Posts for tag: pediatric dentistry
Your sweet, good-natured baby has seemingly gone from zero to grumpy overnight. The reason is simple: They’re teething.
Teething is a natural process in which a baby’s first teeth (primary teeth) begin to break through the gums, usually between six and nine months of age. This process continues intermittently until all twenty of the primary teeth erupt, sometime around age 3.
This uncomfortable and sometimes painful experience can cause gum swelling, biting and gnawing, chin rash and drooling. Your child may become irritable not only from this physical discomfort but also from disrupted sleep patterns and decreased appetite that often accompanies teething.
While you may have an unhappy baby while they’re teething, there’s usually no cause for concern. This is a natural process all children encounter, and the best thing you can do is make them as comfortable as possible. An exception would be accompanying diarrhea, fever or lingering crankiness—these could be symptoms of a more serious condition. If you begin to notice these, consult your doctor as soon as possible.
During teething there are a number of things you can do to reduce irritation. For one, allow your child to chew on clean, chilled (not frozen) teething rings, or a cold wet washcloth. The cold will help numb their irritated gum tissues. Massaging their gums with a clean finger can also help counteract the pressure caused by the incoming tooth.
If your doctor advises, you can also give your child over-the-counter pain relievers like acetaminophen or ibuprofen in an age-appropriate dosage. But be sure you give these medications orally and not rub them on the gums—some ingredients in them could burn the tissues. You should also not apply rubbing alcohol to the gums for the same reason. And avoid products with the numbing agent Benzocaine® in children less than two years of age unless your doctor advises otherwise.
Teething isn’t always a pleasant time for your baby or you, but it’s necessary—and temporary. In no time at all this discomfort will pass, and in its place will be their first set of teeth.
If you would like more information on teething, 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 “Teething Troubles: How to Help Keep Your Baby Comfortable.”
It’s common for kids to be less than enthusiastic about visiting the dentist. For some, though, it’s even more of a challenge: A child with extreme anxiety and fear during dental visits could interfere with them receiving the dental care they need. The impact could even extend into adulthood.
Recognizing the need to reduce this high anxiety, dentistry has used a number of pharmacological tools for many years that relax a child during dental care. Sedatives have often been the only choice for reducing anxiety, especially during extensive procedures and treatments. But now there’s a promising new approach in dentistry that doesn’t depend on drugs.
Cognitive behavioral therapy (CBT), a psychotherapeutic method used for decades to treat depression, phobias and eating disorders, has been investigated recently as a possible approach for relieving children’s dental anxiety. During CBT, trained therapists use specific behavioral techniques to help patients develop mental and emotional strategies for dealing with stress.
During the usual course of CBT therapy, a therapist meets in counseling sessions with patients weekly over several months to help them change their routine thinking or behavior surrounding a stressful issue. Initially, the therapist guides the patient toward understanding the underlying causes for their negative reaction to the issue. They then work with the patient to devise an objective way to test whether those emotions and beliefs about the issue are true.
Using this effective method for changing behavioral and emotional responses for dental anxiety has had encouraging results from initial research. One study found CBT successfully reduced dental anxiety among a majority of a group of European children ages 9 through 16 who participated in the method.
CBT isn’t an overnight cure, often requires a number of months to achieve results. But for children who suffer from extreme fear of professional dental care, this drug-free method may provide long-term benefits that extend well past their childhood years.
Ask any kid and they'll tell you just how valuable "baby" teeth really are—out of the mouth, of course, and under their pillow awaiting a transaction with the Tooth Fairy. But there's more to them than their value on the Fairy Exchange Market—they play a critical role in future dental health.
Primary teeth provide the same kind of dental function as their future replacements. Children weaned from nursing can now eat solid food. They provide contact points for the tongue as a child learns to speak. And they play a role socially, as children with a "toothsome" smile begin to look more like what they will become when they're fully mature.
But primary teeth also serve as guides for the permanent teeth that will follow. As a future tooth develops below the gum line, the primary tooth preserves the space in which it will erupt. Otherwise, the space can be taken over by other teeth. This crowds out the intended tooth, which may erupt out of position or remain impacted below the gum line.
In either case, the situation could create a poor bite (malocclusion) that can be quite costly to correct. But if we can preserve a primary tooth on the verge of premature loss, we may be able to reduce the impact of a developing malocclusion or even prevent it.
