Making Wise Wisdom Teeth Decisions

With age comes wisdom—and, oftentimes, wisdom teeth removal. Third molars, commonly known as wisdom teeth, usually begin to emerge between the ages of 17 and 21 years. If you’re lucky, they come in correctly positioned with adequate space around them to clean properly, so they do not cause any problems in the mouth. But in other cases, removing them may be the best option.

Wisdom teeth removal is usually a simple procedure. The following are four reasons why we may recommend this oral surgery for your teen or young adult:

  • Impacted wisdom teeth. Frequently, wisdom teeth remain hidden below the gums. Referred to as impacted, they may result in infection or the development of a cyst that can damage other teeth.
  • Partially emerged wisdom teeth. If your child’s wisdom teeth remain partly under the gums, they create a passageway for food and bacteria to enter. That can lead to infection.
  • Crowded wisdom teeth. If there is not enough room in your child’s mouth for wisdom teeth, they can crowd, and possibly damage, other teeth. Because wisdom teeth are the last permanent teeth to erupt, they often compete for space in an already full mouth.
  • Other dental concerns. If wisdom teeth cause pain, cysts, gum disease, tooth decay or other issues, they probably should go.

When there is a good chance these problems will occur, we usually recommend extraction of the wisdom teeth sooner rather than later. The surgery is much simpler while the bone is less dense and the roots have not yet fully developed. And, younger people tend to recover more quickly from surgery than do older individuals.

Whether you decide to have your child’s wisdom teeth removed or not, it is important to be vigilant about oral hygiene, especially in the back of the mouth where bacteria can grow more easily. Make sure your child or teen sees us every six months so we can keep a close eye on the potential emergence of wisdom teeth that may lead to crowding or other dental problems. We will be happy to review all your options with you at your child’s next visit.

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When Your Child Loses a Filling

More than 25% of children develop at least one cavity before the age of 5 years. While proper dental care—brushing, flossing and regular dental visits—helps reduce a child’s risk of tooth decay, genetics and diet may also play a role. Once a cavity has been identified and treated, your child will likely receive either a plastic or metal filling.

Fillings can be placed in both baby and permanent teeth. A few days after a filling is inserted, your child will probably forget it is even there. But keep in mind that fillings don’t last forever, and it is important to know what to do if your child loses one.

If a filling becomes dislodged, first remove any remaining pieces from your child’s mouth so they are not accidentally swallowed. Then call our office right away to schedule an appointment so we can replace the filling. Be sure to ask us if you should bring any of the found fragments or not. If some of the filling has been swallowed, don’t worry—just be sure to let us know this, too. We can also walk you through at-home pain relief procedures you can begin before coming to our office.

Regular dental visits are the best way to avoid potential problems with your child’s fillings. However, a filling may still come out unexpectedly. Many factors can contribute to a filling’s falling out or chipping, such as

  • teeth grinding
  • jaw clenching
  • bacterial leaks at the filling’s margin, causing decay that loosens it
  • simple wear and tear

While losing a filling is seldom an emergency, your child may experience some discomfort because the exposed tissue becomes extra sensitive to temperature and air. And if not treated promptly, decay may develop in the newly empty tooth cavity, leading to more serious dental issues.

In the event that your child loses a filling, remain calm so he or she stays calm as well. Give us a call so we can replace the filling right away, ease any tooth pain and prevent new decay.

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Dealing with Your Child’s Canker Sores

Children—and adults—occasionally develop sores in or around their mouths. The most common of these are canker sores that show up in the mouth or on the lips as elevated white or yellow patches of skin surrounded by a red halo. When agitated or prodded, canker sores cause pain and occasionally bleed.

While we are not 100% certain what causes these lesions, we can share several methods to make them less likely to worsen or spread.

  • A child with a canker sore should avoid any activities that directly affect it.
  • Have your child drink through a straw instead of straight from a glass to prevent contact with the sore.
  • Make sure your child brushes only with a soft-bristled toothbrush to avoid agitating the sore.
  • Avoid serving your child hot, spicy, salty or acidic foods until the blister heals.
  • Do not kiss your child if you have problems with canker sores yourself, and wash your hands before you interact with him or her.

Children who habitually chew on their lips or inner cheeks have an increased risk of canker sores, even though they might not even realize they are doing it. Canker sores may also be caused by misaligned teeth or an unusually sharp tooth. At your next visit, ask us if any of these issues might be the cause of your child’s mouth blisters.

Canker sores are not dangerous and tend to go away on their own after a few weeks. However, if they do not disappear, they may be a leading indicator of a more serious condition. Any time your child has a canker sore that lingers for three or more weeks or if he or she develops sores on a regular basis, see us to make sure it is not a sign of something else. Even if the canker sores don’t last very long, be sure to alert us during your next regularly scheduled visit.

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Tongue Thrusting and Your Child

Sometimes a child simply doesn’t outgrow the oral motions of swallowing that served well in infancy. As a child matures, the tongue normally stays behind the front teeth on the roof of the mouth during a swallow, not between the teeth. However, failure to outgrow what worked for the child in infancy leads to a condition called tongue thrusting, or a reverse or immature swallow. In these cases, the tongue projects out of the mouth or pushes hard against the back of the front teeth when the child swallows or talks.

