Emergencies for Pediatric Dentistry

Educational Topics

When should I bring my child for their first dental visit?
The Importance of a Growth and Development Assessment
The Importance Of Six-month Check-ups
Wild Smiles Philosophy On Behavior Management
Common Sense Eating to Prevent Decay
Sodas and Your Health
Baby Bottle or Sippy Cup Decay
Thumbs, Bottles, Sippy Cups, Fingers and Binkies
Thumb Sucking Cessation Technique
The Bottom Line on Fluoride
Preventing Fluorosis
Xylitol! A Sugar that Prevents Decay!
Brushing and Flossing for the Busy Family
Dental Tips For New or Expecting Mothers
Top Ten Shocking Facts about Childhood Dental Decay!
Sleep and Breathing
Remedy for Recurring Mouth Ulcers
What Causes Bad Breath?
Necessity of Stainless Steel Crowns
Interesting Fact About Tooth Decay

When should I bring my child for their first dental visit?

The American Academies of Pediatrics and Pediatric Dentistry recommend a child’s first dental visit by age one. The reason for changing from age 3 to age 1 is the alarming number of children with early childhood decay, mostly from not brushing teeth from the moment they erupt to more importantly, going to bed or nap with a bottle or sippy cup filled with a sugary liquid. This devastating explosion of cavities often requires general anesthesia to rehabilitate a child’s mouth. However, because some children erupt teeth early and damage to these new teeth can occur very quickly, we typically tell parents to bring their child to the dentist when they have their front upper and lower 8 teeth!

This first visit is designed to acquaint a child with a dental home but also to get parents the information and education they need to keep their child free from dental disease. Like most diseases, prevention requires timely and accurate information.

The most important information of parent can have is to understand completely the cavity process. (See the BUG Quiz video) Once a parent understands the cavity process, decisions about brushing, flossing, and diet become very clear.

The Importance of a Growth and Development Assessment

Your child’s growth and development is affected by many factors. These factors influence a young lady’s beauty or a young man’s good looks. As dentists of children, we are concerned about your child’s overall growth as well as the development of the face and jaws. With adequate growth and development of the face and jaws, your child will experience straighter teeth, better facial symmetry, and an overall better face. We are looking at the following factors when evaluating growth and development:

  1. Your child’s overall growth and development.
  2. The size and position of the upper jaw.
  3. The size and position of the lower jaw.
  4. The relationship of the upper and lower jaw.
  5. Skeletal and dental problems that lead to poor growth.
  6. Habits such as thumb, finger, or pacifier sucking.
  7. Habits such as tongue thrusting, lip biting, nail chewing.
  8. Dysfunctional swallowing habits.
  9. Obstructed (blocked) airway causing dysfunctional growth and development.
  10. Genetic problems.
  11. Poor diet leading some degree of malnutrition
  12. The effect of medicines on growth and development.

These are the factors evaluated at each your child’s 6 month check-up visits. By identifying these problems and correcting them, your child’s growth and development of their face and jaws will be more optimum and allow them to grow normally. There are many ways to correct these problems including habit correction, early orthodontic treatment, and solving airway problems. With regular growth and development evaluations, your child can have the most beautiful face and smile possible.

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The Importance Of Six-month Check-ups

Why is it important to have your teeth and mouth checked every six months? Of all parts of the body, the mouth and teeth are abused the most. If the mouth were a vehicle, it would be a work truck carrying heavy loads to and from caustic chemical plants. It is not treated like grandma’s sedan! Can you imagine not washing the truck at the chemical plant? It would rust and fall apart! What about the work truck tire if it had a hole in it? Are you going to get much work done! I don’t think so!

The mouth and teeth are subjected to grinding, tearing, biting fishing line, and chewing up or swishing around various acidic foods and drinks. The mouth is also infested with acid producing bugs or bacteria! These conditions are not unlike the chemical plant truck! Left unmaintained and unclean, the mouth will fall apart and fail you. The mouth is the first in line in the digestive process of food. This is critical to good nutrition. With decreased ability to chew food, a person’s nutrition begins to suffer, and their health declines accordingly. Teeth are also the source of tremendous pain when problems arise. Children are especially sensitive to this pain. Continuous discomfort or pain at the very least distracts children from their schoolwork, friends, and good behavior. At worst, it can be life threatening and most certainly a miserable way to live. Make sure to have your child’s teeth and mouth checked and cleaned every six months so they are in optimum condition to face the challenges ahead!

