Wise Up About Wisdom Teeth

Has your teenager bitten into a piece of food and felt an immediate rush of mouth pain when starting to chew? Does he or she complain of jaw pain or tender, swollen gums? Chances are your child is fighting a losing battle with wisdom teeth, the third molars in the very back of the mouth that begin to emerge during late adolescence and the early twenties. These teeth are not needed for chewing and, because of their location, are difficult to keep clean.

Due to the position of these teeth, they often do not have enough room to grow, or “erupt,” through the gumline in the proper direction. They may partially erupt in a slanted or horizontal direction, leaving an opening for bacteria to enter and cause infection. Partially erupted wisdom teeth are also more prone to tooth decay and gum disease because they are difficult to brush and floss. When a wisdom tooth is trapped, it does not erupt at all—those teeth are called “impacted.”

Partially erupted and impacted wisdom teeth can damage adjacent teeth, the jawbone and related nerves. For that reason, wisdom teeth are often extracted before these problems even develop.

The American Dental Association cites the following as the most prominent reasons for removing wisdom teeth:

  • consistent pain
  • repeated infection of soft tissue behind the lower last tooth
  • presence of cysts
  • presence of tumors
  • damage to nearby teeth
  • gum disease
  • extensive tooth decay

The most important step is the first one: Contact our office if your child experiences any of the above symptoms. If you have been bringing your teen regularly for routine dental examinations as part of a healthy mouth regimen, we will already be aware of the underlying situation. A proper mouth examination, including x-rays, will confirm the presence of the symptomatic wisdom tooth and the extent to which it truly affects his or her mouth.

Above all, don’t ignore your child’s discomfort. It will only progress and lead to emergencies that can affect more than just oral health. So use a little bit of wisdom—schedule an appointment with us today.

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Good Sleep and Good Dental Health Go Together

Every night, your child brushes and flosses, gives you a kiss and climbs into bed. This is an excellent routine to promote dental health—and not just because of the brushing and flossing. While we sleep, our bodies heal. Our blood sugar levels stabilize, our immune system reboots, and our blood vessels and heart can do their important maintenance work. For children, whose bodies are constantly growing and changing, sleep is critically important.

Considering the connection between general health and dental wellness, it makes sense that adequate sleep is essential to keeping your child’s smile healthy and bright. Given evidence in a Japanese study that suggested a correlation between inadequate sleep and periodontal disease, there may be more to the sleep–dental connection than previously thought.

Not only is poor sleep associated with dental problems, dental problems can cause poor sleep—especially in children, who can’t always express what’s causing them to toss and turn. Two common sleep disorders, sleep-related bruxism and sleep-related gastroesophageal reflux, can wreak havoc on the quality of your child’s sleep.

  • Children with sleep-related bruxism grind their teeth at night, which can wear down teeth, alter the child’s bite, and cause pain in the face and jaw.
  • Children with sleep-related gastroesophageal reflux regurgitate stomach acid while sleeping, which can chemically erode tooth enamel.

To be sure your child’s sleep isn’t being disturbed by these problems, we can check his or her mouth for signs of both disorders, especially if the child is complaining of a sour taste in the mouth, jaw pain or interrupted sleep. We may also recommend a thorough examination by a pediatrician or specialist to rule out other issues, such as thyroid disorders and ear/nose/throat problems, that can affect sleep.

To help children get a good night’s sleep that boosts dental health, have them wind down an hour or two before bed with a quiet activity, such as reading or relaxing with family; skip caffeine-containing drinks; and make sure they have a comfortable, quiet, cool sleep environment. And, of course, make sure they brush and floss before bed!

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Is Breast Milk Best for Your Baby’s Teeth?

Is there a link between how a baby is fed (breast vs. bottle) and the future development of cavities? There’s no simple answer to that question.

Here’s what we currently know. First, cavities—technically, dental caries—are infections caused by Streptococcus mutans bacteria. Almost all adults have these bacteria in their mouths, and you will surely transfer them to your baby. If the baby has any teeth, the addition of another necessary element, sugar on a tooth, begins the caries process. The bacteria feed on the sugar and leave acid as a residue; the acid causes decay.

The key, then, is to keep your child’s mouth as sugar-free as possible. That doesn’t just mean sugar out of a box, of course; almost any leftover food or liquid particles (other than plain water) will have sugar or compounds that turn to sugar. That includes baby formula, cow’s milk and breast milk.

One way to get rid of that sugar is to gently clean your child’s gums after each feeding—even before the first tooth erupts, even before he or she eats solid food. Bonus: It will make routine tooth-brushing seem natural as your baby grows up.

The other crucial step to keeping your child’s mouth free of sugar is to make sure he or she does not fall asleep while feeding. The fewer nighttime feedings, the better. If your child falls asleep with breast milk or formula (or any other non-water beverage) in his or her mouth at any time, sugars remain. But at night, everyone (even a baby) makes less saliva, and that contributes to sugars being washed away less efficiently.

