Dental Topics

Why are the Primary Teeth Important:

The main function of primary teeth is to enable a child to chew his food properly and absorb  essential nutrients.  They also give the growing face and airway physical structure and support.  It is important to care for primary teeth to ensure that a child can chew comfortably and grow.  If a tooth is broken or cavitated, pain and loss of tooth structure may occur.  Decay has a tendency to destroy more and more tooth structure over time as well as to affect other teeth in the mouth.  A decay free mouth is a great step toward a healthy body.

 

Dental Emergencies:

Toothache:

Clean the area of the affected tooth. Rinse the mouth thoroughly with warm water or use dental floss to dislodge any food that may be impacted. If the pain still exists, contact your child's dentist. Do not place aspirin or heat on the gum or on the aching tooth. If the face is swollen, apply cold compresses and contact your dentist immediately.

 

Cut or Bitten Tongue, Lip or Cheek:

Apply ice to injured areas to help control swelling. If there is bleeding, apply firm but gentle pressure with a gauze or cloth. If bleeding cannot be controlled by simple pressure, call a doctor or visit the hospital emergency room.

 

Knocked Out Permanent Tooth: If possible, find the tooth. Handle it by the crown, not by the root. You may rinse the tooth with water only. DO NOT clean with soap, scrub or handle the tooth unnecessarily. Inspect the tooth for fractures. If it is sound, try to reinsert it in the socket. Have the patient hold the tooth in place by biting on a gauze. If you cannot reinsert the tooth, transport the tooth in a cup containing the patient’s saliva or milk. If the patient is old enough, the tooth may also be carried in the patient’s mouth (beside the cheek). The patient must see a dentist IMMEDIATELY! Time is a critical factor in saving the tooth.

 

Chipped or Fractured Permanent Tooth: Contact your pediatric dentist immediately. Quick action can save the tooth, prevent infection and reduce the need for extensive dental treatment. Rinse the mouth with water and apply cold compresses to reduce swelling. If possible, locate and save any broken tooth fragments and bring them with you to the dentist.

 

Knocked Out Baby Tooth:

Contact your pediatric dentist during business hours. This is not usually an emergency, and in most cases, no treatment is necessary.

 

Chipped or Fractured Baby Tooth:

Contact your pediatric dentist.

Severe Blow to the Head: Take your child to the nearest hospital emergency room immediately.

Possible Broken or Fractured Jaw: Keep the jaw from moving and take your child to the nearest hospital emergency room.

 

Dental Radiographs (X-Rays):

Radiographs (X-Rays) are a vital and necessary part of your child’s dental diagnostic process. Without them, certain dental conditions can and will be missed.

 

Radiographs detect much more than cavities. For example, radiographs may be needed to survey erupting teeth, diagnose bone diseases, evaluate the results of an injury, or plan orthodontic treatment. Radiographs allow dentists to diagnose and treat health conditions that cannot be detected during a clinical examination. If dental problems are found and treated early, dental care is more comfortable for your child and more affordable for you.

 

The American Academy of Pediatric Dentistry recommends radiographs and examinations every six months for children with a high risk of tooth decay. On average, most pediatric dentists request radiographs approximately once a year. Approximately every 3 years, it is a good idea to obtain a complete set of radiographs, either a panoramic and bitewings or periapicals and bitewings.

 

Pediatric dentists are particularly careful to minimize the exposure of their patients to radiation. With contemporary safeguards, the amount of radiation received in a dental X-ray examination is extremely small. The risk is negligible. In fact, the dental radiographs represent a far smaller risk than an undetected and untreated dental problem. Lead body aprons and shields will protect your child. Today’s equipment filters out unnecessary x-rays and restricts the x-ray beam to the area of interest. High-speed film and proper shielding assure that your child receives a minimal amount of radiation exposure.