Wild Smiles Philosophy On Behavior Management

Wild Smiles believes we must treat the child with the cavities, not the cavities in the child. Forcing a child to cooperate against their will rarely works and can have long lasting emotional scars.

Wild Smiles very rarely uses restraint unless absolutely necessary in the case of trauma or life threatening conditions such as severe infections. Our standard regimens for behavior management start on a gradient and proceed to the level required to treat a child and still have that child excited about coming back to the dentist.

Level 1: This level of behavior management involves lots of communication and explaining to a child what will occur and offering them a way to have control of the situation by allowing them to raise their hand to stop at any point or for any reason.

Level 2: This level of behavior management involves the same as level 1 with the addition of nitrous oxide sedation. Nitrous oxide sedation removes a great deal of the anxiety associated with difficult situations and allows for better communication. Most children who have dental work done receive this level of behavior management. Many children who have work done are not anxious at all but just enjoy the comfort of the nitrous oxide sedation.

Level 3: This level involves the same as levels 1 and 2 with the addition of an oral sedative. This oral sedation is very safe at the doses we administer and delivers more anxiety and pain control than nitrous oxide alone. Our sedation is NOT administered to make a child go to sleep as this becomes unsafe in a dental office setting.

Level 4: For children where levels 1, 2, or 3 are not adequate to deliver safe and comfortable dental care, we offer dental treatment in a hospital or surgery center while under general anesthesia. We provide this service at no additional cost to the dental treatment, however there is a hospital fee that is generally covered in part by your major medical insurance. This hospital dentistry allows us to complete all treatment in one visit in about one to 2 hours without shots, numbness, pain, or restraint. Many children have benefited from this service and most, if not all parents, are very pleased with the dental results and the elimination of the emotional trauma associated with multiple difficult dental visits.

There are some situations where no treatment may be the treatment of choice. Sometimes a cavity unrestored is preferable to a negative experience. We can never forget that a child is attached to the tooth in question.

Common Sense Eating to Prevent Decay

After the bacteria on teeth are exposed to sugar, acid is produced which demineralizes (eats away) the teeth to a small degree. After about 20 minutes, the saliva will neutralize this acid and over the next two hours, the initial damage to teeth is repaired. With this information, changing the diet to enhance good dental health is possible.

If a person were to eat breakfast, brush, then not eat or snack on sugar until lunch, the teeth will have time to repair themselves from the damage from breakfast. The same applies between lunch and dinner. Brushing at night after dinner gives the teeth a long period of repair until breakfast the next day. If something sugary is consumed at night, brush again.

Eat meals and use moderation. Brush morning, at night, and after lunch if possible. Flossing once per day at night removes bacteria from between the teeth. Try not to snack or drink sugary foods or beverages in between meals and give teeth a chance to repair.

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Sodas and Your Health

Were you aware that in every soda there are approximately 9 teaspoons of sugar? Soda pop was introduced in this country many years ago. Recently, marketing soda pop has reached new highs making it widely available even in our schools. Many children have grown up on soda pop and think of no healthy alternative drinks when thirsty.

Unfortunately, soda pop causes many unwanted health problems of which many people are unaware. Soda pop contributes to childhood and adult obesity, caffeine addition that causes sleep disorders (which may be one of the contributing factors to ADD/ADHD), juvenile and adult diabetes, and of interest to the dental community, rampant decay. Sports drinks are also terribly destructive to tooth enamel also!

Because soda has large amounts of sugar and its high acidity (battery acid has a pH of 1, sodas average a pH of 2.5), it is the perfect destroyer of the enamel on your teeth. Not only do sodas destroy enamel and cause cavities, but they also contribute highly to the failure of tooth-colored fillings!

The American Academy of Pediatrics and the American Academy of Pediatric Dentistry are now campaigning against the soda pop manufacturers and distributors to remove soda pop machines from our school systems and offer alternative, healthier drinks such as bottled water.

Unfortunately, soda companies are more worried about profits than the health of our country!

Children especially teenagers, are very susceptible to rampant decay secondary to soda pop because of hormonal changes and less than adequate hygiene. Make sure your child knows how destructive sodas can be, introduce them to healthier beverages, and make sure they acquire the skills and discipline of good brushing and flossing. Their overall health depends on it!

