribe fluoride supplements (fluoride drops or pills). These drops or pills are taken every day, starting when your child is about six months old. Only give as much as the directions say to use because too much fluoride can cause spots on your child’s teeth. Also, be sure to call your local water authority and ask if your water is fluoridated. If it is, tell your dentist or pediatrician so that your child is not being over fluoridated. Children should take these drops or pills until they are 12 to 16 years old (or until you move to an area with fluoride in the water).

What is Fluoride Varnish?

Fluoride varnish is a topical agent containing a high concentration of fluoride (5 percent sodium fluoride (NaF) or 22,600 ppm of fluoride) in a resin or synthetic base. It is painted directly onto teeth and is intended to remain in close contact with enamel for several hours. Because it adheres to the tooth surface, it stays in place so that our patients can eat and drink following their appointment and it minimizes the risk of inadvertent fluoride consumption. The ADA considers fluoride varnish to be safe and efficacious as part of a caries prevention program that includes caries diagnosis, risk assessment, and regular dental care. We recommend this fluoride treatment in our very young patients as well as our patients at high risk for dental decay.


CAVITY PREVENTION

Most of the time cavities are due to a diet high in sugary foods plus a lack of brushing.

Limiting sugar intake and brushing regularly, of course, can help. The longer it takes your child to chew their food, the longer the residue stays on their teeth and the greater the chances of getting cavities.

Every time someone eats, an acid reaction occurs inside their mouth as the bacteria digests the sugars. This reaction lasts approximately 20 minutes. During this time the acid environment can destroy the tooth structure, eventually leading to cavities.

Consistency of a person’s saliva also makes a difference as thinner saliva breaks up and washes away food more quickly. When a person eats diets high in carbohydrates and sugars, they tend to have thicker saliva, which in turn produces more of the acid-producing bacteria that causes cavities.

Some tips for cavity prevention:

  • Limit frequency of meals and snacks.
  • Encourage brushing, flossing, and rinsing.
  • Limit juices to 4-6oz a day and avoid soda.
  • Avoid sticky foods.
  • Make treats part of meals.
  • Choose nutritious snacks.

GUM DISEASE

While many people believe periodontal disease is an adult problem, studies indicate that gingivitis (the first stage of periodontal disease) is nearly a universal problem among children and adolescence. Advanced forms of periodontal disease are more rare in children than adults, but can occur.

Chronic gingivitis is common in children. It can cause gum tissue to swell, turn red, and bleed easily. Gingivitis is preventable and treatable with a regular routine of brushing, flossing, and professional dental care. If left untreated, it can eventually advance to more serious forms of periodontal disease.

Localized aggressive periodontitis can affect young healthy children. It is found in teenagers and young adults and mainly affects the first molars and incisors. It is characterized by the severe loss of alveolar bone, and ironically, patients generally form very little dental plaque or calculus.

Generalized aggressive periodontitis may begin around puberty and involve the entire mouth. It is marked by inflammation of the gums and heavy accumulations of plaque and calculus. Eventually it can cause the teeth to become loose.

Conditions that make children more susceptible to periodontal disease include:

  • Type I diabetes
  • Down syndrome
  • Papillon-Lefevre syndrome

For example, in a survey of 263 Type I diabetics, 11 to 18 years of age, 10 percent had overt periodontitis.