Every February, the American Dental Association sponsors a campaign called National Children’s Dental Health Month. The purpose of this operation is to raise awareness about how important it is to get an early start on developing good dental hygiene habits — and how this can lead to a lifetime of healthy teeth and gums. So we thought this might be a good time to answer some of the most frequently asked questions about how to do exactly that:
When is it time to start cleaning my baby’s teeth?
As soon as you see one! The earlier your child gets used to a daily dental hygiene routine, the better. Baby teeth that have not fully emerged from beneath the gums can be wiped with a clean, moist washcloth after feedings. A tooth that has grown in completely should be brushed twice daily (once in the morning and once in the evening) with a soft, child-sized tooth brush and a thin smear of fluoride toothpaste. Fluoride is an important weapon against tooth decay, but you don’t want your child to swallow too much.
Can babies get cavities?
Absolutely — especially if they are allowed to fall asleep routinely with a bottle filled with anything but water. Milk, formula — even breast milk — all contain sugars that should not be left to pool around your baby’s teeth during sleep, facilitating decay. Juice is an even bigger no-no because it is not only sugary but also acidic.
Can’t I give my child sweets once in a while?
We realize total avoidance of sweets may not be realistic, as beneficial as this would be for your child’s teeth. If you are going to allow your child to have sweets once in a while, better that the treat be given immediately following a meal, and not as a between-meal snack. Soda should really be avoided completely — it’s that bad.
When should I take my child to the dentist for the first time?
The experts say: Get it done in year one. That’s right — even though your child won’t have many teeth by age 1, there’s a lot we can do at that first visit to ensure good oral health now and well into the future. We will do everything possible to make sure your little one has a positive first experience in the dental chair; this helps set the tone for the many important preventive visits yet to come. It’s also a great opportunity for you to ask any specific questions you may have, and receive hands-on instruction on how to care for your child’s teeth and gums.
If you would like more information about children’s oral health, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Taking the Stress Out of Dentistry for Kids” and “Age One Dental Visit.”
If you’ve noticed a small sore in your mouth, it’s possible you have a non-contagious disease known as lichen planus. Although usually benign, it’s still a good idea to have it examined and monitored.
The condition is so named because its lesions are similar in appearance to lichen, the algae and fungi organism often found on rocks and trees. It’s believed to be a type of autoimmune disease, in which the body treats some of its own cells as foreign and reacts adversely to them. Certain medications and substances may also cause a lichenoid reaction. Besides the inner cheeks, gums or tongue, lichen planus may also appear on other skin or mucous surfaces on the wrists, legs or fingernails.
When it appears inside the mouth it usually resembles a lacy pattern of white lines or ulceration. Gum tissues may become red and inflamed, with some soreness after brushing or eating. Although there’s no known cure for lichen planus, it rarely causes serious problems — in fact, you may not even be aware you have the condition unless pointed out during a dental exam. It may, in time, fade away.
If the lesions do become bothersome (painful, itchy or overly-sensitive), there are some ways to ease discomfort: brushing with a soft toothbrush (to minimize irritation), flossing, and avoiding acidic or spicy foods and beverages which have been known to cause flare-ups. Managing stress is also helpful, and a topical steroid may be prescribed for more severe outbreaks.
Perhaps the greatest concern with lichen planus, though, is it may resemble more serious conditions, particularly oral cancer. The only way to be certain that it is a benign condition is to perform a biopsy on some of the affected tissue. If you notice a problem, be sure to visit us for a complete examination. And regardless of whether you have the condition or not, regular oral cancer screenings, as well as limits on alcohol consumption and stopping use of tobacco, will also reduce your risk of oral cancer.
Odds are if you have a case of lichen planus it isn’t causing you any problems. If it does cause you discomfort, though, you can take steps to ease your symptoms.
