Families of children with chronic conditions face many challenges. One that often takes a back seat to other pressing needs is the prevention of tooth decay. But although difficult, it still deserves caregivers’ attention because of the dental disease’s potential long-term impact on oral health.
Chronically ill children are often at higher risk for tooth decay, most commonly due to challenges in practicing effective oral hygiene. Some conditions create severe physical, mental or behavioral impairments in children’s ability to brush and floss: for example, they may have a heightened gag reflex to toothpaste in their mouth or they may not be able to physically perform these tasks on their own.
Some children may be taking medications that inhibit salivary flow as a side effect. Saliva is critical for disease prevention because it both neutralizes mouth acid (which can erode tooth enamel) and is a first line of defense against disease-causing bacteria. And a child’s diet, while designed to support treatment of their chronic condition, may conversely not be the best for supporting their dental health.
It’s best if caregivers and their dentists develop a strategy for decay prevention, which should include the following:
- Regular dental visits beginning at Age One. Besides monitoring dental health, dental visits also provide cleanings and other preventive measures like topical fluoride or sealants;
- Brushing and flossing support. Depending on a child’s physical and mental capacities, caregivers (or an older sibling) may need to model brushing and flossing, or perform the tasks for the child;
- Medication and diet changes. If medications are causing dry mouth, caregivers can speak to their physicians about possible alternatives; likewise, they should see if modifications can be made to their diet to better support dental health.
- Boosting salivary flow. It’s especially important with children who have dry mouth to drink more water or use aids (like xylitol gum or candies) to boost salivary flow.
Although it requires extra effort and time to give attention to a chronically ill child’s dental health, it’s well worth it. By working to prevent tooth decay early in life, these children will be more likely to enjoy good dental health in the future.
If you would like more information on dental care for children with special needs, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor article “Managing Tooth Decay in Children with Chronic Diseases.”
Tooth decay is one of the most common diseases in the world, nearly as prevalent as the common cold. It’s also one of the two major dental diseases—the other being periodontal (gum) disease—most responsible for tooth and bone loss.
Tooth decay begins with high levels of acid, the byproduct of oral bacteria feeding on food remnants like sugar. Acid can erode tooth enamel, leading to a cavity that will require removal of decayed material around it and then a filling.
Sometimes, though, decay can spread deeper into the tooth reaching all the way to its core: the pulp with its bundle of nerves and blood vessels. From there it can travel through the root canals to the bone. The continuing damage could eventually lead to the loss of the infected tooth.
If decay reaches the tooth interior, the best course of action is usually a root canal treatment. In this procedure we access the pulp through the crown, the visible part of the tooth, to remove all of the diseased and dead tissue in the pulp chamber.
We then reshape it and the root canals to receive a filling. The filling is normally a substance called gutta percha that’s easily manipulated to conform to the shape of the root canals and pulp chamber. After filling we seal the access hole and later cap the tooth with a crown to protect it from re-infection.
Root canal treatments have literally saved millions of teeth. Unfortunately, they’ve gained an undeserved reputation for pain. But root canals don’t cause pain—they relieve the pain caused by tooth decay. More importantly, your tooth can gain a new lease on life.
But we’ll need to act promptly. If you experience any kind of tooth pain (even if it goes away) you should see us as soon as possible for an examination. Depending on the level of decay and the type of tooth involved, we may be able to perform the procedure in our office. Some cases, though, may have complications that require the skills, procedures and equipment of an endodontist, a specialist in root canal treatment.
So, don’t delay and allow tooth decay to go too far. Your tooth’s survival could hang in the balance.
If you would like more information on tooth decay treatment, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor article “Root Canal Treatment: What You Need to Know.”
Your teeth are meant to last a lifetime. Even with wear and tear from years of eating and biting they can continue to function properly and look attractive well into your senior years.
Teeth are resilient thanks in part to enamel, the hardest substance in the human body. But the gums also contribute to this resilience: besides attractively framing the teeth, they protect the dentin and roots below the enamel covering.
Unfortunately, the gums can shrink back or “recede” from their normal place. Not only does this look unattractive, the recession can also expose teeth to disease and cause tooth sensitivity to temperature changes or biting pressure.
There are a number of causes for gum recession, some of which you may have little control over. If, for example, your teeth come in off center from their bony housing, the gum tissues may not develop around them properly. You might also have inherited a thinner type of gum tissue from your parents: thinner tissues are more delicate and susceptible to recession.
But there are other causes for which you have more control. Over-aggressive brushing (too hard for too long), ironically, does more harm than good as it can injure your gums and cause them to recede. More likely, though, your recession is a direct result of neglecting proper hygiene for your teeth and gums.
When teeth aren't properly cleaned through daily brushing and flossing, a thin film of bacteria and food remnant called plaque builds up on tooth surfaces. This can trigger periodontal (gum) disease, which subsequently causes the gum tissues to detach from the teeth and often recede.
