The Rocky Road to Tonsil Stones

Lying in the very back of the throat are the tonsils, two gland-like structures believed to play a role in preventing and fighting infections. The tonsils function like nets, trapping viruses and bacteria that pass through your throat. But their nooks and crannies can also trap dead cells and mucous. Mixed with bacteria, this debris may become concentrated into white formations that then harden into tonsil stones.

Because tonsils shrink with age, tonsil stones tend to be more common in adolescents, whose tonsils are generally larger to support a growing immune system. Tonsil stones also occur more frequently in people who experience chronic tonsil inflammation or frequent bouts of tonsillitis.

Although tonsil stones are usually the size of a pea or smaller, their rich amount of bacteria almost guarantees that they will cause bad breath. If your child or teen has bad breath that doesn’t go away with brushing or mouthwash, he or she may well have tonsil stones.

Bring your child to the office. We can shine a light on the back of the throat to see if the tonsils are the source of the breath odor. Although many people try to remove tonsil stones at home, it is better to have them removed in our office.

If your child is prone to tonsil stones, it is important that he or she maintain good oral hygiene—that should prevent them from forming in the first place. In addition to the usual recommendations of flossing daily, brushing twice daily and seeing us regularly, we may also recommend that your child gargle frequently with salt water. This can help dislodge tonsil stones, along with any debris in the tonsils that have yet to harden into stones.

Discuss this condition with us or your child’s pediatrician. If you think your child may have tonsil stones, call our office and make an appointment. We can thoroughly assess your child’s oral health and discuss a plan of oral hygiene that will keep your child’s mouth looking and feeling great.

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Keep Early Childhood Caries Away

Dentists use the term early childhood caries (ECC), sometimes called baby bottle caries, to describe the presence of one or more decayed, missing or filled teeth in a child younger than six years old. Any sign of tooth decay in a child under the age of three years is considered severe ECC.

The presence of ECC has a major impact on your child’s present and future quality of life. Discomfort, pain, infection, abscesses and gastrointestinal disorders can all result from ECC. It may even lead to malnutrition and retarded growth because of pain, chewing difficulties and reluctance to eat. Other consequences of ECC include crooked teeth, delayed or restricted speech, and loss of space for succeeding teeth. The look of a mouthful of decayed teeth can cause psychological problems, including low self-esteem. And children with ECC have an increased risk of developing cavities in their permanent teeth as well.

How early should you be concerned whether your child is developing ECC? An infant’s first teeth may erupt as early as six months of age, and decay can attack your baby’s teeth as soon as they appear. That’s why the American Academy of Pediatrics and the American Dental Association both recommend an initial dental visit by your child’s first birthday.

Unfortunately, many parents delay that first dental appointment until the child is two or three years old. By then, severe ECC may have already set in. A 2006 study published in the journal Pediatric Dentistry presented evidence that children who do not see a dentist before the age of two years are more likely to require emergency visits and tooth restorations. That can get expensive. In fact, children who visit the dentist before their first birthday have 40% lower dental costs between birth and age five. These savings come from less need for dental and medical care resulting from poor oral health.

The American Academy of Pediatric Dentistry has coined a slogan to help parents remember: 1 + 1 = 0. One dental visit when the child has one tooth equals zero cavities. A visit to our office by the time the first baby tooth emerges can be the beginning of a preventive dental care program that will minimize tooth decay and cavities throughout your child’s lifetime.

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Saliva: Nothing to Spit At

Saliva plays an important role in maintaining oral health. The mouth has six major salivary glands, while your mouth and throat have hundreds of minor ones, all of which deliver saliva by way of salivary ducts. Every time you chew food or suck on candy, your body makes more saliva.

Composed mostly of water, saliva plays an important role in maintaining a healthy mouth and smile. It contains vital substances that help digest food and keep teeth strong. Although you probably don’t spend much time thinking about it, saliva

  • helps you chew and swallow by moistening and breaking down food
  • washes away particles of food from teeth and gums
  • provides proteins and minerals to help prevent cavities and other infections
  • delivers high levels of calcium, fluoride and phosphate to the surface of your teeth
  • prevents bad breath

Because saliva does so much to keep your mouth healthy, a reduced saliva flow causes dry mouth; it can lead to cavities and other oral health problems. Diabetes, mouth-breathing, dehydration, cerebral palsy and chemotherapy, along with a wide range of medications—including medication for severe acne—can lead to dry mouth. Although dry mouth is much more common in older adults, children, too, may experience it.

Left untreated, dry mouth can lead to bad breath, tooth decay and gum disease. If your child or teenager has too little saliva in his or her mouth, we might recommend drinking more water, chewing sugar-free gum or sucking on sugar-free candy, all of which help to stimulate saliva production.

If your child complains of dry mouth, tell us so we can assess his or her condition. Addressing this problem early on can head off tooth decay and other oral health problems.

