Posts for tag: tooth decay
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.”
What should you do if your child complains about a toothache? Before calling our office, try first to learn what you can about the toothache.
You should first ask them where exactly the pain is coming from — one particular tooth or a generalized, dull ache. Also try to find out, as best they can tell you, when they first noticed the pain. Try then to look at the tooth or area where they indicate the pain is coming from: since tooth decay is a prime cause for tooth pain, you should look for any obvious signs of it like brown spots or cavities. You should also look at the gums around the teeth for any redness or swelling, a sign of an abscess or periodontal (gum) disease.
If you notice any of these signs, the pain persists for more than a day, or it has kept the child awake during the night, you should have us examine them as soon as possible. If you notice facial swelling or they’re running a fever, please call and we will see them immediately. If it’s definitely tooth decay, it won’t go away on its own. The longer we wait to treat it, the worse its effects in the mouth.
In the meantime, you should also try to alleviate the pain as best you can. If when looking in the mouth you noticed food debris (like a piece of hard candy) wedged between the teeth, try to gently remove it with dental floss. Give them ibuprofen or acetaminophen in an appropriate dosage for their age to relieve pain, or apply an ice pack on and off for about 5 minutes at a time to the outside of their jaw.
If any of these remedies stops the pain within an hour, you can wait until the next day to call for an appointment. If the pain persists, though, then an abscess could be developing — you should call that day to see us.
Regardless of when the pain stops, or whether you see any abnormal signs, it’s still important your child see us for an accurate diagnosis. Their toothache maybe trying to tell you something’s wrong — and the earlier a problem is found and treated, the better the outcome.
If you would like more information on dental problems in young children, 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 “A Child’s Toothache.”
Most often, all of your child’s primary teeth will eventually be replaced by permanent teeth, but you shouldn’t consider them less important — there are serious consequences for losing a primary tooth prematurely. Besides providing a means for a child to chew food and speak clearly, primary teeth also save space for the permanent teeth to erupt; a premature loss could lead to malocclusions (bad bites) that may result in costly orthodontic treatment later.
That’s why it’s important to fight tooth decay in primary teeth. By keeping them healthy and in place until it’s time for their departure, their permanent replacements have a better chance of erupting into their proper positions.
Here are 4 tips for preventing tooth decay in primary teeth:
Begin daily oral hygiene when teeth first appear. Begin brushing with fluoride toothpaste as soon as the first primary teeth come in. Brushing removes bacterial plaque, the primary cause of tooth decay, and fluoride strengthens enamel. Because they tend to swallow toothpaste rather than spit it out, use just a smear of toothpaste for infants and toddlers, and a pea-sized amount for ages two and older.
Start regular dental visits by the child’s first birthday. By beginning regular checkups around age 1, we’ll have a better chance of discovering developing tooth decay or other problems early. You’re also setting a good foundation for what should be a lifelong habit for optimum dental health.
Limit sugar consumption. The oral bacteria that cause tooth decay feed on leftover carbohydrates like sugar, so you should limit intake especially between meals. One culprit to watch out for: a bedtime bottle filled with formula, milk or fruit juices, all of which contain carbohydrates (sugar). Water or no bottle at all is a better alternative.
Consider topical fluoride or sealants for extra protection. In some circumstances, we may advise protecting the enamel of newly erupted teeth with an applied sealant. These protective coatings fill in porous pits and fissures in young teeth to deny access to disease. Supplemental fluoride will further strengthen young tooth enamel.
Taking these measures and remaining vigilant to the first signs of decay can go a long way toward preserving your child’s teeth. Their future oral health depends on it.
If you would like more information on dental care for children, 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 “Dentistry & Oral Health for Children.”
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.”
“Cut down on sweets, especially between meals” is perhaps one of the least popular words of advice we dentists regularly give. We’re not trying to be killjoys, but the facts are undeniable: both the amount and frequency of sugar consumption contributes to tooth decay. Our concern isn’t the naturally occurring sugars in fruits, vegetables, grains or dairy products, but rather refined or “free” sugars added to foods to sweeten them.
The World Health Organization and the U.S. Food and Drug Administration both advise consuming no more than 50 grams (about ten teaspoons) of sugar a day. Unfortunately, our nation’s average per person is much higher: we annually consume around 140 pounds per capita of refined sugars like table sugar or high fructose corn syrup, more than three times the recommended amount. Soft drinks are the single largest source of these in our diets — Americans drink an average of 52 gallons every year.
The connection between sugar and tooth decay begins with bacteria that ferments sugar present in the mouth after eating. This creates high levels of acid, which causes the mineral content of tooth enamel to soften and erode (a process called demineralization) and makes the teeth more susceptible to decay. Saliva naturally neutralizes acid, but it takes about thirty minutes to bring the mouth’s pH to a normal level. Saliva can’t keep up if sugars are continually present from constant snacking or sipping on soft drinks for long periods.
You can reduce the sugar-decay connection with a few dietary changes: limit your intake of sugar-added foods and beverages to no more than recommended levels; consume sweets and soft drinks only at meal times; replace sugar-added foods with fresh fruits and vegetables and foods that inhibit the fermentation process (like cheese or black and green teas); and consider using mint or chewing gum products sweetened with xylitol, a natural alcohol-based sugar that inhibits bacterial growth.
Last but not least, practice good oral hygiene with daily brushing and flossing, along with regular office cleanings and checkups. These practices, along with limits on refined sugar in your diet, will go a long way toward keeping your teeth and mouth healthy and cavity-free.
If you would like more information on the relationship of sugar and dental disease, 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 “Nutrition & Oral Health.”