Sensitive Teeth: Listen for the Alarm

Often children may grab their mouths or put their hands near their jaws and cry out in pain when they eat hot or cold foods. Perhaps they bite down on something, and it hurts for them to close their mouths. Maybe they are telling you it hurts their teeth when they breathe in sometimes. These are signs that your child could be suffering from tooth sensitivity.

Tooth sensitivity can have multiple causes. Some of the most common culprits are infrequent brushing and flossing, which can lead to tooth decay. When the outer layer of a child’s teeth, the enamel, wears away, the next layer, the dentin, is exposed. Dentin is porous, which means that it allows for more sensations to reach the nerves inside a child’s teeth, making them more sensitive to temperature and pressure. Improving dental hygiene and visiting our office on a regular basis can combat this cause.

Conversely, vigorous over-brushing can cause tooth sensitivity. A child who brushes his or her teeth and gums too hard can cause a wearing away of the enamel, exposing the dentin and leading to an outcome similar to not brushing enough. Brushing is important, but it should be done carefully and correctly.

A child with sensitive teeth has many treatment options. We routinely treat such children with a brush-on fluoride gel or a fluoride rinse, or toothpaste with a high fluoride level specially formulated to provide extra protection against decay. We may also recommend using a soft-bristle toothbrush and special desensitizing toothpaste that reduces pain to the teeth.

As with many other conditions, it’s vital to catch tooth sensitivity early and treat it quickly. When a child sounds a mouth alarm, it’s important to listen and respond.

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Exterminating Sugar Bugs

Has your child ever asked you if there are “sugar bugs” in their food? If they have, chances are they have recently been given a lesson on plaque. “Sugar bugs” are a popular teaching tool used by dentists to help children learn about the dangers of plaque. Children are easily confused by discussions of “invisible films of food particles and bacteria that latch on their teeth,” but they are certainly aware of bugs and that they don’t want them in their mouths.

The image of “sugar bugs” eating away at their teeth isn’t far from the truth. Deposits of sugar and carbohydrates mix with the bacteria in the mouth to produce a thin layer of film called plaque on the teeth. If that plaque is not cleaned away by brushing twice a day and flossing at least once a day, it interacts with further sugar and carbohydrates, creating acids that cause holes in the teeth—cavities. That allows more acids to weaken the tooth from the inside. Weak teeth cause pain and run the risk of literally breaking apart.

So use this fear of sugar bugs to your advantage in helping your children take care of their teeth.

  • Eating healthily will stop the sugar bugs from getting into their mouths.
  • Brushing twice a day and flossing at least once a day will keep those sugar bugs away from their teeth.
  • Coming in to see us twice a year will get rid of whatever sugar bugs they may miss.

When children grow up and learn the truth about what’s going on in their mouths, they might find the idea of sugar bugs a little silly, but their healthy gums and bright smiles will justify the fairy tale.

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Kicking the Thumb-sucking Habit

Thumb-sucking is a common way for infants and very young children to soothe themselves when they feel anxious or stressful. Most children abandon the habit once they develop the ability to speak and voice their anxieties. However, for many children, the habit is not so easily abandoned; for them, the risk of developing dental problems such as overbite or jaw malformation is strong.

Although it was once believed that, until the emergence of permanent teeth, thumb-sucking caused no damage, experts now think that the negative effects of thumb-sucking can begin as early as age 2 or 3. If your child refuses to give up the thumb as he or she ages, there are some steps you can take to help your child kick the habit:

  • Praise your child or offer simple rewards when he or she does not suck his or her thumb for a specified period of time, increasing the time period as the child shows repeated success.
  • Remove the thumb from the child’s mouth after he or she falls asleep.
  • Talk to your child about the habit and about the importance of stopping; be supportive and calm instead of scolding or threatening.
  • Help your child become aware of the habit by calmly pointing out when he or she is thumb-sucking. Many children lack self-awareness at this age, and gentle reminders can help them recognize the habit and find other ways to cope (like hugging a stuffed animal, for instance).
  • Remind your child in a positive way that he or she is growing up; point to older role models (cartoon figures are fine) who do not suck their thumbs.
  • Avoid stop-gap measures, like foul-tasting liquids or mittens to prevent thumb-sucking, because these can actually increase a child’s anxiety. If needed, we can create a mouthguard or night guard that can help children quit the habit.
  • For children who are ready to quit, use a plastic bandage on the finger as a reminder not to suck.
  • Finally, don’t panic. Your anxiety will be picked up by your child and may cause him or her to increase the habit to alleviate increased anxiety.

If your child displays aggressive or long-term thumb-sucking habits, bring him or her to our office for an evaluation. We can give you a better understanding of how your child's thumb-sucking is affecting his or her dental development, and we can assess the possible need for dental braces or other orthodontic treatments in the future.

