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Teething is an important phase in your baby's dental maturity. During the approximate two-year process, they will acquire their first set of teeth.

It can also be an unpleasant two years as each tooth sequentially breaks through the gums. The severity of teething problems differs with each child, but there are common signs: irritability, biting and gnawing, chin rash, drooling or ear rubbing among them. Although for most babies the discomfort isn't that great, the pain can occasionally be a lot for them — and their care-givers — to handle.

Although having a very unhappy infant can be nerve-jangling, there's no real cause for concern health-wise. If, however, they begin to run a fever or experience diarrhea, that could be a sign of something more serious. In those cases, you should see a doctor as soon as possible.

Otherwise, there are some things you can do to make them more comfortable during teething episodes. One thing to remember: cold items for biting or gnawing usually work wonders. So, be sure you have chilled teething rings or pacifiers (but not frozen — the extreme temperature could burn their gums). For older children, an occasional cold food like a popsicle can bring relief.

You can also try massaging the gums with your clean finger, which will help counteract the pressure of an erupting tooth. But avoid rubbing alcohol or aspirin on the gums, and you shouldn't apply numbing agents to children less than two years of age unless advised by your doctor.

If their pain persists, it's permissible to give them a mild pain reliever like the appropriate dosage for their age of baby acetaminophen or ibuprofen. Again, you should give this by mouth and avoid rubbing it on the gums.

By the time they're three, all their primary teeth should be in and teething symptoms should have largely dissipated. In the meantime, make them as comfortable as you can â?? in no time the unpleasantness of teething will pass.

If you would like more information on coping with your child's teething, 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 “Teething Troubles: How to Help Keep your Baby Comfortable.”

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Modern dental care wouldn’t be the same without x-rays. Since dentists began capturing x-ray images a century ago to detect beginning tooth decay, billions of teeth have been preserved.

“Catching it early” is the key to staying ahead of this aggressive bacterial infection. Once it breaks through the protective defenses of tooth enamel, it can advance toward the center of the tooth, the pulp, damaging dentin as it goes. While we can effectively stop it at this point with a root canal treatment, it’s better for the tooth’s long-term health to detect and treat any decay early on with a less-invasive filling or other treatment method.

X-ray imaging helps make that possible, revealing decay much easier than we can see with the unaided eye. And while we can often detect decay in front teeth by visual examination or by using very bright lighting, that’s not as easy with the less accessible back teeth. For those teeth we use a special x-ray technique known as the bitewing.

The name comes from the small frame used to hold the film. It’s held in place in the mouth by the patient biting down on small tabs or “wings” extending from the frame. The x-ray beam travels through the outer cheek and teeth to the film being held in the frame on the back side of the teeth. When exposed, we’ll be able to view the interior of these back teeth: a set of four bitewings gives us a full view of all the upper and lower molars and pre-molars on each side of the jaws.

Like other forms of radiation energy, too much or too frequent exposures to x-rays can lead to serious health problems. But bitewing x-rays carry little risk to health. That’s because they fit well with the ALARA principle, meaning “As Low As Reasonably Achievable,” which helps guide our use of x-rays. Patients receive a fraction of the radiation exposure from routine bitewing x-rays than they receive annually from the natural environment.

Without bitewing x-rays and other diagnostic methods, the chances are high that tooth decay or other dental problems can go undetected in their early stages. Using this important tool can help us head off major damage before it occurs.

If you would like more information on the role of x-rays in dental care, 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 “Bitewing X-Rays: A Routine Part of Your Dental Exam.”

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When it comes to our children’s safety, there isn’t much nowadays that isn’t under scrutiny. Whether food, clothing, toys and more, we ask the same question: can it be harmful to children?

That also includes tried and true healthcare practices. One in particular, the routine x-ray, has been an integral part of dental care for nearly a century. As a means for detecting tooth decay much earlier than by sight, it has without a doubt helped save billions of teeth.

But is it safe for children? The reason to ask is because x-rays are an invisible form of electromagnetic radiation that can penetrate human tissue. As with other forms of radiation, elevated or frequent exposure to x-rays could damage tissue and increase the future risk of cancer.