Baby Bottle or Sippy Cup Decay

Baby Bottle Decay is a disease caused by putting your child to bed with a bottle (or sippy cup) that contains some sugary liquid. This sugary liquid such as milk, formula, juice, tea, or soda feeds the bacteria in the mouth and on the teeth. These bacteria then make acid. This acid dissolves the teeth creating holes we know as cavities. The bottle or sippy cup is not the problem. The problem is the sugary liquid bathing the teeth and feeding the bacteria for hours at a time. The number of children with Baby Bottle or Sippy Cup Decay is reaching epidemic proportions. These children are often malnourished, in pain, sleep deprived, and unable to do all the things that children should do. Treatment of this condition is generally hospitalization and general anesthesia to restore or remove their decayed teeth. Only by understanding this disease can prevention be achieved.

To PREVENT Baby Bottle or Sippy Cup Decay

  1. Never put your child to bed with a bottle or sippy cup containing a sugary liquid.
  2. Use the bottle or sippy cup as a feeding tool, not a pacifier.
  3. Begin to clean your child’s teeth as soon as they erupt by either brushing or wiping with a clean washcloth or gauze to remove these acid-producing bacteria.
  4. Make the last thing in your child’s mouth at night a toothbrush or cleaning cloth.
  5. Take your child to the dentist by the age of one year for a new baby exam and further information on your child’s dental well being.
  6. Wean child from breast or bottle by age 12 months.

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Thumbs, Bottles, Sippy Cups, Fingers and Binkies

Suckling is an innate instinct all animals have to be able to feed as an infant. It is natural and important. But like most habits or addictions, it is the natural gone too far!

A suckling issue may begin to affect a child’s well being such a changing the way they grow. These habits can cause an open bite where their teeth flare and possibly negatively affect the way the upper and lower jaw develops. These changes can negatively affect a child’s smile and face. With long term suckling habits, even with the help of orthodontics, some children never reach their full esthetic potential.

Stopping a suckling habit, whether it’s a bottle, sippy cup, pacifier, thumb, or fingers (and even toes!) is quite simple to discuss, but often very difficult to implement!

A bottle or sippy cup that contains a sugary substance such as milk, formula, juice, sweet tea, etc. that essentially has become a child’s pacifier can not only change growth patterns, but becomes very destructive to the teeth. The condition called Baby Bottle Decay or Sippy Cup Decay is epidemic today and sends over 300,000 children annually to the hospital for treatment under general anesthesia!

There are many ways to address these problems. Some are very positive ways to address them and some are more negative. Always start positive and work your way south as needed!

  1. Small Steps to a Big Thumb Habit. This very positive technique is included in the web site and requires time and patience.
  2. Thumb Sucking Contract (or finger, or pacifier). This method seems to work very well. It usually works better coming from a doctor rather than a parent. Others can often get a child to do something that a parent cannot. This contract is an agreement between the doctor and the child where the doctor promises to pay the child $10.00 out of their pocket if the child returns with the sucking habit cured! There is a lot of psychology behind this technique and only works when done correctly and prefaced by the right information. Children love to please the doctor almost as much as they like to take his money!
  3. Plant a pacifier and grow a “paciflower”! Tell your child your idea and plant them all! Make sure there is a flower there the next morning! You may also tell your child, “Did you know you can put a pacifier under your pillow like a lost tooth and get money for it from the Pacifairy?”
  4. Mail your pacifiers to another little girl or boy that cannot afford a pacifier. A picture of a “poor little girl or boy” helps!
  5. Mavala. Mavala is a product sold on the Internet that is the most awful tasting stuff you can imagine! You can put this on pacifiers, fingers, and thumbs and you cannot wash it off! This is a fairly negative method in the fact it punishes the behavior and forces your child to stop against their will. Like most addictions, the best fix is for the person with the problem to handle it by their own determination. A small twist to this technique achieves just that. Paint the object the child loves to suckle (thumb, finger, pacifier) after the child is asleep. Paint all pacifiers or all digits involved. Act dumb the next morning and tell them to go wash it off. Offer another painted pacifier. Once they see there is no end to the taste, even though upset, they soon decide sucking the object is not worth it. If they want new pacifiers, buy them. Make sure to open the package of pacifiers very discreetly and paint them, then reseal. Reapply Mavala to the thumb(s) or finger(s) every night until the desired decision. Very sneaky, but very effective!
  6. Throw all pacifiers or away and hang on! Be supportive, but be ready for a couple of difficult days and nights. Usually the storm passes in about two days, but the storm can be difficult. Prepare yourself for patience and insomnia!

