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Posts for tag: pediatric dentistry

By Kirkland Smiles Dental Care
February 21, 2014
Category: Oral Health
TreatingThumbSuckingNowCouldReduceOrthodonticTreatmentLater

One of the most common parental concerns is the habit of many children, even late into childhood, to suck their thumbs or fingers. Many parents have asked us, “Could this affect their teeth?”

The answer, unfortunately, is yes — thumb sucking can contribute to a malocclusion (bad bite) that could eventually require orthodontic treatment. Before making any assumptions, however, we need to understand the bigger picture.

To begin with, infants have a different swallowing mechanism than adults and older children. When you as an adult swallow, you'll notice the tip of your tongue positions itself just above the back of the top front teeth. An infant, however, will thrust their tongue between their upper and lower jaw as they swallow (also known as an infantile swallowing pattern or primary tongue thrust). The infant normally begins changing to an adult swallowing pattern when their primary (baby) teeth begin to erupt.

However, if a child's swallowing transition is slower than normal and the tongue rests between the jaws for a longer duration, it can inhibit the full eruption of teeth, believed to be the main cause of an open bite (a gap between the upper and lower teeth when the jaws are shut). The thumb during sucking resting between the teeth can have the same effect.

Thumb sucking may not necessarily lead to a malocclusion — for example, an abnormally developing jawbone could be the culprit. If prolonged thumb sucking does become a concern, however, there are steps we can take to reduce the impact of the habit. We can install a thin metal “tongue crib” behind the upper and lower incisors that will not only discourage thumb sucking, but also help retrain the tongue not to rest between the upper and lower teeth. There are also exercise routines known as orofacial myofunctional therapy (OMT) that can retrain specific muscles in the mouth to encourage more normal chewing and swallowing patterns.

These steps may not prevent future orthodontic treatment, but they could reduce its extent. The key is regular dental checkups and consultation to ensure your child's teeth and bite are developing normally.

If you would like more information on the effects of chronic thumb sucking on the mouth, 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 “How Thumb Sucking Affects the Bite.”

By Kirkland Smiles Dental Care
June 14, 2013
Category: Oral Health
ThumbSuckingHarmlessHabitorPotentialProblem

For many parents, the image of an infant intently absorbed in sucking a pacifier — or her own thumb — is one of the cherished memories of babyhood. But if this habit goes on for too long, it can cause problems with the child's bite. Want to know what the potential predicaments are, when you should be concerned about the behavior, and what you can do? Read on!

Thumb sucking is a natural, comforting behavior of humans (and some other primates) related to nursing. It usually goes away on its own by the time the permanent teeth are coming in. But it can be a hard habit to break — and if it becomes a persistent behavior, the consequences may include a problem called an “open bite.”

In a normal bite, the top teeth slightly overlap the bottom teeth. When the thumb (or any other object) constantly rests between the upper and lower teeth, however, the pressure it exerts may prevent the teeth from fully erupting (coming out from the gums into the mouth) and alter the shape and development of the upper and lower jawbone. This result is a gap between the upper and lower teeth.

The same problem may also be caused by prolonging the “infantile swallowing pattern,” a forward-thrusting position of the tongue which, like thumb sucking, normally begins to cease around age four. That's when it is replaced by the adult swallowing pattern, where the tongue is held behind the teeth, against the roof on the mouth. Researchers believe that most open bites result from the failure to change from the infantile to the adult swallowing pattern.

When should you be concerned about the thumb sucking habit? If the behavior continues much past toddlerhood, or if the sucking is particularly active, you may wish to have us evaluate your child's bite. The American Academy of Pediatric Dentistry recommends having the habit stop by age 3. Persistent thumb sucking can actually push the teeth forward and change the growth patterns of the jaw, creating more difficult problems.

There are several methods for controlling the behavior and correcting problems with the bite. One is an appliance called a “tongue crib.” This thin metal device is placed behind the upper and lower incisors. It discourages thumb sucking, while at the same time helping to keep the tongue from inserting itself between the upper and lower teeth. Eliminating these unhelpful habits is essential to allow the teeth to erupt into proper position and to allow for the normal development of the jawbones.

Recent research has also shown that individualized exercise routines called orofacial myofunctional therapy (OMT) can be highly effective in preventing open bite relapses. These exercises are designed to retrain muscles in the face, tongue and lips, and can help to create good chewing and swallowing patterns.

If you would like more information about thumb sucking or children's bite problems, please contact us or schedule an appointment for a consultation. You can also learn more about these issues by reading the Dear Doctor magazine article “How Thumb Sucking Affects The Bite.”

TestingYourKnowledgeDoYourChildrenHaveGoodOralHealth

Ensuring that your children have good oral health is (or should be) the goal of every parent or caregiver. But how confident are you about this topic? The following true/false quiz will help you evaluate your expertise while learning more about keeping your child's teeth healthy.

Questions

  1. All children older than 6 months should receive a fluoride supplement every day.
  2. Parents should start cleaning their child's teeth as soon as the first tooth appears.
  3. Parents should start brushing their child's teeth with toothpaste that contains fluoride at age 3.
  4. Children younger than 6 years should use enough toothpaste with fluoride to cover the toothbrush.
  5. Parents should brush their child's teeth twice a day until the child can handle the toothbrush alone.
  6. Young children should always use fluoride mouthrinses after brushing.

