Pacifiers, Thumbs and Your Baby’s Teeth

Are you concerned when your child sucks his or her thumb or cries for a pacifier? Sucking on fingers and other objects is a perfectly normal habit that provides babies with a sense of security and a way to learn about the world. However, when continued for too long, thumb- or pacifier-sucking can have a negative effect on the child’s dental health, particularly the alignment of the front teeth, as well as the formation of the jaw and the bones that support teeth.

Most babies outgrow the thumb or pacifier habit on their own, usually between the ages of 2 and 4, but some do not. Experts disagree about how long is too long to continue sucking and how early is too early to discourage it, because the action is a natural source of comfort to the child. Some believe that a child can safely suck a thumb or pacifier until school-age or when the permanent teeth start to come in at around age 6. Others argue that persistent sucking after age 2 poses a greater risk for developing protruding front teeth and a misaligned bite (the point at which the top and bottom teeth meet).

Sorting out these conflicting opinions can be confusing for parents, but we can help. We can monitor your child’s developing teeth and jaw and help you to determine whether an intervention is necessary to curtail your child’s habit.

We can also suggest ways to wean your child from sucking. A surprisingly successful tactic is to simply tell the child that his or her new teeth may not come in straight and then show your child photos of permanent teeth that did and did not form properly.

Also effective is a gradual withdrawal technique that limits sucking to certain times of the day, increasing the restricted periods until the habit is completely eliminated. Substituting a soft toy or another comfort object often helps.

These methods are likely to be more effective with children who use pacifiers. Limiting access to a pacifier is easier than restricting the use of a readily available thumb. If these tactics prove ineffective, we may recommend a mouth appliance that discourages thumb-sucking by interfering with the action.

If you have a child who is a persistent thumb- or pacifier-sucker, knowing when to intervene can be critical. We can provide the support and expertise you need to ease the weaning process and avoid trauma for your child.

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Baby Those Baby Teeth

Baby teeth (properly called primary teeth) usually all fall out by the time your child is about 12 years old. Most, in fact, are gone years earlier. So, if baby teeth inhabit your child’s mouth for a relatively short time, why is their health so vitally important? The dental experts at WebMD recently provided some answers.

Healthy primary teeth

  • provide your child’s mouth and face with an essential element of “normal” appearance
  • keep spaces available for the permanent teeth to later erupt in their correct positions
  • are essential for speech development and clarity
  • let your child chew properly, which makes getting good nutrition easier
  • help ensure that the permanent teeth will emerge in a healthy condition

Untreated decay in baby teeth can harm the permanent teeth growing beneath the gumline. If baby teeth are lost too soon because of decay, the adult teeth may grow in crooked or spaced too closely together. What’s more, untreated decay (also called cavities or caries) causes pain and can progress into an abscess that can cause infection to spread to other areas of your child’s body.

Preventing decay is relatively simple. The key: Limit contact between your child’s teeth and liquid carbohydrates—in other words, drinks with sugar. These include not only drinks like soda but also fruit juices, milk, formula and sweetened water.

Avoid laying your baby down for the night or a nap with a bottle that contains anything but plain water. The most common cause of decay in baby teeth occurs when the child is put to bed with a milk- or formula-filled bottle. In fact, early childhood caries is frequently called baby bottle tooth decay.

Before his or her first birthday, transition your child from a bottle to a sippy cup. This helps prevent liquids from settling on the teeth. Even with a sippy cup, however, sugary beverages are still less desirable than plain water. Resist adding sugar to food, and avoid coating a pacifier with sugar or honey.

Finally, after your child eats or drinks, wipe his or her gums with a wet cloth or gauze. Start using a toothbrush once the teeth erupt. This helps remove residue that can develop into bacteria-laden plaque, a precursor to decay.

Taking care of baby teeth helps ensure healthy adult teeth. See us as soon as the first baby tooth erupts or by the age of 12 months. It’s never too early to start good oral care.

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The Right Way to Brush Your Child’s Teeth

Most of us know that brushing twice a day is important. But did you know that the way you brush makes a difference to your oral health? Whether you brush your child’s teeth or he or she is old enough to handle the task alone, here are some tips to ensure a good, thorough cleansing.

Use the MOI method. This acronym stands for Masticatory, Outer and Inner, and was created to help people brush more effectively:

M: For the masticatory (chewing) surfaces, start on the upper right side of the mouth, using gentle back-and-forth movements. Continue with the top left, and then move to the bottom right and bottom left, always starting toward the back and brushing toward the front.

O: For the outer surfaces, start at the back of the mouth and brush the front of the teeth with small, circular movements. Have your child close his or her mouth when brushing the incisors, which will give you better access.

I: Finally, for the inner surfaces, hold the brush in an upright position and move it along the teeth, with strokes going from the gums to the teeth.

Find the right brush. If your child is brushing on his or her own, make sure your child is using the right brush—one with a handle that can be held comfortably and a head compact enough to get into a child’s smaller mouth.

Spend enough time. Experts say that brushing for at least two minutes is ideal. To help your child pass the time, let him or her listen to a favorite two-minute song.

Make sure to rinse and dry the brush. Always rinse the toothbrush after brushing to eliminate any leftover bacteria or toothpaste. Allow the brush to air dry between brushings. And keep an eye on the bristles. When they start to look worn out, it’s time to replace your child’s toothbrush.

The best way to teach your child a proper toothbrushing routine is to model it yourself. Showing your child how it’s done—and that you do it, too—will go a long way toward establishing good oral habits. After all, your child wants to grow up to be “just like mom or dad!”