To reduce your risk of gum disease, you should gently but thoroughly brush and floss daily, and visit us for cleanings and checkups at least twice a year. If you have a poor bite (malocclusion), consider orthodontic treatment: malocclusions make it easier for plaque to accumulate and harder to remove.
Above all, if you begin to see signs of gum problems — swelling, bleeding or pain — see us promptly for an examination and treatment. Dealing with these issues early is the best way to ensure your gums continue to do their jobs for the long-term.
For anyone else, having a tooth accidentally knocked out while practicing a dance routine would be a very big deal. But not for Dancing With The Stars contestant Noah Galloway. Galloway, an Iraq War veteran and a double amputee, took a kick to the face from his partner during a recent practice session, which knocked out a front tooth. As his horrified partner looked on, Galloway picked the missing tooth up from the floor, rinsed out his mouth, and quickly assessed his injury. “No big deal,” he told a cameraman capturing the scene.
Of course, not everyone would have the training — or the presence of mind — to do what Galloway did in that situation. But if you’re facing a serious dental trauma, such as a knocked out tooth, minutes count. Would you know what to do under those circumstances? Here’s a basic guide.
If a permanent tooth is completely knocked out of its socket, you need to act quickly. Once the injured person is stable, recover the tooth and gently clean it with water — but avoid grasping it by its roots! Next, if possible, place the tooth back in its socket in the jaw, making sure it is facing the correct way. Hold it in place with a damp cloth or gauze, and rush to the dental office, or to the emergency room if it’s after hours or if there appear to be other injuries.
If it isn’t possible to put the tooth back, you can place it between the cheek and gum, or in a plastic bag with the patient’s saliva, or in the special tooth-preserving liquid found in some first-aid kits. Either way, the sooner medical attention is received, the better the chances that the tooth can be saved.
When a tooth is loosened or displaced but not knocked out, you should receive dental attention within six hours of the accident. In the meantime, you can rinse the mouth with water and take over-the-counter anti-inflammatory medication (such as ibuprofen) to ease pain. A cold pack temporarily applied to the outside of the face can also help relieve discomfort.
When teeth are broken or chipped, you have up to 12 hours to get dental treatment.Â Follow the guidelines above for pain relief, but don’t forget to come in to the office even if the pain isn’t severe. Of course, if you experience bleeding that can’t be controlled after five minutes, dizziness, loss of consciousness or intense pain, seek emergency medical help right away.
And as for Noah Galloway:Â In an interview a few days later, he showed off his new smile, with the temporary bridge his dentist provided… and he even continued to dance with the same partner!
If you would like more information about dental trauma, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Trauma & Nerve Damage to Teeth” and “The Field-Side Guide to Dental Injuries.”
Laying out goals for the New Year is a great way to inspire yourself to make positive changes that can improve your health. For example, many habits—both good and bad—affect the health of your teeth and gums. Here’s a list of risky habits to kick, and mouth-healthy habits to adopt:
Habits That Risk Oral Health
Smoking. As if oral cancer weren’t enough to worry about, smoking also promotes gum disease and tooth loss. According to the U.S. Centers for Disease Control, smokers have double the risk of gum disease compared to nonsmokers. And according to the Academy of General Dentistry, smokers are about twice as likely to lose their teeth as nonsmokers. For help quitting, visit smokefree.gov.
Snacking. Nibbling all day can create the perfect conditions for tooth decay—especially if your snacks contain sugar and other carbohydrates. Sticky snacks like cookies, crackers, chips and candy bars that cling to teeth tend to remain in the mouth and attract decay-causing oral bacteria. The acid these bacteria produce can penetrate the enamel of your teeth, causing cavities.
Soft Drinks. Speaking of tooth-eroding acid, soft drinks have plenty of it. And this includes both regular and diet varieties of soda, sweetened iced tea, sports drinks and so-called energy drinks. The healthiest drink for your teeth is water!
Brushing. You probably brush your teeth every day already, but are you doing it correctly? To get the most benefit from this healthy habit, brush twice each day for a full two minutes each time. Use a soft-bristled toothbrush with toothpaste that contains fluoride, and don’t scrub too harshly!
Flossing. Yes, it’s worth the effort! If you don’t floss, you’ll miss cleaning about 40% of your tooth surfaces. A toothbrush just can’t reach in between teeth, where decay-causing dental plaque can hide. If you find dental floss difficult to work with, try using disposable floss holders.
Regular Dental Checkups. Keep up a regular schedule of professional teeth cleanings and exams! This allows us to remove any hardened dental plaque (tartar) that has built up on your teeth, screen you for oral cancer, and treat minor dental problems before they become major ones. Plus, it’s a great opportunity to review your at-home oral hygiene.
If you have any questions about how to improve your oral health, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “10 Tips for Daily Oral Care at Home” and “10 Tips to Help You Stop Smoking.”
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