A bottle should be discontinued at 1 year of age and never placed in your child’s mouth at bedtime, nap time, or allowed to be held in their mouth while watching TV. A child that does the above or reaches for the bottle or sippy cup when upset or bored has essentially turned their bottle or sippy cup into their pacifier. If the bottle or sippy cup contains some liquid with sugar, the risk for severe decay increases tremendously. Read “How do Cavities Happen. The Simple Answer” to fully understand how this occurs.

A sippy cup is awful nice to have to save your carpets and floors from spills and stains. Just remember sippy cups (and bottles) are “feeding tools”, not “pacifiers”!!

Thumb Sucking Cessation Technique

Understanding the problem:

Thumb sucking or finger sucking results from an infant’s innate urge to suckle and often occurs in utero. Like all abnormal conditions, it is the normal gone too far. Once this activity becomes a habit, thumb suckers feel they must suck their thumb. It is about this time when adults tell them they should not or can not. The child then loses everyday to their thumb until the thumb has power over the child. They constantly hear, “Take your thumb out!” or “Only babies suck their thumb!” or other such commands that evaluate or invalidate them. Loss after loss after loss, the thumb eventually makes the decisions, not the child!

How should this be handled?

Truth #1: For one to change, one must make the decision to change by one’s own determinism.

So, understanding the above truth, we are really trying to bring the child to a condition of being more powerful than their thumb on a gradient they can handle. This has to be the child’s decision. What parents want is really of no consequence! We want the child to start believing they are capable of deciding whether to suck their thumb or not. It is important to teach a child why you want them to stop. This will involve showing them pictures of other children who sucked their thumb with flared teeth and open bites and children that did not suck their thumbs with normal teeth and bites. We may ask, “Do you see what happens when you suck your thumb?” “Which of these kids do you want your smile to look like?” “Would you like a way to stop that’s easy?” When they “Yes’ you say “Great! Let me show you how!” Remember, we can help another to reach their own decision only by asking the right questions.

Thumb sucker

Not a thumb sucker

Truth #2: Any habit can be overcome when handled on a slight enough gradient.

We want to bring this child to a very gentle cause over the habit of sucking their thumb, not the effect of it. Telling them to stop IMMEDIATELY is way too steep of a gradient and more than they can confront. But they can confront stopping for a few minutes.

The Program:

Our goal here is to start creating wins for the child, even if they are small wins. Many small wins add up to bigger and bigger wins. Ask the child “Do you know when you want to suck your thumb? Is there an exact moment that you say to yourself, ‘I need my thumb now’?” With some questioning, they will generally answer you, ‘yes’. You then acknowledge with “Good! Now when you want to put your thumb in, can you let mommy or daddy know that you are ready to suck your thumb? Good! Now mommy or daddy will look at the clock and we’ll wait a few minutes before you start sucking your thumb.” The wait may be 5 minutes, it may be 6 minutes. The gradient all depends on what the child can easily confront. You may have to start with 1 minute! When the time period is up, tell the child “Way to go! You won! You beat the thumb!” This will be most likely the first time the child has ever won with the thumb so lay it on thick and really admire this win. Children literally will soak up the admiration and will repeat any activity that gives them admiration. This same procedure is repeated each night or each time the child feels the need to suck their thumb. When the parent feels they are comfortable with the waiting time to suck the thumb, they can increase the gradient by whatever amount of time which they and the child can agree. It may go as follows: “Do you think tonight you might make 12 minutes, 15 minutes?” If the answer is affirmative, say “Cool!” or “Awesome”. Continue to increase the gradient until you achieve the end result.


The END RESULT is a child that after a period of time looks at their mom or dad and states “Well, I can suck my thumb if I want or I don’t have to suck my thumb if I want. It’s my choice!” When someone wins enough, they begin to have control over whatever has the power over them. How many wins does it take for one to be in good control? As many as it takes! So be patient!

This technique will work with all habits, whether child or adult. Good luck and remember that admiration and self-determination can melt most problems!

The Bottom Line on Fluoride

Fluoride studies do prove to help prevent cavities by making the minerals in teeth stronger and more resistant to acid. (See “What causes cavities, the simple answer” to see where this acid comes from) Fluoride has proven to be beneficial when it comes into contact with the actual teeth in the mouth. There are two ways for this to happen.

One, fluoride can be placed directly onto an erupted tooth. Fluoride varnish is the most beneficial fluoride as it adheres directly to the teeth for about 5 to 6 hours and loads the tooth with fluoride. Foams and gels stay in contact with teeth for only a few minutes and are essentially non-beneficial.