But while there is potential for harm, dentists take great care to never expose patients, especially children, to that level or frequency of radiation. They incorporate a number of safeguards based on a principle followed by all healthcare professionals in regard to x-rays called ALARA, an acronym for “as low as reasonably achievable.” This means dentists and physicians use as low an exposure of x-ray energy as is needed to achieve a reasonable beneficial outcome. In dentistry, that’s identifying and treating tooth decay.

X-ray equipment advances are a good example of ALARA in action. Digital imaging, which has largely replaced film, requires less x-ray radiation for the same results than its older counterpart. Camera equipment has also become more efficient, with modern units containing lower settings for children to ensure the proper amount of exposure.

Dentists are also careful how often they take x-ray images with their patients, only doing so when absolutely necessary. As a result, dental patients by and large experience lower dosages of x-ray radiation in a year than they receive from natural radiation background sources found every day in the environment.

Dentists are committed to using x-ray technology in as safe and beneficial a way as possible. Still, if you have concerns please feel free to discuss it further with your dental provider. Both of you have the same goal—that your children have both healthy mouths and healthy bodies for the rest of their lives.

If you would like more information on x-ray safety 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 “X-Ray Safety for Children.”

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Did you see the move Cast Away starring Tom Hanks? If so, you probably remember the scene where Hanks, stranded on a remote island, knocks out his own abscessed tooth — with an ice skate, no less — to stop the pain. Recently, Dear Doctor TV interviewed Gary Archer, the dental technician who created that special effect and many others.

“They wanted to have an abscess above the tooth with all sorts of gunk and pus and stuff coming out of it,” Archer explained. “I met with Tom and I took impressions [of his mouth] and we came up with this wonderful little piece. It just slipped over his own natural teeth.” The actor could flick it out with his lower tooth when the time was right during the scene. It ended up looking so real that, as Archer said, “it was not for the easily squeamish!”

That’s for sure. But neither is a real abscess, which is an infection that becomes sealed off beneath the gum line. An abscess may result from a trapped piece of food, uncontrolled periodontal (gum) disease, or even an infection deep inside a tooth that has spread to adjacent periodontal tissues. In any case, the condition can cause intense pain due to the pressure that builds up in the pus-filled sac. Prompt treatment is required to relieve the pain, keep the infection from spreading to other areas of the face (or even elsewhere in the body), and prevent tooth loss.

Treatment involves draining the abscess, which usually stops the pain immediately, and then controlling the infection and removing its cause. This may require antibiotics and any of several in-office dental procedures, including gum surgery, a root canal, or a tooth extraction. But if you do have a tooth that can’t be saved, we promise we won’t remove it with an ice skate!

The best way to prevent an abscess from forming in the first place is to practice conscientious oral hygiene. By brushing your teeth twice each day for two minutes, and flossing at least once a day, you will go a long way towards keeping harmful oral bacteria from thriving in your mouth.

If you have any questions about gum disease or abscesses, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Periodontal (Gum) Abscesses” and “Confusing Tooth Pain.”

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Even after decades emphasizing oral hygiene and supplemental fluoride to fight dental disease, we’re now seeing an increase in tooth decay, especially among children. What’s causing this alarming trend?

Many in both the dental and medical professions link this and other health problems to a rise in the amount and consumption of sugar added to food products. A number of years ago our annual average consumption of added sugar was about 4 pounds per person; today, it’s closer to 90 pounds.

The increase in sugar consumption can be traced to the 1970s when the food industry began adding more sugar to make processed foods stripped of oils and fats taste better. Today, 77% of the approximately 600,000 food items sold in the United States contain some form of sugar (under a variety of names).

This additional sugar, however, has produced an unintended consequence: sugar triggers the release of a brain chemical called dopamine that regulates our sense of reward when we engage in a desirable behavior. The excess dopamine creates a weak addiction to sugar, which then leads to overconsumption, contributing to our current obesity epidemic and the rise in health problems like heart disease or Type 2 diabetes. This is especially alarming among children: thirty years ago Type 2 diabetes was unheard of among children — today there are over 55,000 diagnosed pediatric cases.

