Like the rest of their bodies, children’s teeth and mouth are on a rapid development track. By the time they’re young adults, they will have had two sets of teeth, extensive bone growth and a noticeable change in their features. The natural process is truly amazing.
But dental disease can easily derail their development, with tooth decay the most common problem children encounter. More than at any other time of life, preventive dental care is a top priority.
True preventive care for your child includes the entire mouth, not just the teeth. Our main focus, of course, is to head off tooth decay before it develops, including the application of topical fluoride or sealants when appropriate. But we also monitor bite development and provide protection against sports injuries or other forms of trauma with customized mouth guards.
You also have a part to play in your child’s preventive dental care. It begins when your child’s first teeth begin to emerge in the mouth — the point when you should begin brushing them. You can also reduce the risk of dental disease by providing a nutritious diet that’s high in fresh fruits and vegetables and low in sugar, especially between-meal snacks.
You should also start regular dental visits around their first birthday. This is not only the best time to begin professional care, but your child will also have an easier time at this age becoming comfortable with visiting the dentist than waiting until they’re older.
Taking care of your child’s teeth is a working partnership between you and us: we provide the professional care your child needs to develop properly, while you look to their daily hygiene and nutrition, which is just as important for your child’s healthy development. Through our partnership, we can ensure your child is getting the very best start toward a lifetime of healthy teeth and gums.
Periodontal (gum) disease is the most likely cause of a loose, permanent tooth. This progressive infection causes damage to the gums and bone tissues that hold teeth in place, leading to looseness and ultimately tooth loss.
Gum disease, however, isn’t the only cause: although not as common, excessive biting forces over time may also lead to loose teeth. The excessive force stretches the periodontal ligaments that hold teeth in place, causing the teeth to become loose.
This condition is called occlusal trauma. In its primary form, the patient habitually grinds or clenches their teeth, or bites or chews on hard objects like pencils or nails. Generating 20-30 times the normal biting force, these habits can cause considerable damage. It can also be a factor when gum disease is present — supporting bone becomes so weakened by the disease, even normal biting forces can cause mobility.
If you recognize the early signs of grinding or clenching, particularly jaw soreness in the morning (since many instances of teeth grinding occur while we sleep), it’s important to seek treatment before teeth become loose. The symptoms are usually treated directly with muscle relaxants, an occlusal guard worn to soften the force when teeth bite down, or stress management, a major trigger for teeth grinding. The sooner you address the habit, the more likely you’ll avoid its consequences.
If, however, you’re already noticing a loose tooth, treatment must then focus on preserving the tooth. Initially, the tooth may need to be splinted, physically joined to adjacent teeth to hold it in place while damaged tissues heal. In some cases, minute amounts of enamel may need to be removed from the tooth’s biting surfaces to help the tooth better absorb biting forces. Other treatments, including orthodontics and gum disease treatment, may also be included in your treatment plan.
If you notice a loose tooth, it’s critical you contact us as soon as possible for an evaluation — if you delay you increase the chances of eventually losing it. The earlier you address it, the better your chances of preserving your tooth.
If you would like more information on loose 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 “Loose Teeth.”
One of the most frequent concerns parents express to us is their child’s thumb or finger sucking habit. The good news, though, is that thumb sucking is a completely normal activity for babies and young children, and if they stop by age 4 it should have no adverse effects on their future bite.
In fact, there are positive aspects to thumb sucking: it provides babies with a sense of security, as well as a way to learn about the world. As a child grows and becomes more confident with their surroundings, the thumb sucking habit will fade and eventually stop: for most children this occurs between the ages of two and four.
If, however, the habit continues later in childhood, there is a chance the upper front teeth may be influenced to tip toward the lip during eruption and come into an improper position that could also adversely affect jaw development. The same concern exists for pacifier use — we recommend weaning a child off a pacifier by the time they’re eighteen months of age.
If your child still has a thumb or finger sucking habit as they prepare to enter school, it’s quite appropriate to work on getting them to stop. Punishment, shaming or similar negative approaches, however, aren’t the best ways to accomplish this: it’s much more effective to try to modify their behavior through reward, praise or some creative activity.
