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Posts for tag: pediatric dentistry

DontUseBenzocaineProductstoEaseYourBabysTeethingPain

Although teething is a natural part of your baby's dental development, it can be quite uncomfortable for them—and upsetting to you. During teething, children can experience symptoms like pain, drooling or irritability.

Teething is the two or three-year process of intermittent episodes of the primary ("baby") teeth moving through the gums. These episodes are like storms that build up and then subside after a few days. Your aim as a parent is to help your baby get through the "stormiest" times with as little discomfort as possible. To that end you may have considered using over-the-counter products that temporarily numb irritated gums.

Some of those numbing products, however, contain a pain reliever called benzocaine. In recent years, this and similar ingredients have been found to increase the level of a protein called methemoglobin in the bloodstream. Too much methemoglobin can result in less oxygen delivered to body tissues, a condition known as methemoglobinemia.

This oxygen decrease can cause shortness of breath, fatigue or dizziness. In its severest form it could lead to seizures, coma or even death. Children and infants are at high risk for benzocaine-induced methemoglobinemia, which is why the U.S. Food and Drug Administration has banned marketing for benzocaine products as pain relievers for teething infants and children.

Fortunately, there are alternatives for helping your child weather teething episodes. A clean, chilled (not frozen) teething ring or pacifier, or a cold, wet washcloth can help numb gum pain. You can also massage their gums with a clean finger to help counteract the pressure exerted by an emerging tooth. Be sure, though, that you're not allowing anything in your child's mouth like lead-based paint that could be toxic. And under no circumstances should you use substances containing alcohol.

For severe pain, consult your physician about using a pain reliever like acetaminophen or ibuprofen, and the proper dosage for your child. With these tips you can help your child safely pass through a teething episode.

If you would like more information on helping your child cope with teething discomfort, please contact us or schedule an appointment for a consultation.

AStainlessSteelCrownCouldHelpaStrugglingPrimaryMolarLastLonger

Although primary (“baby”) teeth have a lifespan of only a few years, they’re still important to a child’s current and future dental health. In the present, they help a child eat, speak and smile properly. They also help create a healthy future as placeholders for developing permanent teeth yet to come in.

If, however, a child loses a primary tooth prematurely due to decay, the corresponding permanent tooth could come in misaligned. That’s why we do what we can to help a decayed primary tooth reach its full lifespan. And there are different ways to do this depending on the type of tooth.

With front teeth, which don’t encounter the same chewing forces as those in the back, we may use a tooth-colored filling. This approach is also preferable for appearance’s sake since front teeth are highly visible when a child speaks or smiles.

Primary molars, on the other hand, need a more robust solution. A filling may not be able to withstand the level of long-term chewing forces that these back teeth normally encounter. And because they’re less visible than front teeth, there’s less concern about aesthetics.

That’s why many pediatric dentists prefer stainless steel crowns for molars. Just like their permanent teeth counterparts, a primary crown fits over and completely covers a tooth. They’re typically pre-formed, coming in different shapes and sizes that can then be customized for the tooth in question. After preparing and removing any decayed material from the tooth, we can usually install the crown in one visit with local anesthesia and a sedative (if the child needs it for anxiety).

While a steel crown isn’t the most attractive restoration, it typically handles the higher chewing forces in the back of the mouth better and longer than a filling. That’s especially critical for primary molars, which are some of the last teeth to fall out (as late as ages 10-12).  And besides preserving it as a permanent tooth placeholder, a crown also helps the tooth function effectively in the present.

Regardless of what method we use, though, preserving primary teeth is a primary goal of pediatric dentistry. And with a stainless steel crown, we can keep those important back molars functioning for as long as they’re intended.

If you would like more information on caring for primary 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 “Stainless Steel Crowns for Kids.”

YourChildIsntinDangerfromX-RaysThankstotheALARAPrinciple

Your child’s dental care wouldn’t be the same without x-ray imaging. It’s one of our best tools for finding and treating tooth decay.

But since x-rays emit radiation, is your child in any danger when they’re exposed?

X-rays, an invisible form of electromagnetic energy, will form images on exposed film after passing through the body. Because it takes longer for x-rays to pass through dense tissue like teeth and bones, the corresponding areas appear lighter on the film than less dense tissue like the gums. We can detect decay because the diseased tooth structure is less dense and thus appears darker against healthier tooth structure.

The downside of x-rays, though, is the radiation they emit could potentially alter cell structure and increase the risk of future cancer, especially with children. That’s why we follow a principle known as ALARA when using x-ray imaging. ALARA is an acronym for “as low as reasonably achievable,” meaning the doses for an x-ray session will be as low as possible while still gaining the most benefit.

Advances in technology, particularly the development of digital processing, has helped reduce the amount of radiation exposure. We’re also careful with what types of x-rays we use. The most common type is the bitewing, a device with the film attached to a long piece of plastic that the child holds in their mouth while biting down.

Depending on the number of our patient’s teeth, we can usually get a comprehensive view with two to four bitewings.  A typical bitewing session exposes them to less radiation than what they’re receiving from natural environmental background sources each day.

