Straightening Out Your Child’s Smile

Very few people have perfectly straight teeth. Dentists use the term “malocclusion” to describe the failure of the top and bottom teeth to bite together as they should. If your child has malocclusion, he or she could have an overbite, underbite or crossbite. In addition, your child might have problems with gum tissue, speech development, appearance or the jaw joints.

Even though your child’s teeth may have some degree of malocclusion, that doesn’t necessarily mean his or her bite needs correction. We may refer your child to an orthodontist, a specialist who can help accurately determine what kind of correction is needed, if any.

How can you tell if your child has malocclusion? Symptoms of the condition may include

  • abnormal alignment of the teeth
  • breathing through the mouth
  • problems with speech
  • difficulty biting or chewing
  • abnormal facial appearance

Rarely is malocclusion caused by just one factor. Genetics can play a large role, while children’s habits can influence their bite, as well. Children who suck their thumbs until the age of five or beyond have a higher risk of developing malocclusion. Some children have limited space between their baby teeth. This means that when their larger permanent teeth grow in, there may not be enough room for them.

Treatment for straighter teeth is personalized for each individual child. X-rays and impressions of teeth can evaluate the problem so that your child receives the best recommendations for treatment. Your child’s age and the extent of the condition will be considered to determine treatment. Treatment might include

  • fixed mouth appliances, such as braces
  • removable mouth appliances, such as retainers
  • jaw surgery to correct bite problems where bone is involved

When the top and bottom teeth bite together evenly, your child has a properly aligned bite. Remember: Few children have a perfectly aligned bite, but not all require treatment. For those who do, early intervention is critical to prevent further problems in the face and jaw from a badly positioned bite. The result is your child’s renewed confidence and a beautiful smile to show for it.

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Defeating Decay with Sealants

Dental sealants are commonly used in children to reduce cavities in permanent teeth. Bonded to tooth surfaces, these clear or white plastic coatings safely and effectively prevent tooth decay.

Most decay starts in narrow pits and grooves on the biting surfaces of teeth toward the back of the mouth, spaces that are hard to clean with a toothbrush. Within those pits and grooves, bacteria from plaque produce acid, leading to tooth decay.

Sealants work very simply and effectively to fill the grooves. Applying the sealant is a painless, comfortable process that doesn’t require injections or drilling, and takes just a few minutes.

We will clean and dry your child’s teeth; then a thin layer of a plastic liquid is applied into the groove or pit of the tooth. The liquid hardens into a strong layer that protects the tooth and prevents decay. Permanent teeth in the back of the mouth tend to be at a higher risk of tooth decay, making them a priority for sealant application. Some children benefit from sealants on their baby teeth, too.

Sealants are only one part of a healthy program of dental hygiene. We can show you and your child the right way to clean his or her teeth. In addition, use the following tips to help your family:

  • Avoid giving your child sugary foods and drinks.
  • Provide your child with a balanced, nutritious diet.
  • Offer water after meals.
  • Make sure your child has regular dental checkups.
  • Brush your child’s teeth twice daily.
  • Use fluoride toothpaste for children ages 2 and older.

At your child’s next appointment, we can discuss how sealants can help prevent cavities in his or her teeth. With sealants and good preventive care at home, your child can enjoy a healthy, cavity-free mouth for years to come.

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Children’s Dental X-rays—Safer than Ever

A 2012 study from the Yale University School of Medicine that found an association between dental x-rays in children and an increased risk of a particular type of brain tumor received a great deal of publicity in the media and may well have scared many parents. However, media coverage tended to leave out several important factors suggesting that there was less to worry about than first appeared, including the fact that many of the patients with brain tumors were older people who had undergone dental x-rays decades ago, when the amount of radiation exposure was significantly higher than it is today.

The American Academy of Pediatric Dentistry has issued guidelines on dental x-rays for infants, children and adolescents. These guidelines, which were officially reviewed at the time of the 2012 study, note that x-rays are a valuable tool for diagnosing oral diseases, and monitoring dentofacial development and the progress of therapy. Since every patient is unique, we base decisions about the need for dental x-rays on each child’s individual circumstances.

We use x-rays when we expect that the results will have an impact on patient care. We weigh the benefits of obtaining radiographs against any risks to your child from radiation exposure. The use of lead aprons, thyroid collars and high-speed film minimize your child’s exposure to radiation. Our equipment and procedures conform to the As Low As Reasonably Achievable (ALARA) standard for radiation exposure.

Children may require x-rays more often than adults because their teeth and jaws are still developing, and their teeth are more likely to be affected by tooth decay than are those of adults. Certain oral conditions cannot be diagnosed except through the use of x-rays. Some of these conditions, if left untreated, can be a much greater health threat than the radiation from dental x-rays. Dental x-rays are a valuable diagnostic tool that can help preserve your child’s health.

