Posts for category: Dental Procedures
Although primary (“baby”) teeth have a lifespan of only a few years, they’re still important to a child’s current and future dental health. In the present, they help a child eat, speak and smile properly. They also help create a healthy future as placeholders for developing permanent teeth yet to come in.
If, however, a child loses a primary tooth prematurely due to decay, the corresponding permanent tooth could come in misaligned. That’s why we do what we can to help a decayed primary tooth reach its full lifespan. And there are different ways to do this depending on the type of tooth.
With front teeth, which don’t encounter the same chewing forces as those in the back, we may use a tooth-colored filling. This approach is also preferable for appearance’s sake since front teeth are highly visible when a child speaks or smiles.
Primary molars, on the other hand, need a more robust solution. A filling may not be able to withstand the level of long-term chewing forces that these back teeth normally encounter. And because they’re less visible than front teeth, there’s less concern about aesthetics.
That’s why many pediatric dentists prefer stainless steel crowns for molars. Just like their permanent teeth counterparts, a primary crown fits over and completely covers a tooth. They’re typically pre-formed, coming in different shapes and sizes that can then be customized for the tooth in question. After preparing and removing any decayed material from the tooth, we can usually install the crown in one visit with local anesthesia and a sedative (if the child needs it for anxiety).
While a steel crown isn’t the most attractive restoration, it typically handles the higher chewing forces in the back of the mouth better and longer than a filling. That’s especially critical for primary molars, which are some of the last teeth to fall out (as late as ages 10-12). And besides preserving it as a permanent tooth placeholder, a crown also helps the tooth function effectively in the present.
Regardless of what method we use, though, preserving primary teeth is a primary goal of pediatric dentistry. And with a stainless steel crown, we can keep those important back molars functioning for as long as they’re intended.
If you would like more information on caring for 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 “Stainless Steel Crowns for Kids.”
A lot happens in your child’s mouth from infancy to early adulthood. Not surprisingly, it’s the most active period for development of teeth, gums and jaw structure. Our primary goal as care providers is to keep that development on track.
One of our main concerns, therefore, is to protect their teeth as much as possible from tooth decay. This includes their primary (“baby”) teeth: although your child will eventually lose them, a premature loss of a primary tooth to decay could cause the incoming permanent tooth to erupt out of proper position. And we of course want to protect permanent teeth from decay during these developmental years as well.
That’s why we may recommend applying topical fluoride to your child’s teeth. A naturally occurring chemical, fluoride helps strengthen the mineral content of enamel. While fluoride can help prevent tooth decay all through life, it’s especially important to enamel during this growth period.
Although your child may be receiving fluoride through toothpaste or drinking water, in that form it first passes through the digestive system into the bloodstream and then to the teeth. A topical application is more direct and allows greater absorption into the enamel.
We’ll typically apply fluoride in a gel, foam or varnish form right after a professional cleaning. The fluoride is a much higher dose than what your child may encounter in toothpaste and although not dangerous it can cause temporary vomiting, headache or stomach pain if accidentally swallowed. That’s why we take extra precautions such as a mouth tray (similar to a mouth guard) to catch excess solution.
The benefits, though, outweigh this risk of unpleasant side effects, especially for children six years or older. Several studies over the years with thousands of young patients have shown an average 28% reduction in decayed, missing or filled teeth in children who received a fluoride application.
Topical fluoride, along with a comprehensive dental care program, can make a big difference in your child’s dental care. Not only is it possible for them to enjoy healthier teeth and gums now, but it could also help ensure their future dental health.
If you would like more information on topical fluoride and other dental disease prevention measures, 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 “Fluoride Gels Reduce Decay.”
When you think orthodontics, you may instantly picture braces or clear aligners worn by teenagers or adults. But there’s more to orthodontics than correcting fully developed malocclusions (poor bites). It’s also possible to intervene and potentially reduce a malocclusion’s future severity and cost well beforehand.
Known as interceptive orthodontics, these treatments help guide jaw growth in children while mouth structures are still developing and more pliable. But timing is critical: waiting until late childhood or puberty could be too late.
For example, we can influence an upper jaw developing too narrowly (which can cause erupting teeth to crowd each other) with an expander appliance placed in the roof of the mouth. The expander exerts slight, outward pressure on the upper jaw bones. Because the bones haven’t yet fused as they will later, the pressure maintains a gap between them that fills with additional bone that eventually widens the jaw.
