Learn About Pediatric Dentistry

Your child won't keep his or her first teeth forever, but that doesn't mean those tiny pearly whites don't need conscientious care. Maintaining your child's dental health now will provide health benefits well into adulthood, as primary (baby) teeth serve some extremely important functions. You can learn about pediatric dentistry in Weymouth, MA, when you turn to Dentistry for Children, P.C. for complete care.

Why Early Care Matters

Group of elementary school kids

For one thing, primary teeth serve as guides for the eruption of permanent (adult) teeth, holding the space into which these new teeth will erupt. The crowns (tops) of the permanent teeth actually push against the roots of the baby teeth, causing them to resorb, or melt away. In this way, the adult teeth can take their proper place.

What's more, your child's primary teeth will be there for most of childhood, helping your child to bite, chew and speak. For the first six or so years, he or she will be relying on primary teeth exclusively to perform these important functions. Until around age 12, your child will have a mix of primary and permanent teeth. You will want to make sure those teeth stay healthy and are lost naturally — when it's time.

Taking Care of Baby Teeth

Your child's 20 baby teeth will begin to appear usually between six and nine months, though in some cases it may start as early as three months or as late as twelve months. The two lower front teeth tend to erupt first, followed by the two upper ones. The first molars come in next, followed by the canines (eye teeth). Sometimes your baby can experience teething discomfort during this process. If so, let us know, and we will advise you as to the best course of action.

Your infant's gums and newly erupting teeth should be gently wiped after each feeding with a water-soaked gauze pad or damp washcloth. Starting at age 2, when there are more teeth in the mouth, establish a daily brushing routine with a small, soft-bristled toothbrush and no more than a thin smear of fluoridated toothpaste. Your child may need your help with this important task until about the age of 6.

Your Child's First Dental Appointment

Mom and son celebrate first birthday

The American Academy of Pediatric Dentistry recommends that you bring your child in to see us by his or her first birthday. Though this may sound early, we can teach you proper pediatric oral hygiene techniques, check for cavities, and watch for developmental problems.

There are a number of forms of tooth decay that can affect babies and small children. Early Childhood Caries (tooth decay) can develop rapidly, progressing from the hard, outer enamel layer of a tooth into the softer, inner dentin in six months or less.

Most of all, we want to make sure your child has a positive experience at our office and will be a regular visitor for years to come.

Pediatric Dental Treatments

There are a variety of dental treatments we provide to prevent tooth decay in children, save teeth, and even repair teeth when necessary.

Topical Fluoride: Fluoride incorporates into teeth’s enamel, making it harder and more resistant to decay. Although there is a small amount of fluoride in toothpastes and in some drinking water supplies, we can apply a higher concentration onto your child's teeth for maximum protection.

Dental Sealants: We can apply a plastic coating that prevents cavities by sealing the little grooves on the chewing surfaces of back teeth known as “pits and fissures.” These little crevices become the perfect environments for decay-causing bacteria. Immature tooth enamel is more permeable and therefore less resistant to tooth decay. Dental sealants are easy to apply and provide years of protection.

Root Canal Treatment: Perhaps you have had a root canal treatment yourself, to save an injured or severely decayed tooth. Well, sometimes children need root canals, too. As mentioned above, baby teeth are important guides to the permanent teeth that are already forming beneath your child's gums. Therefore, saving them from premature loss can help prevent a malocclusion (“mal” - bad; “occlusion” - bite) that requires orthodontic treatment.

Bonding: Chips and minor fractures to front teeth - common childhood occurrences - can be repaired with tooth-colored bonding materials. These lifelike resins made of plastic and glass can be used on baby teeth, as well as permanent teeth, and last until the youngster has completed facial growth.

Orthodontic Concerns

By age 7, most malocclusions have become evident. Interceptive orthodontic treatment around this time can help direct proper tooth positioning and/or jaw growth, eliminating or simplifying the need for later treatment. There are many orthodontic problems that can be detected early and are examples of why a trained professional should evaluate your child during his or her growth and development.

Sports and Your Child's Teeth

Boys playing soccer

If your child is active in sports, we highly recommend a custom-made mouth guard. According to the American Dental Association, an athlete is 60 times more likely to suffer dental harm when not wearing one of these protective devices.

