Posts for: October, 2015
Children’s ailments come and go, and thankfully most are relatively minor. Some children, however, have impaired health caused by a more serious, chronic disease. For them, the condition impacts not only their overall well-being, but also their dental health.
This often occurs because the specific healthcare needs of children with these chronic conditions are given greater priority over dental health. Besides the treatment focus, children with special healthcare needs may have physical, mental or behavioral limitations that can make it difficult to keep up with oral hygiene and care.
Children with autism or attention deficit and hyperactivity disorder (ADHD) may have a difficult time practicing (or cooperating with) oral hygiene tasks. Some may not have the physical ability to perform effective brushing and flossing without assistance. In these cases, it’s important for parents or caregivers to seek out instruction and training that will optimize their children’s hygiene and so reduce the chance of dental disease.
Certain medications for chronic conditions can increase mouth dryness, or they’re acidic or sweetened with sugar, any of which can increase the child’s risk for tooth decay or periodontal (gum) disease. Parents or caregivers should consult with their physicians about these medications or if they could be administered at mealtime to minimize their effect on the mouth.
Finally, there’s the direct effect some conditions may have on a child’s teeth and gums. Children with severe gag reflexes due to their condition may not be able to tolerate toothpaste or be able to spit it out completely. Other conditions can give rise to dental defects such as enamel hypoplasia in which not enough enamel develops to adequately protect the teeth.Â Such defects call for special dental attention and closer monitoring of teeth and gum health.
The key is to see us and the other healthcare providers for your child’s chronic condition as part of an overall team. Sharing information and regarding both dental and general care as part of a comprehensive strategy will help to prevent dental problems from developing and improve their health.
If you would like more information on dental care for children with chronic conditions, 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 “Managing Tooth Decay in Children with Chronic Diseases.”
Like the rest of their bodies, children’s teeth and mouth are on a rapid development track. By the time they’re young adults, they will have had two sets of teeth, extensive bone growth and a noticeable change in their features. The natural process is truly amazing.
But dental disease can easily derail their development, with tooth decay the most common problem children encounter. More than at any other time of life, preventive dental care is a top priority.
True preventive care for your child includes the entire mouth, not just the teeth. Our main focus, of course, is to head off tooth decay before it develops, including the application of topical fluoride or sealants when appropriate. But we also monitor bite development and provide protection against sports injuries or other forms of trauma with customized mouth guards.
You also have a part to play in your child’s preventive dental care. It begins when your child’s first teeth begin to emerge in the mouth — the point when you should begin brushing them. You can also reduce the risk of dental disease by providing a nutritious diet that’s high in fresh fruits and vegetables and low in sugar, especially between-meal snacks.
You should also start regular dental visits around their first birthday. This is not only the best time to begin professional care, but your child will also have an easier time at this age becoming comfortable with visiting the dentist than waiting until they’re older.
Taking care of your child’s teeth is a working partnership between you and us: we provide the professional care your child needs to develop properly, while you look to their daily hygiene and nutrition, which is just as important for your child’s healthy development. Through our partnership, we can ensure your child is getting the very best start toward a lifetime of healthy teeth and gums.
There are good reasons, for both health and appearance, to replace a missing tooth with a dental implant or similar restoration as soon as is practical. The bone around a tooth socket diminishes the longer it remains empty, up to 25% the first year. And, of course, your smile is less attractive, especially with a highly visible tooth.
If it’s your teenager, though, you may need to wait on a permanent restoration because their jaws are still developing. An implant placed before completion of jaw development could eventually appear out of alignment with neighboring teeth.
Our biggest concern is protecting bone health at the site of the missing tooth. We can do this and encourage growth by placing bone grafts (processed minerals from another donor) that serve as scaffolds on which surrounding bone can grow. Grafts usually dissolve (resorb) over time, but the rate of resorption can be slowed for a younger patient in need of long-term bone growth.
Planned orthodontic treatment can usually go on as scheduled. The orthodontist may accommodate the tooth loss by adding a temporary tooth within the braces or other device that matches the color and shape of the patient’s natural teeth. The orthodontist will also take care to maintain the empty space for a future implant or other restoration.