Functional appliances like the Herbst appliance influence muscle and bone development in the jaws to eventually reshape and reposition them. The Herbst appliance utilizes a set of metal hinges connected to the top and bottom jaws; when the patient opens and closes their jaws the hinges encourage the lower jaw to move (and eventually grow) forward. If successful, it could help a patient avoid more invasive treatments like tooth extraction or jaw surgery.
Some interceptive objectives are quite simple in comparison like preserving the space created by a prematurely lost primary tooth. If a child loses a primary tooth before the incoming permanent tooth is ready to erupt, the nearby teeth can drift into the empty space. Without enough room, the permanent tooth could erupt out of position. We can hold the space with a simple loop device known as a space maintainer: usually made of acrylic or metal, the device fits between adjacent teeth and prevents them from drifting into the space until the permanent tooth is ready to come in.
Interceptive orthodontics can have a positive impact on your child’s jaw development, now and in the future. For these techniques to be effective, though, they must begin early, so be sure your child has a complete orthodontic evaluation beginning around age 7. You may be able to head off future bite problems before they happen.
If we could go back in time, we all probably have a few things we wish we could change. Recently, Dr. Travis Stork, emergency room physician and host of the syndicated TV show The Doctors, shared one of his do-over dreams with Dear Doctor magazine: “If I [could have] gone back and told myself as a teenager what to do, I would have worn a mouthguard, not only to protect my teeth but also to help potentially reduce risk of concussion.”
What prompted this wish? The fact that as a teenage basketball player, Stork received an elbow to the mouth that caused his two front teeth to be knocked out of place. The teeth were put back in position, but they soon became darker and began to hurt. Eventually, both were successfully restored with dental crowns. Still, it was a painful (and costly) injury — and one that could have been avoided.
You might not realize it, but when it comes to dental injuries, basketball ranks among the riskier sports. Yet it’s far from the only one. In fact, according to the American Dental Association (ADA), there are some two dozen others — including baseball, hockey, surfing and bicycling — that carry a heightened risk of dental injury. Whenever you’re playing those sports, the ADA recommends you wear a high-quality mouth guard.
Mouthguards have come a long way since they were introduced as protective equipment for boxers in the early 1900’s. Today, three different types are widely available: stock “off-the-shelf” types that come in just a few sizes; mouth-formed “boil-and-bite” types that you adapt to the general contours of your mouth; and custom-made high-quality mouthguards that are made just for you at the dental office.
Of all three types, the dentist-made mouthguards are consistently found to be the most comfortable and best-fitting, and the ones that offer your teeth the greatest protection. What’s more, recent studies suggest that custom-fabricated mouthguards can provide an additional defense against concussion — in fact, they are twice as effective as the other types. That’s why you’ll see more and more professional athletes (and plenty of amateurs as well) sporting custom-made mouthguards at games and practices.
“I would have saved myself a lot of dental heartache if I had worn a mouthguard,” noted Dr. Stork. So take his advice: Wear a mouthguard whenever you play sports — unless you’d like to meet him (or one of his medical colleagues) in a professional capacity…
When your child says they have a toothache, should you see your dentist? In most cases, the answer is yes.
And for good reason: their “toothache” could be a sign of a serious condition like tooth decay or a localized area of infection called an abscess, which could adversely affect their long-term dental health. The best way to know for sure –and to know what treatment will be necessary—is through a dental exam.
So, how quickly should you make the appointment? You can usually wait until morning if the pain has persisted for a day or through the night—most toothaches don’t constitute an emergency. One exception, though, is if the child has accompanying fever or facial swelling: in those cases you should call your dentist immediately or, if unavailable, visit an emergency room.
In the meantime, you can do a little detective work to share with the dentist at the appointment. Ask your child exactly where in their mouth they feel the pain and if they remember when it started. Look at that part of the mouth—you may be able to see brown spots on the teeth or obvious cavities indicative of decay, or reddened, swollen gums caused by an abscess. Also ask them if they remember getting hit in the mouth, which may mean their pain is the result of trauma and not disease.
You can also look for one other possible cause: a piece of candy, popcorn or other hard object wedged between the teeth putting painful pressure on the gums. Try gently flossing the teeth to see if anything dislodges. If so, the pain may alleviate quickly if the wedged object was the cause.
Speaking of pain, you can try to ease it before the dental appointment with ibuprofen or acetaminophen in appropriate doses for the child’s age. A chilled cloth or ice pack (no direct ice on skin) applied to the outside of the jaw may also help.
Seeing the dentist for any tooth pain is always a good idea. By paying prompt attention to this particular “call for help” from the body could stop a painful situation from getting worse.
If you would like more information on dental care for 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 “A Child’s Toothache: Have a Dental Exam to Figure out the Real Cause.”