Dr.lu International Dental Clinic--your kid's teeth

A Visit To Your Dentist
A visit to the dentist should be pleasant and beneficial. Establishing a relationship with your dentist and his or her staff will help to make your visits to the office more pleasant and comfortable. By getting to know the people who you are working with, will make asking questions about your mouth easier and thereby help to remove some of the fears you may have associated with going to the dentist. When your dentist speaks to you about the condition of your mouth and recommends treatment to you, feel free to ask questions about the type of work, what is involved and what the outcome should be. The more you know about your mouth, the more involved you can be in the care and maintenance of your mouth. Since you will have the greatest amount of contact with the dental staff, get to know the rest of the dental team.

The staff is trained to assist the Dentist. A hygienist may clean and polish your teeth and instruct you in proper home care. If you have any problems or questions the hygienist will alert the doctor for you. The office staff is responsible for the appointments, billing and insurance. They are well versed in these areas and are usually able to answer any questions you may have about such matters. Together with your dentist you can keep your smile healthy and happy.

Teething
Babies are as individual in their teething as they are in everything else they do. It’s not uncommon for some babies to drool for weeks before their first tooth comes in. For others, teeth just seem to appear without much fuss at all. Quite often a baby will have sore or tender gums and that tends to make them irritable. To help soothe any sore spots, gently rub them with a clean finger or the back of a small, cold spoon. Teething rings also work well. Try and avoid teething biscuits since many of them contain sugar and shouldn’t be offered.
Some parents worry that their child’s teething is either to early or too late. There is absolutely no link between when the child’s teeth come in and how strong the teeth will be. Most babies begin to get primary teeth after the age of four months, usually six to nine months. The timing of teeth is genetic, and late-teething parents are likely to have late-teething children.

Be sure to examine all of your baby’s teeth especially on the inside or the tongue side every two weeks for dull whiter spots or lines. These can be signs of nursing bottle decay. If a bottle is left in an infants mouth for a long period of time and it contains anything but water, decay can occur more rapidly. Sugar in the liquid mixes with bacteria in the dental plaque to form acids that attack tooth enamel. Each time your child drinks liquids containing sugar, acids attack the teeth for at least 20 minutes. When children are awake, their saliva tends to carry away the liquid. But during sleep the saliva flow decreases and these liquids pool around the child’s teeth for long periods bathing the teeth in acids. If your baby needs a bottle for comfort before falling asleep, fill the bottle with plain water. Regardless of your child's age, if you notice anything unusual in your baby’s mouth, seek dental care immediately.

Loosing Baby Teeth
The process by which a child looses their baby teeth is a simple one. At about age six the roots of the baby teeth begin to dissolve, as this happens the teeth begin to get loose. A baby tooth may wiggle about for quite a while before the tooth actually falls out. Gentle coaxing by pushing on the tooth is not harmful, however, be sure that your child does not put excess pressure on the tooth with his tongue. It is not abnormal for the permanent tooth to make an appearance with the baby tooth still in the mouth. If however, the baby tooth does NOT fall out soon after the permanent tooth breaks through, notify your dentist. An over retained baby tooth may interfere with the normal development of the adult tooth.

Baby teeth are also responsible for guiding the permanent teeth into their proper position in the jaw. If a baby tooth is lost prematurely due to an accident or decay it is important that the space be held open. Usually this is done with a little device called a space maintainer. If this space is not held open, the tooth underneath may have problems growing in later on. Baby teeth generally come out when they are ready, without any complications. Notify your dentist of any problems or questions.

Thumbsucking
Sucking is a normal reflex of a baby. Simply put, it relaxes and comforts them. The need for sucking usually comes to an end between the age of two or three. But for some, prolonged and vigorous sucking after the age of four can cause problems with normal dental development. If you are concerned your child’s sucking may cause dental problems, visit your dentist and discuss the matter. He or she can tell you the best method for weaning
your child from the habit.