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Tot Toothbrushes Promote Good Habits

The toothbrush aisle can be an exercise in frustration, especially if you’re shopping with your little ones. With images of Dora the Explorer on toothbrushes and Transformers on toothpaste, chances are your children will beg you to buy something with their favorite character on the package. Luckily, this can be a good thing: The more excited children are about their toothpaste and toothbrush, the more likely they are to use them. And, as most parents know, getting small children to brush their teeth can be challenging even on the best of days.

In recent years, the children’s oral health market has exploded with options for toddlers and preschoolers. For very young children, the goal is to get them used to brushing on a regular basis. From light-up toothbrushes to toddler toothbrushes that double as teething aids, there is a brush for every need and desire. So how do you go about choosing one? Here are some helpful guidelines:

  • Look for brushes that carry the American Dental Association (ADA) seal. These brushes will last for a normal amount of time and will have no unsafe features or rough edges.
  • Stick to brushes designed for your child’s age group. Choose ones with soft, rounded bristles that will be gentle on fragile teeth and gums.
  • Choose a brush proportioned for your toddler’s hands. A big brush handle is easy for little hands to hold and control.
  • Select a brush head that will fit comfortably into your child’s mouth so you (and eventually he or she) can clean all those places where food debris can hide. A brush head that is too large can be “overinserted” and gag a toddler, while one that is too small can be swallowed.

Some newer options include brushes that play music for one to two minutes, helping you and your child monitor how long to brush. There are also interactive toothbrushes that can be used with apps on smartphones or tablets, so that children can track their brushing habits and earn stars or awards.

In the end, the best toothbrush for your child is the one that he or she will use. Let your child pick it out (with your help and guidance, of course), and brushing may become something fun instead of a chore.

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Diabetes and Bad Breath

A child with type 1 diabetes presents special challenges to a parent. Maintaining your child’s proper blood sugar levels through diet is likely your primary concern. But maintaining your child’s oral health should also be high on the list, not only because diabetes can lead to cavities and periodontal disease but also because it can cause bad breath.

When there is too little insulin in the blood or when insulin resistance is too high, the body utilizes fats instead of glucose to provide energy. That process produces ketones, an acidic waste product that can be excreted on the breath.

High sugar levels in the blood can also lead to high sugar levels in saliva. Because bacteria thrive in high-sugar environments, people with diabetes are much more prone to cavities and periodontal disease, which also can cause bad breath.

If your child has diabetes, it is important that you be extra vigilant about his or her blood sugar regulation and dental care so that the diabetes does not lead to bad breath and other dental conditions. To maintain a healthy mouth, we recommend the following tips for your child:

  • Brush the teeth at least twice a day, and floss once a day.
  • Brush the tongue as well, because it is a breeding place for bacteria.
  • Drink plenty of water.
  • Eat a healthy diet with few sugary foods and drinks.
  • Visit us regularly.

If your child has type 1 diabetes, be sure to let our office know so that we can provide him or her with optimal dental care. Between visits, it is also important that you and your child remain focused on dental hygiene. Together, we can prevent many of the oral conditions associated with diabetes so that your child maintains a healthy mouth as he or she grows into adulthood.

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Avoiding the Pitfalls of Fluorosis

Most of us think of fluoride as a champion in the fight against tooth decay. Indeed, decay rates have dropped in the United States since the introduction of fluoride to many public water supplies in the middle of the twentieth century. But while a little fluoride might be good for teeth, too much can cause a condition known as fluorosis.

Fluorosis occurs from exposure to high levels of fluoride. It can cause discoloration and defects such as pitting on the surface of the teeth.

Fluorosis develops before the teeth have erupted, which means that only younger children are affected. In many cases, the effects of fluorosis are so mild that no treatment is necessary. But when the discoloration or pitting is more severe, we may recommend bonding, veneers or tooth whitening procedures to improve the appearance of the affected teeth.

The good news is that fluorosis is merely a cosmetic problem; it does not affect the integrity or overall health of the affected teeth. Here are some tips to help your children avoid fluorosis:

  • Keep fluoridated products such as mouthwash, toothpaste and supplements containing fluoride out of your child’s reach. Do not allow your child to use these without supervision.
  • Before your child receives a fluoride treatment from us, call your town or city water department or ask us how much fluoride is in the water your family is drinking. The Environmental Protection Agency recommends levels no higher than 2 mg of fluoride per liter of water. If you have a well, have your water analyzed for fluoride content. Once you determine how much fluoride your child is already receiving, we can decide together whether additional fluoride treatment is a good idea.
  • Use only a pea-sized amount of toothpaste on your child’s toothbrush—that is plenty to avoid decay.
  • Make sure your child spits out the toothpaste and rinses thoroughly with water after brushing.
  • To encourage spitting, avoid flavored toothpastes that your child may be more likely to swallow.
  • Alternate between tap water and low-fluoride water—such as demineralized, purified, deionized or distilled—to mix with concentrated liquid or powdered formula.

To learn more about fluorosis, fluoride treatments and other tips to maintain your childrenʼs optimal dental health, call our office and schedule a consultation.

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