Choosing the Right Mouthwash for Your Child

It can be hard enough getting children to brush and floss their teeth; is it really necessary to add mouthwash to the mix? According to the American Dental Association, mouthwash can help prevent gingivitis, combat bacteria in the mouth and, if the mouthwash contains fluoride, reduce cavities. And for children who are not always the most diligent brushers, this extra step can actually do a lot of good. Remember that mouthwash is not a substitute for routine brushing and flossing.

After the age of six, most children can begin to incorporate mouthwash into their oral health routine. Younger children are not adept at the swish-and-spit process and may swallow too much of the fluid. Always instruct children younger than 12 years of age in good rinsing habits. Supervise as necessary to minimize swallowing. You can show your child how to use the mouthwash by using it yourself. When your child uses mouthwash, start by diluting it with water to make it less potent until he or she gets the hang of spitting it all out.

It is important to choose a mouthwash that your child will actually want to use as well as one that is safe for children. Most children’s mouthwashes contain fluoride to give young teeth an extra boost. Some brands have special dyes that show your child the location of bacteria and food in the mouth; they may find this feature intriguing. Child-friendly mouthwashes also contain less alcohol and come in fun flavors like bubble gum or grape. For those who prefer natural options, there are products on the market that use naturally derived ingredients, such as xylitol, baking soda and essential oils.

Mouthwashes marketed to adults can be used, as well, but these are best used by teens. Young children often end up swallowing more mouthwash than they should, and adult mouthwashes may contain higher levels of ingredients that are harmful if ingested in large amounts.

Before using a new mouthwash, always check with us to make sure that it is safe for children—and happy swishing!

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Crowns Protect Little Teeth, Too

Most people are surprised to learn that young children can have dental problems that may be treated with crowns—even on baby teeth. A crown is a cover placed over the entire tooth. It is fabricated to look like a tooth and is usually used on teeth that are badly damaged or so decayed that there is not enough tooth structure left to support a large filling.

Although baby teeth eventually fall out and are replaced by permanent teeth, it is important to try to save them until they fall out on their own. Primary teeth enable the child to chew food and develop normal speech patterns, and help to guide emerging permanent teeth into place.

If your child has broken, decayed or severely discolored baby teeth or new permanent teeth, we may recommend treating the problem with a crown. There are several kinds of crown treatments, and we will take into consideration the type and extent of your child’s dental problem, as well as his or her biting patterns, when recommending treatment.

Conventional crowns are usually made of stainless steel, which is very durable. For a more esthetically pleasing result, stainless steel crowns placed on the front teeth may have a white veneer bonded to them. Conventional crowns protect the problem tooth, but their placement requires that the tooth be ground down to accommodate the adhesive needed to attach the crown firmly, resulting in the loss of even more natural tooth structure.

Another treatment option is the composite strip crown, sometimes called acid-etched resin crowns. They involve using a form that is filled with plastic material and placed over the tooth. Strip crowns take longer to place than do stainless steel crowns. In addition, injury to the tooth can break, loosen or dislodge this type of crown. Their durability may depend on how much tooth structure was left in the treated tooth and how prone the child is to cavities. A recent study of 200 children reported a strip crown survival success rate of more than 80% after two years. Strip crowns were found to be a satisfactory and esthetically pleasing treatment.

If your child needs a crown, we will recommend the option that is best suited to your child’s oral health and overall well-being.

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Guard Your Child’s Teeth Against Injuries and Grinding

If your child plays sports or grinds his or her teeth, your pediatric dentist may recommend a mouth guard, a covering worn over the teeth to protect them from injury. Sports injuries can cause chipped, broken or lost teeth, or other damage to the mouth area. Bruxism, or teeth grinding, may result in fractures, cracks or worn-down teeth. A mouth guard can protect the teeth from injury and offer relief from the painful results of bruxism.

To be effective, a mouth guard should fit well, feel comfortable and stay in place. It should also allow your child to breathe freely and talk without sputtering or spitting. Comfort and ease are essential, since children often do not want to wear a guard and may even remove an uncomfortable one when no one is looking.

Over-the-counter (OTC) mouth guards are inexpensive, but they have several disadvantages. The one-size-fits-all OTC guard does not provide an exact fit, so it may not be comfortable or effective. Teeth grinding could also cause it to loosen or fall out. Most OTC mouth guards require the child to clench his or her teeth to keep it in place—an inconvenience most children cannot manage.

The boil-and-bite mouth guard, another OTC style, is made from thermoplastic material that is placed in hot water to soften. Once it cools, the child bites down on it so that the mouth guard hardens to form around his or her teeth. This may give a better fit than the one-size model but is not recommended for children with braces.

The custom-fit guard is the option recommended by the American Dental Association. Molded according to exact measurements of the child’s mouth, the custom guard provides the best fit and function. Although they are more expensive, custom mouth guards may actually save money in the long run, because they prevent dental injuries and costly repairs more effectively.

If your child plays sports or grinds his or her teeth, make an appointment to see us. We can help you choose the best mouth guard for your child.

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Keep Your Child’s Gums Healthy

When we consider their oral health, we tend to think of our children’s teeth most often. But their gums should be on our minds as well. Gingivitis, or inflammation of the gums, is not uncommon in children, and it can signify more than just a little redness.

