Managing—and Avoiding—Early Childhood Caries

Early childhood caries (ECC), the technical term for tooth decay in babies and toddlers, can cause tremendous discomfort as well as headaches, eating and sleeping problems, and even learning delays. Parents must also endure the high treatment costs of ECC, along with missed work or school.

To make matters worse, even when children are properly treated for ECC, they can experience further decay and ECC-related problems. Typical treatment for ECC involves putting the child under anesthesia and performing the necessary drilling, filling and root canal. But one study found that, even with this aggressive treatment, more than half of the children treated for ECC develop new caries within two years.

Until recently, ECC was not treated as a chronic disease—but that’s exactly what it is. By simply fixing the damage that ECC has done to teeth, we treat the symptoms and not the cause. New research reveals the effectiveness of a chronic disease management approach. This approach involves more than just treating cavities; it works to prevent more cavities from occurring.

We will work with parents to make sure youngsters with ECC have frequent checkups. That allows us to catch early signs of decay before bigger problems ensue. Children receive proven treatments, such as sealants, restorations and fluoride varnish applications, but we also teach them how to practice good oral hygiene, mouth-healthy nutrition and other behaviors that help reduce the risk of further decay.

So what does this mean for you and your child? If your child has ECC, be proactive. Talk to us after your child’s ECC procedures about how to help ensure he or she does not have to go through more procedures in the future. Make sure to attend all follow-up appointments, and follow our instructions and recommendations. Working together as an oral-health team, we can help your child break free from the pain and aggravation of ECC.

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Crooked Teeth: No Laughing Matter

Uh-oh … one of your child’s permanent teeth is coming in funny. Is this a cause for panic, or at least immediate treatment? An abnormally positioned tooth has definite drawbacks:

  • It might have an impact on appearance, especially if it’s a front tooth.
  • It may cause discomfort.
  • It could prevent easy flossing.

But how do you treat abnormal tooth positioning? That question is a bit trickier, because every child’s situation—and every tooth—is a little bit different.

In many cases, orthodontic treatment is the recognized solution. Orthodontists specialize in straightening teeth—with braces, wires, bands and other implements—to give your child a spectacular smile … eventually. It’s never too early to discuss whether your child needs corrective treatment. We will keep tabs on his or her developing mouth and teeth in order to help the orthodontist formulate a customized future treatment strategy.

First, we will determine the underlying reason for an emerging tooth’s crookedness. Was the baby tooth in its spot (or next to it) lost too early? Is your child’s mouth “crowded,” with seemingly insufficient room for all 32 adult teeth? If so, why? Will the crooked tooth straighten out on its own over time (as is often the case with permanent front teeth)?

Once the reason for the problem is ascertained, we can provide treatment or refer your child to an orthodontist. Space maintainers may be useful if a primary tooth falls out too soon. By placing one in your child’s mouth, we may be able to ensure that an adjacent permanent tooth doesn’t cause problems by invading that space and taking up two spots. The goal is to prevent the tooth from having a permanently abnormal position.

An orthodontist may recommend extracting one or more healthy permanent teeth if they are causing harmful crowding in your child’s mouth. This gives the other teeth room to spread out attractively and makes for more ideal positioning.

We can help your child achieve a healthy, attractive smile for life. Let us know at your next appointment if you have concerns about any teeth that are coming in funny.

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ABCs of Oral Health: Z Is for Zinc

Zinc formulations have become popular nutritional supplements. Adult bodies have only two grams of zinc—a tiny fraction of an ounce. Yet that small amount of zinc is crucial for certain functions, including the senses of taste and smell. Would a zinc supplement be right for your child? Talk to your pediatrician.

How does zinc affect oral health? At least one study focusing on children showed that compared with those taking a placebo syrup, children taking zinc developed less gingivitis (gum swelling), presumably from reduced plaque formation. Indeed, some toothpastes contain a zinc compound because of some credible evidence that zinc can keep plaque formation down. Another study showed that mouthwash or chewing gum containing zinc chloride significantly reduced formation of sulfur-rich compounds that contribute to bad breath. Evidence is inconclusive about zinc’s ability to help canker sores heal.

In medical use, zinc helps heal adult stomach ulcers. Some evidence exists for its beneficial role in treating acne and attention deficit hyperactivity disorder and in boosting immune function. There are those who swear by zinc at the first sign of a common cold to decrease the cold’s length and minimize its symptoms.

Zinc deficiency is uncommon, but the condition is marked by frequent infections, hair loss, nerve and olfactory dysfunction, skin sores, slow-healing wounds and trouble seeing in the dark. If your child seems to suffer from any combination of these symptoms, see your pediatrician at once.

On the other hand, if after taking zinc supplements your child has diarrhea and stomach cramps and/or is vomiting, he or she is showing signs of a zinc overdose. Again, take your child to the pediatrician.