For both you and your family’s general and dental health, you should consider ways to reduce your sugar intake: purchase and eat most of your food from the “outer edges” of your supermarket — meats, dairy, and fresh vegetables and fruits (which do contain the sugar fructose, but are mostly fiber that slows the liver’s processing of the sugar); limit processed foods with added sugar, and learn to recognize its inclusion in products by reading ingredients labels. You should also be wary of sweetened beverages such as sodas, sports drinks, teas or juices, and try to drink more water.

The recommended daily sugar consumption is less than six teaspoons a day (about two-thirds the amount in one can of soda). By restricting this consumption, you’ll improve your general health and reduce your risk for dental disease.

If you would like more information on the general and dental health effects of sugar, please contact us or schedule an appointment for a consultation.

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There are many health concerns when you’re pregnant. And not just for you — what you eat, how you sleep or what medications or supplements you’re taking all have an effect on your baby.

With so many concerns, it’s easy to neglect caring for your teeth. But like other health issues, dental care affects both you and your baby and their future teeth and gum health. For both your sakes taking care of your mouth is a must.

For one thing, you’re more susceptible during pregnancy to periodontal (gum) disease, an infection caused by bacterial plaque built up on teeth surfaces due to ineffective hygiene. It’s believed hormonal changes increase the risk of gingivitis, the inflammation of infected gum tissues, common to expectant mothers.

Gum disease is a serious matter for anyone because of the increased risk of tooth loss. But there’s another potential risk for expectant mothers: the bacteria that causes gum disease can pass through the placenta to the fetus. This can stimulate an inflammatory response from the mother that may result in a pre-term delivery and low birth weight.

There are some things you can do to protect your dental health and your baby’s future health. Maintain a healthy diet with a wide range of whole foods: whole grains, fruits, vegetables, proteins and dairy products. Your doctor may also recommend iron and other supplements to reduce anemia. For the baby’s dental development, be sure you’re taking in sufficient calcium in your diet as well as other vitamins and nutrients. And although it’s common to develop carbohydrate cravings, limit your consumption — especially sugar. Carbohydrates increase the levels of bacteria that cause tooth decay and gum disease.

Above all, practice consistent daily hygiene by brushing at least twice a day and flossing once. Be sure to visit us at least twice a year for cleanings and checkups. If you notice bleeding, swelling or redness of your gums (signs of gum disease) contact us as soon as possible.

A little extra attention to your teeth and gums while you’re expecting can make a big difference in the health of your own teeth and gums, as well as build a strong foundation for your child’s future oral health.

If you would like more information on dental health and care during pregnancy, 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 “Pregnancy and Oral Health.”

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Helping your infant or toddler develop good dental habits is one of the best head starts you can give them toward optimum oral health. But even after they’ve matured enough to handle hygiene tasks without you, they still need your guidance.

This is especially true in the “tween” and teen years. Although they’re beginning to flex their independence muscles, they’re still vulnerable at this age to peer pressure urging them to try things that, among other outcomes, could hurt their oral health.

Here are 3 areas where your input and guidance could save your older children and teens from oral health problems.

Sports activities. As children mature, they may also become involved with various physical activities, including contact sports. Years of diligent hygiene and dental care can be undone with one traumatic blow to the mouth. You can help avoid this by urging your child to wear a mouth guard during sports activity. While there are some good choices on the retail market, the most effective mouth guards are custom-created by a dentist to precisely fit your child’s mouth.

Oral piercings. While expressions of solidarity among young people are popular and often harmless, some like oral piercings and their hardware could potentially damage teeth and gums. You should especially discourage your child from obtaining tongue bolts or other types of lip or mouth hardware, which can cause tooth wear or fracture. Instead, encourage them to take up safer forms of self-expression.

Bad habits and addictions. A young person “spreading their wings” may be tempted to dabble in habit-forming or addictive activities. In addition to their effect on the rest of the body, tobacco, alcohol and drugs can have severe long-term consequences for oral health. Unsafe sexual practices could lead to the contraction of the human papilloma virus, which has been linked to oral cancer in young adults. Be sure your teen understands the dangers of these habits to both their oral and general health—and don’t hesitate to seek professional help when a habit becomes an addiction.

If you would like more information on helping your child develop great oral habits, 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 “How to Help Your Child Develop the Best Habits for Oral Health.”