We can have a mouth guard custom-made specifically for your child using a model of his or her teeth. Custom mouth guards offer better protection than off-the-shelf models. It's an investment that pays off highly in the form of reduced pain, suffering, and dental expenses down the road. Please ask us about mouth guards during your child's next appointment.

Infant Oral Examinations

According to the American Academy of Pediatric Dentistry, a child’s first checkup should occur by age one. Surprised? You shouldn’t be! Even though there may only be a few baby teeth visible at that age, there are plenty of things we can start working on — including the development of healthy habits that will make future visits to the dentist far more pleasurable.

We feel so strongly about this that at Dentistry For Children, P.C., we offer complimentary examinations for all infants under 18 months. Call us today to schedule your child’s examination!

New parents have plenty to worry about: making sure their baby is healthy and happy, re-arranging their lives around hectic schedules and lost sleep, and figuring out what to do in all sorts of novel situations. When it comes to your child’s oral health, though, there’s plenty of help available. It all begins at our practice, when you bring your youngster in for his or her first visit to visit us.

Unfortunately, some kids develop tooth decay at an early age. We will be on the lookout for cavities — but that’s only one reason for an early visit to our office. Equally important is reviewing the proper ways to care for a young child’s mouth, going over your child’s developmental milestones, and discussing the importance of good oral hygiene.

Preparing for the Big Day

The way kids seem to pick up on their parents’ feelings sometimes seems uncanny; so, if you’re nervous about going to the dentist yourself, try not to let it show. Generally, during this visit we’ll simply be talking to you and your child, looking in his or her mouth, and making oral health assessments. It’s best to tell your child what to expect beforehand, without making too big a fuss about it. You could even build some excitement by helping them get ready for “the big day.”

When you come in, it’s a good idea to bring a comforting toy, a snack, and an extra diaper or two, just in case of fussiness. If possible, leave other kids at home, so we can concentrate on the new patient — but if you can bring another adult along, it may free your attention to focus on your child’s oral health. Likewise, filling out our forms in advance may save time and effort on the day of the visit.

The Checkup

When you and your child are comfortably seated in the office, we’ll spend a few minutes getting to know each other and explaining what we will be doing. Then, we’ll perform a gentle examination of the mouth. We will be looking for any early signs of dental problems such as tooth decay, and assessing the risk that your child may develop the disease in the future. Often, this kind of risk assessment can help us prevent — and even reverse — the early stages of tooth decay, without any drilling.

Finally, we’ll discuss various ways to keep your child’s oral health in top condition. For instance, we may talk about how diet, eating habits and oral hygiene practices can help prevent tooth decay, the most common chronic disease of childhood. That’s an important subject for everyone — even more so if your child is at greater risk. If any treatments (such as fluoride) are needed, we will explain what they are and why we recommend them. We will also review tips on cleaning and brushing effectively, and we’ll schedule a follow-up visit as required.

Many habits are developed early in life. That’s why it’s important to “get it done by age one.” So when it’s time for your child’s first visit… don’t hesitate! You’ll be glad you came in. And it’s free!

Fluoride and Your Child

Child drinking water from fountainFluoride, a naturally occurring mineral, is essential for proper tooth development and the prevention of tooth decay. In communities throughout the United States, tooth decay may still be a significant problem — but it is far less prevalent than it would have been, if not for the fluoridation of public water supplies. That’s why the major associations of pediatric dentists and doctors support water fluoridation to the current recommended levels of 0.70 parts per million (ppm). It’s also why the federal Centers for Disease Control and Prevention (CDC) has called fluoridated water one of the most significant health achievements of the 20th century.

Of course, not everyone has access to fluoridated water. That’s one reason why we sometimes recommend a fluoride supplement for your child and/or the use of toothpastes and other products that contain this important mineral. Because it is possible for children to get too much fluoride, it is best to consult with us on the use of any fluoride-containing product.

How Fluoride Helps

The protective outer layer of teeth, called enamel, is often subject to attacks from acids. These can come directly from acidic foods and beverages, such as sodas and citrus fruits — or sometimes through a middleman: the decay-causing bacteria already in the mouth that create acid from sugar. These bacteria congregate in dental plaque and feed on sugar that is not cleansed from your child’s mouth. In metabolizing (breaking down) sugar, the bacteria produce acids that can eat through tooth enamel. This is how cavities are formed. When fluoride is present, it becomes part of the crystalline structure of tooth enamel, hardening it and making it more resistant to acid attack. Fluoride can even help repair small cavities that are already forming.

