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Posts for tag: pediatric dentistry

By Gary W. Machiko, DMD
December 15, 2016
Category: Oral Health
ActorDavidRamseyDiscussesBabyBottleToothDecay

Cavities can happen even before a baby has his first piece of candy. This was the difficult lesson actor David Ramsey of the TV shows Arrow and Dexter learned when his son DJ’s teeth were first emerging.

“His first teeth came in weak,” Ramsey recalled in a recent interview. “They had brown spots on them and they were brittle.” Those brown spots, he said, quickly turned into cavi­ties. How did this happen?

Ramsey said DJ’s dentist suspected it had to do with the child’s feedings — not what he was being fed but how. DJ was often nursed to sleep, “so there were pools of breast milk that he could go to sleep with in his mouth,” Ramsey explained.

While breastfeeding offers an infant many health benefits, problems can occur when the natural sugars in breast milk are left in contact with teeth for long periods.  Sugar feeds decay-causing oral bacteria, and these bacteria in turn release tooth-eroding acids. The softer teeth of a young child are particularly vulnerable to these acids; the end result can be tooth decay.

This condition, technically known as “early child caries,” is referred to in laymen’s terms as “baby bottle tooth decay.” However, it can result from nighttime feedings by bottle or breast. The best way to prevent this problem is to avoid nursing babies to sleep at night once they reach the teething stage; a bottle-fed baby should not be allowed to fall asleep with anything but water in their bottle or “sippy cup.”

Here are some other basics of infant dental care that every parent should know:

  • Wipe your baby’s newly emerging teeth with a clean, moist washcloth after feedings.
  • Brush teeth that have completely grown in with a soft-bristled, child-size toothbrush and a smear of fluoride toothpaste no bigger than a grain of rice.
  • Start regular dental checkups by the first birthday.

Fortunately, Ramsey reports that his son is doing very well after an extended period of professional dental treatments and parental vigilance.

“It took a number of months, but his teeth are much, much better,” he said. “Right now we’re still helping him and we’re still really on top of the teeth situation.”

If you would like more information on dental care for babies and toddlers, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “The Age One Dental Visit” and “Dentistry & Oral Health for Children.”

TreatingaBabyToothwithInnerDecaycanbeComplicated-butStillNecessary

Even though a child’s primary (“baby”) teeth eventually give way, it’s still important to treat them if they become decayed. Primary teeth serve as guides for the emerging permanent teeth — if they’re lost prematurely, the permanent tooth may come in misaligned.

If the decay, however, affects the tooth’s inner pulp, it poses complications. A similarly decayed adult tooth would be treated with a root canal in which all the pulp tissue, including nerve fibers and blood vessels, are removed before filling and sealing. Primary teeth, however, are more dependent on these nerves and blood vessels, and conventional filling materials can impede the tooth’s natural loss process. It’s better to use more conservative treatments with primary teeth depending on the degree of decay and how much of the pulp may be affected.

If the decay is near or just at the pulp, it’s possible to use an indirect pulp treatment to remove as much of the softer decay as possible while leaving harder remnants in place: this will help keep the pulp from exposure. This is then followed with an antibacterial agent and a filling to seal the tooth.

If the pulp is partially exposed but doesn’t appear infected, a technique called direct pulp capping could be used to cover or “cap” the exposed pulp with filling material, which creates a protective barrier against decay. If decay in a portion of the pulp is present, a pulpotomy can be performed to remove the infected pulp portion. It’s important with a pulpotomy to minimize the spread of further infection by appropriately dressing the wound and sealing the tooth during and after the procedure.

A pulpectomy to completely remove pulp tissue may be necessary if in the worst case scenario the pulp is completely infected. While this closely resembles a traditional root canal treatment, we must use sealant material that can be absorbed by the body. Using other sealants could inhibit the natural process when the primary tooth’s roots begin to dissolve (resorb) to allow it to eventually give way.

These all may seem like extraordinary efforts to save a tooth with such a short lifespan. But by giving primary teeth a second chance, their permanent successors will have a better chance of future good health.

If you would like more information on treating decay in primary 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 “Root Canal Treatment for Children’s Teeth.”

By Gary W. Machiko, DMD
October 20, 2014
Category: Oral Health
OralCareTipsforyourToddler

Caring for a young child can be overwhelming at times. Sometimes, it may feel like you can't read enough books to learn the correct way to do everything from potty training to feeding. It's also important to teach your child healthcare habits during these crucial years, so that they continue these habits for a lifetime!

Here are a few simple ways you can help your child to institute lifetime oral care habits.

  1. DO: Encourage your Child to Brush Every Day with Fluoride Toothpaste. Fluoride will help make your child's teeth more resistant to tooth decay. You should use a thin smear of fluoride toothpaste for children under age two and a pea-sized amount for older children. At age two, you can also begin empowering your child to brush, but make sure that you supervise and finish the job. Your child will probably need your help until around the age of six.
  2. DON'T: Share your Germs. Did you know that children are not born with the bacteria that cause tooth decay? In fact, the bacteria are transmitted to them from adults! You should never share a cup or spoon with your child. Also, next time you kiss your child, kiss him or her on the cheeks instead of the lips. Believe it or not, you can transmit harmful bacteria through this quick little kiss.
  3. DO: Limit your Child's Sugar Intake. When your child consumes sugar, the bacteria use the sugar to produce acids that dissolve tooth enamel, eventually leading to tooth decay. Saliva can neutralize those acids, but it needs enough time, 30 to 60 minutes, to work its magic. That is why it is important to limit sugar intake between meals.
  4. DON'T: Give Your Child a Bottle at Night. Juice, milk and even breast milk contain sugars that promote tooth decay, in particular during sleep, when less saliva is being produced. So, though it may be tempting, do not let your child go to bed with a bottle.
  5. DO: Take your Child to the Dentist Early. The American Academy of Pediatric Dentistry recommends that all children have their first dental visit by the age of one. Your toddler will benefit from regular dental visits, because we will monitor tooth decay, correct brushing techniques and also, most importantly, ensure that he or she is comfortable in the dental chair.
  6. DON'T: Allow your Child to Suck His or Her Thumb Past Age Three. Thumb sucking for comfort is a very normal behavior for babies and toddlers. However, if your child constantly sucks his or her thumb past the age of three, it can affect teeth alignment and jaw development.

If you would like more information about oral care for your child, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Dentistry and Oral Health for Children.”