Posts for tag: tooth decay

AlthoughaChallengeChronicallyIllChildrenNeedToothDecayPrevention

Families of children with chronic conditions face many challenges. One that often takes a back seat to other pressing needs is the prevention of tooth decay. But although difficult, it still deserves caregivers’ attention because of the dental disease’s potential long-term impact on oral health.

Chronically ill children are often at higher risk for tooth decay, most commonly due to challenges in practicing effective oral hygiene. Some conditions create severe physical, mental or behavioral impairments in children’s ability to brush and floss: for example, they may have a heightened gag reflex to toothpaste in their mouth or they may not be able to physically perform these tasks on their own.

Some children may be taking medications that inhibit salivary flow as a side effect. Saliva is critical for disease prevention because it both neutralizes mouth acid (which can erode tooth enamel) and is a first line of defense against disease-causing bacteria. And a child’s diet, while designed to support treatment of their chronic condition, may conversely not be the best for supporting their dental health.

It’s best if caregivers and their dentists develop a strategy for decay prevention, which should include the following:

  • Regular dental visits beginning at Age One. Besides monitoring dental health, dental visits also provide cleanings and other preventive measures like topical fluoride or sealants;
  • Brushing and flossing support. Depending on a child’s physical and mental capacities, caregivers (or an older sibling) may need to model brushing and flossing, or perform the tasks for the child;
  • Medication and diet changes. If medications are causing dry mouth, caregivers can speak to their physicians about possible alternatives; likewise, they should see if modifications can be made to their diet to better support dental health.
  • Boosting salivary flow. It’s especially important with children who have dry mouth to drink more water or use aids (like xylitol gum or candies) to boost salivary flow.

Although it requires extra effort and time to give attention to a chronically ill child’s dental health, it’s well worth it. By working to prevent tooth decay early in life, these children will be more likely to enjoy good dental health in the future.

If you would like more information on dental care for children with special needs, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor article “Managing Tooth Decay in Children with Chronic Diseases.”

By Bill Johnson, DMD
August 03, 2018
Category: Dental Procedures
Tags: tooth decay   fluoride  
TopicalFluorideAddsExtraProtectionagainstToothDecay

Protecting a child's primary (“baby”) teeth from tooth decay should be a top priority. If one is lost prematurely due to decay, it could cause the permanent tooth to misalign when it comes in.

The basic prevention strategy for every child is daily brushing and flossing and regular dental visits. But children at higher risk for decay may need more:  additional fluoride applied to teeth enamel during office visits.

This natural mineral has been shown to strengthen enamel, teeth's protective layer against decay, especially during its early development. Enamel is composed of calcium and phosphate minerals interwoven to form a crystalline structure called hydroxyapatite. Fluoride joins with this structure and changes it to fluorapatite, which is more resistant to mouth acid than the original structure.

We mostly receive fluoride through fluoridated drinking water and dental care products like toothpaste. Topical fluoride takes it a step further with a stronger dose than found in either of these sources. It can be applied with a foam, varnish or gel using an isolation tray (foam or gel) or painted onto the enamel (varnish or gel).

But does topical fluoride effectively reduce the occurrence of decay? Research indicates yes: a recent review of 28 studies involving over 9,000 children found an average 28% reduction in decayed teeth in children who underwent topical fluoride treatments.

There is, though, one potential side effect: children who swallow the fluoride substance can become sick and experience headache, stomach pain or vomiting. This can be avoided with proper precautions when applying it; the American Dental Association also recommends using only varnish for children younger than 6 years. It's also recommended that children receiving gel or foam not eat or drink at least thirty minutes after the treatment (those who receive the varnish aren't restricted in this way).

Topical fluoride is most effective as part of an overall prevention strategy. Besides daily hygiene and regular dental visits, you can also help reduce your child's decay risk by limiting the amount of sugar in their diet. Sealants, which are applied to the nooks and grooves of teeth where plaque can build up, may also help.

If you would like more information on fluoride gels and other clinical treatments to prevent tooth decay, please contact us or schedule an appointment for a consultation.

ActorDavidRamseyDiscussesBabyBottleToothDecay

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 cavities. 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.  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.”

By Bill Johnson, DMD
October 27, 2016
Category: Oral Health
Tags: tooth decay   toothache  
HeresWhattoDoifYourChildhasaToothache

What should you do if your child complains about a toothache? Before calling our office, try first to learn what you can about the toothache.

You should first ask them where exactly the pain is coming from — one particular tooth or a generalized, dull ache. Also try to find out, as best they can tell you, when they first noticed the pain. Try then to look at the tooth or area where they indicate the pain is coming from: since tooth decay is a prime cause for tooth pain, you should look for any obvious signs of it like brown spots or cavities. You should also look at the gums around the teeth for any redness or swelling, a sign of an abscess or periodontal (gum) disease.

If you notice any of these signs, the pain persists for more than a day, or it has kept the child awake during the night, you should have us examine them as soon as possible. If you notice facial swelling or they’re running a fever, please call and we will see them immediately. If it’s definitely tooth decay, it won’t go away on its own. The longer we wait to treat it, the worse its effects in the mouth.

In the meantime, you should also try to alleviate the pain as best you can. If when looking in the mouth you noticed food debris (like a piece of hard candy) wedged between the teeth, try to gently remove it with dental floss. Give them ibuprofen or acetaminophen in an appropriate dosage for their age to relieve pain, or apply an ice pack on and off for about 5 minutes at a time to the outside of their jaw.

If any of these remedies stops the pain within an hour, you can wait until the next day to call for an appointment. If the pain persists, though, then an abscess could be developing — you should call that day to see us.

Regardless of when the pain stops, or whether you see any abnormal signs, it’s still important your child see us for an accurate diagnosis. Their toothache maybe trying to tell you something’s wrong — and the earlier a problem is found and treated, the better the outcome.

If you would like more information on dental problems in young 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.”

TakingtheRightStepstoPreventEarlyToothDecayinChildren

While the prevention and treatment of tooth decay has improved dramatically over the last half century, it continues to be a major health issue, especially for children. One in four children 5 and younger will develop some form of the disease.

Although tooth decay in children stems from the same causes as in adults — the presence of decay-causing bacteria in plaque, unprotected teeth and the right mix of carbohydrates like sugar left in the mouth — the means by which it occurs may be different. We even define tooth decay differently in children as Early Childhood Caries (ECC), “caries” the dental profession’s term for tooth decay.

ECC highlights a number of cause factors specific to young children, such as: continuous use of a bottle or “sippy cup” filled with juice or other sweetened beverages; at-will breast-feeding throughout the night; use of a sweetened pacifier; or regular use of sugar-based oral medicine to treat chronic illness.

If you noticed sugar as a common denominator in these factors, you’re right. As a primary food source for bacteria, refined sugar is a major trigger for the disease especially if it constantly resides in the mouth from constant snacking or sipping. In fact, it’s the primary driver for a particular pattern of decay known as Baby Bottle Tooth Decay (BBTD). This pattern is specifically linked to sleep-time bottles filled with juice, milk, formula or other sweetened beverages, given to an infant or toddler to help soothe them through the night or during naps.

All these factors cause a cycle of decay. To interrupt that cycle, there are some things you as a parent should do: perform daily hygiene with your child to reduce decay-causing bacteria; reduce the amount and frequency of carbohydrates in the diet, particularly sugar; and protect the teeth by having us apply fluoride or sealants directly to the teeth.

Early tooth decay could affect your child's oral health for years to come. With a little care and vigilance, you improve your chances of avoiding that encounter.

If you would like more information on preventing tooth decay in 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 “Dentistry & Oral Health for Children.”