Children's Dental Problems

Tooth Decay
There are two words used to describe tooth decay. The most common term used is 'cavity'. The other is 'caries', which is derived from the Latin word meaning 'rot'. (Animated-teeth)


Baby Bottle Caries
Baby bottle caries is a pattern of tooth decay in infants and toddlers, caused by the use of a bottle with sugary liquids. It affects the upper front teeth the most because they are subject to the sugars more often. The bottom front teeth tend to not be affected because the tongue protects these teeth in the motion of drinking from the bottle or similar cup. The baby bottle caries arise from prolonged exposure to sugary liquids. Drinking anything other than water over nap time or overnight can lead to caries. Juices, milk and breast milk all contain sugars, and are advised to not be drunk over long periods of time. It is advised to not breast feed throughout the night because it has the same results as if drinking from a bottle. Dipping a pacifier in a sugary substance such as honey will also have the same results as drinking from a bottle.


Thumb-Sucking
Thumb-sucking is normal for many children and is fine up to a certain age. Usually if the child is still sucking their thumb at the age of five, the parent needs to help the child stop. The prolonged practice can lead to crowded and crooked teeth, and can contribute to problems in their bite.
University of Maryland Medical Center


Prevent Cavities with Sealants
The two main times in a person's life to be the most susceptible to tooth decay are as children and the elderly. Because of the high sugar diets that many children have, it seems obvious that they end up with more decay. Using sealants is one option to help prevent decay.

Due to the natural anatomy of some teeth, they are more difficult to clean than others because a toothbrush cannot reach all the way into the groves. The molars are a prime example of this. The plaque gets into the pits and fissures (the grooves on the surface of the teeth) and is not removed properly by a toothbrush. A sealant can be a solution for this problem. The dentist will bond a plastic sealant to the surface of the teeth, filling in the grooves to make it a flatter, smoother surface that a toothbrush can clean. Without the buildup of plaque, tooth decay is less likely to occur.
Tooth Sealants


Diet
Another way to help prevent tooth decay is by monitoring your child's diet. By reducing the amount of sugar that they consume they will have fewer cases of demineralization (the process that causes cavities). It is not necessary to cut all sugars out of your child's diet, which could be close to impossible. Simply monitor the amount of sugar they do eat and focus on proper tooth care. Make sure they thoroughly brush their teeth two times a day and floss once a day. These simple cautionary steps can greatly reduce the number of cavities that form. Incorporating this with sealants would be the most beneficial. As everyone's tooth enamel is specific to themselves, these processes may not be 100% effective, but they will help significantly. As always, consult your dentist to learn about the best dental care procedures for your child.

FYI: The Animated Teeth and Tooth Sealant links have wonderful animations to visually show the processes that have been discussed. I could not put the animations on the blog, but I would recommend taking time to see the animations; they are very helpful.

Children's Teeth

What could be a fonder memory as a child, other than loosing their first tooth? The anticipation leading up to it, with the tooth just barely holding on by a little thread can make any child nervous. I look back and remember being scared and anxious at the same time, hoping that my dad really wouldn't tie a string to my tooth and a door knob, to pull it out as the door was shut! Getting past that stage in my life and developing into my permanent teeth I wonder how children's teeth differ from adults.

The "baby" or "milk" teeth, more properly called deciduous, do more than just allow children to eat solid food and speak properly. Their primary purpose is to hold a space open for the permanent tooth to fill. If pulled too early, that space may close up leading to problems in the future. The 20 deciduous teeth are present in the jaw from birth. Since the jaw bone has not fully grown by birth, it is unable to hold 32 larger, permanent teeth. These will develop over the years and form very closely to the ends of the rootless deciduous teeth. As the permanent teeth develop, they push the baby teeth up, eventually leading to them falling out.

The primary teeth begin to push through the gum line about 6 months after birth, and all are completely erupted near 2 years of age. The teeth erupt in a pattern starting from the center of the mouth, usually the lower teeth first, then their upper counterparts. The American Dental Association has a great animation following the order teeth erupt and the average age. When the teeth begin to fall out, they tend to come out in the same order they grew in. From the ages of 6 to 12 years, the permanent teeth move into the primary spaces, pushing the teeth to fall out, called exfoliation.

The first dentist visit should occur by the first birthday. Once the primary teeth begin erupting, you should contact a pediatric dentist who specializes in children's dentistry. The dentist should be visited twice a year for regular check-ups. These appointments are important because they allow the dentist to make sure the teeth are coming in properly, and to analyze the child's mouth. They will also clean the teeth and if old enough, use a fluoride treatment and take x-rays when needed.

Home oral care should include brushing the primary teeth and gums with an infant toothbrush. Until the age of two, just water should be used to brush. By two or three, a small amount of fluoride toothpaste can be used. Always ask your dentist for specifics concerning your child, as treatment can vary between people. In the next post we will discuss the various dental problems that can arise early in a child's life and how to prevent them.

Sites used for this post: ADA Children, Wikipedia, and University of Maryland Medical Center.

A Replacement for Floss? Not so fast…

I wrote this blog in response to a wonderful, controversial subject brought up in a comment from Patrick.

Recently (2004), Listerine aired a commercial claiming that rinsing your mouth two times a day for 30 seconds with their mouth wash is comparable to flossing daily. This claim was backed with research conducted by an independent research firm, in contract with the company Pfizer. Pfizer funded this research project and manufactures Listerine.

The study was published in the Journal of the American Dental Association (JADA). Medical News Today summarizes the results:

"Listerine Antiseptic reduced plaque between the teeth by 20 percent and gingivitis by 11 percent, while flossing led to 3.4 percent and 4.3 percent reductions respectively. This trial reinforces the findings of a prior study published in the American Journal of Dentistry (AJD)."

These results are something to consider, but one cannot stop here. The American Dental Association (ADA) published these results and gave their seal of approval to Listerine on the condition that Listerine must promote both brushing and flossing. The ADA never concluded that rinsing could replace flossing, only that it had the possibility to be as good as flossing.

The controversy arouse when Listerine’s commercial informing the public of these finding was aired. The commercial only had in small print across the bottom, “floss daily” and “ask your dentist”. The overall commercial however gave the impression that rinsing could completely replace flossing. It was deceiving to the uninformed public.

Judge Chin became active on the case when a company of Johnson & Johnson, a leading manufacturer of dental floss, sued Pfizer. Judge Chin ruled that the commercial did not clearly relay that “Listerine is as effective as floss against plaque and gingivitis.” He also noted that the study only proved their point to be true in people with mild cases of plaque and gingivitis. The study did not incorporate people with advanced levels of gingivitis or gum disease. Thus, Judge Chin ruled Listerine to remove the commercial from the air because they were falsely informing the consumer.

Many dentists were outraged with Pfizer’s claim as well. Dr. Chris Smiley of Smiley Family Dentistry wonderfully explains why rinsing cannot replace flossing.

"A rinse can flush off things on the tooth surface, but it will only penetrate a couple of millimeters into the gum line. Floss goes along the root’s surface and scrapes off that debris. No matter how hard you swish, you can’t blow some of that stuff off."

This is very important to note, in my opinion. If you think about what flossing is actually doing, which follows how Dr. Smiley describes, a simple liquid could not have the same benefits. (It seems difficult to me to believe that a liquid could clean your mouth well enough to add six years to your life!)

The conclusion that many dentists share, now that Listerine has changed its ad, is that adding rinsing to your daily oral care practices of brushing and flossing is a smart idea, but by no means can it replace the age-old preaching of floss.