Two, fluoride can come into contact with an erupted tooth after being ingested and have the body excrete the fluoride through the saliva. There is very little evidence that systemic fluoride helps an unerupted tooth become more cavity resistant, but lots of evidence that it may harm an unerupted tooth by causing fluorosis (discolored enamel, sometimes chalky).

Doctors at Wild Smiles believe fluoride should be determined for each child individually. One size (drug) does not fit all. Some children may need no fluoride, where others may need fluoride supplements. We feel fluoride supplements are best achieved by using topical fluoride products only and not ingested fluoride products where fluorosis can arise.

Preventing Fluorosis

Fluorosis can be devastating to a young person when they see their permanent teeth are discolored and/or chalky. Permanent front teeth are forming between birth and about one year of age and THIS is the age when too much fluoride can damage their permanent front teeth! Other teeth are forming between the ages of 1 and 8 years old and fluoride must be carefully monitored throughout these years, but especially from birth to one!

Permanent teeth are only susceptible to fluorosis while they are forming and permanent teeth are forming between birth and 8 years old. Permanent front teeth are forming between birth and 1 year of age. Babies between birth and six months should ingest no fluoride. Babies between 6 months and one year should have no more than .25 ppm per day. One 8 oz. glass of public drinking water contains about .25 ppm. This one 8 oz. glass of water is the total amount of fluoride an infant between 6 months and one year can have daily. If a parent is mixing formula with 8 oz. of water 4 times a day, this is 4 times too much fluoride!

When formula feeding, mix formula with water that contains no fluoride to prevent fluorosis. A source of non-fluoridated water is Gerber Pure Baby Water. Breast milk contains very little fluoride even if mom is consuming fluoridated water. If using a pre-mixed formula, check to see if it contains fluoride. Remember, between birth and 6 months, a baby should have no fluoride and between 6 months and 1 year of age, no more than .25 ppm should be ingested daily!

Be careful with water filters as some state they remove fluoride, when in actuality, they do not! Be careful how much fluoridated water your child drinks as each 8 oz. glass adds an additional .25-ppm. Check the recommended dosage levels of systemic fluoride for your child’s age (go to the AAPD web site). Keep in mind that fluoride may be in other drinks and foods made with fluoridated water!

Swallowing toothpaste is another way children can ingest too much fluoride. It is best to use non-fluoridated toothpaste until your child can safely spit excess toothpaste. Two non-fluoridate toothpastes for children are AquaFresh Training Toothpaste and Oragel Toddler Training Toothpaste. Children’s toothpaste generally has 1000 - 1500-ppm fluoride along with a detergent to help break up and remove the film of bacteria. Adult toothpaste generally has 2500-ppm fluoride and definitely should not be used for children, especially if they cannot spit the excess! Children should not be using fluoridated toothpaste when they are known to swallow the excess toothpaste.

The latest on the amount of fluoridated toothpaste to use at each brushing is a “smear” of toothpaste across the tip of the toothbrush. Do not use the past “pea sized” dollop of toothpaste and certainly not the antiquated ribbon of toothpaste for children. Children up to 6 years of age should be supervised to make sure that are spitting the excess toothpaste and not swallowing the toothpaste!

Fluorosis affects about 30% of children in the U.S. and may actually be much more in certain areas of the country. It is a huge problem that can be devastating to a young person’s self-esteem and very costly to remedy. Remedies range from no treatment all the way to porcelain crowns or veneers.

Fluoride is helpful in preventing cavities when it comes into contact with the teeth. Fluoride can be placed topically on the teeth by using fluoride varnish, fluoride toothpaste, and fluoride home gels. Fluoride in water only helps the teeth when the fluoride is secreted onto the teeth via saliva. Ingested fluoride cannot help developing permanent teeth, but can only harm them by causing fluorosis. Because of this emerging data, many cities and townships are removing fluoride from the public water. It will become vital that every person, especially children be evaluated for their fluoride needs. This evaluation is critical in deciding a child’s risk for decay. All risk factors for dental decay are evaluated and a child’s fluoride needs can be determined. These risk factors are many and include their oral hygiene, diet, anatomy and closeness of the teeth, and family history.

Consult with your dentist on your child’s risk for decay and their fluoride needs.

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Xylitol! A Sugar that Prevents Decay!

