Posts for tag: pediatric dentistry
Teeth lost to tooth decay can have devastating consequences for a child’s dental health. Not only can it disrupt their current nutrition, speech and social interaction, it can also skew their oral development for years to come.
Fortunately, we have a number of preventive tools to curb decay in young children. One of the most important of these, dental sealants, has been around for decades. We apply these resin or glass-like material coatings to the pits and crevices of teeth (especially molars) to help prevent the buildup of bacterial plaque in areas where bacteria tend to thrive.
Applying sealants is a simple and pain-free process. We first brush the coating in liquid form onto the teeth’s surface areas we wish to protect. We then use a special curing light to harden the sealant and create a durable seal.
So how effective are sealants in preventing tooth decay? Two studies in recent years reviewing dental care results from thousands of patients concluded sealants could effectively reduce cavities even four years after their application. Children who didn’t receive sealants had cavities at least three times the rate of those who did.
Sealant applications, of course, have some expense attached to them. However, it’s far less than the cost for cavity filling and other treatments for decay, not to mention future treatment costs resulting from previous decay. What’s more important, though, is the beneficial impact sealants can have a child’s dental health now and on into adulthood. That’s why sealants are recommended by both the American Dental Association and the American Academy of Pediatric Dentistry.
And while sealants are effective, they’re only one part of a comprehensive strategy to promote your child’s optimum dental health. Daily brushing and flossing, a “tooth-friendly” diet and regular dental cleanings and checkups are also necessary in helping to keep your child’s teeth healthy and free of tooth decay.
Watching your newborn develop into a toddler, then an elementary schooler, a teenager, and finally an adult is one of the most exciting and rewarding experiences there is. Throughout the years, you’ll note the passing of many physical milestones — including changes that involve the coming and going of primary and permanent teeth. Here are some answers to frequently asked questions about children’s dental development.
When will I see my baby’s first tooth come in?
The two lower front teeth usually erupt (emerge from the gums) together, between the ages of 6 and 10 months. But your baby’s teeth may come earlier or later. Some babies are even born with teeth! You will know the first tooth is about to come in if you see signs of teething, such as irritability and a lot of drooling. The last of the 20 baby teeth to come in are the 2-year molars, so named for the age at which they erupt.
When do kids start to lose their baby teeth?
Baby teeth are generally lost in the same order in which they appeared, starting with the lower front teeth around age 6. Children will continue to lose their primary teeth until around age 12.
What makes baby teeth fall out?
Pressure from the emerging permanent tooth below the gum will cause the roots of the baby tooth to break down or “resorb” little by little. As more of the root structure disappears, the primary tooth loses its anchorage in the jawbone and falls out.
When will I know if my child needs braces?
Bite problems (malocclusions) usually become apparent when a child has a mixture of primary and permanent teeth, around age 6-8. Certain malocclusions are easier to treat while a child’s jaw is still growing, before puberty is reached. Using appliances designed for this purpose, orthodontists can actually influence the growth and development of a child’s jaw — to make more room for crowded teeth, for example. We can discuss interceptive orthodontics more fully with you at your child’s next appointment.
When do wisdom teeth come in and why do they cause problems?
Wisdom teeth (also called third molars) usually come in between the ages of 17 and 25. By that time, there may not be enough room in the jaw to accommodate them — or they may be positioned to come in at an angle instead of vertically. Either of these situations can cause them to push against the roots of a neighboring tooth and become trapped beneath the gum, which is known as impaction. An impacted wisdom tooth may lead to an infection or damage to adjacent healthy teeth. That it is why it is important for developing wisdom teeth to be monitored regularly at the dental office.
If you have additional questions about your child’s dental development, please contact us or schedule a consultation. You can also learn more by reading the Dear Doctor magazine articles “Losing a Baby Tooth” and “The Importance of Baby Teeth.”
To get your child on the right track for lifelong dental health we recommend you begin their dental visits around their first birthday. You can certainly visit your family dentist, especially if you and your family feel comfortable with them. But you also might want to consider a pediatric dentist for your child's dental needs.
What's the difference between a family dentist and a pediatric dentist? Both offer the same kind of prevention and treatment services like cleanings, fluoride applications or fillings. But like their counterparts in medicine — the family practice physician and pediatrician — the family dentist sees patients of all ages; the pediatric dentist specializes in care for children and teens only.
In this regard, pediatric dentists undergo additional training to address dental issues specifically involving children. Furthermore, their practices are geared toward children, from toys and child-sized chairs in the waiting room to “kid-friendly” exam rooms decorated to appeal to children.