We can help primary teeth last for their intended lifespan by preventing tooth decay with daily oral hygiene or clinically-applied sealants and topical fluoride. If they do become infected, it may be worth the effort to preserve them using procedures similar to a root canal treatment.
If a tooth can't be preserved, then we can try to reserve the empty space for the future tooth. One way is a space maintainer, which is a stiff wire loop attached to metal band bonded around an adjacent tooth. This keeps other teeth from drifting into the space until the permanent tooth is ready to erupt, at which time we can remove the appliance.
Your child may be anxious to get another tooth to put under their pillow. But helping that primary tooth go the distance will be more than worth it for their future dental health.
If you would like more information on the care and treatment of baby 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 “Importance of Baby Teeth.”
The American Academy of Pediatrics and other healthcare organizations recommend breastfeeding as the best means for infant feeding. While bottle feeding can supply the nutrition necessary for a baby's healthy development, breastfeeding also provides emotional benefits for both baby and mother.
But there might be an obstacle in a baby's mouth that prevents them from getting a good seal on the mother's breast nipple—a small band of tissue called a frenum. This term describes any tissue that connects a soft part of the mouth like the upper lip or tongue to a more rigid structure like the gums or the floor of the mouth, respectively.
Although a normal part of anatomy, frenums that are too short, thick or inelastic can restrict a baby's lip or tongue movement and prevent an adequate seal while nursing. The baby may adjust by chewing rather than sucking on the nipple. Besides a painful experience for the mother, the baby may still not receive an adequate flow of breast milk.
Bottle-feeding is an option since it may be easier for a baby with abnormal frenums to negotiate during nursing. But the problem might also be alleviated with a minor surgical procedure to snip the frenum tissue and allow more freedom of movement.
Often performed in the office, we would first numb the frenum and surrounding area with a topical anesthetic, sometimes accompanied by injection into the frenum if it's abnormally thick. After the numbing takes effect, we gently expose the tissue and cut it with either surgical scissors or a laser, the latter of which may involve less bleeding and discomfort. The baby should be able to nurse right away.
If you wait later to undergo the procedure, the baby may already have developed compensation habits while nursing. It may then be necessary for a lactation consultant to help you and your baby "re-learn" normal nursing behavior. It's much easier, therefore, to attempt this procedure earlier rather than later to avoid extensive re-training.
While there's little risk, frenum procedures are still minor surgery. You should, therefore, discuss your options completely with your dental provider. Treating an abnormal frenum, though, could be the best way to realize the full benefits of breastfeeding.
Your child's oral development generates considerable changes during their "growing up" years. There are a number of things you can do to help support their development—but also things you shouldn't.
Here are 4 things not to do if you want your child to develop healthy teeth and gums.
Neglect daily oral hygiene. To set the best long-term course for optimum oral health, begin cleaning the inside of your child's mouth even before they have teeth. Simply use a clean wet washcloth to wipe their gums after feeding to reduce bacterial growth. Once you begin seeing teeth, start brushing them every day with just a smear of toothpaste; at about age 2 you can increase that to a pea-sized amount. And don't forget to teach them when they're ready to brush and floss on their own!
Allow unlimited sugar consumption. Besides the effect it has on overall health, sugar is also a prime food source for disease-causing oral bacteria. You can reduce the sugar available for bacterial growth by avoiding sugary snacks and limiting sweet foods to meal times. Less sugar means less bacterial growth—and a lower risk of tooth decay for your child.
Put them to bed with a sugary liquid-filled bottle. Although a bedtime bottle may help calm your baby to sleep, it could also increase their risk of tooth decay. Allowing them to sip on sugar-filled liquids like juice, milk, formula or even breast milk encourages bacterial growth. Bacteria in turn produce acid, which can dissolve the minerals in enamel and open the door to tooth decay. Sipping through the night also deprives saliva of adequate time to neutralize acid.
Wait on dental visits until they're older. Dental and pediatric associations all recommend first taking your child to the dentist sooner rather than later—by their first birthday. Starting dental visits early will help you stay ahead of any developing tooth decay or other oral problems. And just as important, your child will have an easier time "warming up" to the dental office environment at a younger age than if you wait. Dental visit anxiety, on the other hand, could continue into adulthood and interfere with regular dental care.
If you would like more information on the best dental care practices for your child, 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 “Top 10 Oral Health Tips for Children.”