When your baby’s first teeth come in, you might not think it necessary yet to worry about tooth decay. But even infants can develop this common dental disease. In fact, it has a specific name in children 6 and under: early childhood caries (ECC).
About one-fourth of U.S. children have ECC, and poor or minority children are at highest risk. Because of primary (“baby”) teeth’s thin enamel layer, ECC can spread to healthier teeth with unnerving speed, causing extensive damage.
While such damage immediately affects a child’s nutrition, speech development and self-esteem, it could also impact their future oral health. Permanent teeth often erupt out of position because of missing primary teeth lost prematurely, creating a poor bite. And children with ECC are more likely to have cavities in their future permanent teeth.
While there are a number of effective treatments for repairing ECC-caused damage, it’s best to try to prevent it before damage occurs. A large part of prevention depends on you. You should, for example, begin oral hygiene even before teeth come in by wiping their gums with a clean, damp cloth after feeding. After teeth appear, switch to daily brushing with just a smear of toothpaste.
Because refined sugar is a primary food source for decay-causing bacteria, you should limit it in their diet. In the same vein, avoid sleep-time bottles with fluids like juices, milk or formula. As they grow older, make sure snacks are also low in sugar.
You should also avoid spreading your own oral bacteria to your baby. In this regard, don’t put their eating utensils or pacifier in your mouth and don’t drink from the same cup. Avoid kissing your baby on the lips. And above all, take care of your own oral health to prevent your own encounter with dental disease.
Finally, start regular dental visits on or before your baby’s first birthday. Regular cleanings and checkups increase the chances for early decay detection, as well as provide for treatments and prevention measures that can reduce the disease’s spread and destruction.
ECC can be devastating to both your baby’s current and future dental health. But with vigilance and good dental practices, you may be able to help them avoid this serious disease.
The March 27th game started off pretty well for NBA star Kevin Love. His team, the Cleveland Cavaliers, were coming off a 5-game winning streak as they faced the Miami Heat that night. Less than two minutes into the contest, Love charged in for a shot on Heat center Jordan Mickey—but instead of a basket, he got an elbow in the face that sent him to the floor (and out of the game) with an injury to his mouth.
In pictures from the aftermath, Love’s front tooth seemed clearly out of position. According to the Cavs’ official statement, “Love suffered a front tooth subluxation.” But what exactly does that mean, and how serious is his injury?
The dental term “subluxation” refers to one specific type of luxation injury—a situation where a tooth has become loosened or displaced from its proper location. A subluxation is an injury to tooth-supporting structures such as the periodontal ligament: a stretchy network of fibrous tissue that keeps the tooth in its socket. The affected tooth becomes abnormally loose, but as long as the nerves inside the tooth and the underlying bone have not been damaged, it generally has a favorable prognosis.
Treatment of a subluxation injury may involve correcting the tooth’s position immediately and/or stabilizing the tooth—often by temporarily splinting (joining) it to adjacent teeth—and maintaining a soft diet for a few weeks. This gives the injured tissues a chance to heal and helps the ligament regain proper attachment to the tooth. The condition of tooth’s pulp (soft inner tissue) must also be closely monitored; if it becomes infected, root canal treatment may be needed to preserve the tooth.
So while Kevin Love’s dental dilemma might have looked scary in the pictures, with proper care he has a good chance of keeping the tooth. Significantly, Love acknowledged on Twitter that the damage “…could have been so much worse if I wasn’t protected with [a] mouthguard.”
Love’s injury reminds us that whether they’re played at a big arena, a high school gym or an outdoor court, sports like basketball (as well as baseball, football and many others) have a high potential for facial injuries. That’s why all players should wear a mouthguard whenever they’re in the game. Custom-made mouthguards, available for a reasonable cost at the dental office, are the most comfortable to wear, and offer protection that’s superior to the kind available at big-box retailers.
If you have questions about dental injuries or custom-made mouthguards, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Field-Side Guide to Dental Injuries” and “Athletic Mouthguards.”
After months of treatment we’ve removed your braces and your new smile emerges. Upon closer view, however, you notice a number of chalky white spots on your teeth.
These pale areas are white spot lesions (WSLs), the result of mineral breakdown from the long-term contact of acid with the enamel surface. The underlying cause is built-up bacterial plaque due to inadequate oral hygiene, and as such WSLs are the beginning stages of tooth decay.
While anyone can develop WSLs, brace wearers are highly susceptible because of the extra care required to clean around orthodontic hardware. Poor dietary habits such as frequent snacking on sugary or acidic foods and beverages also increase the risk of WSLs.
