Posts for tag: pediatric dentistry
The American Academy of Pediatrics and other healthcare organizations recommend breastfeeding as the best means for infant feeding. While bottle feeding can supply the nutrition necessary for a baby's healthy development, breastfeeding also provides emotional benefits for both baby and mother.
But there might be an obstacle in a baby's mouth that prevents them from getting a good seal on the mother's breast nipple—a small band of tissue called a frenum. This term describes any tissue that connects a soft part of the mouth like the upper lip or tongue to a more rigid structure like the gums or the floor of the mouth, respectively.
Although a normal part of anatomy, frenums that are too short, thick or inelastic can restrict a baby's lip or tongue movement and prevent an adequate seal while nursing. The baby may adjust by chewing rather than sucking on the nipple. Besides a painful experience for the mother, the baby may still not receive an adequate flow of breast milk.
Bottle-feeding is an option since it may be easier for a baby with abnormal frenums to negotiate during nursing. But the problem might also be alleviated with a minor surgical procedure to snip the frenum tissue and allow more freedom of movement.
Often performed in the office, we would first numb the frenum and surrounding area with a topical anesthetic, sometimes accompanied by injection into the frenum if it's abnormally thick. After the numbing takes effect, we gently expose the tissue and cut it with either surgical scissors or a laser, the latter of which may involve less bleeding and discomfort. The baby should be able to nurse right away.
If you wait later to undergo the procedure, the baby may already have developed compensation habits while nursing. It may then be necessary for a lactation consultant to help you and your baby "re-learn" normal nursing behavior. It's much easier, therefore, to attempt this procedure earlier rather than later to avoid extensive re-training.
While there's little risk, frenum procedures are still minor surgery. You should, therefore, discuss your options completely with your dental provider. Treating an abnormal frenum, though, could be the best way to realize the full benefits of breastfeeding.
There’s a potential threat lurking in your young child’s mouth—tooth decay. This destructive disease can not only rob them of teeth now, it could also impact their dental health long into their adult years.
That’s why we focus heavily on decay prevention measures even in primary (“baby”) teeth, as well as early treatment should it still occur. It’s a straightforward treatment strategy: minimize the factors that contribute to disease and maximize those that protect against it.
We can represent the disease-causing factors with the acronym BAD. Bad bacteria top the list: they produce oral acid that erodes tooth enamel. Couple that with an Absence of healthy saliva function, necessary for acid neutralization, and you have the potential opening for tooth decay. Poor Dietary habits that include too much added sugar (a prime food source for bacteria) and acidic foods help fuel the decay process.
But there are also SAFE factors that can help counteract the BAD. Promoting better Saliva function helps control acid levels, while Sealants applied to chewing surfaces strengthen these vulnerable areas against decay. We can prescribe Antimicrobials in the form of mouth rinses that reduce abnormally high bacterial concentrations. Fluoride applied directly to the enamel bolsters its mineral content. And an Effective diet high in nutrition and low in sugar or acidic foods rounds out our protective measures.
Promoting SAFE factors greatly reduces the risk of childhood tooth decay. To keep on track it’s important to start regular, six-month dental visits beginning around your child’s first birthday. These visits are the most important way to take advantage of prevention measures like sealants or topical fluoride, as well as keeping an eye out for any signs of decay.
And what you do at home is just as important. Besides providing a teeth-friendly diet, you should also brush and floss your child’s teeth every day, teaching them to do it for themselves when they’re old enough. Playing it “SAFE” with your child’s dental health will help ensure your child’s teeth stay decay-free.
If you would like more information on dental care for your child, 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 “Taking the Stress out of Dentistry for Kids.”
Often as children grow older, their participation in sports or similar activities increases. While generally encouraged, this greater activity does increase injury risk, especially to the mouth.
In fact, the late childhood to early adulthood demographic is the most prone portion of the population to incur dental injuries. To complicate matters, their dental development is often incomplete, posing a number of treatment obstacles for an injured tooth.
For example, the primary means for preserving an injured adult tooth is a root canal treatment: damaged or diseased tissue within the pulp, the tooth’s innermost layer, is removed and the empty chamber and root canals filled and sealed to prevent infection. But while a fully matured tooth can function without the nerves and blood vessels of the pulp, a developing tooth needs these tissues for continued tooth formation. Otherwise, tooth development can stall and cause problems later on.
