Posts for tag: pediatric dentistry
Cavities can happen even before a baby has his first piece of candy. This was the difficult lesson actor David Ramsey of the TV shows Arrow and Dexter learned when his son DJ’s teeth were first emerging.
“His first teeth came in weak,” Ramsey recalled in a recent interview. “They had brown spots on them and they were brittle.” Those brown spots, he said, quickly turned into caviÂties. How did this happen?
Ramsey said DJ’s dentist suspected it had to do with the child’s feedings — not what he was being fed but how. DJ was often nursed to sleep, “so there were pools of breast milk that he could go to sleep with in his mouth,” Ramsey explained.
While breastfeeding offers an infant many health benefits, problems can occur when the natural sugars in breast milk are left in contact with teeth for long periods.Â Sugar feeds decay-causing oral bacteria, and these bacteria in turn release tooth-eroding acids. The softer teeth of a young child are particularly vulnerable to these acids; the end result can be tooth decay.
This condition, technically known as “early child caries,” is referred to in laymen’s terms as “baby bottle tooth decay.” However, it can result from nighttime feedings by bottle or breast. The best way to prevent this problem is to avoid nursing babies to sleep at night once they reach the teething stage; a bottle-fed baby should not be allowed to fall asleep with anything but water in their bottle or “sippy cup.”
Here are some other basics of infant dental care that every parent should know:
- Wipe your baby’s newly emerging teeth with a clean, moist washcloth after feedings.
- Brush teeth that have completely grown in with a soft-bristled, child-size toothbrush and a smear of fluoride toothpaste no bigger than a grain of rice.
- Start regular dental checkups by the first birthday.
Fortunately, Ramsey reports that his son is doing very well after an extended period of professional dental treatments and parental vigilance.
“It took a number of months, but his teeth are much, much better,” he said. “Right now we’re still helping him and we’re still really on top of the teeth situation.”
If you would like more information on dental care for babies and toddlers, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “The Age One Dental Visit” and “Dentistry & Oral Health for Children.”
It’s important for your child’s current and future health that we watch out for tooth decay. Taking x-rays is a critical part of staying one step ahead of this common disease.
But while x-ray imaging is commonplace, we can’t forget it’s still a form of radiation that could be potentially harmful, especially for a child whose tissues are rapidly developing. We must, therefore, carefully weigh the potential benefits against risk.
This concern has given birth to an important principle in the use of x-rays known as ALARA, an acronym for “As Low As Reasonably Achievable.” In basic terms, we want to use the lowest amount of x-ray energy for the shortest period of time to gain the most effectiveness in diagnosing tooth decay and other conditions.
A good example of this principle is a common type of radiograph known as a bitewing. The exposable x-ray film is attached to a plastic devise that looks like a wing; the patient bites down on it to hold it in place while the x-ray exposure takes place. Depending on the number of teeth in a child’s mouth, an appointment usually involves 2 to 4 films, and children are typically spaced at six months apart. Frequency of x-rays depends on your child’s tooth decay risk: lower risk, less need for frequent intervals.
Each bitewing exposes the child to 2 microsieverts, the standard unit for radiation measurement. This amount of radiation is relatively low: by contrast, we’re all exposed to 10 microsieverts of background radiation (natural radiation occurring in the environment) every day or 3,600 microsieverts annually. Even two appointments of four bitewings each year is a fraction of a percent of the background radiation we’re exposed to in the same year.
This conservative use of x-rays is well within safe parameters for children. As x-ray technology continues to advance (as with the development of digital imaging) we anticipate the exposure rate to diminish even more. Prudently used, x-rays remain one of our best tools for ensuring your child’s teeth are healthy and developing normally.
If you would like more information on the use of x-rays with children, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “X-Ray Safety for Children.”
If you were to look closely at many of your teeth, you would notice deep, natural grooves in the enamel surface. Often referred to as “pits and fissures,” these are some of the most difficult places in the mouth to keep clean. Toothbrush bristles simply can't reach deep enough into them to be effective; what's more, their warm, moist environment is the perfect breeding ground for bacterial growth. Consequently, pits and fissures are the most common location for tooth decay.
Children are especially susceptible — pits and fissures account for 43% of tooth decay in patients between the ages of six and seven. This is because when children's teeth erupt (first become visible in the mouth) the new enamel is more permeable and less resistant to decay than older teeth. Until the enamel matures, the risk for decay remains high.
Fortunately, in recent years there has been a decrease in the occurrence of tooth decay among children. Better hygiene practices, fluoride products and fluoridated drinking water, better nutrition, and regular dental visits are all factors in this improvement. One development in particular provides children an extra layer of protection — the use of sealants on the tooth surfaces.
Sealants are protective coatings applied to tooth surfaces, especially in pits and fissures that act as a barrier between bacteria and the immature enamel. Although the degree and extent of sealant use varies across the profession, many dentists recommend sealant application in children for all permanent molars and many primary molars soon after eruption.
The accessibility of regular dental care also plays a factor — those who have no or limited access (and thus are at high risk for tooth decay) may benefit from sealants on all of their back teeth, while children with regular care access (low risk) may need only a few. In fact, some dentists only recommend sealants in low-risk children when tooth decay is already present and after first removing as much decay as possible.
The goal, of course, is to prevent decay, or reduce its effects, in children. Sealants can help, but only when coupled with other measures — and a good habit of oral hygiene.
If you would like more information on sealants for children's teeth, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Sealants for Children.”