Delivering Fluoride to the Teeth

Correct amount of toothpaste for childrenFluoride ingested by children in drinking water or supplements can be taken up by their developing permanent teeth. Once a tooth has erupted, it can be strengthened by fluoride topically (on the surface). Using a fluoride-containing toothpaste is one way to make sure your children’s teeth receive helpful fluoride exposure daily. We recommend using only a pea-sized amount for children ages 2-6 and just a tiny smear for kids under two. Fluoride should not be used on children younger than six months. A very beneficial way to deliver fluoride to the teeth is with topical fluoride applications right here at the dental office. We can paint it right onto your child’s freshly cleaned teeth and let it sit for a few minutes for maximum effectiveness.

How Much Is Too Much?

Teeth that are over-exposed to fluoride as they are forming beneath the gum line can develop a condition called enamel fluorosis, which is characterized by a streaked or mottled appearance. Mild fluorosis takes the form of white spots that are hard to see. In more severe cases (which are rare), the discoloration can be darker, with a pitted texture. The condition is not harmful, but may eventually require cosmetic dental treatment. Tooth decay, on the other hand, is harmful to your child’s health and can also be quite painful in severe cases.

Sealants

Toothbrush unable to clean grooves on teethThe most likely location for a cavity to develop in your child’s mouth is on the chewing surfaces of the back teeth. Run your tongue over this area in your mouth, and you will feel the reason why: These surfaces are not smooth, as other areas of your teeth are. Instead, they are filled with tiny grooves referred to as “pits and fissures,” which trap bacteria and food particles. The bristles on a toothbrush can’t always reach all the way into these dark, moist little crevices. This creates the perfect conditions for tooth decay.

A child’s newly erupted permanent teeth are not as resistant to decay as adult teeth are. The hard enamel coating that protects the teeth changes as it ages to become stronger. Fluoride, which is found in toothpaste and some drinking water — and in treatments we use here at the dental office — can strengthen enamel, but, again, it’s hard to get fluoride into those pits and fissures on a regular basis. Fortunately, there is a good solution to this problem: dental sealants.

Dental sealants are invisible plastic resin coatings that smooth out the chewing surfaces of the back teeth, making them resistant to decay. A sealed tooth is far less likely to develop a cavity, require more expensive dental treatment later on, or, most importantly, cause your child pain.

How Sealants Are Placed

Dental sealants (step by step)You can think of a sealant as a mini plastic filling, though please reassure your child that it doesn’t “count” as having a cavity filled. Because tooth enamel does not contain any nerves, placing a sealant is painless and does not routinely require numbing shots. First we will examine the tooth or teeth to be sealed, and if any minimal decay is found, it will be gently removed. The tooth will then be cleaned and dried. Then we will apply a solution that will slightly roughen or “etch” the surface, to make the sealing material adhere better. The tooth is then rinsed and dried again. The sealant is then painted on the tooth in liquid form and hardens in about a minute, sometimes with the help of a special curing light. That’s all there is to it!

Our sealants are BPA Free.

Taking Care of Sealants

Sealed teeth require the same conscientious dental hygiene as unsealed teeth. Your child should continue to brush and floss his or her teeth daily and visit us for regular professional cleanings. This will give us a chance to check for wear and tear on the sealants, which should last for up to 10 years. During this time, your child will benefit from a preventive treatment proven to reduce decay.

Teething

Baby crying from teething painNew parents sometimes anticipate their baby’s first tooth with a mixture of excitement and worry. While reaching a new developmental milestone is always a cause for celebration, this particular one can come with considerable discomfort. However, teething is different for each baby, and need not be painful at all; plus, there are steps you can take to make the process easier for your baby — and yourself.

Teething refers to the process by which primary (baby) teeth emerge through the gums and become visible in the mouth. This usually begins between six and nine months of age, though it may start as early as three months or as late as one year. Usually, the lower front teeth erupt first, followed by the ones directly above. Most children have all 20 of their primary teeth by the age of 3 (View Tooth Eruption Chart).

Recognizing the Signs

Common signs that your baby is teething include:

  • Irritability
  • Biting and gnawing
  • Drooling
  • Chin rash (caused by excessive salivation)
  • Swollen gums
  • Ear rubbing
  • Decreased appetite
  • Disrupted sleep patterns

You are most likely to notice any of the above from about four days before the tooth breaks through the gums up until three days after the tooth appears.

