Although it’s a natural part of dental development, teething is no picnic for your baby. This process in which each of their twenty primary teeth gradually erupt through the gums usually begins around their sixth to ninth month and may not end until around age three.
These periodic tooth eruptions can cause your baby to bite, gnaw, drool or rub their ears. Teething can also disrupt sleeping patterns, decrease appetite and cause gum swelling and pain that can turn your otherwise happy baby into an unhappy one.
Managing these teething episodes is one of the most common topics parents bring up with their dentists. Since teething is supposed to happen, there’s no need for medical intervention unless the child is also experiencing diarrhea, rashes, fever or prolonged irritability associated with teething episodes. In most cases, the best you can do is to make your child more comfortable. Here are a few things to help you do just that.
Provide cold items for gnawing. Rubber teething rings, wet wash cloths or pacifiers that have been chilled can give your child something to gnaw on and ease the pressure of sore gums while the chilled temperatures help numb pain. Be sure, though, that the items aren’t frozen because extremely cold temperatures can burn the skin.
Gum massage. You can massage your child’s gums with one of your fingers during a teething episode to counteract the throbbing pressure coming from the erupting tooth. Just be sure your finger is clean and don’t use any numbing agents unless advised by your dentist or pediatrician.
OTC medication. You can ease mild to moderate teething pain with over-the-counter pain relievers like acetaminophen or ibuprofen in dosages appropriate for your child’s age. But don’t apply rubbing alcohol to the gums or massage in any pain reliever—both practices can burn the skin. And, as mentioned before, only apply numbing agents like Benzocaine with the advice and supervision of a healthcare professional.
Besides these practices, be sure to keep up regular dental checkups to monitor the teething process and ensure all is going normally. And remember: though it may seem harrowing at times, the teething process won’t last forever.
If you would like more information on easing the effects of teething, 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 “Teething Troubles: How to Help Keep Your Baby Comfortable.”
A lot happens in your child’s mouth from infancy to early adulthood. Not surprisingly, it’s the most active period for development of teeth, gums and jaw structure. Our primary goal as care providers is to keep that development on track.
One of our main concerns, therefore, is to protect their teeth as much as possible from tooth decay. This includes their primary (“baby”) teeth: although your child will eventually lose them, a premature loss of a primary tooth to decay could cause the incoming permanent tooth to erupt out of proper position. And we of course want to protect permanent teeth from decay during these developmental years as well.
That’s why we may recommend applying topical fluoride to your child’s teeth. A naturally occurring chemical, fluoride helps strengthen the mineral content of enamel. While fluoride can help prevent tooth decay all through life, it’s especially important to enamel during this growth period.
Although your child may be receiving fluoride through toothpaste or drinking water, in that form it first passes through the digestive system into the bloodstream and then to the teeth. A topical application is more direct and allows greater absorption into the enamel.
We’ll typically apply fluoride in a gel, foam or varnish form right after a professional cleaning. The fluoride is a much higher dose than what your child may encounter in toothpaste and although not dangerous it can cause temporary vomiting, headache or stomach pain if accidentally swallowed. That’s why we take extra precautions such as a mouth tray (similar to a mouth guard) to catch excess solution.
The benefits, though, outweigh this risk of unpleasant side effects, especially for children six years or older. Several studies over the years with thousands of young patients have shown an average 28% reduction in decayed, missing or filled teeth in children who received a fluoride application.
Topical fluoride, along with a comprehensive dental care program, can make a big difference in your child’s dental care. Not only is it possible for them to enjoy healthier teeth and gums now, but it could also help ensure their future dental health.
If you would like more information on topical fluoride and other dental disease prevention measures, 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 “Fluoride Gels Reduce Decay.”
X-ray imaging is such an intricate part of dentistry, we usually don't think twice about it. Without it, though, the fight against dental disease would be much harder.
At the same time, we can't forget that x-rays are a form of electromagnetic radiation that can penetrate human tissue. It's that very quality and the difference in the absorption rate between denser bone and teeth and softer diseased tissue that makes disease diagnosis possible.
But this same penetrative power can potentially harm the tissues it passes through. For that reason when practicing any form of x-ray diagnostics, dentists follow a principle known as ALARA, an acronym for "As Low As Reasonably Achievable." In lay terms ALARA means getting the most benefit from x-rays that we can with the lowest dose and exposure time possible.
While practicing ALARA with x-rays is important for patients of any age, it's especially so for children who are more sensitive to radiological energy given their smaller size and anatomy. We can't use the same settings, dosages or exposure times with them as with an adult.
