PRIMARY TEETH ARE IMPORTANT!
Your child's first set of teeth, called "primary teeth" are more important than most people realize. Healthy and cavity-free primary teeth are crucial in:
- speech development.
- proper feeding and nutrition. Oral issues can affect a child's physical and mental growth and development.
- the guidance and positioning of permanent teeth. They also act as "space-savers" in the jaw for they reduce the need for future orthodontic work.
- the development good self-esteem.
Your Child’s First Visit
he first visit sets the stage for a life of good dental health. Therefore, it is important that it be a positive experience for your child. If the first visit, which we sometimes called a “tickle visit”, is not an emergency we will do the following:
· Show your child the office, and introduce him to some of our equipment and instruments such as the dental chair, the light, the mirror and the explorer (dental pick)
· Examine their Mouth, Teeth and Gums
· Evaluate adverse habits like: Thumb sucking or finger sucking
· Identify the child's fluoride needs
· Teach the parent how to effectively clean the child's teeth and gums
· Suggest a schedule of dental visits for your child, as each child has different needs
It's also important for parents to make dental visits enjoyable for their children. You can help your child feel comfortable in several ways:
· Don't let anyone tell your child scary stories about dental visits or let the child know you feel any anxiety about going to the dentist.
· Try not to let them overhear your stories of dental horror or the stories of others before their all-important early visits.
· Take your child with you or an older sibling for the first time. Let them play while you or the sibling are having your cleaning.
· Read your child some books about visiting the dentist. This will ease their fears and tell them exactly what to expect. Children need to be told what to expect and truthfully. There are many excellent books. The one I recommend the most however is The Berenstain Bears Visit the Dentist, by Stan and Jan Berenstain.
· Show your child the office, and introduce him to some of our equipment and instruments such as the dental chair, the light, the mirror and the explorer (dental pick)
· Examine their Mouth, Teeth and Gums
· Evaluate adverse habits like: Thumb sucking or finger sucking
· Identify the child's fluoride needs
· Teach the parent how to effectively clean the child's teeth and gums
· Suggest a schedule of dental visits for your child, as each child has different needs
It's also important for parents to make dental visits enjoyable for their children. You can help your child feel comfortable in several ways:
· Don't let anyone tell your child scary stories about dental visits or let the child know you feel any anxiety about going to the dentist.
· Try not to let them overhear your stories of dental horror or the stories of others before their all-important early visits.
· Take your child with you or an older sibling for the first time. Let them play while you or the sibling are having your cleaning.
· Read your child some books about visiting the dentist. This will ease their fears and tell them exactly what to expect. Children need to be told what to expect and truthfully. There are many excellent books. The one I recommend the most however is The Berenstain Bears Visit the Dentist, by Stan and Jan Berenstain.
Common Dental Issues
Teething
Babies are as individual in their teething as they are in everything else. Some babies drool for weeks before their first tooth comes in. For others, teeth seem to “pop” in without much fuss. Many babies have sore or tender gums that make them irritable. To soothe tender gums, gently rub them with a clean finger or the back of a small, cool spoon. A clean, cold teething ring may also be soothing. If your baby is still uncomfortable, we may recommend a medicine (acetaminophen) to reduce the discomfort. Teething biscuits may contain sugar a should not be offered. Parents sometimes worry about whether their child’s teething is too early or too late. There is absolutely no correlation between when a child’s teeth come in and how strong those teeth will be.
Teething can make babies cranky but it does not make them sick or cause fever. Teething and fevers can occur together because the infant is losing an inborn immunity to diseases at about the same time as teething starts. Do not ignore a fever because your baby is teething. Contact your physician.
Babies are as individual in their teething as they are in everything else. Some babies drool for weeks before their first tooth comes in. For others, teeth seem to “pop” in without much fuss. Many babies have sore or tender gums that make them irritable. To soothe tender gums, gently rub them with a clean finger or the back of a small, cool spoon. A clean, cold teething ring may also be soothing. If your baby is still uncomfortable, we may recommend a medicine (acetaminophen) to reduce the discomfort. Teething biscuits may contain sugar a should not be offered. Parents sometimes worry about whether their child’s teething is too early or too late. There is absolutely no correlation between when a child’s teeth come in and how strong those teeth will be.
