Posts for tag: pediatric dentistry
It’s often best health-wise to preserve even the most troubled tooth—including a child’s primary (“baby”) tooth. If that sounds like too much effort for a tooth that lasts only a few years, there’s a big reason why—if it’s lost prematurely, the incoming permanent tooth above it could erupt out of position.
Preserving a decayed primary tooth could include procedures similar to a root canal treatment, commonly used in adult permanent teeth with inner decay. However, we may need to modify this approach to protect the primary tooth’s pulp. This innermost layer plays a critical role in early dental development.
Because an adult tooth has reached maturity, removing diseased pulp tissue has little effect on its permanent health. But the pulp contributes to dentin growth (the layer between it and the outer enamel) in primary and young permanent teeth, so removing it could ultimately compromise the tooth’s long-term health.
Our goal then with a child’s tooth is to remove as much diseased tissue as possible while involving the pulp as little as possible. What techniques we use will depend on how much of the pulp has become infected.
For example, if decay has advanced to but hasn’t yet penetrated the pulp, we may remove all but a small amount of the decayed structure just next to the pulp to avoid its exposure. We may then apply an antibacterial agent to this remaining portion and seal the tooth to curb further infection.
If on the other hand the pulp has become infected, we may try to remove only the infected portion and leave the remaining pulp intact. We’ll only be able to do this, however, if we deem the remaining pulp healthy enough to remain infection-free after the procedure. If not, we may need to remove the entire pulp as with a traditional root canal. This option, though, is a last resort due to the possible effect on dentin growth and the tooth’s long-term health.
As you can see attempts to preserve a primary tooth can be quite involved. But if we can help it reach its full life span, it could mean better dental health for a lifetime.
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 “Root Canal Treatment for Children’s Teeth.”
A child with a chronic illness or condition often requires a lot of focus on care for their special needs. Other aspects of their health can often take a back seat — too often including dental care.
Proper dental care can be a challenge for special needs children if they have diminished physical, intellectual or behavioral capacities. Children with autism or attention deficit disorders may not be able or willing to perform tasks like brushing and flossing. Other conditions could make them intolerant to toothpaste in the mouth, or create an inability to keep their mouths open or to spit.
Some chronic conditions also seem predisposed to dental defects. For example, enamel hypoplasia, a lack of sufficient tooth enamel, is common with Down, Treacher-Collins or Turner Syndromes, and can greatly increase the risk of tooth decay.
But even though difficult, effective dental care isn't impossible. It begins with your dental provider.
Pediatric dentists are often excellent in this regard: they often have the training and experience to treat children with chronic conditions. Whoever you choose must be able to partner with you in caring for your child's dental needs.
Daily hygiene is also a critical factor. Your goal should be the same as with any child — to teach them to brush and floss for themselves. Depending on their condition, however, you may need to assist them for a longer term, perhaps permanently. But it is imperative — daily hygiene is their best defense against oral diseases.
You should also consider their medication and how it may impact their dental health. Antidepressants, antihistamines or drugs that assist with breathing function can cause mouth dryness. This, as well as drugs with sugar or acid compounds, can increase risk for dental disease. If they must take these types of medications, try to give them at mealtime to reduce their effect in the mouth.
Above all, pursue the same professional dental care as you would for any other child. Keep up regular dental visits beginning around their first birthday for cleanings and preventive measures like topical fluoride or sealants. By taking these measures you'll help ensure their dental health won't suffer.
If you would like more information on dental care for special needs 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 “Managing Tooth Decay in Children with Chronic Diseases.”
A child's toothache is no fun for either the child or the parent. But if you're faced with this situation, don't panic — unless they have a fever or you notice facial swelling, it's unlikely an emergency.
Â Instead, take the following steps:
Find out where it hurts and for how long. Tooth pain can stem from a lot of causes, including decay or a localized area of infection called an abscess. See if your child can tell you if it's coming from one particular tooth or from a general area. Although children can't always judge how long they've hurt, try to get a general idea so you'll know if you need to call us sooner rather than later.
Look for problem signs in the mouth. As you look where they say it hurts, see if you can see brown spots or cavities on any teeth — this would indicate tooth decay. Look also at the gums or inner areas of the mouth for sores or swelling. Unless they've had an injury, this could indicate an abscess.
Try to dislodge any food shards between teeth. It's also possible the pain is coming from a piece of hard food like a popcorn kernel wedged between their teeth. Help them gently floss between the teeth to see if you can dislodge any.
Try to ease the pain. Although you may not need to see us immediately, your child's mouth still aches. You can help relieve it temporarily with a child's dose of ibuprofen or acetaminophen. You can also apply an ice pack to the outside cheek for swelling, but don't apply the ice directly to the skin, which can burn it. And don't rub aspirin or other pain relievers on the gums — they're acidic and can irritate soft tissue.
See us for a full examination. It's wise to have any tooth pain checked — the question is often how soon. You should see us the same day or first thing in the morning if the pain has persisted for more than a day or night, pain relievers haven't eased the pain or they have fever or facial swelling. If the pain is short-lived you can usually wait until the next day — but do get it checked out.
If you would like more information on treating your child's toothache, 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.”
Cavities can happen even before a baby has his first piece of candy. This was the difficult lesson actor David Ramsey of the TV shows Arrow and Dexter learned when his son DJ’s teeth were first emerging.
“His first teeth came in weak,” Ramsey recalled in a recent interview. “They had brown spots on them and they were brittle.” Those brown spots, he said, quickly turned into caviÂties. How did this happen?
Ramsey said DJ’s dentist suspected it had to do with the child’s feedings — not what he was being fed but how. DJ was often nursed to sleep, “so there were pools of breast milk that he could go to sleep with in his mouth,” Ramsey explained.
While breastfeeding offers an infant many health benefits, problems can occur when the natural sugars in breast milk are left in contact with teeth for long periods.Â Sugar feeds decay-causing oral bacteria, and these bacteria in turn release tooth-eroding acids. The softer teeth of a young child are particularly vulnerable to these acids; the end result can be tooth decay.
This condition, technically known as “early child caries,” is referred to in laymen’s terms as “baby bottle tooth decay.” However, it can result from nighttime feedings by bottle or breast. The best way to prevent this problem is to avoid nursing babies to sleep at night once they reach the teething stage; a bottle-fed baby should not be allowed to fall asleep with anything but water in their bottle or “sippy cup.”
Here are some other basics of infant dental care that every parent should know:
- Wipe your baby’s newly emerging teeth with a clean, moist washcloth after feedings.
- Brush teeth that have completely grown in with a soft-bristled, child-size toothbrush and a smear of fluoride toothpaste no bigger than a grain of rice.
- Start regular dental checkups by the first birthday.
Fortunately, Ramsey reports that his son is doing very well after an extended period of professional dental treatments and parental vigilance.
“It took a number of months, but his teeth are much, much better,” he said. “Right now we’re still helping him and we’re still really on top of the teeth situation.”
If you would like more information on dental care for babies and toddlers, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “The Age One Dental Visit” and “Dentistry & Oral Health for Children.”