Posts for category: Oral Health
The change from primary teeth to permanent is an announcement to the world that a boy or girl is "growing up." "Growing up," though, is still not "grown"—the new teeth are still in a period of development that can affect how we treat them if they're injured or diseased.
While a new tooth erupts with all its anatomical layers, the middle dentin is somewhat thinner than it will be after it matures. The pulp, the tooth's innermost layer, produces new dentin and gradually increases the dentin layer during this early development period. While the pulp continues to produce dentin over a tooth's lifetime, most of it occurs in these early years.
To prevent or stop any infection, we would normally perform a root canal treatment in which we remove the pulp tissue and fill the empty pulp chamber and root canals. This poses no real issue in an older tooth with mature dentin. Removing the pulp from an immature tooth, though, could interrupt dentin development and interfere with the tooth's root growth. Besides a higher risk of discoloration, the tooth could become more brittle and prone to fracture.
That's why we place a high priority on preserving a younger tooth's pulp. Rather than a root canal treatment, we may treat it instead with one of a number of modified techniques that interact less with the pulp. Which of these we use will depend on the extent of the pulp's involvement with the injury or disease.
If it's unexposed, we may use a procedure called indirect pulp therapy, where we remove most of the tooth's damaged dentin but leave some of the harder portion intact next to the pulp to avoid exposure. If, though, some but not all of the pulp is damaged, we may perform a pulpotomy: here we remove the damaged pulp tissue while leaving the healthier portion intact. We may then apply a stimulant substance to encourage more dentin production to seal the exposure.
These and other techniques can help repair an injured young tooth while preserving most or all of its vital pulp. Although we can't always use them, when we can they could give the tooth its best chance for a full life.
If you would like more information on caring for your child's 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 “Saving New Permanent Teeth after Injury.”
Tooth decay and developing bite problems could be major obstacles to your child's normal growth and development. Without good, preventive dental care at home and from the dentist, these obstacles could impact their health now and well into adulthood.
Here are 3 things you should do to help your child stay ahead of harmful dental problems.
Start daily hygiene early. To protect your child from tooth decay, you should begin cleaning their teeth and gums early, even before teeth appear. For your first hygiene efforts use a clean wet cloth to wipe their gums after feeding to reduce bacterial growth in the mouth. After teeth begin to erupt start brushing them with a fluoride toothpaste—a slight smear for infants and up to a pea-sized amount when they get older.
Keep sugar to a minimum. The bacteria that causes tooth decay thrive on sugar. To minimize bacterial growth, keep your child's sugar intake to a minimum by providing dental-friendly snacks and foods. Also, try to limit any sugar they eat to mealtimes rather than with snacking through the day. And avoid sending them to bed with a bottle filled with a sugary liquid (including formula and breastmilk).
Begin dental visits around age one. Dentists and pediatricians recommend regular dental visits for children starting around their first birthday. This increases the chances of detecting disease or bite problems early before too much damage occurs. Your dentist can also provide preventive measures like sealants or topical fluoride to reduce the risks of tooth decay. And early visits lessen the chance of your child developing dental visit anxiety, a phobia that could continue into adulthood.
X-ray imaging is such an intricate part of dentistry, we usually don't think twice about it. Without it, though, the fight against dental disease would be much harder.
At the same time, we can't forget that x-rays are a form of electromagnetic radiation that can penetrate human tissue. It's that very quality and the difference in the absorption rate between denser bone and teeth and softer diseased tissue that makes disease diagnosis possible.
But this same penetrative power can potentially harm the tissues it passes through. For that reason when practicing any form of x-ray diagnostics, dentists follow a principle known as ALARA, an acronym for "As Low As Reasonably Achievable." In lay terms ALARA means getting the most benefit from x-rays that we can with the lowest dose and exposure time possible.
While practicing ALARA with x-rays is important for patients of any age, it's especially so for children who are more sensitive to radiological energy given their smaller size and anatomy. We can't use the same settings, dosages or exposure times with them as with an adult.
To protect children, dentists have developed techniques and protocols that lessen their exposure time and rate, while still providing usable images for diagnosing disease. The bitewing is a good example of safe and effective pediatric x-ray imaging.
A bitewing is a plastic device holding exposable film that patients bite down on and hold in their mouth while x-raying. The x-rays pass through the teeth and gums and expose the film behind them on the bitewing. Using a bitewing we can capture a set of two to four radiographs to give us a comprehensive view of the back teeth, while exposing the child less radiation than they normally receive daily from background environmental sources.