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Oral Piercing and Your Teen’s Dental Health

Speaking with a forked tongue was once just an expression, implying that the speaker was not truthful. Today, forked tongues—tongues surgically split in two—are a reality, just one of the numerous forms of oral “body art” currently popular among teens and young adults. Your teen may want a mouth piercing, but be aware that inserting rings and other jewelry into the tongue, lip or cheek can pose serious health risks and cause permanent dental damage.

In fact, one seven-year study reported in Pediatric Dentistry in 2012 found that 25,000 people—nearly three-quarters of them 14 to 22 years of age—visited American emergency rooms for injuries involving oral piercings. The most common complaint was infection, usually the result of touching the jewelry with unsanitary hands or contact with food and drink. In 1997 the British Dental Journal reported on a severe case of infection for which antibiotic therapy failed; the 25-year-old patient required surgery to remove the barbell-shaped jewelry and decompress the swelling in the floor of her mouth. And in 2008 a healthy 19-year-old woman who had had a recent tongue piercing contracted herpes simplex virus that progressed to hepatitis and subsequent death.

Because the location of a piercing is usually selected for its visual effect, rather than oral safety, the piercing process itself can be hazardous, posing the risk of permanent nerve damage that can affect the sense of taste or a swelling of the tongue that blocks the airway and inhibits breathing. Other complaints—particularly in the post-piercing healing period—include pain, swelling, excessive bleeding and an allergic reaction to the jewelry.

Oral piercings have been linked to gum recession, bone loss and drooling due to increased salivary flow. If jewelry becomes embedded in oral tissue, surgery may be required to remove it. And piercings can interfere with dental care by obscuring x-rays.

The healing period after piercing requires meticulous attention to hygiene. Your teen should floss daily and brush the teeth, tongue and jewelry after every meal, using a new, soft toothbrush stored away from other toothbrushes to prevent contamination. And your teen must learn to eat carefully in order to avoid biting down on jewelry and damaging teeth, restorations and fillings. Opening the mouth too wide can cause some piercings to catch on the teeth.

If your teen wants an oral piercing, we can provide an individualized assessment of the risks and devise a care plan to maintain oral health. Regular visits to our office will ensure supervision of the piercing and timely repair of any damage before it worsens. If your teen experiences an adverse reaction that does not respond to treatment, we may suggest permanent removal of the piercing and a rehabilitation plan to restore oral health.

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Special-Needs Children Require Special Oral Health Strategies

While oral health is important to sustain a child’s overall good physical health, children with special needs—and their parents—often find necessary oral-care maintenance routines challenging.

At home, consistent, creative preparation can be very useful to keep toothbrushing time as stress-free as possible. If your child resists brushing in the bathroom, for instance, choose another room or setting. Make sure all objects you might need—everything from toothbrush to fresh water to swabs—are close at hand before beginning.

If a traditional toothbrush poses difficulties, you can buy or make an adaptive toothbrush that your child may be able to maneuver alone. The sense of independence this fosters will create positivity around the oral-health experience—something important for any special-needs child. If your child finds toothpaste difficult to tolerate, try using a very small amount (the size of half a pea) on the toothbrush.

Specific precautions can help prevent cavities that might be caused by taking certain liquid medications that contain sugar. Have your child rinse with water, if possible, after taking these medications, and ask your pharmacist if there are sugar-free variants for your child’s prescriptions. If your child experiences gastroesophageal reflux or another condition that causes frequent vomiting, you, your child and caregivers should understand that to get rid of even small amounts of residue, rinsing the mouth with water after an incident is crucial to preventing tooth decay.

We want to work with you and your child to make his or her dental care experiences as pleasant as possible. When you schedule your child’s appointment, remind us of his or her special needs. If necessary, we can devote the first appointment—or even the first several appointments—to small steps that get your child acclimated to the office, the chair and the activities of a “real” visit. Then he or she will know what to expect during actual cleanings and care, and the chance of successful dental visits for years to come will rise exponentially.

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Keep Your Teen Cavity-Free

It’s true: Teenagers do know everything. Just ask one; he or she will assure you that it is adults who have their facts—about pretty much everything—wrong.

Sometimes facing off against teen attitude can feel poignant, in an “I remember being like that” way. But when your adolescent decides that he or she has outgrown worrying about cavities, there is no cause for smiles, wry or otherwise.

Just like children, adolescents must maintain proper dental hygiene to prevent cavities. To help your teen do an adequate job, suggest that your teen brush his or her teeth twice a day for the length (or half the length, depending) of a favorite song. Flossing is important, too. Because the hormonal shifts of adolescence can sometimes increase gum sensitivity, work with your teen to find a dental floss or tape that feels comfortable.

As for diet, it’s unrealistic to expect a teen to avoid carbohydrates and sugars totally. And as for brushing during the day after eating lunch—at school? in the bathroom?—that might also be an unpalatable proposition. Suggest in-a-pinch substitutes: rinsing with mouthwash or water or chewing sugarless gum sweetened with xylitol.

Save your strongest arguments for insisting on pre-bedtime toothbrushing. The lessened production of saliva during sleep makes food residue more likely to contribute to decay formation overnight—and increases the possibility that any mouth piercings your child may have can become infected. Infections at a piercing site can lead to systemic infections, such as hepatitis.

Schedule your teen for regular appointments at our office. Professional cleanings contribute to cavity prevention (or easier treatment if they’re caught early); we also offer sealants that contribute some protection against decay. This makes the occasional teenage dental hygiene slip-up less of a big deal.

We promise that your adolescent will be treated like a young adult—no baby stuff, no balloon animals, and no SpongeBob or Dora stickers will be foisted upon them. Alert us in advance that a sensitive teen is coming in, and we’ll be extra-conscientious about leaving childhood references at the door.

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