Answers

  1. False. Check with your child's physician or dentist about your children's specific fluoride needs. If your drinking water does not have enough fluoride to help prevent cavities, parents of a child older than 6 months should discuss the need for a fluoride supplement with a physician or our office.
  2. True. Start cleaning as soon as the first tooth appears by wiping the tooth every day with a clean, damp cloth. Once more teeth erupt, switch to a small, soft-bristled toothbrush.
  3. False. Parents should start using toothpaste with fluoride to brush their children’s teeth at age 2. Only use toothpaste with fluoride earlier than age 2 if the child's doctor or our office recommends it.
  4. False. Young children should use only a pea-sized amount of fluoride toothpaste. Fluoride is important for fighting cavities, but if children younger than 6 years swallow too much fluoride, their permanent teeth may develop white spots. Using no more than a pea-sized amount of toothpaste with fluoride can help prevent this from happening.
  5. True. Because children usually do not have the skill to brush their teeth well until around age 4 or 5, parents should brush their young children's teeth thoroughly twice a day. You should continue doing this until the child can demonstrate a proper brushing technique.
  6. False. Fluoride mouthrinses have a higher concentration of fluoride than toothpaste containing fluoride. Children younger than 6 years of age should not use fluoride mouthrinses unless your child's doctor or our office recommends it. Young children tend to swallow rather than spit it out, and swallowing too much fluoride before age 6 may cause the permanent teeth to have white spots.

Learn More

If you feel you missed too many of the above questions, read the Dear Doctor article, “Oral Hygiene Behavior.”

DentalSealantsOneoftheChildhoodSecretsTVDesignerNateBerkusCreditsforHisBeautifulSmile

As a successful author, interior design guru (with 127 makeovers in eight years on The Oprah Winfrey Show), and host of his own television program, The Nate Berkus Show, Nate Berkus understands the important role a beautiful smile plays in one's life and career. In a recent interview with Dear Doctor magazine, Nate discussed his oral health history. Berkus credits his all natural smile — no cosmetic dentistry here — to the treatments he received as a child from his dentist. “I'm grateful for having been given fluoride treatments and sealants as a child.” He then added that, “healthy habits should start at a young age.”

Dental sealants are important because they help protect developing young teeth until the enamel has matured. Without dental sealants, the newly erupted immature enamel of teeth is more permeable, meaning that the acids produced by bacteria in the mouth can damage these teeth more easily. This makes the teeth less resistant and thus more susceptible to tooth decay.

Regardless of how much your children brush their teeth, the reality is that toothbrush bristles cannot reach down to clean out the crevices found in the deep grooves (“pits and fissures”) of teeth. And if not removed, the bacteria found in these grooves produce decay-causing acids as a byproduct of metabolizing sugar. However, when sealants are used in combination with fluoride, good hygiene and nutrition (including lower sugar consumption), the odds of having tooth decay is dramatically reduced.

We refer to dental sealants as “pit and fissure” sealants because they protect the grooves found in the top of back teeth and the back of front teeth. Sealants also may reduce the need for subsequent treatments as your child grows older — just as it did for Nate Berkus. For these reasons, sealants are definitely something that all parents and caregivers should consider for their young children.

To learn more about dental sealants, contact us today to schedule an appointment so that we can conduct a thorough examination, discuss any questions you have as well as what treatment options will be best for you or your child. Or to learn more about sealants now, you can continue reading the Dear Doctor magazine article “Sealants for Children.” And to read the entire interview with Nate Berkus, please see the Dear Doctor magazine article “Nate Berkus.”

By Kirkland Smiles Dental Care
November 19, 2012
Category: Oral Health
IfYourChildChippedAToothWhatShouldYouDo

Nearly every parent and caregiver has experienced that almost instantaneous sick feeling when they see that their child has been injured, especially when it is an injury to the mouth and teeth. For some, it is just a bloody lip; however, if the accident chipped a tooth, then you may have a completely different situation on your hands. If the nerve of the tooth has not been damaged, you needn't worry too much — a composite (plastic) tooth-colored restoration that is actually bonded to the tooth is an ideal material for repairing most broken or chipped teeth. See us as soon as possible to assess the extent of injury, so that proper and appropriate action can be taken.

An additional reason why bonding with composite resin may be the ideal choice for repairing a child's chipped tooth is that it can be custom created in virtually any shade so that it perfectly matches the damaged tooth and the surrounding teeth. It is also far less expensive than a crown, an important factor to consider when repairing a primary (baby) tooth that will eventually fall out to make room for a permanent tooth. If the injury is to a permanent tooth, a composite resin still may be ideal to use as a restoration until your child or teenager has stopped growing or playing contact sports. This is because your teenager may be too young for a more permanent restoration such as a crown or porcelain veneer.

An important, proactive step you can take to be prepared for the next time your child has a dental injury is to download Dear Doctor's Field-side Pocket Guide for Dental Injuries. This handy, quick reference guide is a must have for athletes, parents, caregivers, teachers, coaches or anyone who is often in an environment where a mouth injury is likely to occur. Knowing what to do and how quickly you must respond can make the critical difference between saving and losing a tooth.