Another factor that may help is to begin regular dental visits around their first birthday. Regular checkups give us a chance to monitor the development of their bite, especially if thumb sucking continues longer than normal. We can also assist you with strategies to encourage them to stop thumb sucking or pacifier use.
Thumb sucking that continues later than normal isn’t a cause for panic, but it does require attention and action. Helping your child “grow” past this stage in their life will improve their chances of developing a normal and healthy bite.
If you would like more information on thumb sucking, please contact us to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Thumb Sucking in Children.”
Have you noticed a clicking, popping, or grating sound when you open or close your jaw? As many as 36 million U.S. adults experience this phenomenon in one or both of the joints that connect the lower jaw (mandible) to the skull.
While the sounds may be disconcerting, there’s generally no cause for concern in the absence of other symptoms. They’re most likely caused by a harmless shift in the position of the disk inside each temporomandibular (jaw) joint, and it can diminish or disappear entirely over time. But, if you’re also experiencing persistent discomfort, severe pain, or limited function in your jaw (which can include getting it “stuck” in an opened or closed position), then you may be suffering from a temporomandibular joint disorder — part of a complex set of conditions affecting one or both jaw joints, muscles and/or other surrounding tissues. (You may have heard the condition called TMJ, which is actually the abbreviation for the temporomandibular joint itself. Health care professionals prefer TMJD or TMD.)
Depending on the severity, TMD can interfere with your ability to speak, chew and even make facial expressions. The cause is unclear, but genes, gender, environment, stress and behavior are believed to play a role. It can also be symptomatic of a larger medical problem, such as fibromyalgia, which can produce pain all over the body.
Management Options for TMD
TMD traditionally was viewed as a bite problem (malocclusion) requiring mechanical correction — e.g., through orthodontic braces or surgery. But the current therapeutic model approaches TMD as an orthopedic problem (joint inflammation, muscle soreness, strained tendons and ligaments, and disk damage) and favors a sequence of conservative, reversible procedures — hot or cold compresses in the jaw area, soft foods, physical therapy/massage, medication, and/or a bite guard to decrease pressure on jaw joints from tooth clenching and grinding — prior to more aggressive, irreversible treatment alternatives.
If you would like more information about TMD, please contact us or schedule an appointment for a consultation. You can also learn more about the subject by reading the Dear Doctor magazine articles “Seeking Relief from TMD” and “Chronic Jaw Pain and Associated Conditions.”
Periodontal (gum) disease is an aggressive bacterial infection caused by built-up plaque on tooth surfaces. Gum disease results in bone loss and causes loss of attachment from the teeth, leading to eventual tooth loss.
The goal of any gum disease treatment is to remove as much plaque and calculus (hardened deposits of plaque) from the gums and teeth as possible. Scaling with special hand instruments or ultrasonic equipment is the basic technique for plaque and calculus removal above and below the gum line. As the infection spreads below the gum line, it can widen the natural gap between teeth and gums to form voids known as periodontal pockets that fill with infection. Accessing and cleaning these pockets, which can occur as deep as the tooth roots, will require more invasive procedures.
Pockets that form at a depth greater than 5 mm below the gum line will most likely require surgical access through the gum tissue. But for pockets not quite that deep there’s an intermediary technique called root planing without surgical intervention. As the name suggests, the roots are physically “planed,” much like shaving a wooden board to remove minute layers of wood.
Using similar instruments as with scaling, root planing removes calculus, bacteria and other infected matter adhering to the root surfaces. It’s best to perform the procedure with local anesthesia to numb the gum tissues, which may be quite sensitive depending on the degree of infection. Working in a pain-free environment also helps us to be as thorough as possible in detecting and removing every bit of plaque and calculus we can find.
In advanced cases, it may be necessary to perform this procedure during multiple visits. As plaque and calculus are removed the inflammation in affected tissues will begin to subside, revealing more deposits of plaque and calculus. It’s also important to begin and maintain a daily habit of effective brushing and flossing to lessen the chances of a recurring infection.
Treating gum disease is an ongoing effort that requires constant monitoring and sustained efforts to remove plaque and calculus, including root planing. Saving your teeth, however, is well worth the effort.
If you would like more information on treating periodontal 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 “Root Planing.”
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