We’ll be happy to speak with you in more detail about the pros and cons of zinc supplements for oral health at your child’s next appointment.

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Devour Some Good Children’s Books About Oral Health

Reading to children is important for a myriad of reasons, but there’s one you may not have thought about: promoting dental health. Dental caries (tooth decay) is actually the most common infectious disease affecting children in the United States. Cavities in baby teeth can affect dental health for a lifetime, and getting fillings can have painful—and financial—consequences. The best way to help your children avoid dental problems is to make sure they practice good oral hygiene from a very early age.

Picture books are a great way to bring oral health concepts to life. They can help explain the whys and hows of teeth to young children. Some books focus on proper brushing technique, such as Brushing Well by Helen Frost; Brush Your Teeth, Please by Leslie McGuire; and Ready, Set, Brush! featuring the characters from Sesame Street. Author Sally Huss’ Who Needs Teeth? focuses more on the importance of teeth, while other books like Sugarbug Doug by dentist Ben Magleby describe in child-friendly terms how cavities happen.

New experiences can be scary for children, and going to the dentist for the first time is no exception. Sharing stories with your child about dental visits can help demystify the process and may even get him or her excited about going. A number of your children’s favorite characters have books on this topic, such as the Berenstain Bears, Curious George, Dora the Explorer and Mercer Mayer’s Little Critter. If your child does get a cavity, you can prepare her or him for what’s to come with Lisa M. Herrington’s I Have a Cavity.

For older children, losing primary teeth can be a big deal. Help prepare them with titles such as Loose Tooth by Lola M. Schaefer and The Night Before the Tooth Fairy by Natasha Wing. School-age children may also enjoy The Tooth Book by Edward Miller, which takes a more science-oriented (but still fun) approach to teaching dental health.

By sharing these books and others like them with your youngsters, you can give them a solid foundation in dental health—and maybe discover some favorite stories along the way.

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Mind the Gap: Dealing with Prematurely Lost Baby Teeth

People get two sets of teeth, their primary teeth and their permanent teeth. Losing baby teeth is a normal, healthy part of life. As children grow, their baby teeth fall out to make room for the larger adult teeth that should last them for the rest of their lives. But some children might lose them too soon, usually from cavities or accidents. For others, not all their baby teeth grow in normally. If this should happen to your child, we may recommend a space maintainer.

Without a space maintainer, the premature loss of a tooth could lead to problems when the permanent teeth grow in. The baby teeth on either side of the gap can move closer together as your child grows, which can cause the adult teeth to grow in either crooked or crowded and, perhaps, make it more difficult to chew and speak.

Space maintainers are generally made out of either metal or plastic. There are two common types of space maintainers:

  • a fixed maintainer that will generally be cemented in place between two other teeth. Often this will be in the form of a wire loop that simulates the continued presence of the missing tooth. In other cases, it will take the form of a temporary crown.
  • a removable space maintainer that is created from a mold of your child’s mouth. It looks something like a retainer.

It is important for children with a space maintainer to take extra-special care of their teeth. Poor oral hygiene can cause the gums to swell up over the wire in a fixed maintainer, which can cause infection. Young children are also prone to playing with their space maintainers, which can cause the maintainers to end up misshapen and less effective.

If your child has a space maintainer, you must bring him or her in for follow-up appointments with us at least every six months. That way we can ensure that the space maintainer is still in place, shaped properly and doing its job.

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Smile an Everlasting Smile

We like to talk about maintaining your children’s healthy smiles. That’s not just about protecting their teeth. Believe it or not, smiles themselves are very important.

Here are a few reasons why.

  • We are born to smile. Almost from birth, we are able to smile and recognize smiles. It’s the easiest of all expressions to identify—you can actually recognize a smile from 300 feet away! But people who can’t see that far still know what a smile is. Even babies born without sight smile.
  • Smiling causes the release of endorphins. Endorphins are chemicals that make people feel happier. That means that the act of looking happy can make you feel happy.
  • Smiling boosts your immune system. Smiles are actually physically easier than frowns. They use fewer muscles. That means that your body is more relaxed when you smile than when you frown, and a body that is under less strain is taking better care of itself.
  • Smiles are attractive. A majority of people (61%) report having been attracted to other people by their smile alone.
  • Smiling shows confidence. People who smile readily are viewed as more sociable, attractive and confident.
  • Smiles are contagious. All of the benefits of smiling we’ve mentioned can be shared. When you smile, people around you are more likely to smile. That means smiling makes people around you happier, healthier, more confident and more attractive.

So the next time you come into our office and we talk about protecting your child’s healthy smile, remember that it’s about a lot more than making sure he or she will be able to bite and chew. A big, happy smile is a benefit that pays off every day of your youngster’s life.

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