To reduce the risk of developing this condition, brace wearers must give extra attention and effort to daily oral hygiene, including brushing and flossing. The extra effort required in brushing can be aided by specialized toothbrushes designed to clean around brackets and wires, along with prescription-level fluoride toothpastes for added enamel strength. Floss threaders or a water flosser, a device that uses pulsating water under high pressure, may help you maneuver around hardware to remove plaque between teeth. It's also important to maintain a healthy mouth environment by limiting intake of sugary or acidic snacks and beverages, avoiding tobacco or excessive alcohol or caffeine, and drinking plenty of water to keep your mouth from drying out.
If you’ve already developed lesions, it’s important to stop the decay process before it causes more damage. One way is to assist your body’s natural mechanism for re-mineralizing tooth enamel with fluoride pastes or gels or re-mineralizing agents, or undergoing micro-abrasion to repair a tooth’s surface.
To improve a tooth’s appearance a procedure known as “caries infiltration” involves injecting a liquid tooth-colored resin into the lesion, which is then hardened with a curing light. The spot becomes less noticeable and appears more like normal enamel. For extensive defects, conventional bonding with composite resins or porcelain veneers can be used to cosmetically cover the tooth.
Getting ahead of the problem with effective oral hygiene and good dietary and lifestyle practices will keep WSLs at bay while you undergo orthodontic treatment. If they do develop, however, there are ways to minimize their effect and restore the look of your teeth.
Philosopher Will Durant wrote, "…We are what we repeatedly do. Excellence, then, is not an act but a habit." While that observation could aptly apply to a great deal of life, it's certainly true of dental health. Strong, healthy teeth and gums are largely the result of good oral habits started in early childhood.
Here are some important dental care habits you'll want to instill in your child, as well as yourself.
Practice and teach daily oral hygiene. Keeping your child's mouth clean helps prevent future dental disease. It should begin before teeth appear by wiping your baby's gums with a clean, wet cloth after every feeding to keep decay-causing bacteria from growing. Once teeth appear, switch to brushing with just a smear of toothpaste until age 2, when you can increase to a pea-sized amount. As your child matures, be sure to teach them to brush and floss for themselves, especially by modeling the behavior for them.
Begin dental visits early. Besides daily hygiene, regular professional dental care is one of the best habits for keeping healthy teeth and gums. Plan to begin your child's dental visits by age 1 when some of their teeth may have already come in. And by beginning early, it's more likely your child will view dental visits as a routine part of life, a habit they'll more likely continue into adulthood.
Keep your oral bacteria to yourself. Many strains of bacteria, especially harmful ones, don't occur spontaneously in a child's mouth. They come from the outside environment, most often from their parents or caregivers. To avoid transmitting disease-causing bacteria from you to your baby don't share eating utensils, don't lick a pacifier to clean it, and avoid kissing infants (whose immune systems are immature) on the mouth.
Encourage your teenager to avoid bad habits. Hopefully when your children reach adolescence, they've already developed good oral habits. But there are some bad habits you should also help your teen avoid. While piercings are a popular expression among this age group, teens should avoid tongue and lip bolts and other piercings that could damage teeth. A tobacco habit can also have negative consequences for dental health including increased decay or gum disease risk and cancer.
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.”
Want to give your kids the best start possible for a lifetime of good dental health? The most important thing you can do is train them in effective brushing and flossing. It's more than having a nice smile and fresh breath: these hygiene tasks remove the daily buildup of bacterial plaque, the primary cause for both tooth decay and periodontal (gum) disease, which are most responsible for poor oral health.
But those aren't the only habits they should be cultivating. Here are 3 tips for helping your child develop great dental health habits.
Encourage healthy eating. Teeth and gums are like other parts of the body: they need the "building blocks" found in nutritious foods to help grow strong, healthy tissues. By focusing on a diet leaner on processed items and richer in whole, less-processed vegetables, meats and dairy products, you'll be helping your child build strong defenses against dental disease.
Keep sugary snacks under control. Of all the items in your child's diet, sugar could have the greatest impact on their teeth. Disease-causing bacteria thrive on this particular carbohydrate, multiplying and producing mouth acid—the main enemy of tooth enamel—as a byproduct. So, limit sugary snacks as much as possible, opting instead for more nutritional between-meal treats. In fact, try to make sure they only consume sugary treats at mealtime, not in between.
Encourage an end to thumb-sucking or pacifiers by age 3. Most infants and very young children suck their thumbs or, alternatively, a pacifier. There's no harm in this habit unless it extends into later childhood where it could affect their bite. You can avoid this outcome by encouraging your child with mainly positive reinforcement to stop sucking their thumbs or other objects before their third birthday. Your dentist can also help with tips and support in those efforts.
If you would like more information on dental care for your child, 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 “Help your Child Develop the Best Habits for Oral Health.”
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