Keeping the exposure as low and as less frequent as possible greatly reduces health risks while still getting the full benefit of early decay detection. Still, if you have concerns about your child’s x-ray exposure, we’ll be happy to discuss our approach and all the precautions we take using x-ray imaging.

If you would like more information on x-ray diagnostics and 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 “X-Ray Safety for Children.”

By Mark Ferrari DDS LTD
January 01, 2018
Category: Oral Health
KidsCatsandCaninesDentalDevelopmentThroughtheAges

What do young saber tooth tigers, which have been extinct about 10,000 years, have in common with human kids today? At first glance, not a lot. Smilodon fatalis, the big cat of North America, reached adulthood at around age three and weighed up to 600 pounds. But these ice-age mammals are probably best known for their dagger-like canine teeth, which (as shown by many well-preserved skeletons) grew up to 7 inches long. And that’s where the comparison between kids and kitties gets interesting.

The toothy felines had primary (baby) teeth and adult teeth, which developed in a similar way to human dentition. The primary teeth came in first, persisted during the young cat’s development, and shared space in the mouth as the adult teeth were erupting (growing in) — with one big difference. According to a recent study reported in the academic journal PLOS ONE, those colossal canines grew at an astonishing rate: up to 6 millimeters per month! By comparison, human primary teeth emerge from the gums at around 0.7mm per month, while permanent teeth may grow up to 2mm per month.

It’s understandable why those tiger teeth developed so rapidly: Life in the Ice Age was hard, and predators needed every advantage just to stay alive. But while human baby teeth take longer to develop (and to go away), they, too, are vitally important. For one thing, the primary teeth let kids bite, chew, speak (and smile) properly, until they are replaced by adult teeth — a process that isn’t usually finished until a child reaches the age of 12-13. So those “baby” teeth allow kids to have good nutrition — and positive social interactions — for a significant part of childhood!

There’s another important thing primary teeth do before they’re gone: They help ensure that the succeeding teeth come in properly, by holding a space in the jaw that will later be filled by a permanent tooth. If baby teeth are lost prematurely, those spaces can close up, resulting in permanent teeth that emerge too close together, or in the wrong places. This condition, called malocclusion (bad bite), can usually be corrected by orthodontics. But it’s better to avoid the inconvenience (and cost) of braces, if possible.

That’s why it’s so important to take care of your child’s baby teeth. Even though they won’t be around forever, they have a vital role to play right now. So be sure proper attention is paid to your child’s oral hygiene: That means avoiding sugar, and remembering to brush and floss every day. And be sure to come in regularly for routine exams, cleanings, and needed care. It’s the best way to keep those little teeth from “going extinct” too soon!

If you have questions or concerns about your child’s baby teeth, please call our office to schedule a consultation. You can read more in the Dear Doctor magazine articles “Importance of Baby Teeth” and “Early Loss of Baby Teeth.”

By Mark Ferrari DDS LTD
November 24, 2017
Category: Oral Health
ActorDavidRamseyDiscussesBabyBottleToothDecay

Cavities can happen even before a baby has his first piece of candy. This was the difficult lesson actor David Ramsey of the TV shows Arrow and Dexter learned when his son DJ’s teeth were first emerging.

“His first teeth came in weak,” Ramsey recalled in a recent interview. “They had brown spots on them and they were brittle.” Those brown spots, he said, quickly turned into cavities. How did this happen?

Ramsey said DJ’s dentist suspected it had to do with the child’s feedings — not what he was being fed but how. DJ was often nursed to sleep, “so there were pools of breast milk that he could go to sleep with in his mouth,” Ramsey explained.

While breastfeeding offers an infant many health benefits, problems can occur when the natural sugars in breast milk are left in contact with teeth for long periods.  Sugar feeds decay-causing oral bacteria, and these bacteria in turn release tooth-eroding acids. The softer teeth of a young child are particularly vulnerable to these acids; the end result can be tooth decay.

This condition, technically known as “early child caries,” is referred to in laymen’s terms as “baby bottle tooth decay.” However, it can result from nighttime feedings by bottle or breast. The best way to prevent this problem is to avoid nursing babies to sleep at night once they reach the teething stage; a bottle-fed baby should not be allowed to fall asleep with anything but water in their bottle or “sippy cup.”

Here are some other basics of infant dental care that every parent should know:

  • Wipe your baby’s newly emerging teeth with a clean, moist washcloth after feedings.
  • Brush teeth that have completely grown in with a soft-bristled, child-size toothbrush and a smear of fluoride toothpaste no bigger than a grain of rice.
  • Start regular dental checkups by the first birthday.

Fortunately, Ramsey reports that his son is doing very well after an extended period of professional dental treatments and parental vigilance.

“It took a number of months, but his teeth are much, much better,” he said. “Right now we’re still helping him and we’re still really on top of the teeth situation.”

If you would like more information on dental care for babies and toddlers, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “The Age One Dental Visit” and “Dentistry & Oral Health for Children.”