While they're resilient, your child's teeth aren't invincible. Daily hygiene and regular dental visits are important, but you should also be alert for problems and take action when they arise.
Here are 4 areas that could cause problems for your child's teeth, and what you should do — or not do — if you encounter them.
Teething. This is a normal experience as your child's first teeth erupt through the gums. The gums become tender and painful, causing constant gnawing, drooling, disturbed sleep and similar symptoms. You can help relieve discomfort by letting them bite on a chilled (not frozen) teething ring or a cold, wet washcloth. Pain relievers like ibuprofen in appropriate dosages can also help — but don't apply ice, alcohol or numbing agents containing Benzocaine directly to the gums.
Toothache. Tooth pain could be a sign of decay, so you should see us for an examination. In the meantime you can help relieve pain with a warm-water rinse, a cold compress to the outside of the face, or appropriately-dosed pain relievers. If the pain is intense or persists overnight, see us no later than the next day if possible.
Swollen or bleeding gums. If you notice your child's gums are red and swollen or easily bleed during brushing, they could have periodontal (gum) disease. This is an infection caused by bacterial plaque, a thin film of food particles that build up on the teeth. You can stop plaque buildup by helping them practice effective, daily brushing and flossing. If they're showing symptoms, though, see us for an exam. In the meantime, be sure they continue to gently brush their teeth, even if their gums are irritated.
Chipped, cracked or knocked out tooth. If your child's teeth are injured, you should see us immediately. If part of the tooth has broken off, try to retrieve the broken pieces and bring them with you. If it's a permanent tooth that was knocked out, pick it up by the crown (not the root), rinse it with clean water and attempt to place it back in the socket. If you can't, bring the tooth with you in a container with clean water or milk. The sooner you see us, the better the chances for saving the tooth — minutes count.
Gum recession — when the gum tissue covering teeth wears away — is a serious matter. If the roots become exposed you'll not only have increased sensitivity and possible discomfort, your teeth can become more susceptible to decay.
There are a number of reasons for gum recession, including overaggressive brushing and flossing, poor fitting appliances like dentures or braces, or genetics (inheriting a thin gum tissue type or poor tooth position). Perhaps the most common reason, though, is periodontal (gum) disease. Caused by bacterial plaque, a thin film of food particles that builds up on tooth surfaces, the disease weakens the gum tissues around teeth, causing them ultimately to detach and “roll up” toward the roots.
Treating the gum infection by removing the built-up plaque and calculus (hardened plaque deposits) will help stop recession or even reverse it. As we remove plaque the infection subsides and the gums cease to be inflamed. If they haven't receded too far they may re-grow and renew their attachment to the teeth.
In other cases, though, the recession may have progressed too far and too rapidly toward root exposure. Gums in this condition may require tissue grafts to the recessed area to create or regenerate new tissue.
Most grafting techniques fall into one of two categories. The first is known as free gingival grafting where a thin layer of skin is removed or "freed" from the roof of the patient's mouth (the palate), shaped and then stitched to the recession site.
The second category is called connective tissue grafting, most often used to cover exposed roots. In this case the donor material is transplanted from the donor site to the recipient site, but the recipient site's tissue covers the donor connective tissue graft as it still maintains a physical attachment to the original location. The recipient site can thus maintain a blood supply, which can result in quicker, more comfortable healing than with free gingival grafting.
Connective tissue grafting does, however, require sophisticated microsurgical techniques, along with the surgeon's in-depth skill and art, to prepare both the donor and recipient sites. Allografts (donor skin from another person) may also be used as a donor tissue and placed beneath the recipient site tissue thereby avoiding a second surgical site.
Gum tissue grafting can be an intense undertaking, but the results can be astounding. Not only will restoring recessed gum tissues give your teeth a new lease on life, it will revitalize your smile.
If you would like more information on treatment for gum recession, 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 “Periodontal Plastic Surgery.”
Root canal treatments are an essential part of dental care — countless teeth with deep decay would be lost each year without it. Now, this traditional dental care procedure is advancing to a new level of precision through lasers.
Root canal treatments have a simple goal: access a tooth's infected pulp and root canals, clean out the infected tissue and fill the empty pulp chamber and canals with a special filling. Once filled, the access is sealed and a porcelain crown later placed for additional protection against re-infection.
In the traditional procedure, we perform these steps manually with a dental drill and hand instruments. We may also need to remove a good portion of tooth structure, both healthy and infected tissue. A laser, on the other hand, is a highly focused beam of light with the ability to interact with healthy and infected tissues differently: destroying infected tissue while having no effect on nearby healthy tissue. The end result: we may be able to remove less healthy tissue with lasers than with the conventional procedure.