Xylitol interferes with the metabolic processes of strep mutans and inhibits proliferation of the bacteria, thus reducing strep mutans' concentration in the oral cavity. For maximum effectiveness, the gum should be sweetened with 100% xylitol. It is also effective for delaying the inoculation of strep mutans from caregiver to infant. The Journal of Dental Research reported a 2001 Finnish study in which mothers chewed xylitol sweetened gum 4X daily from the time their infants were 3 months old until they were 24 months old ( the mean age of inoculation is 18 months of age). At the age of 5 years, children whose mothers chewed xylitol gum had a 71-74% decrease in the incidence of caries over the control group. Soderling of the

The only OTC gum I am aware of that is sweetened entirely with Xylitol is Koo-Aid Koolerz.

Although it isn't really answering your question, here is a nice ist of xylitol-containing products I came across last year. It would be nice to know how much xylitol is in them.

Xylitol-containing Dental Products: BetaCell Oral Rinse • B-Fresh Gum • Biotene Dry Mouth Gum • Biotene Dry Mouth Toothpaste • Biotene mouthwash • Chicklets Sugarless gum • Clen-Dent Chewing Gum • Epic Gum • Epic Mints • Epic Oral Rinse • Epic Toothpaste • Kiss My Face AloeDyne FreshBreath Mouthwash • Oral Balance Mouth Moisturizing Gel, by Biotene • Rembrandt Naturals toothpaste • Rembrandt toothpaste for Canker Sore Sufferers • Spry Gum • Spry Xylitol Breath Mints • Squigle Toothpaste • Smint Mints • TheraBrite Oral Rinse • TheraGum Xylitol Gum • Tom’s of Maine Natural Anticavity & Dry Mouth Toothpaste • Tom’s of Maine Natural Homeopathic-style Toothpaste • Tom’s of Maine Natural Liquid Toothpaste • Tom’s of Maine Natural Mouthwash, Oral Moistening • Tom’s of Maine Natural Toothpaste for Sensitive Teeth • Trident gum • XyliChew mints

Brushing and Flossing for the Busy Family

Most kids say they brush two times a day, but most parents never know if they really brushed or not! The day begins for most parents in a rush hoping to get the kids up and dressed for school. If the child is lucky, they might get a POPTART! The clock is ticking and now you ask the question, “Did you brush your teeth?” After a ‘No” or a squirming “Yes”, you send them back to the bathroom to brush. This makes you even later and angrier; or you say “Alright, we’ll brush real good tonight”. Am I close to the truth? It happens at my house also!

Let’s just play a little game of logistics and move their toothbrush and toothpaste to the kitchen sink. Here they can eat and then quickly brush right after their breakfast. The same can be done right after dinner or before bedtime all within sight of the overseeing parent so they can’t cheat on the amount of time they brush and you can check to see how well they brushed.

Now for the nightcap, while watching television, surfing the net, or talking on the phone, place plastic-handled flossers wherever the kids may settle during the evening. You are more likely to floss! Parents should floss at the same time setting a good example! Have the kids floss while watching television. Have them floss while talking on the phone. Have them floss while on the computer! Linking a common activity to flossing works! Parents can get very good at “flinging” a flosser to their child from the next sofa! You know you’ve won when your child can’t watch television without a flosser!

These flossers can be bought for very little money in packs of 100. Your kids win, you win and the dentist can take a breather!

Dental Tips For New or Expecting Mothers

  • Because dental decay results from a bacterial infection, the bugs that cause decay can be transmitted to your baby.
  • Make sure your oral hygiene is immaculate to prevent transmitting these bugs to your baby.
  • Brush and floss 2-3 times daily during pregnancy and until your child reaches three years old. This is the time when children are most susceptible to these bugs.
  • Never taste test your baby’s food.
  • Never lick their pacifier clean.
  • Sadly, kissing your baby on the mouth can transmit these bacteria!
  • Wash your hands before putting them in your baby’s mouth.
  • Chewing xylitol gum 3 times daily can significantly reduce the number of bacteria in your mouth.
  • Breastfeeding is far superior for your baby’s facial growth and development and their overall health.
  • Heating milk or formula in a plastic bottle releases plastic particles (plasticizers) into the liquid and is not good for your baby’s long-term health!

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Top Ten Shocking Facts about Childhood Dental Decay!