A less common teething issue is the formation of an “eruption cyst,” a small bubble-like swelling filled with fluid that covers an erupting tooth. Eruption cysts usually do not require treatment as the tooth will simply pop the cyst when it comes through.

While there has been some disagreement as to whether diarrhea, rashes and fever are signs of teething, these are more likely to be associated with an unrelated illness and should be reported to your pediatrician.

How to Help

Teething babies get the most relief from cold and/or pressure on the affected area. This can be applied with:

  • Chilled teething rings
  • Cold, wet washcloths
  • Chilled pacifiers
  • Massaging baby’s gums

Make sure not to actually freeze your baby’s teething ring or pacifier because this could burn if left in the mouth for too long. The outmoded “remedy” of rubbing whiskey or other alcohol on the gums is neither effective nor appropriate. Over-the-counter medication may be helpful, but always check the correct dosage with your pediatrician or pharmacist. These, too, should not be rubbed on the gums because they can burn. Numbing agents shouldn’t be used on babies under age 2 unless directed by a physician.

Finally, if you have any questions or concerns about teething, feel free to contact our office. Remember, it’s best to start dental visits by your child’s first birthday to establish this lifelong health-promoting routine. We look forward to meeting your little one!

Nitrous Oxide for Children

Child in dental chairSome children are just too fearful to receive necessary dental care. In that type of situation, we may recommend sedation with nitrous oxide to help make your child’s experience of dental treatment stress-free.

Nitrous oxide, a colorless gas with a slightly sweet odor, has been used in medicine for about a century. It’s a safe and effective method of administering sedation, which means that a child (or adult) will stay awake during the procedure, but feel completely relaxed — even happy. All bodily functions remain normal during the administration of nitrous oxide, and its effects wear off quickly afterwards.

How Is Nitrous Oxide Administered?

As a form of conscious sedation, nitrous oxide is inhaled through a small mask that fits comfortably over a child’s nose. The gas is mixed with oxygen as it is being delivered, and both gases are always kept at a level that is safe for the body. In just a few minutes, the patient may start to experience a floating sensation, and perhaps some tingling in the hands and feet. That’s a sign that the sedation is working. Once it has been verified that your child is calm and comfortable, and that the dose is correct, the dental procedure can begin.

Nitrous oxide itself isn’t a substitute for a local anesthetic in children or adults as it’s considered an anxiolytic, which means it makes anxiety disappear. However, for some pediatric procedures, a child receiving nitrous oxide may not need an anesthetic injection. Even if they do need a numbing shot, they won’t mind at all while under sedation with nitrous oxide. Yet they won’t be asleep — they’ll be able to speak, be aware of what’s going on, and they will remain in control during the procedure. In fact, the dose can be fine-tuned to just the level of sedation they need to make them comfortable yet alert.

When the procedure is over, the flow of nitrous oxide is decreased to zero, and the oxygen will be increased. After resting in the chair for a few minutes, the child will feel completely normal.

Who Can Benefit From Nitrous Oxide?

Any child whose anxiety would otherwise keep them out of the dental chair can benefit from sedation with nitrous oxide. Before beginning treatment, we will take a complete medical history, including any medications your child is taking. We will make sure that your child is safe and comfortable.

Pacifier Tips

Tips on weaning your child from the pacifier, including different approaches that can reduce stress for both kids and parents when trying to “ban the binky!”

By AAPD President Dr. Ed Moody

Many parents are thankful for the invention of pacifiers that can help calm and soothe fussy babies. Infants often use a pacifier or suck on a thumb for comfort, security or simply as a method to make contact with the world. In fact, some babies begin to suck on their fingers or thumbs even before they are born! The American Academy of Pediatric Dentistry (AAPD) recommends a pacifier over a thumb to comfort new babies since a pacifier habit is easier to break at an earlier age.

Why does this matter?

Steps for pacifier weaningThe sucking reflex is completely normal and many children will stop sucking on thumbs, pacifiers or other objects on their own between 2 and 4 years of age. Frequent pacifier use over a longer period of time can affect the way a child’s teeth bite together and the growth of the jaw. The upper teeth may tip outward or become crooked and other changes in tooth position or jaw alignment could occur. Intervention may be recommended for children beyond 3 years of age. The earlier a child can stop a sucking habit, the less chance there is that it will lead to orthodontic problems down the road.