This and other advances in equipment and digital imaging greatly reduce the amount of radiation patients receive during x-rays. If, though, you're still concerned about your child's x-ray exposure, talk with your dentist who can explain in more detail the x-ray safety protocols they follow. Just like you, they want your child to be as safe as possible while still benefiting from the diagnostic power of x-rays.
If you would like more information on safety precautions using 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.”
Today's dental restorations are truly amazing. Not only are they life-like and functional, they can endure for many years a hostile environment of bacteria, acid and heavy biting forces.
Even so, you'll still need to take care of your restorations to help them last. Here's how to extend the life of 3 common forms of dental work.
Fillings. We use fillings, both metal amalgam and tooth-colored materials, to repair holes or cavities in teeth caused by tooth decay. Although strong, dental fillings can break if you subject them to abnormally high biting force (like chewing ice). There's also a chance that if a slight separation occurs between the filling and tooth, bacteria can take up residence and reignite the decay process. To prevent this, practice a daily regimen of oral hygiene to clean away bacterial plaque—and reduce sugar in your diet, a prime food source for bacteria.
Veneers. Usually made of thin porcelain, veneers are bonded to the front of teeth to mask chips, stains, gaps or other blemishes. But although they're strong, veneers aren't immune to damage. Habits like biting nails, the aforementioned ice chewing or unconsciously grinding your teeth could cause a chipped veneer. And if periodontal (gum) disease causes your gums to recede, the exposed part of the tooth may look noticeably darker than the veneer. To protect your veneers and their appearance, avoid habits like ice chewing, and seek treatment for teeth grinding and dental disease.
Bridgework. Bridges are used to replace one or more missing teeth. Traditional bridges use the natural teeth on either side of the gap to support the bridge; for a single missing tooth, implants are a preferable option because they don't require permanently altering the neighboring teeth to support it. With either option, though, you should brush and floss around the restoration to reduce the risk of dental disease. Infections like gum disease or tooth decay could eventually weaken the bridge's supporting teeth or gum disease can damage an implant's gum and bone support.
With any dental restoration, be sure to practice daily oral hygiene, eat a nutritious, low-sugar diet, and see your dentist regularly for cleanings and checkups. Taking care of your dental work will help it take care of you for a long time to come.
After your son or daughter's dental exam, you expect to hear about cavities, poor bites or other dental problems. But your dentist might suggest a different kind of problem you didn't expect—an eating disorder.
It's not a fluke occurrence—a dental exam is a common way bulimia nervosa or anorexia nervosa come to light. That's because the teeth are often damaged by the behaviors of a patient with an eating disorder.
Most of this damage occurs because of purging, the practice of induced vomiting after eating. During vomiting stomach acid can enter the mouth and "wash" against the back of the teeth. After repeated episodes, the acid dissolves the mineral content of tooth enamel and causes it to erode. There's also a tell-tale pattern with eating disorders: because the tongue partially shields the back of the lower teeth while purging, the lower teeth may show less enamel erosion than the upper.
Hygiene practices, both negligent and too aggressive, can accelerate erosion. Anorexics often neglect basic grooming and hygiene like brushing and flossing, which increases the likelihood of dental disease. Bulimia patients, on the other hand, can be fastidious about their hygiene. They're more likely to brush immediately after purging, which can cause tiny bits of the enamel immediately softened by the acid wash to slough off.
In dealing with a family member's eating disorder, you should consider both a short and long-term approach to protect their dental health. In the sort-term the goal is to treat the current damage and minimize the extent of any future harm. In that regard, encourage them to rinse with water (mixed optionally with baking soda to help neutralize acid) after purging, and wait an hour before brushing. This will give saliva in the mouth a chance to fully neutralize any remaining acid. Your dentist may also recommend a sodium fluoride mouth rinse to help strengthen their tooth enamel.
For the long-term, your goal should be to help your loved one overcome this potentially life-threatening condition through counseling and therapy. To find out more about treatment resources near you, visit the National Eating Disorders Association website at nationaleatingdisorders.org. Taking steps to treat an eating disorder could save not only your loved one's dental health, but also their life.
If you would like more information on eating disorders and dental health, 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 “Bulimia, Anorexia & Oral Health.”