Breast milk contains natural chemicals that confer protection of many kinds, including, to some degree, against Streptococcus mutans. Another benefit is that—all other things being equal—breast milk doesn’t contribute to much acid production in your child’s mouth. But those benefits can’t fully counter the risks of prolonged nighttime nursings.

Your child should have his or her first dental appointment no later than when their first tooth erupts. We can give you additional sensible guidelines for caring for your little one’s teeth that will give him or her the best chance of avoiding cavities, whether they are breast- or bottle-fed.

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When the Tooth Fairy Visits Too Soon

For both children and their parents, the first visit from the tooth fairy can be an exciting rite of passage. But when a baby tooth is lost prematurely, that excitement can quickly turn to concern.

Primary (baby) teeth act as “placeholders” for the permanent (adult) teeth that sprout up later in childhood. If a lost baby tooth produces a gap in your toddler’s smile, the other teeth can shift around, leading to poor spacing or overcrowding. Unfortunately, due to accidents, severe decay or certain health problems, some toddlers lose teeth long before they are supposed to. If this happens, what should a parent do?

If your child has a tooth knocked out as a result of an accident, try to find the lost tooth. If the tooth is salvageable, do the following:

  • Rinse the tooth in water.
  • Do not scrub it or clean it; this can damage important tissue fragments that may help the chances of successful reimplantation.
  • Place the tooth and/or any tooth fragments in a glass of milk.
  • Bring your child and the tooth to our office or the emergency room as quickly as possible.

After checking for additional injury to the mouth and jaw, we may be able to reinsert or “splint” the lost tooth into your child’s mouth. If that’s not possible, we may recommend a space maintainer to ensure proper alignment of future permanent teeth.

If the tooth is lost due to a medical condition, such as a metabolic disorder, immunological issue or poor oral hygiene, we may perform special dental work to minimize further damage to gums or surrounding teeth. Then we will help you make a plan to maintain your child’s oral health.

Obviously, the best way to handle the premature loss of a primary tooth is to not lose the tooth in the first place. Safety precautions and good oral habits, like regular brushing, flossing and dental visits, can help keep the tooth fairy away—until you want her to visit.

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Dental Care for Children with Cerebral Palsy

Parents of children with cerebral palsy already know the unique demands and requirements that must be met just to cope with everyday life. While other life challenges may seem to be of more concern, dental care for children with cerebral palsy is as much a priority as it is for other youngsters.

It is important that parents of a child with cerebral palsy partner with us to create an individualized treatment plan that meets the child’s needs with a minimum of undue difficulty, while still protecting his or her teeth and creating a self-care program they can use when they reach adulthood.

The first thing the parent needs to do is communicate the child’s needs in advance of their visit. Although we are trained to deal with the challenges of cerebral palsy, every case is unique. The more we know before your child sits in our dental chair, the better we can tailor our office environment to meet his or her needs, and the better equipped we will be to recommend a specialist if necessary. We have specialized equipment and protocols we can follow, from anesthetics that will make dental procedures less stressful to the use of nonverbal communication methods, such as squeezing a hand in place of speech to indicate discomfort.

Children with cerebral palsy often have elevated risks of certain dental disorders, including

  • bruxism (tooth grinding)
  • malocclusion (displacement of the teeth)
  • difficulty swallowing
  • gum disease

It’s important to determine whether your child exhibits any of these conditions. If he or she does, we need to create a plan to best deal with it at home.

Protecting the dental health of your child with cerebral palsy is a team effort. Make sure to keep us involved.

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How Heartache Leads to Toothache

Children are sensitive beings. Stress in their environment may trigger behavioral changes such as “acting out.” But stress can also lead to physical responses, including changes in their oral health.

In addition, an emotionally stressed child may not feel like keeping to his or her normal oral hygiene routine; he or she may even go back, consciously or unconsciously, to thumb-sucking or tooth grinding, which can have negative effects on the developing mouth and teeth. If such problems last more than a couple of days, it’s best to gently address them in an age-appropriate way.

Financial troubles can lead to lapses in dental care—with serious negative effects. Do your best to keep up with regular dental checkups, professional cleanings and fluoride treatments. If your financial situation has changed, or you find yourself without dental insurance, please discuss your concerns with us. We will do our best to work with you, perhaps coming up with a payment plan that will work with your budget.

Finally, in times of stress, all of us—adults and children—often turn to less-healthy food choices—because they are quick (fast food) or comforting (sweet and salty snacks, such as doughnuts and chips). Try to shop for fresh fruits and vegetables, and have them on hand at home, so they can become “fast food” choices, too.

Even when everyone is stressed and cranky, make sure your child brushes after every meal or snack, especially after sugary and starchy ones. This will help prevent decay and problems that can occur long after the current problems have resolved.

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