To protect children, dentists have developed techniques and protocols that lessen their exposure time and rate, while still providing usable images for diagnosing disease. The bitewing is a good example of safe and effective pediatric x-ray imaging.
A bitewing is a plastic device holding exposable film that patients bite down on and hold in their mouth while x-raying. The x-rays pass through the teeth and gums and expose the film behind them on the bitewing. Using a bitewing we can capture a set of two to four radiographs to give us a comprehensive view of the back teeth, while exposing the child less radiation than they normally receive daily from background environmental sources.
This and other advances in equipment and digital imaging greatly reduce the amount of radiation patients receive during x-rays. If, though, you're still concerned about your child's x-ray exposure, talk with your dentist who can explain in more detail the x-ray safety protocols they follow. Just like you, they want your child to be as safe as possible while still benefiting from the diagnostic power of x-rays.
If you would like more information on safety precautions using x-rays with 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 “X-Ray Safety for Children.”
One of the key elements in a child’s development is their first set of teeth. Although primary (“baby”) teeth last only a few years, they’re critically important for enabling a child to eat solid foods, speak and smile.
But they also provide one more important benefit—they hold the space in the jaw reserved for the permanent teeth developing just under the gums until they erupt. But if a child loses a primary tooth prematurely because of disease or injury, other teeth may drift into the vacant space and crowd it out for the intended permanent tooth. It may then come in misaligned or remain stuck within the gums (impaction).
To avoid this, we try to treat and preserve a diseased primary tooth if at all practical. For a primary molar, one of the large teeth in the back of the mouth, this might include capping it with a stainless steel crown.
Why a metal crown? Primary molars normally don’t fall out until around ages 10-12, so it may be years for a younger child before their permanent molars erupt. All during that time these particular teeth will encounter heavier biting forces than teeth in the front.
A steel crown is often the best solution for a molar given their longer lifespans and encountered biting forces. The crown’s metal construction can stand up to these forces while still protecting the tooth from re-infection from decay. And because molars are typically outside of the “smile zone” occupied by more visible front teeth, the crown’s metal appearance isn’t usually an aesthetic issue.
Crowning a molar usually takes one visit, a dentist typically performing the procedure with local anesthesia and possibly a mild sedative like nitrous oxide gas (“laughing gas”). After removing any decayed structure from the tooth, the dentist will then fit a pre-formed crown over the remaining structure, sized and shaped to match the original tooth as close as possible.
A stainless steel crown is a cost-effective way to added needed years to a primary molar that could otherwise be lost prematurely. Preserving it may help a child avoid bite problems and expensive future treatments.
If you would like more information on dental care 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: A Safe and Effective Way to Restore Primary Molars.”
“That kid is growing like a weed!” Every proud parent likes to hear something like that about their child: It means they’re growing up—and it shows!
As nature takes its course, your child will physically transform into an adult. And that also includes their mouth: By the time they enter early adulthood they will have had two sets of teeth and their jaw structure will have changed dramatically.
All of this happens without you needing to do anything. But there can be bumps along the road like tooth decay or abnormal bite development. For that, you can and should intervene by preventing or at least slowing the formation of such situations.
The best way to do this is to form a partnership with your child’s dentist. Like any partnership, each party contributes something to the relationship.
For you that means first and foremost keeping up your child’s regular oral hygiene practice. This should start even before they begin showing teeth. As an infant you should start wiping their gums after each feeding with a clean wet cloth to hold down bacterial growth. When teeth appear, you can graduate them to brushing and flossing, teaching them along the way to do it for themselves.
You can also boost their dental health by cutting back on sugar consumption, which feeds bacteria. Besides monitoring their snacks, also avoid sending them to bed with a bottle filled with a sugary liquid (including formula, breast milk, or regular milk). And be sure you provide them a nutritious diet filled with tooth-strengthening foods.
On your dentist’s part, they provide regular cleanings that help ensure decay-causing plaque doesn’t build up on the teeth. They’ll also monitor for any signs of decay, and provide treatment when necessary. To further protect them against decay, dentists can apply sealants and topical fluoride to your child’s teeth, especially if they appear to be at high risk. And they’ll also be watching for early signs of a bite problem: Early intervention could prevent or at least minimize this development.
With that kind of solid partnership, your child’s normal dental development can proceed as smoothly as possible. Avoiding the possible pitfalls will help them achieve optimal oral health now and throughout their lives.
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