My child won’t give up their pacifier – what do I do?

Some parents swear by cold turkey, while others have gradually weaned their children off pacifiers. Below are some techniques that will help your infant give up the Binky for good. But no matter which route you take, remember that as the experts in little teeth, pediatric dentists will be an invaluable resource for guidance and recommendations on the best approach to quit the pacifier.

Ask your pediatric dentist

A pediatric dentist can assist in encouraging children to stop a sucking habit and discuss each child’s particular situation. This, along with support from parents and caregivers, helps many children quit their pacifier and thumb-sucking habits. If your child needs further encouragement, pediatric dentists can also recommend behavior modification techniques to persuade children to quit the pacifier for good.

Offer an alternative

What causes your child to cry out for their beloved Binky? Once you’ve identified which situations trigger your child’s desire for a pacifier, be ready to replace it with comfort and reassurance. It can be helpful to swap out the pacifier with a transitional object such as a cuddly doll or stuffed toy. Additionally, distracting your child with a fun activity can help take their mind off the desired Binky. Be sure to offer positive reinforcement and praise when your child sleeps through the night or self-soothes without his pacifier.

Time to get creative

If you’re still running into roadblocks, it’s time to put a creative spin on the “bye-bye Binky” process. One idea is to take your child and pacifier to the store to pick out a new toy to replace their pacifier. There are many experienced store clerks who are used to this trick and are willing to play along when your child “trades in” the pacifier for a new toy of her choosing. Other parents have thrown a “Goodbye Binky” party, set out the pacifier for the Binky Fairy or donated the Binky to children who need it.

Use a countdown

If your child is resisting the idea of losing his or her pacifier, try making the process into a game. Similar to the graphic shown on this page, create a countdown game where you tell the child that over the next three to four weeks Binky will be shrinking. The first week, cut a very small hole in the top of the pacifier. Be careful to make clean cuts that do not leave any part of the pacifier hanging which could break off in your child’s mouth. Continue to cut a portion of Binky off each week until there is no longer anything left for your child to suck on. This is a great way to separate your child’s association from someone taking the pacifier away to the pacifier just breaking on its own. At the end, you can tell your child it’s time to bid Binky bye-bye.

Timing is key

Whether you decide to gradually wean or go cold turkey, make sure to time it right. Try not to take away the pacifier during life changes, major transitions or traveling so as not to put further stress on the process. Once you’ve made the plan to ditch the pacifier, make sure all caregivers are on board and stick with it! If you choose to gradually remove the pacifier, try limiting use to nap time and bed time at first. Or, let your child use the pacifier for short periods of time if you feel he particularly needs it, and gradually shorten the frequency and length of time the pacifier is used.

If you decide to go cold turkey, be sure to collect all pacifiers around the house – the last thing you need is your little one finding a pacifier the week after she gave it up and going back to square one! If you need additional ideas on how to wean your child off the pacifier be sure to ask your pediatric dentist or visit mychildrensteeth.org for further tips and a pediatric dentist locator to find a pediatric dentist near you.

Photo of Dr. MoodyDr. Ed Moody is in private practice in Morristown, Tennessee. He is a graduate of Auburn University and the University Of Tennessee College Of Dentistry, and received his certificate in pediatric dentistry from the Medical College of Virginia. He has been a member of the AAPD for 25 years. Moody and his wife, Jenny, are the parents of three daughters.

Thumb Sucking and Your Child

Dangers of thumb suckingSucking on a thumb or finger is a completely normal habit that some babies develop even before they’re born. It’s soothing, and it also helps babies make contact with and explore their environment. If sucking habits go on much past the age of 3, however, it’s possible that bite problems may arise.

In a normal bite, the upper teeth grow to overlap the lower teeth. But it’s possible for the pressure of a thumb, finger or pacifier resting on the gums to interfere with normal tooth eruption and even jaw growth. Some thumb-suckers develop an “open bite,” meaning the teeth don’t overlap when a child bites together (View Example); instead, there is an open space between the upper and lower teeth. That’s why thumb sucking is definitely something we should keep an eye on, though we don’t want to intervene too soon.