  1. Childhood dental decay is a chronic bacterial infection in the mouth caused mainly by the Streptococcus mutans bacteria!
  2. Childhood dental decay is a transmissible disease usually transferred from the child’s primary caregiver!
  3. Childhood dental decay is the most common chronic childhood disease in U.S. and the world, 5 times more common than asthma, 20 times more common than diabetes!
  4. Childhood dental decay is caused by bacteria and sugar together making acid that dissolves teeth and IS NOT HEREDITARY!
  5. Childhood dental decay is now at epidemic proportions, mostly due to excessive consumption of soft drinks and lack of parental help with brushing and flossing!
  6. Childhood dental decay is responsible for 52 million hours of school lost annually to treat dental problems, more than any other childhood disease!
  7. Childhood dental decay treatment cost people more money than any other childhood disease!
  8. Childhood dental decay is a major reason for child ER and surgical hospitalizations in the U.S.!
  9. Childhood dental decay places children at higher risk for decay as an adolescent and adult!
  10. Childhood dental decay can be preventable with good brushing, flossing, and routine dental check-ups every 6 months!

Sleep and Breathing

As dentists for children, we are very concerned about children’s airways and their ability to breathe well. Breathing also affects how they sleep. Why is this important? There are many reasons, and these are but a few.

First, children grow and develop as well as they breathe. Muscles and bones grow according to their ability to function. If breathing is poor, growth and development is poor. This is especially true with the growth and development of the face and head. When the growth and development of the face and head is inadequate, a child’s full beauty potential may never be realized. Therefore, it is very important for growing children to be able to breathe well.

Secondly, children sleep as well as they breathe. The snoring child (or adult) never sleeps to their full potential. In addition, poor sleep not only affects a child’s growth but also affects a child’s emotional stability. All parents soon understand that their child will act and behave as well as they sleep. If they stay up late, emotional breakdowns usually occur the next day. When children have enlarged tonsils, adenoids, or other obstructive airway problem, snoring is the result. It is a sign something is not right. Although these children seem to sleep all night long, they generally flip and flop and never reach the stages of sleep needed for restful sleep. They are generally difficult to awaken and crash at night. Some children become real “Couch Potatoes” and begin to get overweight while others become “wired”! They also have a very difficult time in school because they cannot pay attention. Unfortunately, this phenomenon is all too often misunderstood and labeled ADD/ADHD and prescribed amphetamine-like drugs. Now they have a sleep problem and a drug problem! Combine airway problems with a diet consisting of lots of sugar, caffeine, and amphetamine-like drugs; we soon find ourselves in a very messy situation that no one can figure out!

Thirdly, children that have breathing issues must use their mouths to breathe. This dries the mouth, especially at night, and increases the risk for dental decay. The air breathed through the mouth instead of the nose is also not humidified and filtered and leads many children to more sicknesses and unhealthy conditions than you may think. The research is ongoing.

So what do you do?

  • Certainly have your pediatrician, ENT, or dentist look at your child’s airway for any physical obstructions like enlarged tonsils or adenoids.
  • Watch your child sleep. Do they snore? Do they flip and flop throughout the night?
  • What foods make up their primary diet? Foods high in processed sugars, red dye, and drinks with caffeine can severely affect how children sleep and act.
  • How do your child’s medicines affect their sleep. Children taking allergy medications or other medications like ADD/ADHD stimulant drugs can severely affect how they sleep.
  • Consider a Sleep Study to rule out Sleep Apnea, especially when children are young.

Remember, air is life and life excels when children can breathe!

Remedy for Recurring Mouth Ulcers

Eliminate sodium lauryth sulfate (SLS). Most toothpastes, shampoos, and clothes washing powders contain the detergent SLS. Some people do not tolerate this detergent on their skin or in their mouth. This detergent breaks down the lining of the mouth and causes painful ulcers. Switch to toothpaste that does not contain SLS. Two brands that do not contain SLS are: Biotene and Tom’s of Maine.

Some people have a slight Vitamin C deficiency that affects the lining of their mouth and may cause ulcers. A multivitamin with 500 to 1000 mg of Vitamin C may help ulcers. More Vitamin C may be taken, but watch for stomach upset. Multivitamins with vitamin C, iron, folic acid, and B 12 have shown improvements in the frequency of these painful ulcers.

Some people are deficient in the amino acid L-lysine and this may lead to ulcers in the mouth. L-lysine supplements may help heal and prevent ulcers.

Over usage of anti-inflammatory medicines such as Ibuprofen may cause recurring mouth ulcers.

Food allergies may contribute the recurring mouth ulcers. Common foods that cause ulcers are tomatoes and pineapple. Keeping a food diary may help you locate a possible food allergy.

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What Causes Bad Breath?

The creation of bad breath is a natural and ongoing process in our mouths each day. There are millions of germs in our mouths that break down protein particles that are always present in our saliva. This results in the production of foul smelling sulfur gas. This gas is what we perceive as embarrassing bad breath.