Lasers are also helpful with softening and precisely molding the filling material within each canal's particular shape. And, early reports seem to indicate a higher degree of comfort for patients (less drill noise and need for anesthesia), less bleeding and faster recovery times than the conventional approach.
But as a tool for root canal treatments, lasers do have a couple of disadvantages. While light travels in a straight line, root canals are rarely straight — conventional instruments with curved designs usually accommodate odd canal shapes better than a laser. Lasers can also raise temperatures within a tooth that can damage healthy tissue, both within the pulp and outward into the dentin.
Still, lasers for root canal treatments appear promising with some dentists using a combination of lasers and manual techniques to garner benefits from both approaches. While you won't see lasers replacing the traditional root canal treatment anytime soon, the future looks bright for more efficient ways to treat deep tooth decay.
The market for sugar alternatives has grown exponentially since saccharin was accidentally discovered in 1878. Today, saccharin has been joined by other FDA-approved zero-calorie artificial sweeteners, including aspartame (“Equal®” or “NutraSweet®”), sucralose (“Splenda®”) and rebaudioside A, derived from the stevia plant. You can also choose low-calorie alcohol sugars like erythritol or xylitol.
With rare exceptions, all these choices are widely considered safe substitutes for table sugar, high fructose corn syrup or other versions of this plentiful carbohydrate. Finding substitutes for sugar is a worthy health goal: besides its role in obesity, sugar is considered a contributing factor in cardiovascular disease and diabetes.
It's also a prime food for oral bacteria that cause dental disease. As bacteria consume sugar they produce acid as a byproduct. Acid softens and dissolves the mineral content in enamel, leading to erosion and the formation of cavities. While saliva normally neutralizes acid after we eat, constant snacking and higher quantities of sugar in our food make it difficult for it to control or neutralize acid in the oral environment.
Because most of us are hard-wired with a “sweet tooth,” it's difficult for many to cut back on sugar. Artificial sweeteners help reduce the amount of sugar in the diet with obvious benefits for general health. It can also make a big difference in your dental health by helping you prevent tooth decay.
One alcohol sugar may even go a step further. In addition to reducing the presence of sugar in the mouth, xylitol (found in chewing gums, candy and breath mints) also seems to reduce bacterial growth by interfering with their ability to ferment the sugar.
If you're considering using an artificial sweetener, get to know them first: some like aspartame aren't suitable for baked goods or cooking, while saccharine or sucralose are. People with a rare genetic condition called phenylketonuria also can't properly process aspartame in the body.
Be sure you also talk to us about artificial sweeteners' impact on oral health, especially the benefits of xylitol for dental care. Used in a wise and informed way, these sugar alternatives can improve both your oral and general health.
If you would like more information on artificial sweeteners impact on dental health, 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 “Artificial Sweeteners: Satisfying and Protecting your Sweet Tooth.”
Tooth sensitivity can be quite uncomfortable. But the glancing pain you feel may be more than an irritation — it may also be telling you there’s a deeper problem that needs attention.
As with other types of oral pain, tooth sensitivity can be a symptom for a variety of problems. Some of them are relatively minor, while others require immediate attention. It’s important to pay attention to the details about your tooth sensitivity and what they might be indicating you should do about it.
For example, your teeth may be sensitive to hot or cold foods or beverages. If it’s just a momentary pain it generally doesn’t mean an emergency — it could be a small area of decay on a tooth, a loose filling or an exposed root due to gum recession or overaggressive brushing. Besides seeing us for treatment for any decay, you can adjust your brushing habits to more gentle pressure with a soft-bristled brush. Fluoride toothpaste has also been shown to reduce this kind of sensitivity.
If, however, the pain from hot or cold substances lingers, then decay or some form of trauma may have affected the pulp, the innermost layer of a tooth. The pulp is rich in nerve fibers and can become inflamed and irritated from the decay or injury. You should visit us as soon as possible: you may require a root canal treatment that will not only relieve the pain but also save the tooth.
If you notice a sharp pain when biting down on food, it’s possible you have a loose filling or even a cracked tooth. As with inner decay, a fracture requires immediate attention. A loose filling should be easy to repair, but if it’s a fracture you may need extensive treatment to save the tooth or, if beyond salvage, have the tooth removed to make way for dental implant or similar restoration.
The key point is not to delay seeking treatment, especially if the pain is persistent, severe or long-lasting. The sooner you visit us about your tooth sensitivity, the sooner you’ll have solutions to stop the discomfort.
If you would like more information on tooth pain, 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 “Tooth Pain? Don’t Wait!”
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