Breaking the Habit

It’s important to keep in mind that most children break thumb-sucking habits on their own between the ages of 2 and 4. So if you’re trying to get your child to stop, the first thing to do is simply ignore it. Pacifiers will usually be given up more quickly than thumbs or fingers. If your child seems unable to stop when it’s time, positive reinforcements tend to work better than negative (e.g., putting a bitter substance on the thumb). Here are some things you can try:

  • Praise & Reward. Explain to your child why it’s so important not to suck thumbs and think of a way to reward them for not doing it — as long as it’s not with tooth-harming sweets! Stickers or an activity they enjoy might serve well. Always offer gentle reminders rather than scold when you notice a thumb in your child’s mouth, and praise them when they stop.
  • Comfort & Distract. Children have different triggers for thumb sucking. Does your child tend to do it when stressed or bored? If so, some extra hugs might help, or an activity to keep those little hands busy.
  • Get Creative. You know your child best. Maybe there’s a method that would be particularly motivating to him. For example, you could tie his pacifier to a helium balloon and send it up to the Tooth Fairy. When she receives it, she can leave a special present under his pillow!
  • Let Us Help. If your child sucks her thumb, fingers, or a pacifier, be sure to let us know. We can talk to her and help her understand how it will help her teeth to kick the habit. If necessary, we can fit her with a special oral appliance called a tongue crib (View Example), which physically prevents thumb sucking and can usually break the habit in a few months.

Thumb sucking is just one reason why it’s important to maintain your child’s regular schedule of dental exams, starting from the age of 1 year. We can also teach you and your child effective oral hygiene techniques, help prevent tooth decay, and generally monitor dental growth and development. Though orthodontics can usually fix bite problems that result from sucking habits, we’d just as soon help you avoid this expense if possible!

Space Maintainers

Young girl missing teethYour child’s little baby teeth have some big responsibilities. Until the adolescent years, they will not only help your youngster bite and chew (i.e., get proper nutrition) and speak correctly but also help guide the permanent teeth underneath them into proper position. In fact, a major function of baby teeth is to hold space for the adult teeth that will eventually push them out.

At least that’s how it’s supposed to work; sometimes, however, injury or disease can cause a baby tooth to be lost prematurely. When that happens, the permanent teeth that are coming in on either side can actually drift into the space that was reserved for another tooth. This can cause teeth to erupt out of position or to be blocked entirely, and it may result in crowded or crooked teeth.

Fortunately, if your child loses a tooth prematurely, there’s a dental appliance we can use to hold the space open for the permanent tooth that is meant to fill it. The device is, not surprisingly, called a “space maintainer” or a “space maintenance appliance.” Made of metal and/or plastic, space maintainers can be fixed (cemented) or removable, but either way their purpose is the same: to help your child develop the best bite possible and hopefully avoid the need for braces later on.

Fixed appliances are cemented onto adjacent teeth. They are made in many different designs: One consists of a band that goes around a tooth and then a wire loop that extends out from the band to hold the space; another features a loop attached to a stainless steel crown, which goes over a nearby tooth. In either case, the loop extends just to the point where it touches the next tooth. Fixed space maintainers are often preferred with younger children, because they are less easy to fidget with, break, or misplace than appliances that can be removed.

Removable appliances look like the type of retainer that is worn at the end of orthodontic treatment. It can have a false tooth on it, which is particularly useful when the lost tooth was visible in the mouth. Older children can usually handle the responsibility of wearing this appliance and caring for it properly.

Whether fixed or removable, your child’s space maintainer will be custom-made after we take impressions of his or her mouth. A child will wear a space maintainer until x-rays reveal that the tooth underneath is ready to erupt naturally. It is very important that anyone wearing a space maintainer keep up good oral hygiene at home and come in for regular professional dental cleanings.

Space maintainers are also useful when one or more permanent teeth are congenitally missing — in other words, they have never existed at all. In cases like this, which are not uncommon, permanent dental implant teeth are often recommended for adolescents or adults to replace a tooth they weren’t born with. But timing is very important with dental implants — they can’t be placed in a growing child. Therefore, we may use a space maintainer with a false tooth on it until jaw growth is complete and an implant can be appropriately placed. It’s a simple, non-invasive way we can avoid a malocclusion (bad bite) with some timely intervention.

Mouthguards for Children

Kids who take part in athletic activities — whether they’re playing on organized sports teams, bicycling, or just kicking a ball around — gain a host of well-documented health benefits. Yet inevitably, along with all the fun, the sense of achievement, and the character-building features of athletics, the possibility of injury exists. Does this mean your kids shouldn’t play sports? Of course not! But it makes sense to learn about the risks involved, and to take appropriate precautions.