Teething can make babies cranky but it does not make them sick or cause fever. Teething and fevers can occur together because the infant is losing an inborn immunity to diseases at about the same time as teething starts. Do not ignore a fever because your baby is teething. Contact your physician.
Tooth Decay
The most common cause of tooth loss in children is tooth decay (cavities). Tooth decay is caused by the action of bacteria in the plaque. Plaque is a sticky, clear film that forms on our teeth every day. Plaque helps the bacteria stick to our teeth. The sugar in food and drinks reacts with bacteria to form an acid that eats away the hard outer layer (enamel). Over time, this acid will make a hole or cavity in the enamel.
The three main factors that predispose some children to developing more tooth decay than others include:
The most common cause of tooth loss in children is tooth decay (cavities). Tooth decay is caused by the action of bacteria in the plaque. Plaque is a sticky, clear film that forms on our teeth every day. Plaque helps the bacteria stick to our teeth. The sugar in food and drinks reacts with bacteria to form an acid that eats away the hard outer layer (enamel). Over time, this acid will make a hole or cavity in the enamel.
The three main factors that predispose some children to developing more tooth decay than others include:
- Frequent consumption of sugars.
- Low fluoride levels. Fluoride acts with minerals in saliva to restore and harden enamel damaged by the very early stages of decay. This remineralising may help to arrest the decay and to make fully formed teeth more resistant to further damage.
- Failure to brush adequately to remove all plaque and the associated bacteria.
Baby Bottle Caries
"Baby bottle caries" (or "nursing bottle caries") refers to a pattern of tooth decay which occurs in the teeth of infants and preschoolers who are allowed to nurse from a bottle containing a sugary beverage either frequently or for prolonged periods of time (such as while napping or sleeping at night). Baby bottle caries is also observed in those infants who are breast fed frequently throughout the night.
Baby Bottle Decay can be completely avoidable
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Orthodontics
Your child may require orthodontics if he or she has crowding, poor upper and/or lower jaw development, poor arch development, finger, thumb or tongue habits, tooth eruption problems, or airway and/or speech problems.
Your child may require orthodontics if he or she has crowding, poor upper and/or lower jaw development, poor arch development, finger, thumb or tongue habits, tooth eruption problems, or airway and/or speech problems.
Trauma
Baby begins to walk; be alert to dental injuries.
Baby begins to walk; be alert to dental injuries.
TIPS ON PREVENTION
Brushing and Flossing
Diet and Snacking
- Start brushing your child's teeth daily as soon as the first tooth appears.
- Brush at least twice per day with small, soft-bristled brush for at least two minutes. This ensures adequate time is spent cleaning all the surfaces of each tooth (See the Hippo Diagram)
- Start using only a pea-sized drop of a Children's fluoride toothpaste when child is able to rinse. Make sure that your child gets in the habit of spitting out the toothpaste.
- Use a Power Toothbrush. They clean teeth better than manual brushes. Battery–powered brushes by Oral B, Crest, or Colgate are suitable, inexpensive and widely available at drug stores. If your child prefers a manual toothbrush make sure it is a children’s size with soft bristles.
- Floss your child’s teeth. It is advisable to begin at about age three when their teeth begin to fit closer together in the back. To improve access to the back teeth and make the job easier, we suggest using a “floss pick” which is also readily available in drug stores.
- The key to getting your child to brush is to make it fun. If you are enthusiastic about the activity, your children will be enthusiastic. Look for fun ways to engage your children in the activity. Make it seem as if brushing is a fun thing to do rather than a chore which must be done.
- Help your child brush and floss. Children do not have the manual dexterity to use a toothbrush or floss properly until they are about seven or eight so an adult should help to ensure thorough oral care. However always allow them to "brush" their own teeth under supervision and then follow up if needed
- Children are great emulators. They tend to want to do the things that their parents do. If your children see you brushing your teeth and displaying good dental habits, they will follow.
- Give your child a nightly fluoridated mouthrinse when they can understand and perform the “rinse and spit” routine (about 4 or 5 years old. This is not a mouthwash used to cover bad breath. It is a supplement to the topical fluoride treatments your child receives at the dentist’s office. However, it is not nearly as strong as the office version.