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When Your Child Loses a Filling

Although losing a dental filling is rarely a major emergency, the experience can be traumatic, especially for a young child. If your child has fillings, it is not likely he or she will lose one, but it is still important that you know what to do in case it falls out. In the event your child loses a dental filling, call our office right away to schedule an appointment. We can replace the filling.

In the meantime, here are some first-aid tips you can apply:

  • First, keep your child calm and try to retrieve the filling before he or she swallows it. If it is too late for that, assure the child that a swallowed filling will pass through the digestive system and is not a cause for concern. Fillings may fall out for a number of reasons, including a cracked tooth or decay that has affected the shape of the tooth and caused the filling to loosen. If you retrieve the filling, bring it with you to us, so we can evaluate it when we re-treat the tooth.
  • Rinsing the mouth with a mixture of warm water and salt can soothe the area and remove any food particles or debris from the filling. You can also gently brush around the area to keep it clean. This is important if there is decay in the tooth.
  • Because the exposed area may be sensitive to temperature, pressure or air, feed your child a soft diet and avoid hot or cold food and drink until he or she can be seen by us. You can also ask us or your child’s pediatrician if a pain medication, such as children’s Tylenol, is appropriate.
  • An unfilled tooth can be a magnet for bacteria, particularly if the dental appointment is a day or two away, so good hygiene is essential. Also, you can ask us about applying an over-the-counter temporary dental filling. These are not intended for long-term use but can provide additional immediate protection for the exposed area.

Above all, be prepared. At the time your child receives his or her first filling, assemble a first-aid kit with some of the items mentioned in this article, so you will have them close at hand if necessary.

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Brace Yourself: Early Orthodontic Treatment

When today’s generation of parents was growing up, a metal mouth was an adolescent rite of passage. Now, braces might be associated with elementary school. The American Association of Orthodontists recommends that children be evaluated at age 7 and, in some cases, treatment be started shortly thereafter. There are pros and cons to early orthodontic care, most of which depend on the problem being treated.

Some conditions, such as narrow upper arches, anterior crossbites or underbites, are better treated while the jaw is still growing. Early treatment may save a child from oral surgery later, and even if further treatment is required in the teen years, it will be less extensive.

Some parents opt for earlier orthodontics out of concern for their child’s self-esteem. Having a prominent underbite or protruding upper teeth can lead to teasing; other issues, such as problems with the palate, can cause speech impediments. In these cases, even if getting braces at age 8 won’t keep a child from needing them at age 14, it might be worth pursuing early orthodontic treatment. Parents should weigh the cost and discomfort of these treatments with the benefits of a better-looking smile or clearer speech.

However, some studies suggest that certain problems are best left untreated until adolescence. It’s not really a matter of the orthodontics’ damaging a child in any way, but more because the treatment is simply ineffective. For example, several randomized clinical trials since the 1990s have shown that class II malocclusions treated early lead to more treatment time (and more money spent) than those treated in adolescence. In other words, having braces applied for this problem at age 8 will be no more effective and more costly than getting them at age 13.

Your best bet? Have your child evaluated around the age of 7, and discuss the benefits and risks of early treatment with us and an orthodontist. This dental specialist will have a good grasp on the best course of action, to ensure that your child’s smile is healthy—and beautiful—for years to come.

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Emergency Dental Help: Always Available

It’s Murphy’s Law of Parenthood: Your child’s teeth will be fine until our office has closed for the day. So what should you do when it’s 9 p.m. and your kindergartner cracks a tooth, your son suddenly complains of terrible pain from an unrecognized infection or your teenage daughter breaks her braces?

In some cases, a hospital emergency room will be your best bet. Jaw fractures or serious cuts to the mouth that require immediate medical care are best left to the hospital. But other dental problems, such as those mentioned above, also need urgent attention—and hospital emergency rooms are often not equipped to handle these, and the fees for such services can be high.

Of course, we should be the first person you call. When you reach the office, you will hear a recorded message telling you what to do in case of emergency. If we are unable to see you after-hours, we will direct you to an on-call substitute. Keep this information handy so that if and when an emergency occurs, you won’t waste time searching for the number to call.

However, emergency dentistry is more of a stop-gap than a final solution. Most substitute dentists contacted in an emergency will make your child more comfortable and apply temporary fixes that will suffice until he or she comes in to see us during normal office hours.

If you are not sure whether your child’s problem requires after-hours care or if it can wait until morning, don’t hesitate to call our office. With more and more practices offering after-hours care, there’s really no good reason to sit there worrying, with a child in tears, waiting for the office to open!

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