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Come Home to Your Pediatric Dentist

The American Academy of Pediatrics has developed a concept it calls the “medical home.” The idea is to create one place to deliver and coordinate care for infants, children and adolescents. Similarly, the American Academy of Pediatric Dentistry (AAPD) supports the establishment of a “dental home,” a place where all aspects of oral health that result from the interaction of the patient, parents, non-dental professionals (such as pediatricians) and dental professionals can be coordinated.

Dental problems can begin early in your child’s life. One of the most common diseases among infants is early childhood caries (tooth decay that can lead to cavities), an infectious disease caused by bacteria. As soon as the first tooth erupts, your child is at risk for early childhood caries.

A dental home should be established when your child’s first tooth erupts or when he or she reaches the age of one year, whichever comes first. Frequently, your child’s pediatrician will tell you when it is the right time.

An early visit to a pediatric dentist, before any dental problems have developed, has several benefits:

  • The child’s first dental experience will be a positive one.
  • Parents will receive important information about how to keep their child’s teeth and mouth healthy.
  • The dentist can evaluate the child’s oral health and check for any dental anomalies.

Once your child’s dental home is established, regularly scheduled checkups let us spot any issues, such as the first signs of early childhood caries, before they can develop into serious problems. You can be sure that your child will receive all the appropriate preventive and prophylactic measures.

Studies have shown that children who have a dental home are more likely to receive preventive and routine oral health care. That means both fewer oral health problems and lower overall cost of treatment—and a better smile for both parent and child.

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Hyperdontia—Too Many Teeth

When children are born, most will have 20 primary teeth and 32 permanent teeth in their jaws, waiting to erupt at the appropriate time. Some children, however—approximately 1% to 4% of the population—will have additional teeth, a condition known as hyperdontia; the extra tooth is known as a supernumerary tooth. Most children with the condition are otherwise healthy—that means we can usually ensure a good outcome.

There is no clear cause of hyperdontia, but it probably has a genetic basis. While most children with hyperdontia will have just one supernumerary tooth, others may have several. Those children with more than one extra tooth may suffer from other conditions, such as Gardner syndrome (cancerous polyps in the gastrointestinal tract), cleft lip and palate, or Ehler-Danlos syndrome (a disorder of the connective tissue).

Although not all children with extra teeth have negative outcomes, hyperdontia can cause a number of problems, including

  • delayed eruption and growth of adjacent teeth
  • irregular alignment of teeth
  • bite problems

While extra teeth will not automatically cause damage to the mouth or require removal, they should always be monitored. We will make the best decision for treatment based on the location of the tooth and other factors. Your child’s extra tooth might look abnormal or it could look completely normal. Treatment depends on the tooth’s appearance, whether it’s crowding other teeth and how it erupted.

We will check to see whether the extra tooth is likely to prevent future teeth from erupting or cause a nearby one to shift or rotate. It is important that your child see us early on, because parents can’t always detect an extra tooth. A visit within six months of your child’s first tooth’s eruption and regular visits afterward will ensure that hyperdontia and any related problems are detected early.

For some children, orthodontic treatment can be a successful treatment for hyperdontia. Other children may require extraction of the additional tooth, especially if it causes crowding in the mouth. After examining your child’s teeth, we can determine whether he or she has hyperdontia and what is the best course of treatment.

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Better Oral Health = Better Sleep

Sleep may be the most important part of a child’s day. For the body to rest and the brain to recharge, a typical child aged five to twelve should get 10 to 11 hours of sleep each night. Without restorative sleep, a child may be cranky, clumsy and less attentive than usual the next day. If the pattern persists, his or her growth and resistance to immunity can be affected, too.

Oral conditions can affect sleep more severely than you might imagine. One, obstructive sleep apnea, is caused by enlarged adenoids or tonsils (which can be surgically removed if necessary); allergies (treatable with nasal steroids or other medications); and/or obesity (for which weight management is recommended). Symptoms include gasping during sleep and snoring marked by occasional pauses. Without treatment, obstructive sleep apnea can lead to developmental and learning delays, behavior issues, daytime fatigue or hyperactivity.

Sleep bruxism affects 20% to 30% of children at one time or another, although most children outgrow it. Bruxism involves teeth-grinding or jaw-clenching. Often, a child is not aware of grinding his or her teeth; the child only knows that he or she awakes with jaw or head pain and possibly a feeling of fatigue. Evidence of bruxism includes chipped tooth enamel and unusually worn surfaces.

One common cause of bruxism is the misalignment of the upper and lower teeth, which can be treated appropriately with orthodontia. Another cause, though, is emotional stress, which needs to be addressed in order to be alleviated. In any case, a night guard—a custom-molded plastic device that fits in the mouth—may help prevent permanent damage.

Finally, the pain of untreated tooth decay can seriously affect a child’s sleep. According to the California Society of Pediatric Dentistry, “Failure to identify and prevent dental disease has consequential and costly long-term adverse effects….Untreated dental disease compromises the child’s ability to eat well, sleep well, and function well at home and at school.”

If you notice that your child’s sleeping habits are unusual, let us know so we can examine his or her oral health. This no time for a parent to snooze on the job!

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