- Make sure your child receives a fluoride treatment at the time of their cleaning appointment
- Consider Fluoride supplements if you do not live in an area with fluoridated water. Dosage will depend on the water’s present Fl content (water testing required), and the age and weight of your child. This should continue until the child develops wisdom teeth well into the teen years. We can write a prescription for these systemic fluoride vitamins after your water is tested. Testing is very important because too much fluoride can lead to fluorosis where the new adult front teeth become mottled or have brown stains.
Diet and Snacking
- Minimize your child's exposure to sugar.
- Eat sugary drinks, cakes, cookies, breads at meal times and not as snacks. The increased saliva flow during a meal dilutes sugars and helps wash them away.
- Choose nutritious, unsweetened snack foods.
- Read ingredient lists when choosing snacks. Molasses, honey, fructose, glucose and sucrose are all types of sugar.
- Reduce the time that sweet food stays in contact with the teeth. Limit sugared drinks (This includes Fruit juices and sports drinks), chewing sugared gum or sucking on candy over long periods of time.
- After your child eats sweet, sticky foods, brush your child’s teeth.
- When brushing is not possible, rinse the mouth with water or chew sugar-free gum.
Regular Preventive Visits
Start preventive visits every six to nine months by the child's second birthday when most of the teeth have erupted. Of course if you have any concerns or suspect your child has a dental problem before then, call us. At preventive visits we :
Start preventive visits every six to nine months by the child's second birthday when most of the teeth have erupted. Of course if you have any concerns or suspect your child has a dental problem before then, call us. At preventive visits we :
- check for potential problems, such as decay or developmental problems, so they can be detected and treated early.
- We clean and polish their teeth,
- give a professional fluoride treatment,
- reinforce proper home care (brushing and flossing) and diet, and
- if necessary, give home fluoride recommendations.
Video:
Useful information from Government of Canada: Oral health for children - Canada.ca
Dental Sealants
Dental sealants may be recommended for your child if he or she has any newly erupted molars and premolars . Dental Sealants are a white or clear plastic material that is applied to the chewing surfaces of teeth. The sealant acts as a barrier to protect these chewing surfaces. The chewing surfaces are very prone to decay because they have small depressions, called pits and fissures, where germs and food can pack. Sealants should be applied as soon as these teeth appear in the mouth and before they have a chance to decay.
Dental sealants may be recommended for your child if he or she has any newly erupted molars and premolars . Dental Sealants are a white or clear plastic material that is applied to the chewing surfaces of teeth. The sealant acts as a barrier to protect these chewing surfaces. The chewing surfaces are very prone to decay because they have small depressions, called pits and fissures, where germs and food can pack. Sealants should be applied as soon as these teeth appear in the mouth and before they have a chance to decay.
Watch Sealant Video:
Sealant Information sheet
Link to ODHA facts-sealants pdf
DENTAL TREATMENT
illings
White fillings or Composite Resin- To achieve an aesthetic result most cavities on front teeth are filled with white filling. Smaller cavities on back teeth can also be restored with white fillings. But compared to amalgam, white filling is generally weaker , takes longer to place, costs more and requires some cooperation from the child, as it must be placed in a dry environment without saliva.
Silver or Amalgam Fillings- Most back teeth are done with Silver filling. It is required for decay between teeth, which requires a larger restoration. Silver filling is strong, durable, cost-effective and can be placed in minutes. In baby teeth, Silver fillings generally longer lasting than white fillings. Silver fillings contain various metals such as silver, copper, tin and mercury. Mercury is necessary to chemically bind the compounds together to form a hard, stable material.
Stainless steel crowns are needed when decay has destroyed a tooth to such a degree that there is little of the tooth remaining. Amalgam or silver fillings are not recommended for large fillings in "baby" teeth because if this large filling fractures there is a greater chance that a pulpectomy or extraction will be necessary. Stainless steel crowns are highly recommended on primary ("baby") molars so they will have the benefit of a much more durable and reliable restoration.
Extensive Decay or Infection
Pulpectomy- Deep decay may reach the nerve and to restore this a pulpectomy is required. This procedure involves removing the infected nerve tissue and placing medicament directly over the nerve tissue of the roots. The tooth is then restored in the most appropriate manner (i.e. an amalgam or stainless steel crown. Because of the difficult root structure of baby teeth, the procedure has only an 80 per cent success rate.
Tooth extraction may be necessary if there is extensive damage, pain, infection or where an abscess has formed.