The most common solution for younger teeth is to remove any damaged tooth structure without disturbing the pulp if at all possible followed by a filling. That’s contingent, though, on whether we find the pulp unexposed or undamaged—if it is, we’ll try to remove only damaged or diseased pulp tissue and leave as much healthy tissue intact as possible. To aid with healing and tissue re-growth, we may also place medicinal stimulators between the pulp and the filling.
Jaw development may also pose a challenge if the injured tooth is too far gone and must be removed. Our best choice is to replace it with a dental implant; but if we install the implant while the jaw is still growing, it may eventually appear out of place with the rest of the teeth. It’s best to postpone an implant until full jaw maturity in early adulthood.
In the meantime we could provide a temporary solution like a removable partial denture or a modified bonded bridge that won’t permanently alter nearby teeth. These methods can adequately restore the function and appearance of missing teeth until the jaw is mature enough for an implant.
While injuries with young permanent teeth do pose extra challenges, we have effective ways to address them. With the right approach, the outcome can be just as successful as with a mature tooth.
If you would like more information on dental care in the formative years, 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.”
As a parent you’re concerned with a number of issues involving your child’s health, not the least of which involves their teeth. One of the most common is thumb-sucking.
While later thumb-sucking is a cause for concern, it’s quite normal and not viewed as harmful in infant’s and very young children. This universal habit is rooted in an infant swallowing pattern: all babies tend to push the tongue forward against the back of the teeth when they swallow, which allows them to form a seal while breast or bottle feeding. Infants and young children take comfort or experience a sense of security from sucking their thumb, which simulates infant feeding.
Soon after their primary teeth begin to erupt, the swallowing pattern changes and they begin to rest the tongue on the roof of the mouth just behind the front teeth when swallowing. For most children thumb sucking begins to fade as their swallowing pattern changes.
Some children, though, continue the habit longer even as their permanent teeth are beginning to come in. As they suck their thumb the tongue constantly rests between the front teeth, which over time may interfere with how they develop. This can cause an “open bite” in which the upper and lower teeth don’t meet properly, a problem that usually requires orthodontic treatment to correct it.
For this reason, dentists typically recommend encouraging children to stop thumb-sucking by age 3 (18-24 months to stop using a pacifier). The best approach is positive reinforcement — giving appropriate rewards over time for appropriate behavior: for example, praising them as a “big” boy or girl when they have gone a certain length of time without sucking their thumb or a pacifier. You should also use training or “Sippy” cups to help them transition from a bottle to a regular cup, which will further diminish the infant swallowing pattern and need for thumb-sucking.
Habits like thumb-sucking in young children should be kept in perspective: the habit really isn’t a problem unless it goes on too long. Gentle persuasion, along with other techniques we can help you with, is the best way to help your child eventually stop.
If you would like more information on thumb sucking, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Thumb Sucking in Children” and “How Thumb Sucking Affects the Bite.”
Your child’s dental care wouldn’t be the same without x-ray imaging. It’s one of our best tools for finding and treating tooth decay.
But since x-rays emit radiation, is your child in any danger when they’re exposed?
X-rays, an invisible form of electromagnetic energy, will form images on exposed film after passing through the body. Because it takes longer for x-rays to pass through dense tissue like teeth and bones, the corresponding areas appear lighter on the film than less dense tissue like the gums. We can detect decay because the diseased tooth structure is less dense and thus appears darker against healthier tooth structure.
The downside of x-rays, though, is the radiation they emit could potentially alter cell structure and increase the risk of future cancer, especially with children. That’s why we follow a principle known as ALARA when using x-ray imaging. ALARA is an acronym for “as low as reasonably achievable,” meaning the doses for an x-ray session will be as low as possible while still gaining the most benefit.
Advances in technology, particularly the development of digital processing, has helped reduce the amount of radiation exposure. We’re also careful with what types of x-rays we use. The most common type is the bitewing, a device with the film attached to a long piece of plastic that the child holds in their mouth while biting down.
Depending on the number of our patient’s teeth, we can usually get a comprehensive view with two to four bitewings. A typical bitewing session exposes them to less radiation than what they’re receiving from natural environmental background sources each day.
Keeping the exposure as low and as less frequent as possible greatly reduces health risks while still getting the full benefit of early decay detection. Still, if you have concerns about your child’s x-ray exposure, we’ll be happy to discuss our approach and all the precautions we take using x-ray imaging.
If you would like more information on x-ray diagnostics and your child, 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.”