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The long-running hit show Dancing with the Stars has had its share of memorable moments, including a wedding proposal, a wardrobe malfunction, and lots of sharp dance moves. But just recently, one DWTS contestant had the bad luck of taking an elbow to the mouth on two separate occasions—one of which resulted in some serious dental damage.

Nationally syndicated radio personality Bobby Bones received the accidental blows while practicing with his partner, professional dancer Sharna Burgess. “I got hit really hard,” he said. “There was blood and a tooth. [My partner] was doing what she was supposed to do, and my face was not doing what it was supposed to do.”

Accidents like this can happen at any time—especially when people take part in activities where there’s a risk of dental trauma. Fortunately, dentists have many ways to treat oral injuries and restore damaged teeth. How do we do it?

It all depends on how much of the tooth is missing, whether the damage extends to the soft tissue in the tooth’s pulp, and whether the tooth’s roots are intact. If the roots are broken or seriously damaged, the tooth may need to be extracted (removed). It can then generally be replaced with a dental bridge or a state-of-the-art dental implant.

If the roots are healthy but the pulp is exposed, the tooth may become infected—a painful and potentially serious condition. A root canal is needed. In this procedure, the infected pulp tissue is removed and the “canals” (hollow spaces deep inside the tooth) are disinfected and sealed up. The tooth is then restored: A crown (cap) is generally used to replace the visible part above the gum line. A timely root canal procedure can often save a tooth that would otherwise be lost.

For moderate cracks and chips, dental veneers may be an option. Veneers are wafer-thin shells made of translucent material that go over the front surfaces of teeth. Custom-made from a model of your smile, veneers are securely cemented on to give you a restoration that looks natural and lasts for a long time.

It’s often possible to fix minor chips with dental bonding—and this type of restoration can frequently be done in just one office visit. In this procedure, layers of tooth-colored resin are applied to fill in the parts of the tooth that are missing, and then hardened by a special light. While it may not be as long-lasting as some other restoration methods, bonding is a relatively simple and inexpensive technique that can produce good results.

If you would like more information about emergency dental treatment, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor articles “The Field-Side Guide to Dental Injuries” and “Knocked Out Tooth.”

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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 you would like more information on orthodontic treatments, please contact us or schedule an appointment for a consultation.

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Tooth decay is an ever present danger for your baby’s developing teeth. It begins with disease-causing bacteria feasting on leftover sugar, producing high levels of oral acid that slowly dissolves the teeth’s protective enamel. The softened enamel then becomes an open door for decay to infect the tooth.

Meanwhile, those bacteria continue to eat and produce acid….

So how can you stop this devastating cycle? Besides daily oral hygiene and regular dental visits, the most important thing you can do is deprive bacteria in your baby’s mouth of sugar through limiting their consumption of it. This means you’ll first need to identify the different sources of sugar available to your baby—and some of them might surprise you.

Here, then, are 3 not-so-obvious sugar sources your baby might be consuming.

During feeding. If you’re breast-feeding, you may not think this is causing a sugar problem for your baby. True, breast milk by itself doesn’t promote decay: it’s the combination of it with other sugar-rich foods and liquids the baby might be consuming as they get older. Together this could significantly increase their risk of pediatric tooth decay (also known as early childhood caries or ECC). So, be careful to limit sugar in other things they’re eating or drinking in addition to nursing.

24/7 Baby bottles and pacifiers. To calm infants at nap or sleep time, parents or caregivers often use bottles filled with sweet liquids or pacifiers dipped in jam, syrup or sugar. This practice increases decay risk from both the added sugar and its constant availability to bacteria in the mouth around the clock. Instead, avoid this practice and limit any sugary foods or liquids to mealtimes.

Medications. Some medications an infant may be taking for a chronic illness may contain small amounts of sugar. Additionally, medications like antihistamines can reduce the production of saliva that’s needed to neutralize acid after meals. If your child is on medication, ask your healthcare provider about its dental effects and if there are any sugar-free alternatives. Be sure to keep up daily brushing and flossing and regular dental visits too.

Limiting your baby’s sugar intake is critical in preventing tooth decay. It’s one of the most important things you can do to protect their dental health.

If you would like more information on helping your child avoid tooth decay, 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 “Age One Dental Visit: Why It’s Important for Your Baby.”

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