Everyone has to face the music at some time — even John Lydon, former lead singer of The Sex Pistols, arguably England’s best known punk rock band. The 59-year old musician was once better known by his stage name, Johnny Rotten — a brash reference to the visibly degraded state of his teeth. But in the decades since his band broke up, Lydon’s lifelong deficiency in dental hygiene had begun to cause him serious problems.
In recent years, Lydon has had several dental surgeries — including one to resolve two serious abscesses in his mouth, which left him with stitches in his gums and a temporary speech impediment. Photos show that he also had missing teeth, which, sources say, he opted to replace with dental implants.
For Lydon (and many others in the same situation) that’s likely to be an excellent choice. Dental implants are the gold standard for tooth replacement today, for some very good reasons. The most natural-looking of all tooth replacements, implants also have a higher success rate than any other method: over 95 percent. They can be used to replace one tooth, several teeth, or an entire arch (top or bottom row) of teeth. And with only routine care, they can last for the rest of your life.
Like natural teeth, dental implants get support from the bone in your jaw. The implant itself — a screw-like titanium post — is inserted into the jaw in a minor surgical operation. The lifelike, visible part of the tooth — the crown — is attached to the implant by a sturdy connector called an abutment. In time, the titanium metal of the implant actually becomes fused with the living bone tissue. This not only provides a solid anchorage for the prosthetic, but it also prevents bone loss at the site of the missing tooth — which is something neither bridgework nor dentures can do.
It’s true that implants may have a higher initial cost than other tooth replacement methods; in the long run, however, they may prove more economical. Over time, the cost of repeated dental treatments and periodic replacement of shorter-lived tooth restorations (not to mention lost time and discomfort) can easily exceed the expense of implants.
That’s a lesson John Lydon has learned. “A lot of ill health came from neglecting my teeth,” he told a newspaper reporter. “I felt sick all the time, and I decided to do something about it… I’ve had all kinds of abscesses, jaw surgery. It costs money and is very painful. So Johnny says: ‘Get your brush!’”
We couldn’t agree more. But if brushing isn’t enough, it may be time to consider dental implants. If you would like more information about dental implants, please call our office to schedule a consultation. You can read more in the Dear Doctor magazine articles “Dental Implants” and “Save a Tooth or Get an Implant?”
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.”
Tooth decay is a highly destructive dental disease, responsible along with periodontal (gum) disease for most adult tooth loss. And we become even more susceptible to it as we get older.
One form of decay that’s especially prominent among senior adults is a root cavity. Similar to a cavity in the crown (visible tooth), this form instead occurs at or below the gum line in the roots. They happen mainly because the roots have become exposed due to gum recession, a common consequence of periodontal (gum) disease and/or brushing too hard.
Exposed roots are extremely vulnerable to disease because they don’t have the benefit of protective enamel like the tooth crown, covered instead with a thin and less protective mineral-like material called cementum. Normally, that’s not a problem because the gums that would normally cover them offer the bulk of the protection. But with the gums receded, the roots must depend on the less-effective cementum for protection against disease.
Although we treat root cavities in a similar way to those in the crown by removing decayed structure and then filling them, there’s often an added difficulty in accessing them below the gum line. Because of its location we may need to surgically enter through the gums to reach the cavity. This can increase the effort and expense to treat them.
It’s best then to prevent them if at all possible. This means practicing daily brushing and flossing to remove bacterial plaque, the thin, built-up biofilm on teeth most responsible for both tooth decay and gum disease. You should also visit your dentist at least twice a year for professional cleanings and advanced prevention methods like topical fluoride to strengthen any at-risk teeth.
You should also seek immediate treatment at the first sign of gum disease to help prevent gum recession. Even if it has occurred, treating the overall disease could help renew gum attachment. We may also need to support tissue regeneration with grafting surgery.
Root cavities are a serious matter that could lead to tooth loss. But by practicing prevention and getting prompt treatment for any dental disease, you can stop them from destroying your smile.
If you would like more information on diagnosing and treating root cavities, 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 Cavities: Tooth Decay near the Gum Line Affects Many Older Adults.”
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