Space Maintainers- If a child loses a primary back tooth prematurely, crowding of the future permanent teeth may occur. A space maintainer may be recommended to prevent teeth moving and allow adequate space for the permanent tooth to erupt. Even with a space maintainer, crowding may need to be corrected later with orthodontic braces. However, a space maintainer is not usually required for missing front teeth, as these tend to align themselves correctly in most cases.
White fillings or Composite Resin- To achieve an aesthetic result most cavities on front teeth are filled with white filling. Smaller cavities on back teeth can also be restored with white fillings. But compared to amalgam, white filling is generally weaker , takes longer to place, costs more and requires some cooperation from the child, as it must be placed in a dry environment without saliva.
Silver or Amalgam Fillings- Most back teeth are done with Silver filling. It is required for decay between teeth, which requires a larger restoration. Silver filling is strong, durable, cost-effective and can be placed in minutes. In baby teeth, Silver fillings generally longer lasting than white fillings. Silver fillings contain various metals such as silver, copper, tin and mercury. Mercury is necessary to chemically bind the compounds together to form a hard, stable material.
Stainless steel crowns are needed when decay has destroyed a tooth to such a degree that there is little of the tooth remaining. Amalgam or silver fillings are not recommended for large fillings in "baby" teeth because if this large filling fractures there is a greater chance that a pulpectomy or extraction will be necessary. Stainless steel crowns are highly recommended on primary ("baby") molars so they will have the benefit of a much more durable and reliable restoration.
Extensive Decay or Infection
Pulpectomy- Deep decay may reach the nerve and to restore this a pulpectomy is required. This procedure involves removing the infected nerve tissue and placing medicament directly over the nerve tissue of the roots. The tooth is then restored in the most appropriate manner (i.e. an amalgam or stainless steel crown. Because of the difficult root structure of baby teeth, the procedure has only an 80 per cent success rate.
Tooth extraction may be necessary if there is extensive damage, pain, infection or where an abscess has formed.
Space Maintainers- If a child loses a primary back tooth prematurely, crowding of the future permanent teeth may occur. A space maintainer may be recommended to prevent teeth moving and allow adequate space for the permanent tooth to erupt. Even with a space maintainer, crowding may need to be corrected later with orthodontic braces. However, a space maintainer is not usually required for missing front teeth, as these tend to align themselves correctly in most cases.
Nitrous Oxide Sedation
If your child requires one or two short visits to complete small fillings or an extraction and is a little anxious nitrous oxide sedation maybe recommended. Nitrous Oxide will calm them enough to safely complete the procedures.
If your child requires one or two short visits to complete small fillings or an extraction and is a little anxious nitrous oxide sedation maybe recommended. Nitrous Oxide will calm them enough to safely complete the procedures.
Hospital Dentistry
However if work is more extensive or cooperation is poor it may be recommended your child’s treatment be done in the OR at North Bay General. An anesthesiologist will put your child to sleep utilizing a general anesthetic so Dr. Guy can do all necessary dental work. The main advantage of having your child placed under general anesthesia is all procedures can be done at once. This is much easier on your child than enduring the long hours in the dental chair, or repeated visits. It is so important young children develop a health attitude toward dentistry and dental visits. Dental visits must remain positive or at least negative ones minimized. Numerous long visits to do extensive treatment can negatively impact a young child’s attitude to dentistry. These attitudes can affect them for life and in turn have a negative impact on their future dental health.
However if work is more extensive or cooperation is poor it may be recommended your child’s treatment be done in the OR at North Bay General. An anesthesiologist will put your child to sleep utilizing a general anesthetic so Dr. Guy can do all necessary dental work. The main advantage of having your child placed under general anesthesia is all procedures can be done at once. This is much easier on your child than enduring the long hours in the dental chair, or repeated visits. It is so important young children develop a health attitude toward dentistry and dental visits. Dental visits must remain positive or at least negative ones minimized. Numerous long visits to do extensive treatment can negatively impact a young child’s attitude to dentistry. These attitudes can affect them for life and in turn have a negative impact on their future dental health.
Pacifiers
Pacifiers are less likely to cause a malocclusion and are usually discontinued at an earlier age than is thumbsucking. It is easier to take away a pacifier then a finger or thumb. Thumbsuckers typically continue the habit until 3-5 years.