Helping A Child Get Through Thumbsucking . . .
Instead of scolding children for thumbsucking, praise them when they are not.
Children often suck their thumbs when feeling insecure - focus on correcting the cause of anxiety, instead of the thumbsucking.

Children who are sucking for comfort will feel less of a need when their parents provide comfort.
Reward children when they refrain from sucking during difficult periods, such as being separated from their parents.

A visit to your dentist can encourage children to stop sucking as an explanation by your dentist to them could explain what will happen if they continue.

If these approaches don't work, remind the children of their habit by placing a bandage on the thumb or possibly by placing a sock on the hand at night. But, by all means, don't forget to consult with your dentist or pediatrician about your concerns of your child.

All About Our Teeth
We are born with two sets of teeth, primary or first and secondary or permanent. The primary teeth are also called deciduous, as are trees, which lose their leaves every fall. Deciduous teeth begin to appear at about six to eight months. 20 teeth make a complete set and all are in by age three. The three-year molar is the last to appear. The permanent teeth start to grow at about age six and all are present except the wisdom teeth between the ages of twelve to fourteen. The twelve-year molars are the lasts to grow in, until the wisdom teeth start to break through from age 17 on.

Including wisdom teeth our permanent teeth number 32. Few people however have room for all 32 teeth, which is why wisdom teeth may need to be removed. The front teeth are called incisors; the eyeteeth are referred to as canines; side teeth as premolars or bicuspids and back teeth as molars. Since our second set of teeth is the set we are supposed to keep for the rest of our lives, it is important that they be given proper care. Regular and thorough brushing and flossing as well as routine check ups by your dentist will do much to safeguard your smile.

Mammalons
Each anterior tooth grows from tooth buds. These three tooth buds fuse to form our permanent teeth. Anterior teeth have three points on them when they first erupt. These points are called the Mammalons. Within one or two years the points of the Mammalons wear away, but the internal structure is still present.

Your Child’s New Teeth
Even though your child’s first teeth are replaced by a permanent set, they play a very important role in your baby’s dental development. When your child is born, all 20 of the primary teeth, which will appear over the next two years, are already present in your baby’s jaws. These teeth are almost fully developed but will remain hidden under the gums until the front teeth begin to emerge at about six or seven months. Teething will continue on and off for about two years. Around age six the permanent teeth begin to appear and teething will continue on and off until about age twelve. At that point all the permanent teeth with the exception of the wisdom teeth are present.
Even though baby teeth will be replaced by the permanent teeth, they are crucial to the jaw development and positioning of the permanent teeth of your child. Because the baby teeth are responsible for guiding the permanent teeth into their proper place in the mouth, baby teeth that are missing or prematurely lost may need to have their natural space held open, usually by a little device called a space maintainer. Any missing teeth should be brought to the attention of your dentist. How your child cares for his baby teeth will play an important role in how he treats his second and final set. Children’s teeth get plaque just as adult teeth do; therefore they need to be cleaned just as permanent teeth. Because children’s mouths accumulate plaque just like adult teeth, their gums are also susceptible to the gum problems plaque can cause. Bleeding gums need to be cared for. Notify your dentist if your child’s gums bleed when he or she brushes.

Diet also plays as an important role in the dental health of a child as it does an adult. Your child’s teeth should be cleaned daily and sweets and starchy foods kept to a minimum. Also, try to avoid having your child sleep with a bottle with milk, formula or fruit juice, you run the risk of "nursing bottle mouth" – a dental condition that destroys your child’s teeth through early, serious decay. Sugar in these liquids mixes with the bacteria in the dental plaque in the mouth to from acids that attack tooth enamel. Each time your child drinks liquids containing sugar, the acids attack the teeth for at least 20 minutes. When the child is awake, their saliva tends to carry away the liquid. During sleep, the saliva flow decreases and these liquids pool around the child’s teeth for long periods, bathing the teeth in acid. Don’t think that a pacifier dipped in honey or sugar is beneficial either – this will damage the teeth just as easy. Best advice, if your child needs a bottle at bedtime, fill the bottle with plain water. Any discoloration on your child’s teeth should be brought to the attention of your dentist for his or her evaluation.