 

Toothpaste for Children:

Children’s teeth should be brushed at least twice daily with toothpaste that is ADA approved.  The American Academy of Pediatric Dentistry recommends that children under two years old use a smear of toothpaste and children between the ages of 2-5 use a pea sized portion of toothpaste.  Toothbrushing should always be supervised by a parent or caregiver.  If a child inadvertently swallows a large amount of paste a glass of milk should be administered and  the pediatrician or pediatric dentist should be consulted immediately to determine how much was ingested and whether  emergency care need be administered.

 

Pulp Therapy:

The pulp of a tooth is the inner, central core of the tooth. The pulp contains nerves, blood vessels, connective tissue and reparative cells. The purpose of pulp therapy in Pediatric Dentistry is to maintain the vitality of the affected tooth (so the tooth is not lost).

Dental caries (cavities) and traumatic injury are the main reasons for a tooth to require pulp therapy. Pulp therapy is often referred to as a "nerve treatment", "children's root canal", "pulpectomy" or "pulpotomy". The two common forms of pulp therapy in children's teeth are the pulpotomy and pulpectomy.

 

A pulpotomy removes the diseased pulp tissue within the crown portion of the tooth. Next, an agent is placed to prevent bacterial growth and to calm the remaining nerve tissue. This is followed by a final restoration (usually a stainless steel crown).

A pulpectomy is required when the entire pulp is involved (into the root canal(s) of the tooth). During this treatment, the diseased pulp tissue is completely removed from both the crown and root. The canals are cleansed, disinfected and, in the case of primary teeth, filled with a resorbable material. Then, a final restoration is placed. A permanent tooth would be filled with a non-resorbing material.

 

Bottles, Sippy Cups & Pacifiers:

Infants fulfill their nutritional needs by breast or bottle-feeding.   However, as they approach their first birthday (or possibly before), we encourage  conversion to cup drinking, although children that are nursing should continue to do so until they are ready to wean.  Sucking liquids in bottles and sippy cups encourages a low tongue posture due to the space that is taken up by the rubber nipple or sippy cup piece.  Ideally, the tongue should lay flush against the palate for good beathing, swallowing and facial development. 

 

Additionally, use of sweet liquids in a bottle of sippy cup can rapidly decay the baby teeth if the child falls asleep with it or holds it continually in his mouth.  Large diameter straws can be used to replace bottles and sippy cups in the case where liquids need to be transported in a no spill receptacle.  Pacifier sucking causes the same low tongue posture as  sippy cups and bottles.

 

Prevention:

 

Care Of Your Child's Teeth

Good Diet = Healthy Teeth

 

Healthy eating habits lead to healthy teeth. Like the rest of the body, the teeth, bones and the soft tissues of the mouth need a well-balanced diet. Children should eat a variety of foods from the five major food groups. Most snacks that children eat can lead to cavity formation. The more frequently a child snacks, the greater the chance for tooth decay. How long food remains in themouth also plays a role. For example, hard candy and breath mints stay in the mouth a long time,which cause longer acid attacks on tooth enamel. If your child must snack, choose nutritious foods such as vegetables, low-fat yogurt, and low-fat cheese, which are healthier and better for children's teeth.

 

How Do I Prevent Cavities?

Good oral hygiene removes bacteria and the leftover food particles that combine to create cavities. For infants, use a wet gauze or clean washcloth to wipe the plaque from teeth and gums. Avoid putting your child to bed with a bottle filled with anything other than water. See "Baby Bottle Tooth Decay" for more information.

For older children, brush their teeth at least twice a day. Also, watch the number of snacks containing sugar that you give your children.

The American Academy of Pediatric Dentistry recommends visits every six months to the pediatric dentist, beginning at your child’s first birthday. Routine visits will start your child on a lifetime of good dental health.

Your pediatric dentist may also recommend protective sealants or home fluoride treatments for your child. Sealants can be applied to your child’s molars to prevent decay on hard to clean surfaces.

 

Seal Out Decay

A sealant is a protective coating that is applied to the chewing surfaces (grooves) of the back teeth (premolars and molars), where four out of five cavities in children are found. This sealant acts as a barrier to food, plaque and acid, thus protecting the decay-prone areas of the teeth.