· To avoid any trauma to the gums, it's important to buy a pacifier with a nipple made of rubber
· do not use the soother around the clock, only when necessary
· in rare instances, pacifiers may cause complications, like abnormal swallowing patterns
· check the pacifier daily for breakage. They do not last forever. The child could suck a "ripped" pacifier and choke on it
· do not hang the pacifier around your baby's neck with a string. Your baby could be accidentally strangled
· to avoid improper breathing and abnormal molding of the baby's jaws, choose a soother that resembles the natural nipple and breast
· Pacifier use can cause abnormal development of the jaws and teeth.
Some reasons are:
improperly sized and shaped soother
strength of sucking action
length of time the soother is present within the mouth
Most children should grow out of thumbsucking and pacifier use by age 3 or 4. As long as the habit is discontinued before their permanent teeth come in (around ages 4-5) your child will be fine. If, however, they continue this habit as their permanent teeth come in it is best to help your child discontinue their habit.
The most effective way to accomplish this is to simply explain to your child that they must do so in order for their teeth to come in straight. You would be surprised at how effective simply explaining this to your child can be. When they do suck their thumb or use a pacifier give them a gentle verbal reminder.
Under no circumstances should you give negative reinforcement or punish a child for this behavior as this often causes the child to further embrace the habit. Many professionals urge parents to tape their children's fingers or apply bitter tasting solutions to the fingers to prevent thumbsucking. We would advise against this. It is somewhat cruel and is not as effective as providing positive reinforcement What should you do if your child is having trouble giving up the pacifier or thumbsucking ? We suggest gradually weaning your child. First start by not allowing them to suck their thumb or use a pacifier during certain hours of the day.
Offer them rewards when they successfully do this. Also, since thumbsucking and pacifier use are often security mechanisms, consider giving them a teddy bear, a blanket, or lots of hugs to, in effect, replace the pacifier or thumbsucking.
Gradually increase the number of hours in which they are not allowed to use the pacifier or suck their thumb until they no longer need these habits. Remember, the time they need the pacifier the most (during bed) should be the last time period phased out.
Pacifiers are less likely to cause a malocclusion and are usually discontinued at an earlier age than is thumbsucking. It is easier to take away a pacifier then a finger or thumb. Thumbsuckers typically continue the habit until 3-5 years.
· To avoid any trauma to the gums, it's important to buy a pacifier with a nipple made of rubber
· do not use the soother around the clock, only when necessary
· in rare instances, pacifiers may cause complications, like abnormal swallowing patterns
· check the pacifier daily for breakage. They do not last forever. The child could suck a "ripped" pacifier and choke on it
· do not hang the pacifier around your baby's neck with a string. Your baby could be accidentally strangled
· to avoid improper breathing and abnormal molding of the baby's jaws, choose a soother that resembles the natural nipple and breast
· Pacifier use can cause abnormal development of the jaws and teeth.
Some reasons are:
improperly sized and shaped soother
strength of sucking action
length of time the soother is present within the mouth
Most children should grow out of thumbsucking and pacifier use by age 3 or 4. As long as the habit is discontinued before their permanent teeth come in (around ages 4-5) your child will be fine. If, however, they continue this habit as their permanent teeth come in it is best to help your child discontinue their habit.
The most effective way to accomplish this is to simply explain to your child that they must do so in order for their teeth to come in straight. You would be surprised at how effective simply explaining this to your child can be. When they do suck their thumb or use a pacifier give them a gentle verbal reminder.
Under no circumstances should you give negative reinforcement or punish a child for this behavior as this often causes the child to further embrace the habit. Many professionals urge parents to tape their children's fingers or apply bitter tasting solutions to the fingers to prevent thumbsucking. We would advise against this. It is somewhat cruel and is not as effective as providing positive reinforcement What should you do if your child is having trouble giving up the pacifier or thumbsucking ? We suggest gradually weaning your child. First start by not allowing them to suck their thumb or use a pacifier during certain hours of the day.
Offer them rewards when they successfully do this. Also, since thumbsucking and pacifier use are often security mechanisms, consider giving them a teddy bear, a blanket, or lots of hugs to, in effect, replace the pacifier or thumbsucking.
Gradually increase the number of hours in which they are not allowed to use the pacifier or suck their thumb until they no longer need these habits. Remember, the time they need the pacifier the most (during bed) should be the last time period phased out.