Though the problem is virtually universal (100% of the population has experienced the problem daily in the form of morning breath, and at least 10% suffer from a more serious bad breath problem), it is a social taboo that can interfere with every relationship.

When addressing a child with bad breath, it is important to be discreet as to not make a child upset or think something is wrong about them. We typically examine the child first to make sure there are no obvious dental reasons for the bad breath. Do they have an abscessed tooth? Do they have a broken tooth or cavity that is trapping food that eventually turns rancid!

If we see no apparent dental problems, we then turn to their oral hygiene. We take a few weeks for a child and parent to improve their brushing and flossing twice to three times daily including using a tongue scraper to eliminate as many bacteria from the mouth as possible. The top of the tongue harbors the majority of the bacteria in the mouth in crevices and on the long cells on the tongue. A tongue scraper can dramatically reduce the bacteria that cause much of the bad breath. If the malodor disappears, most likely the reason for bad breath was a simple hygiene problem.

Some children, even after great oral hygiene, still have bad breath. In these cases, other sources must be addressed. The main source of chronic bad breath is the airway.

Children can have tonsils that are inflamed with pus pockets known as tonsilloliths These rotten spots on the tonsils can emit a rotten odor.

Some children are chronic mouth breathers because of an airway problems such as large tonsils, large adenoids, nasal polyps, or allergies that cause the mouth to dry. Medications such as antihistamines and ADHD drugs can also dry the mouth. Saliva is important in cleaning the mouth and killing bacteria. Bacteria that thrive in a dry environment devour sulfur-containing foods and produce a rotten egg smell.

Sinus infections or allergies that cause post-nasal drip feed certain bacteria that also produce these volatile sulfur-containing compounds that produce bad breath.

Another source of bad breath may be the use of antibiotics. Antibiotics can selectively kill good bacteria allowing other bacteria to thrive causing bad breath. Sometimes antibiotics can allow fungal cells such a candidiasis or thrush to dominate in the mouth and this can cause bad breath.

Various systemic diseases can cause bad breath. If all the above causes are eliminated, and bad breath continues, a visit to the pediatrician is recommended for a more thorough evaluation.

Chlorine Dioxide: chlorine dioxide is an oxidizing agent (this means that it releases oxygen). Because most of the bacteria that cause bad breath are anaerobic (meaning, they prefer to live in environments devoid of oxygen), exposing them to an oxidizing agent can help to minimize their numbers. Chlorine dioxide has the ability to neutralize volatile sulfur compounds. It also has the ability to degrade the precursor components utilized by bacteria use when making VSC's. The net effect is that the overall concentration of volatile sulfur compounds found in a person's breath is reduced, and as a result their breath will be more pleasant.

Three chlorine dioxide mouthrinses available are ProFresh, DioxiRinse, and Freshen.

Necessity of Stainless Steel Crowns

Dentistry today has progressed with new technology and esthetics. Tooth colored fillings have become more the standard than the exception. Unfortunately, some baby teeth that are badly broken down by decay or have decay in areas hard to clean do not do well with these standard fillings. These teeth are best treated by placing stainless steel crowns. These crowns, although not as esthetic, will generally restore a tooth for their entire lifetime preventing future dental problems and future treatment. A child that is apprehensive about dentistry is certainly better served by placing a durable, trouble free restoration so that future dentistry can be as minimal as possible. Baby teeth restored using stainless steel crowns usually do much better and are replaced by healthy natural permanent teeth later in life.

Interesting Fact About Tooth Decay

More specifically, tooth decay was not a major problem before the fateful year of 1886. Why 1886? That was the year that Coca Cola was first invented and marketed. What’s Coca Cola got to do with it?

Prior to the mass marketing of Coca Cola, Americans (and the rest of the world) tended to eat sweet foods only at meal times, which in an agrarian society happened at only two or three discreet times a day. Meals were high in fat, but fairly low in sugar, and the closest most people got to sugar during the course of a week was a slice or two of mom’s apple pie. In general, tooth decay wasn’t all that much of a problem with most Americans unless they were among the upper classes. Rich folks were somewhat more likely to indulge in recreational eating and could afford to hire cooks and servants whose livelihood was dependent on pleasing their employers.

Almost everyone who is prone to caries has a specific habit in which sugar soaks the teeth many, many times a day. These sugar habits account for perhaps 95% of all cavities! If you can identify the habit, and substitute water, or a non-sugared food in its place, the decay simply stops where it is.

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