How prevalent are sports-related dental injuries? In 2012, the National Youth Sports Safety Foundation forecast that more than 3 million teeth would be knocked out in youth sporting events that year! Among all the dental injuries we treat in children, it is estimated that over 25% are sports-related, and the majority of these involve the top front teeth.

Besides the immediate trauma, sports-related injuries can result in time lost from school and work, and substantial cost — up to $20,000 over a lifetime to treat a missing permanent tooth. Yet there’s a simple and relatively inexpensive way to reduce the chance of dental injury in children: A properly-fitted, comfortable mouthguard, worn whenever playing sports where the possibility of orofacial injury exists.

Use the Right Equipment

Diagram of athletic mouthguardsYou wouldn’t let your child play football without a helmet and protective padding, right? Yet it might surprise you to know that kids playing basketball are 15 times more likely to sustain injuries to the mouth or face than football players! Mandatory mouthguards are one reason for that: More American kids wear mouth protection for football than any other sport, which has resulted in a dramatic drop in injuries.

Mouthguards are required in only four school-based sports: football, ice hockey, lacrosse, and field hockey. Yet basketball and baseball are associated with the largest number of dental injuries. Other sports for which the American Dental Association (ADA) recommends wearing a mouthguard include bicycling, soccer, skateboarding, wrestling and volleyball. According to the Academy of General Dentistry, mouthguards prevent more than 200,000 injuries each year.

Types of Mouthguards

The best mouthguard for your child is the one he or she actually wears, both at practice and on game day. There are several different types of mouthguards on the market, which generally fall into three categories:

  • Off-the-shelf mouthguard. Available at many sporting goods stores, this type comes in a limited range of sizes, and varies widely in quality. The least expensive option, it offers a minimal level of protection that’s probably better than nothing. It generally must be clenched in the mouth, which can make wearing it uncomfortable and cause trouble breathing and speaking.
  • “Boil and bite” mouthguard. These are designed to be immersed in hot water, and then formed in the mouth using finger, tongue and bite pressure. When they can be made to fit adequately, they generally offer better protection than the first type — but they may still be uncomfortable, and usually fail to offer full coverage of the teeth.
  • Custom-made mouthguard. This is a piece of quality sports equipment that’s custom-fabricated for your child’s mouth. We start by making a model of the teeth, and then mold the protector around it for a perfect fit. It’s made from tough, high-quality material, offering maximum protection and a superior level of comfort — and its cost is quite reasonable.

At the present time, when top-quality sports equipment for kids can run in the hundreds of dollars, it makes more sense than ever to invest in the proven protection of a professionally made, custom-fitted mouthguard. Just ask us about it!

Emergency Care

When you have a dental emergency — whether it’s caused by a sudden accident or chronic disease — your teeth and/or the tissues of the mouth that surround them need to receive proper care right away. As with any type of medical emergency, it’s important to be aware, before you’re actually in the situation, of what you can do to ensure the best outcome.

Traumatic Dental Injuries

Child getting hit by baseballA knocked-out permanent tooth requires quick thinking and immediate action. You’ll increase the chances that the tooth can be saved if you pick it up without touching the root, gently clean it off with water, and put it back in its socket facing the correct way. Hold it in place with gentle pressure as you rush to the dental office or emergency room. If you can’t replant it immediately, tuck it between the patient’s cheek and gum, or carry it in a container of cold milk.

For a more traumatic injury such as a tooth that has been moved or loosened, treatment needs to occur within six hours. However, if there is uncontrollable bleeding, go immediately to the ER. Fortunately, other dental injuries that happen most frequently are less severe. The most common traumatic dental injuries are chipped teeth. If a tooth is chipped, try to find any pieces that have come off, as it might be possible to reattach them. Make an appointment for an office visit as soon as possible, and bring the pieces with you.

Tooth Pain

Woman with tooth painAcute or persistent tooth pain always signals a need for an urgent visit to the dental office. The most common cause of dental pain is tooth decay, a bacterial infection that can spread through many parts of the tooth, and even into the gum tissue. Sometimes, tooth pain indicates that you may need a root canal treatment — a procedure that not only relieves the pain of an infection deep inside the tooth, but also can keep the tooth from having to be removed. Other times, pain may be caused by a loose filling or sensitive tooth. The only way to know for sure what’s causing your tooth pain is to make an appointment at the dental office right away.