Your child’s first visit to the dentist should be a pleasant experience and should be before age 2, definitely before all 20 teeth are in the mouth. You can do much to prepare your child for his first visit, and help him or her to look forward to this new experience. . Children visiting the dentist for the first time are full of questions. Entertain your child’s curiosity by talking about the upcoming visit. Don’t mention needles or "that it won’t hurt" - this may frighten your child. You can tell your child the dentist will count their teeth to see how many there are and maybe take some pictures of their teeth as well. Your dental office may have a book you can read to your child about the first visit to the dentist, if not the library has a lot of information about this subject matter. Proper care of your child’s’ teeth will avoid problems in the future and help to keep your child’s’ smile bright and healthy.

Tooth Tips For Tots . . .
Put only water in a child's nap time or bedtime bottle.
Wipe an infant's gums with a clean, damp cloth after feeding.
Start brushing baby's teeth as soon as the first tooth erupts.
Take you child to see the dentist regularly, scheduling the first visit soon after the child's first birthday.
Discuss your child's fluoride needs with your dentist and pediatrician.
Brush and floss your child's teeth until the child can be taught to do this alone.
Set a good example by brushing and flossing your teeth everyday and seeing your dentist and hygienist on a regular basis.
Contact your dentist immediately should you notice anything unusual

Gingivitis: The most common disease among kids in the world
By Dr. Michael Bral
New York University
New York - What is the most common disease in the world among kids? Polio? Cancer? Malnutrition?
No, it's gingivitis which, is inflammation of the gums. An estimated 98 percent of all young people have some degree of gum inflammation.

Although gingivitis in children rarely causes a serious problem such as permanent tooth loss, it has a tendency to peak in severity at the time of puberty. Existing gingivitis is intensified during the period of hormonal changes, although it is gradually reduced throughout the remainder of the teen years.

Fortunately, gingivitis has a simple solution: good oral hygiene. Daily brushing and flossing not only prevents gingivitis, but more importantly, also controls tooth decay and more long-term dental problems.

Gingivitis results form the buildup of bacterial plaque on the tooth. The plaque serves as a breeding ground for multiplication of bacteria and their destructive byproducts, which eventually, through some complex changes, cause the gums to bleed.

When gums bleed on brushing, it is a clear sign the gums are inflamed and that gingivitis is present.
If your child's gums bleed, don't be alarmed; regular correct brushing should eventually remove the plaque, stop the bleeding, and cure gingivitis.

Dental visits for checkups and tooth cleaning should take place at least every six months, regardless of the presence or absence of bleeding and gingivitis.

For children who have physical or mental handicaps that make up regular brushing difficult, assistance at home as well as power-operated toothbrushes and antibacterial mouth rinses can be used to prevent or treat gingivitis.
Use of dental floss at least two or three times a week should be introduced when the child is old enough to use it. Like tooth brushing, flossing is essential for good oral health, and should become a matter of habit.

It is also important for the child to know to brush every tooth - not just the ones in the front.
As signs in some dentists' offices says: "You do not have to brush every tooth - only the ones you want to keep."
Dr. Michael Bral is Professor and Chairman of Periodontics at New York University College of Dentistry.

How do we prevent tooth decay & What are Sealants?
There are several things that you can do to help prevent tooth decay. The most important of course is the diet. What you eat plays a very important role in the overall well being of your mouth and the rest of your body. Since sugars are directly related to the breakdown process, which causes decay, eliminating sugar from the diet will have a direct impact on cavities.

