Posts for: December, 2017
Your sweet, happy baby has suddenly become a gnawing, drooling bundle of irritation. Don't worry, though, no one has switched babies on you. Your child is teething.
For most children, their first teeth begin breaking through the gums around six to nine months. Usually by age three all twenty primary (“baby”) teeth have erupted. While the duration and intensity of teething differs among children, there are some common symptoms to expect.
Top of the list, of course, is irritability from pain, discomfort and disrupted sleep. You'll also notice increased gnawing, ear rubbing, decreased appetite, gum swelling or facial rash brought on by increased saliva (drooling). Teething symptoms seem to increase about four days before a tooth begins to break through the gums and taper off about three days after.
You may occasionally see bluish swellings along the gums known as eruption cysts. These typically aren't cause for concern: Â the cyst usually “pops” and disappears as the tooth breaks through it. On the other hand, diarrhea, body rashes or fever are causes for concern — if these occur you should call us or your pediatrician for an examination.
While teething must run its course, there are some things you can do to minimize your child's discomfort:
Provide them a clean, soft teething ring or pacifier to gnaw or chew — a wet washcloth (or a cold treat for older children) may also work. Chill it first to provide a pain-reducing effect, but don't freeze it — that could burn the gums.
Use a clean finger to massage swollen gums — gently rubbing the gums helps counteract the pressure caused by an erupting tooth.
Alleviate persistent pain with medication — With your doctor's recommendation, you can give them a child's dosage of acetaminophen or ibuprofen (not aspirin), to take the edge off teething pain.
There are also things you should not do, like applying rubbing alcohol to the gums or using products with Benzocaine®, a numbing agent, with children younger than two years of age. Be sure you consult us or a physician before administering any drugs.
While it isn't pleasant at the time, teething is part of your child's dental development. With your help, you can ease their discomfort for the relatively short time it lasts.
If you would like more information on relieving discomfort during 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.”
Whitening is a great solution, but certain precautions should be taken before starting. As always, dentistry is always patient-specific, so check with your dental care provider first if whitening is for you.
One of the most common side effects of whitening is sensitivity. If you are a patient who experiences sensitivity on a day-to-day basis, talk to your dental health care provider before starting any whitening treatment, so they make your whitening experience as comfortable as possible for you or seek alternative procedures that might be required before you start.
It is recommended that before you use whitening, to use a strong sensitivity-fighting toothpaste. These toothpaste contain ingredients like potassium nitrate, arginine, strontium acetate hemihydrate or calcium sodium phosphosilicate. These ingredients have been clinically proven to reduce sensitivity effectively. Before bed, rub a pea-sized amount of this toothpaste on your teeth with a clean finger. Leave it alone for one minute to let the toothpaste desensitize your teeth. Then, brush your two minutes, and rinse with as little water as possible. Do not eat or drink before bed. This should be done 14 days before you start whitening your teeth, especially if you have sensitive teeth or a history of sensitive teeth from whitening products.
The most effective whitening products that can be bought over the counter (i.e., at your local Shoppers or Walmart) are the whitening strips. Whitening strips are most effective if your teeth are perfectly aligned. If you have misaligned teeth, you might not get all of your smile whitened, because of the shape of the strips.
The best option for whitening is to go with custom whitening. This is done in two ways. The first is in-office whitening, which is usually an hour or longer appointment, where a strong whitening gel is applied directly to the teeth and activated by a special light. The other option is custom trays, where models of your teeth are used to make custom trays. These trays are take home, and a special whitening gel is accompanied. The duration of how many days and for how long each day depends on your goals and your tolerance for the products.
Home care while using whitening treatments
If you are now using either the whitening strips or the professional custom trays, similar to prevention, apply sensitive toothpaste on your teeth for one minute before brushing. Then, apply the strips or custom trays filled with whitening gel. Remove as instructed by the instruction on the box or as informed by your dental professional, respectively.
If you begin to feel sensitivity or discomfort, contact the hotline on the box for the whitening strips or call your dental professional for the whitening gels.
Soon after the primary (baby) teeth begin to give way, the teeth a child will have the rest of their lives start erupting into the mouth. But while they’re permanent, they’re not as strong and developed as they will be in adulthood.
That’s why we treat young permanent teeth differently from older adult teeth. For example, a decayed adult tooth may need a root canal treatment; but this standard treatment would often be the wrong choice for a child’s tooth.
The reason why involves the pulp, the innermost layer of a tooth, which plays a critical role in early development. Young permanent teeth continue to grow in sync with the jaws and facial structure. Most of this growth is in the dentin, the layer between the enamel and pulp, which increases proportionally to the other layers as the tooth matures. The pulp generates this new dentin.
A root canal treatment completely removes the diseased tissue of the pulp. This isn’t a major issue for a mature tooth because it no longer needs to generate more dentin. But it can have long-term consequences for an immature tooth whose growth may become stunted and the roots not fully formed. The tooth may thus become brittle and darkened, and might eventually require removal.
Because of these potential consequences, a root canal treatment is a last resort for a young permanent tooth. But there are modified alternatives, depending on the degree of pulp exposure or infection. For example, if the pulp is intact, we may be able to remove as much soft decayed dentin as we can, place an antibacterial agent and then fill the tooth to seal it without disturbing the pulp. If the pulp is partially affected, we can remove that part and place substances that encourage dentin growth and repair.
Our main goal is to treat a young tooth with as little contact with the pulp as possible, so as not to diminish its capacity to generate new dentin. Avoiding a full root canal treatment if at all possible by using these and other techniques will help ensure the tooth continues to develop to full maturity.
If you would like more information on dental care for 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 “Saving New Permanent Teeth after Injury.”