Because the tongue is such a strong muscle, the force of its improper use—if untreated—can have significant negative impacts on a child’s tooth, jaw, face and speech development.

Who is affected?
Factors that can cause a child older than 5 or 6 years of age to have a reverse swallow include oral habits (nail biting, thumb sucking, prolonged pacifier reliance), enlarged tonsils, allergies, a developmental abnormality or family history. However, sometimes there is no obvious reason.

How can it be recognized?
The signs of tongue thrusting include an anterior open bite (meaning there is more-than-average space between the upper and lower teeth for the tongue to push through), protruding upper front teeth and face elongation. Usually, the child will pucker or lick his or her lips before every swallow, and the lower lip may be perpetually cracked and swollen. A dry mouth can lead to a propensity for tooth decay.

How is it treated?
It is very helpful if your child is motivated to correct his or her tongue thrust because it can be an intense process. Often, a combination of potentially uncomfortable orthodontic appliances, therapy sessions with a speech and language pathologist, and consistent at-home practice is needed. But the longer treatment is put off, the harder tongue thrusting is to correct.

What if it is ignored?
Over time, untreated tongue thrusting can cause a retruded (pushed back) lower jaw; a noticeably narrow, long face and nose; limp lip and neck muscles; an abnormally narrow airway and palate; tooth misalignment; speech impediments; and the inability for the lips to touch together without chin muscles contracting.

If you suspect your child might have a reverse or immature swallow, schedule an appointment to plan a course of action now. We will do all we can to address the problem before it leads to further complications.

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Secondhand Smoke Harms Your Children

Most of us are already aware of the potentially harmful effects of smoking on the smoker. From oral diseases to emphysema to lung cancer, smoking can be a serious threat to a person’s life. The dangers of secondhand smoke, however, are something we are only now starting to fully understand. Secondhand smoke can have disastrous effects on your children’s oral health.

Exposure to secondhand smoke can result in numerous severe medical conditions, several of which are related to oral health. Contact with secondhand smoke has the ability to double children’s risk of developing periodontitis—chronic gum disease—which may lead to gum detachment from the teeth, leading to severe pain, bleeding and even tooth loss. Inhalation of secondhand smoke may even cause bad breath, cavities and tooth decay, while harming a child’s senses of smell and taste.

It is important to educate your children about how to handle themselves around smokers. Just being in the same house or car with a smoker is not without risks. With more than 7,000 chemicals in tobacco smoke, opening windows does not do enough to reduce the dangers of secondhand smoke.

Do any members of your family smoke? We strongly advise you to encourage them to quit. If that doesn’t work, make sure the smoker (even if it’s you) only smokes far away from your children and avoids places where they like to play or study. Do not smoke in communal areas, such as the car, the kitchen or the bathroom.

In addition to shielding your children from secondhand smoke, teach them about the associated dangers, and encourage them to make healthy decisions when you are not around. Remind them to avoid contact with cigarette smoke whenever possible.

In the event that your child is unavoidably subjected to secondhand smoke, let us know during his or her next scheduled checkup. We will then know to look for conditions related to smoke exposure.

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Dental Care After a Pediatric Organ Transplant

Organ transplants help save the lives of more than 28,000 Americans every year. Among the organs most often transplanted are the heart, intestine, kidney, liver, lung and pancreas, usually with the assistance of immunosuppressive drugs. Because of the side effects of these drugs and the compromised health and immune systems of children who receive organ transplants, pediatric transplant patients often need specialized dental care, which we can provide.

If your child is a candidate for an organ transplant, it is best to treat dental concerns aggressively before the surgery because the immunosuppressive medications given after the transplant can affect your child’s ability to fight systemic infections. We will try to eliminate or stabilize any oral infection in your child’s mouth before the procedure.

After an organ transplant, it is crucial to be vigilant against infections. For any necessary dental procedures, we will prescribe, in consultation with your child’s physician, a pretreatment antibiotic, because transplant surgery leaves patients at increased risk of major infections.

Should your child’s transplant surgery require the drug cyclosporine, he or she could be at increased risk of gingival overgrowth. By some estimates, this affects 97% of pediatric heart and lung transplant patients. Gingival overgrowth can be treated with antibiotics or a surgical procedure, depending on its severity. In addition, we will closely monitor your child for other side effects, such as oral lesions, excessive bleeding and oral malignancies.

You and your child must be meticulous about oral hygiene before and after an organ transplant. This includes the recommendations we give to all patients—brushing twice daily for two minutes each time, atraumatic/gentle flossing once a day and visiting us at least twice a year for dental checkups. We may also prescribe a special mouth rinse to further prevent tooth decay and gum disease.

If your child has recently undergone, or will soon undergo, an organ transplant, be sure to visit our office for regular examinations and cleanings. We will take a complete medical history and work closely with you and your child’s physician to minimize any oral complications from the surgery or side effects from the medication.

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