Plaque and sugar interact with one another to form an acid, which breaks down the enamel of the teeth, resulting in a cavity. Proper removal of plaque will also greatly reduce the risk of getting cavities. Thorough brushing and flossing will not only remove sugar from the mouth but also the plaque, which has formed on the surfaces of the teeth since the last brushing. Certain foods will help to keep the mouth in a healthy state. These foods include whole grains, fresh fruits and vegetables, and any low sugar foods that won’t aid in tooth decay.
Sealants are a very good way of protecting the biting surfaces of teeth that have never had a filling nor have no decay. Sealants are a clear or white material, which is applied on the biting surfaces of the teeth. The purpose of sealants is to smooth over the normal crevices of the teeth were germs could easily accumulate, thereby protecting the teeth from decay.

Concerns regarding Tongue Piercing . . .
Tongue piercing is becoming more common. Like other forms of body piercing, it carries serious risks during the procedure itself. These include the risk of local or systemic infection. Local infection can occur because the mouth is hard to sterilize and many places that pierce tongues do not always maintain a sterile environment.
Systemic infection is always a possibility and includes the risk of hepatitis and AIDS. The rinsing with mouthwash may not take care of an infection if it is serious. It is important to remember that piercing establishments are not regulated by law nor are the operators licensed. The operator's experience and competence can vary and are not guaranteed. Like other forms of body piercing, tongue piercing also can result in an allergy if the metals used are not of the highest quality. Many times, the stated price of the piercing does not include the jewelry to be placed.

Unlike other forms of piercing, the tongue also caries the increased risk of bleeding problems. The tongue has major blood vessels within it and many operators are not aware of this. The jewelry may also be swallowed if loosened and result in choking.

In addition, unlike other forms of body piercing, tongue piercing also caries the risk of damage to the surrounding teeth. The hard jewelry can chip and break the enamel or fillings of the teeth as one talks and eats. This damage can also result in the death of the tooth's inner pulp if the trauma to the tooth is chronic. This tooth damage may result in the need for expensive crowns to restore a smile or even a root canal to keep the tooth. These are important matters to consider before undergoing tongue piercing. If there is a problem after tongue piercing, it is important not only to contact the piercing establishment, but your physician and dentist as needed. Your smile and your health are important in the long run!

Question:
"I read the "article" about tongue piercing, because I was recently planning to get my tongue pierced. As mentioned, one should be sure that the highest quality metal be used for the piercing to avoid allergic reactions. Are there any specific suggestions for a metal? "
Reply:
"I think it is great that you want to get the highest quality metal for your jewelry but hold it, what about the protection of your own high quality crystalline structures already in your mouth-your teeth? Remember now matter how high the quality of the jewelry in your tongue, all metal jewelry can injury one thing you cannot replace easily, the beautiful enamel of your teeth. Enamel of the teeth can permanently chip or even worse, the whole tooth, pulp and all can become injured. So not only think of how your body responds to metal with allergy, but think how your teeth will respond with an injurious force in your mouth of metal."
Above information on Tongue Piercing complements of :
Margaret J. Fehrenbach, RDH, MS Educational Consultant

How about 17 year old Jennifer...
About a week ago Jen decided she could use some jewelry - only this time she wanted to wear it in her mouth. When Jen came into our office, her teeth ached and her entire right side of her mouth was swollen. When I saw her in our reception area, she held her throbbing jaw with one hand. In her other hand she held what looked like a tiny barbell with one end missing. It was jewelry that she had worn through her tongue before it became infected. She thought that she had taken precautions after she had paid for the barbell to inserted through her tongue. She had rinsed with some mouthwash she found at home in an attempt to control the "millions of bacteria" swimming around. However, when her tongue was pierced, it created an open wound, a breeding ground for germs. In a few days an infection developed. I asked Jen what happened to the other end of the barbell? She told me she swallowed it as it had come loose because of the pressure under her swollen tongue. She's thankful that she didn't choke on the remaining piece. Jen told me that she also wanted to add a hoop and a stud to her lips and a hoop above her eyelid at the same time as her tongue was pierced. Now the thought of piercing made her head throb!