While your family dentist could certainly do the same, pediatric dentists are also skilled in reducing the anxiety level that's natural for children visiting the dental office. This can be especially helpful if you have a special needs child with behavioral or developmental disorders like autism or ADHD. A pediatric dentist's soothing manner and the calm, happy environment of the office can go a long way in minimizing any related anxiety issues.
Your child may have other needs related to their oral health that could benefit from a pediatric dentist. Some children have a very aggressive form of dental caries disease (tooth decay) called early childhood caries (ECC).Â If not treated promptly, many of their teeth can become severely decayed and prematurely lost, leading to possible bite problems later in life. Pediatric dentists are well-suited to treat ECC and to recognize other developmental issues.
Again, there's certainly nothing wrong with taking your child to your family dentist, especially if a long-term relationship is important to you (your child will eventually “age out” with a pediatric dentist and no longer see them). It's best to weigh this and other factors such as your child's emotional, physical and dental needs before making a decision.
Proactive dental care is an essential part of childhood growth. But that care can be much harder for children with chronic health issues than for healthier children.
“Chronic condition” is an umbrella term for any permanent and ongoing health issue. Asthma, Down’s syndrome, cystic fibrosis, congenital heart defects and many others fall under this umbrella, with varying symptoms and degrees of intensity. But they all have one common characteristic — a long-term effect on all aspects of a child’s health.
That includes the health of a child’s teeth and gums. Here, then, are a few areas where a chronic health condition could impact dental care and treatment.
Ineffective oral hygiene. Some chronic conditions like autism or hyperactivity disorder (ADHD) that affect behavior or cognitive skills can decrease a child’s ability or willingness to brush or floss; some conditions may also limit their physical ability to perform these tasks. Parents and caregivers may need to seek out tailored training for their child’s needs, or assist them on a regular basis.
Developmental defects. Children with chronic conditions are also more likely to have other developmental problems. For example, a child with Down, Treacher-Collins or Turner syndromes mayÂ be more likely to develop a birth defect called enamel hypoplasia in which not enough tooth enamel develops. Children with this defect must be monitored more closely and frequently for tooth decay.
Special diets and medications. A child with a chronic condition may need to eat different foods at different times as part of their treatment. But different dietary patterns like nutritional shakes or more frequent feedings to boost caloric intake can increase risk for tooth decay. Likewise, children on certain medications may develop lower saliva flow, leading to higher chance of disease. You’ll need to be more alert to the signs of tooth decay if your child is on such a diet or on certain medications, and they may need to see the dentist more often.
While many chronic conditions raise the risk of dental disease, that outcome isn’t inevitable. Working with your dentist and remaining vigilant with good hygiene practices, your special needs child can develop and maintain healthy teeth and gums.
If you would like more information on dental care for children with chronic health 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.”
The best way to prevent dental visit anxiety in your children is start those visits around their first birthday, and continue with them through childhood. Age One visits are the best way to ensure they're comfortable with the dentist now and that they'll continue the habit into adulthood.
But in spite of your best efforts and those of your dental provider, there's no guarantee your child won't experience dental visit anxiety at some point. If that happens, we recommend conscious sedation.
Conscious sedation is the use of certain medications to help a patient relax. It's not the same as anesthesia, which eliminates pain by numbing tissues (local anesthesia) or inducing unconsciousness (general anesthesia). During conscious sedation a patient remains awake or at the most in a dream-like state, can still respond to touch or verbal commands, and although monitored doesn't require assistance in heart or lung function.
We can induce this relaxed state in a number of ways: orally, with medication given by mouth a short time before the visit; intravenously, the medication delivered through a drip directly into the bloodstream; or by inhalation, usually nitrous oxide gas mixed with oxygen and delivered by mask.
Oral sedation is the most common. On the day of the procedure, we'll give your child one or more sedative drugs, usually in syrup form. For best results we advise they eat a low-fat dinner the night before and not eat or drink any food or liquid afterward. We typically use Midazolam and Hydroxyzine, both of which are proven safe and fast acting.
During the procedure, we'll also assign a team member to monitor their vital signs while they're under the influence of the drugs. We may also employ special positioning or immobilization equipment to keep movement to a minimum.
After the procedure, we'll continue to monitor vitals until they return to pre-sedation levels. The child should remain home the rest of the day to rest and return to school the next day.
Conscious sedation is regulated by states: providers must be trained and licensed to administer sedation drugs with continuing education requirements. Even so, the use of sedation for children is becoming more widespread and helps to safely ensure they're getting the dental care they need.
If you would like more information on comfortable dentistry for 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 “Sedation Dentistry for Kids.”