Children’s Dentistry

    iStock_000009141589XSmallGood dental habits start early, and our goal for our youngest patients is to help develop a good relationship with the dentist for great oral health and a lifetime of beautiful smiles.  Most children see the dentist around age three but it is very important to bring them in sooner if you notice any problems with their teeth.

    Our first concern is that your child feels comfortable, so we are committed to explaining all the sights and sounds they will experience at our office.  We use only digital x-rays which  emit far less radiation than traditional x-rays and only recommend them when necessary.  We will clean and check their teeth for proper development of adult teeth which may already be present and those still forming in the jaw.  We also offer preventive measures to keep teeth strong and cavity-free, such as fluoride supplements and dental sealants.

    Many parents ask about orthodontics at their child’s dental visits.  We’ll be sure to tell you if and when it’s time for your child to see an orthodontist.  We can begin to determine the need for an orthodontic visit around the ages of 7-8 when adult teeth are erupting.  Each smile is different, and with some children we may want to watch a bit longer.  If we do find it’s necessary for your child to see an orthodontist, we can also provide you with referrals to trusted colleagues.

    Fluoride

    fluoride-treatmentFluoride is a mineral that occurs naturally in many foods and water. Every day, minerals are added to and lost from a tooth’s enamel layer through two processes, demineralization and remineralization. Minerals are lost (demineralization) from a tooth’s enamel layer when acids — formed from plaque bacteria and sugars in the mouth — attack the enamel. Minerals such as fluoride, calcium, and phosphate are redeposited (remineralization) to the enamel layer from the foods and waters consumed. Too much demineralization without enough remineralization to repair the enamel layer leads to tooth decay.

    Fluoride helps prevent tooth decay by making the tooth more resistant to acid attacks from plaque bacteria and sugars in the mouth. It also reverses early decay. In children under 6 years of age, fluoride becomes incorporated into the development of permanent teeth, making it difficult for acids to demineralize the teeth. Fluoride also helps speed remineralization as well as disrupts acid production in already erupted teeth of both children and adults.

    When Is Fluoride Intake Most Critical?

    It is certainly important for infants and children between the ages of 6 months and 16 years to be exposed to fluoride. This is the timeframe during which the primary and permanent teeth come in. However, adults benefit from fluoride, too. New research indicates that topical fluoride — from toothpastes, mouth rinses, and fluoride treatments — are as important in fighting tooth decay as in strengthening developing teeth.

    In addition, people with certain conditions may be at increased risk of tooth decay and would therefore benefit from additional fluoride treatment. They include people with:

    • Dry mouth conditions : Also called xerostomia, dry mouth caused by diseases such as Sjögren’s syndrome, certain medications (such as allergy medications, antihistamines, antianxiety drugs, and high blood pressure drugs), and head and neck radiation treatment makes someone more prone to tooth decay. The lack of saliva makes it harder for food particles to be washed away and acids to be neutralized.
    • Gum disease: Gum disease, also called gingivitis, can expose more of your tooth and tooth roots to bacteria increasing the chance of tooth decay.
    • History of frequent cavities: If you have one cavity every year or every other year, you might benefit from additional fluoride.
    • Presence of crowns and/or bridges or braces: These treatments can put teeth at risk for decay at the point where the crown meets the underlying tooth structure or around the brackets of orthodontic appliances.

    We are happy to discuss if you could benefit from additional fluoride.

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    Gum Disease

    phototake_rm_photo_of_gingivitisThe longer plaque and tartar are on teeth, the more harmful they become. The bacteria cause inflammation of the gums, which is called “gingivitis.” With gingivitis, the gums become red, swollen and can bleed easily. Gingivitis is a mild form of gum disease that can usually be reversed with daily brushing and flossing, and regular cleaning by a dentist or dental hygienist. This form of gum disease does not include any loss of bone and tissue that hold teeth in place.

    When gingivitis is not treated, it can advance to “periodontitis” (which means “inflammation around the tooth”). In periodontitis, gums pull away from the teeth and form spaces (called “pockets”) that become infected. The body’s immune system fights the bacteria as the plaque spreads and grows below the gum line. Bacterial toxins and the body’s natural response to infection start to break down the bone and connective tissue that hold teeth in place. If not treated, the bones, gums, and tissue that support the teeth are destroyed. The teeth may eventually become loose and have to be removed.

    The main goal in treating gum disease is to control the infection. The number and types of treatment will vary, depending on the extent of the gum disease. Any type of treatment requires that the patient keep up good daily care at home. The doctor may also suggest changing certain behaviors, such as quitting smoking, as a way to improve treatment outcome.

    The dentist, periodontist, or dental hygienist removes the plaque through a deep-cleaning method called scaling and root planing. Scaling means scraping off the tartar from above and below the gum line. Root planing gets rid of rough spots on the tooth root where the germs gather, and helps remove bacteria that contribute to the disease.

    Sealants

    11112-SealantAfterDental sealants are thin plastic coatings that are applied to the grooves on the chewing surfaces of the back teeth to protect them from  tooth decay.  Permanent molars are the most likely teeth to benefit from sealants as most tooth decay in children and teens occurs on the biting surfaces of these teeth.

    The first permanent molars usually erupt around age 6 and the second molars erupt around age 12 and it is best if the sealant is applied soon after the teeth appear before they have a chance to decay.

    Applying sealants does not require drilling or removing tooth structure and the process is short and easy. After the tooth is cleaned, a special gel is placed on the chewing surface for a few seconds. The tooth is then washed off and dried. Then, the sealant is painted on the tooth. The dentist or dental hygienist also may shine a light on the tooth to help harden the sealant. It takes about a minute for the sealant to form a protective shield.

    A sealant can last for as long as 5 to 10 years. Sealants are checked at each regular dental appointment and can be reapplied if they are no longer in place.