Common symptoms after piecing includes pain, swelling, infection, an increased flow of saliva and injuries to gum tissue. If a blood vessel had been in the path of the needle, severe and difficult- to-control bleeding could have resulted. Jennifer could have suffered nerve damage as well as chipped or cracked teeth, blood poisoning, or blood clots. With regard the tongue - following piercing of the tongue swelling is common. Unlike an earlobe that is pierced, the tongue is in constant motion, which slows and complicates the healing process. A severely swollen tongue can actually close off your airway which could be life threatening!

How do we prevent tooth decay & What are Sealants?
There are several things that you can do to help prevent tooth decay. The most important of course is the diet. What you eat plays a very important role in the overall well being of your mouth and the rest of your body. Since sugars are directly related to the breakdown process, which causes decay, eliminating sugar from the diet will have a direct impact on cavities.

Plaque and sugar interact with one another to form an acid, which breaks down the enamel of the teeth, resulting in a cavity. Proper removal of plaque will also greatly reduce the risk of getting cavities. Thorough brushing and flossing will not only remove sugar from the mouth but also the plaque, which has formed on the surfaces of the teeth since the last brushing. Certain foods will help to keep the mouth in a healthy state. These foods include whole grains, fresh fruits and vegetables, and any low sugar foods that won’t aid in tooth decay.
Sealants are a very good way of protecting the biting surfaces of teeth that have never had a filling nor have no decay. Sealants are a clear or white material, which is applied on the biting surfaces of the teeth. The purpose of sealants is to smooth over the normal crevices of the teeth were germs could easily accumulate, thereby protecting the teeth from decay.

Too much fluoride
While fluoride is very beneficial in strengthening teeth and preventing tooth decay, parents need to be concerned about the levels of of fluoride their children are ingesting. Too much fluoride from fluoride supplements, toothpaste and other sources can lead to a condition in young children called fluorosis.

Fluorosis causes discolored teeth and in some cases will cause pitting in the enamel surface of the teeth. While fluorosis damage tends to be cosmetic in most cases, excessive fluoride intake can be harmful.

Fluorosis appears more often in young children whose developing teeth are more vulnerable. Children are also the most numerous recipients of the "halo effect" - well-intentioned over exposure to fluoride from a multitude of sources. Fluoride is in toothpaste, fluoride supplements, fluoride mouth rinses and, in some areas, fluoride is added to the water supply. Fluorosis is not caused by fluoride in city water systems but by over-exposure through an accumulation of sources.

The best way to prevent childhood fluorosis is know if your public water supply contains fluoride and to then monitor your children's intake accordingly. If your children use a toothpaste that contains fluoride, be sure they are using only a pea size amount of toothpaste and not covering all the bristles like a TV commercial. Be sure they try not to swallow toothpaste containing fluoride. Before giving your child fluoride supplements, confirm with Dr. Arredondo whether or not additional fluoride is needed. Exposure to normal levels of fluoride is definitely beneficial, but too much fluoride can be harmful.

Thumb sucking

Your dentist can help.

For babies and young children, thumb sucking is a natural reflex. It gives them a sense of security and helps them fall asleep. However, when teeth begin to develop, thumb sucking or sucking on a pacifier can lead to dental problems.
Children who vigorously suck their thumbs are more likely to develop dental problems than children who suck their thumbs more passively. Vigorous thumb sucking can cause a child's baby teeth to shift, and correct alignment of a child's permanent teeth and proper growth of the mouth can be inhibited by persistent thumb sucking.

Children should not suck their thumbs or use pacifiers when their permanent teeth are coming in. Most children will naturally stop thumb sucking between the ages of two and four as they become more interested in their surroundings. But if a child persists in thumb sucking, a dentist, pediatric dentist or orthodontist can help.

A couple of tips...

Most children use thumb sucking as a means of comfort, parents can try to identify and then remove the cause of anxiety. Parents have also had success using praise and rewards to encourage their child to stop thumb sucking.
If you notice changes in your child's teeth due to thumb sucking or due to any reason, call us for a consultation.