Although gingivitis is a condition unto itself, if left untreated it also can lead to more serious periodontal (gum) disease. Gingivitis can run in families, but whether it has affected other relatives or not, you and your child should check regularly for these gingivitis symptoms:

  • Bleeding: Gums may bleed with the gentlest brushing or flossing, or even at other times.
  • Color changes: Gums may be red-purple or bright red, possibly with a shiny appearance.
  • Swelling: A puffy appearance may accompany tenderness.
  • Bad breath: If bad breath (halitosis) does not go away with vigilant flossing and brushing, gingivitis may be the cause.
  • Receding gums: When gums recede, more of the front surface of the teeth than normal is visible, potentially exposing the roots.

If one or more of these symptoms exist, extra-vigilant oral care is the first line of defense to reduce inflammation, starting with a professional cleaning and evaluation. Afterward, even though gums may remain sensitive for one to two weeks, strict adherence to brushing and flossing routines has to begin. Mild anti-inflammatory pain medicine may help during this time. In addition, rinsing with an antibacterial mouthwash or warm salt water may reduce the chance of recurrence. In severe cases, specialized therapies can be used to keep disease from spreading to nearby tissues and tooth-supporting bone.

As boys and girls reach puberty, circulating hormones increase blood flow to the gums, resulting in greater sensitivity. Flossing, for instance, may hurt more, as may food particles or plaque. While the sensitivity is real and understandable, and may last for a while, your child needs to maintain good oral habits.

Helping children to remember that their gums will always be as important as their teeth is a lesson worth its weight in gold—or a lifetime supply of floss.

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Type 1 Diabetes: The Oral Health Challenge

If your child or teen has type 1 diabetes mellitus, you, your child and your pediatric dentist must form a proactive team to ward off potential oral effects of the disease. Give the dentist all the information you can about your child’s diabetes and its management. Periodontal (gum) disease is a frequent complication of type 1 diabetes, but with the right efforts, its effects can often be minimized.

Experts suspect that diabetes makes it easier for bacteria to infect and inflame gums, and that the chemicals (cytokines) produced by the inflammation find their way into the blood of people with diabetes more easily. These cytokines, in turn, can lead to increased insulin resistance and glycemic levels that are more difficult to control.

A key strategy, then, is to keep these inflammatory bacteria in the mouth to an absolute minimum. To accomplish this, your child needs to do the following:

  • Have his or her teeth professionally cleaned at least every six months.
  • Floss at least once a day.
  • Brush twice daily with a toothpaste designated as “antibacterial” by the American Dental Association.
  • Treat “dry mouth” as effectively as possible. Harmful bacteria grow better when there is less saliva and the saliva that is present contains excess glucose.
  • If periodontal symptoms such as bad breath, gum swelling, redness, bleeding and sensitivity develop between cleanings, bring your child in to see us.
  • If your child needs nonemergency dental work, be sure it is performed during a time when his or her blood sugar is well controlled.

The better your child’s glucose levels are managed, the better his or her oral health—and, of course, overall health—is likely to be. Follow the dentist’s recommendations as closely as possible.

Type 1 diabetes is a challenge for both child and parents. But taking ownership of self-management techniques—from as young an age as possible—is a time-tested way to keep at least some of its potential effects at bay. This includes acquiring good oral health habits and being attuned to any changes to the mouth and teeth that need to be treated by your dentist.

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When Your Child’s Tooth Injury Requires a Trip to the Emergency Room

Nearly half of all children will experience a tooth injury at some point in their lives. Falls, car accidents and sports are the most common causes of tooth injury in children. Most childhood tooth injuries do not lead to complications, yet any dental emergency can be potentially serious and should not be ignored.

Usually, administering immediate first aid and then visiting our office for treatment is enough to ensure a successful outcome. But when does a dental emergency warrant a visit to the hospital emergency room or walk-in clinic? Here are some guidelines to help you make that decision.

Bleeding: If your child incurs an injury to the teeth, gums, lips or mouth that causes bleeding that cannot be stopped with cold compresses or other first-aid remedies, take your child to the hospital. Use a moistened piece of gauze or tea bag to apply pressure to the area until you arrive at the emergency room.

Jaw fracture or dislocation: A jaw that appears to be fractured or dislocated warrants a trip to the hospital. This injury can cause bleeding and affect breathing. Do not attempt to move the jaw yourself. Use your hands to gently hold your child’s jaw steady during the trip to the hospital.

Infections: An abscess is an infection that occurs around the root of a tooth or in the space between the teeth and gums. It is a serious condition that can damage tissue and surrounding teeth; if left untreated, the infection can spread to other parts of the body. If your child has an oral infection that is causing pain, you can ease the discomfort by having him or her rinse several times a day with a mild solution of a half teaspoon of table salt dissolved in 8 ounces of water. However, if the pain persists or there is swelling that cannot be controlled with cold compresses, visit the emergency room as soon as possible.

A dislocated or knocked-out tooth: If a tooth is dislocated or knocked out and you are unable to reach your dentist, take your child to the hospital or to a walk-in clinic for prompt treatment. A knocked-out tooth should be replaced in the tooth socket as soon as possible. Try to do this yourself, then seek professional help. If you cannot replace the tooth, store it in cold milk and take it with you when you go for emergency treatment. Teeth replaced within 15 minutes usually heal successfully. After one hour, chances for tooth survival are slim.

In any circumstance, if your child experiences difficulty breathing, intense pain or fever that cannot be reduced, or seems disoriented, seek immediate emergency care. Then call our office for an assessment and, if necessary, further treatment.

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