A dental implant is considered the best option for a missing tooth, not only for its life-like appearance and durability, but also its ability to encourage bone maintenance. Timing, though, is essential for teenagers. As it grows, the upper jaw will tend to move forward and down. Natural teeth move with this growth; implants, though, are attached differently and won’t move with the jawbone. While the other teeth around them move, the implants can appear to shrink back resulting in an unattractive smile appearance. So waiting until the jaw has finished growing is important.
For most people, jaw growth finishes by age twenty-one for men, women usually faster, but each person is different. The dentist’s expertise and experience, coupled with comparisons of adult family members’ facial appearances, will help determine the right time to undertake a permanent restoration for the best outcome both for health and a permanent, attractive smile.
If you would like more information on treating teenagers with missing teeth, please contact us to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dental Implants for Teenagers.”
For over a hundred years dental amalgam — a combination of silver, mercury, tin and other metals — has been an effective filling material for teeth damaged by decay. But it has one major drawback — its metallic appearance stands out in stark contrast to the natural color of teeth.
As an alternative, composite resin fillings can match the color, shape and texture of natural teeth. These materials and the techniques used to bond them are proving just as effective as and more aesthetically pleasing than dental amalgam.
Fillings help protect and preserve a decayed tooth. By first removing decayed tooth structure through drilling, the resulting void is filled with durable material that strengthens the tooth and provides it protection from further decay.
The ultimate goal for restoration is to return the tooth to as near normal form and function as possible. Dental amalgam serves well in terms of function, providing the tooth strength in the face of the daily biting forces it encounters. In contrast, composite resins excel in appearance, but haven’t always matched the durability of amalgam. They’re material construction has improved over time, though, as well as the techniques used to bond them to teeth.
Most of these bonding techniques incorporate layering. The first step is to seal the dentin (the porous, living tissue just below the enamel); we then build up the composite material layer by layer within the tooth using special bonding adhesive and curing lights. In some cases where a large volume of tooth structure must be replaced, the restoration is first formed on the tooth and then removed for curing before being cemented into the tooth or a separate restoration is formed by a dental lab.
The end result is a tooth which both looks and functions like a fully intact tooth. Though care must be taken not to subject composite resin restorations to undue forces (no cracking open nutshells, for example), your new filling should continue to serve you and look great for a long time to come.
If you would like more information on metal-free restorations, 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 “The Natural Beauty of Tooth Colored Fillings.”
“You need a root canal,” isn’t something you want to hear during a dental visit. But whatever your preconceptions about it may be, the fact is root canal treatments don’t cause pain — they alleviate it. What’s more, it may be your best chance to save a tooth that’s at high risk for loss.
First of all, root canal treatments address a serious problem that may be occurring inside a tooth — tooth decay that’s infiltrated the pulp chamber. If it’s not stopped, the decay will continue to advance through the root canals to the bone and weaken the tooth’s attachment. To access the pulp and root canals we first administer a local anesthesia and then create an opening in the tooth, typically in the biting surface.
After accessing the pulp chamber, we then remove all the pulp tissue and clean out any infection. Â We then fill the empty pulp chamber and root canals with a special filling and seal the opening we first created. The procedure is often followed some weeks later with a laboratory made crown that permanently covers the tooth for extra protection against another occurrence of decay and protects the tooth from fracturing years later.
Besides stopping the infection from continuing beyond the roots and saving the tooth from loss, root canal treatments also alleviate the symptoms caused by decay, including tenderness and swelling of surrounding gum tissue and sensitivity to hot and cold foods or pressure when biting down. And, it reduces pain — the dull ache or sometimes acute pain from the tooth that may have brought you to our office in the first place.
General dentists commonly perform root canal treatments; in more complicated cases they’re performed by an endodontist, a specialist in root canal treatments. Afterward, any discomfort is usually managed with non-steroidal anti-inflammatory drugs (NSAID) such as ibuprofen or aspirin.
Root canal treatments are a common procedure with a high rate of success. Undergoing one will end the pain and discomfort your infected tooth has caused you; more importantly, your tooth will gain a new lease on life.
If you would like more information on root canal treatments, 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 “Common Concerns about Root Canal Treatment.”