Gum Emergencies

Injuries and infections involving the soft tissues of the mouth may also require emergency treatment. The tissues of the gums, tongue, or cheek lining can be damaged by accidental bites, falls, sports injuries, and scalding liquids. They may also suffer injury from foreign bodies that become lodged below the gum line, and they can develop painful and potentially serious abscesses. A periodontal (gum) abscess is a pus-filled sac caused by an infection and is usually quite painful. Abscesses require immediate attention at the dental office.

Any injury to the soft tissues of the mouth should be rinsed with dilute salt water. If there is visible debris, it should be cleared. Bleeding can usually be controlled by pressing a clean, damp material to the area for 10-15 minutes. If this does not work, go to the emergency room immediately.

A foreign body lodged beneath the gum line can sometimes be gently worked out with dental floss or a toothpick. But if this can’t be accomplished easily, make a dental appointment so the area does not become damaged and/or infected.

Orthodontic Emergencies

Although there can be discomfort associated with orthodontic treatment, there are only a few true orthodontic emergencies. They include trauma or injury to the teeth, face or mouth. Infection or swelling of the gums, mouth or face, and severe, unmanageable discomfort or pain in these areas can also be orthodontic emergencies. In any of these situations, seek immediate care from the dental office or emergency room — whichever is your best option. For loose, broken or irritating pieces of orthodontic hardware, please call the dental office for advice.

Root Canal Treatment for Children

Mother and child posingRoot canal treatment is a safe and effective way to stop many kinds of tooth pain, and to keep a tooth from being lost due to decay or injury. But if a root canal is recommended for your young child, you may wonder why: Isn’t that baby tooth going to fall out in a few years anyway?

That’s true — the primary (baby) teeth typically are shed between the ages of 6 and 12 years. Yet there are some good reasons for trying to save baby teeth for as long as possible with root canal treatment, rather than simply extracting any that are damaged by trauma or infection.

For one, primary teeth have the same functions as adult teeth — and a missing tooth at any age can cause problems with speech and eating. Baby teeth also have another important role: They serve as guides for the proper placement of the permanent teeth. Without primary teeth to guide them in, permanent teeth tend to emerge in a crooked fashion, often becoming tilted or crowded because of inadequate space. This can result in bite problems that may require extensive orthodontic treatment later.

Saving The Tooth Is Always Best

Root canal treatment for childrenUnlike its hard outer surface, the soft pulp inside the tooth is rich in blood vessels and nerves. Problems in this area are often signaled by tooth sensitivity and pain. When we find these symptoms during an examination, we generally use radiographs (x-rays) to confirm that the pulp is diseased, or dying. That’s when we need to take action, before an abscess or further infection can develop.

In severe cases, the tooth may need to be removed, and a space maintainer installed to fill the gap. But many times, space maintainers don’t fully restore the tooth’s functionality. Plus, they are susceptible to coming loose and must be monitored constantly. If possible, we prefer to use treatment methods such as:

  • Indirect pulp treatment. If pulp damage is minimal, it’s possible to remove most of the decay (but not the pulp), apply an antibiotic, and then seal the tooth up again; that’s referred to as an “indirect” treatment.
  • Pulpotomy. Alternatively, if decay is limited to the upper portion of the pulp, we may recommend a “pulpotomy.” This involves removing the damaged part of the pulp, stabilizing the remaining healthy portion, and then disinfecting and sealing the tooth. This “partial” root canal is a time-tested technique that’s successful in many cases.

Preparing for Your Child’s Root Canal Treatment

As you probably already know, most of the legends you may have heard about root canal therapy simply aren’t true. In fact, the procedure generally causes little discomfort, but is quite successful in relieving tooth pain! We are adept at using anesthesia to block the sensation of pain, and experienced in calming the fears of young ones. While it’s understandable that you may be nervous, it will help if you don’t let your child pick up on your own anxiety. A calming voice and a gentle touch can do much to relieve stress.

After a thorough examination, we will recommend the best options for your child’s treatment. The procedures are routinely done right here in our office. A root canal is nothing to fear: Think of it as a treatment that may save your child from some tooth pain now, and potentially a lot of corrective dental work later on.

We proudly serve families in Weymouth, Massachusetts,
as well as those throughout the South Shore.