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Posts for tag: pediatric dentistry

By Stephen J. Oustatcher, DDS
November 25, 2018
Category: Dental Procedures
Tags: pediatric dentistry   crown  
AStainlessSteelCrownCouldHelpaStrugglingPrimaryMolarLastLonger

Although primary (“baby”) teeth have a lifespan of only a few years, they’re still important to a child’s current and future dental health. In the present, they help a child eat, speak and smile properly. They also help create a healthy future as placeholders for developing permanent teeth yet to come in.

If, however, a child loses a primary tooth prematurely due to decay, the corresponding permanent tooth could come in misaligned. That’s why we do what we can to help a decayed primary tooth reach its full lifespan. And there are different ways to do this depending on the type of tooth.

With front teeth, which don’t encounter the same chewing forces as those in the back, we may use a tooth-colored filling. This approach is also preferable for appearance’s sake since front teeth are highly visible when a child speaks or smiles.

Primary molars, on the other hand, need a more robust solution. A filling may not be able to withstand the level of long-term chewing forces that these back teeth normally encounter. And because they’re less visible than front teeth, there’s less concern about aesthetics.

That’s why many pediatric dentists prefer stainless steel crowns for molars. Just like their permanent teeth counterparts, a primary crown fits over and completely covers a tooth. They’re typically pre-formed, coming in different shapes and sizes that can then be customized for the tooth in question. After preparing and removing any decayed material from the tooth, we can usually install the crown in one visit with local anesthesia and a sedative (if the child needs it for anxiety).

While a steel crown isn’t the most attractive restoration, it typically handles the higher chewing forces in the back of the mouth better and longer than a filling. That’s especially critical for primary molars, which are some of the last teeth to fall out (as late as ages 10-12).  And besides preserving it as a permanent tooth placeholder, a crown also helps the tooth function effectively in the present.

Regardless of what method we use, though, preserving primary teeth is a primary goal of pediatric dentistry. And with a stainless steel crown, we can keep those important back molars functioning for as long as they’re intended.

If you would like more information on caring 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.”

By Stephen J. Oustatcher, DDS
November 05, 2018
Category: Dental Procedures
ResearchConfirmsDentalSealantsReallyWork

Have you heard about dental sealants? These preventive treatments have been available for many decades, and more and more children are taking advantage of them. The National Institutes of Health (NIH) estimates that around 30% of kids from 6 to 11 years of age have had sealants applied to their molars (back teeth). Sealants are designed to reduce the incidence of cavities by filling in or eliminating the pits or crevices found in all molars, where decay-causing bacteria can hide and your brush can't reach. But do they really work?

Now, the research is in, and the answer is clear — YES!

Two major studies, each of which reviewed the results of thousands of patients over several years, recently came to the same conclusion: Dental sealants are effective at reducing cavities, and their benefits can last for four years (or more) after application. In general, the studies showed that kids who didn't get sealants were twice, three times, or even more likely to get cavities, compared to kids treated with sealants.

Sealants themselves are protective coatings made of plastic resins or glass-like materials. They are applied in liquid form, and then hardened by a special light. When “painted on” to the chewing surface of a molar, sealants fill in the tiny crevices, or “pits and fissures,” that are found there. Uneven tooth surfaces form a perfect breeding ground for the bacteria that cause tooth decay; worse yet, the bristles of a tooth brush can't usually reach them. That's what makes these areas highly susceptible to tooth decay.

Applying sealants is a quick and painless procedure that doesn't require any numbing shots or drilling. Many kids start getting sealants when the first permanent molars come in, around age 5 to 7; they may have more sealant treatments when additional molars emerge, between the ages of 11 and 14.

Sealants are recommended by the American Dental Association and the American Academy of Pediatric Dentistry, and have only a modest cost per tooth. On the other hand, having a cavity filled generally costs substantially more, and may result in more trouble (and expense) down the line — so sealants can make sense economically, as well as preventively. This is especially true for those at high risk for tooth decay.

If you have questions about dental sealants, please contact us or schedule a consultation. You can read more in the Dear Doctor magazine article “Sealants for Children,” and “Top 10 Oral Health Tips for Children.”

DentalCareofPrimeImportanceforChildrenwithSpecialHealthNeeds

Children’s ailments come and go, and thankfully most are relatively minor. Some children, however, have impaired health caused by a more serious, chronic disease. For them, the condition impacts not only their overall well-being, but also their dental health.

This often occurs because the specific healthcare needs of children with these chronic conditions are given greater priority over dental health. Besides the treatment focus, children with special healthcare needs may have physical, mental or behavioral limitations that can make it difficult to keep up with oral hygiene and care.

Children with autism or attention deficit and hyperactivity disorder (ADHD) may have a difficult time practicing (or cooperating with) oral hygiene tasks. Some may not have the physical ability to perform effective brushing and flossing without assistance. In these cases, it’s important for parents or caregivers to seek out instruction and training that will optimize their children’s hygiene and so reduce the chance of dental disease.

Certain medications for chronic conditions can increase mouth dryness, or they’re acidic or sweetened with sugar, any of which can increase the child’s risk for tooth decay or periodontal (gum) disease. Parents or caregivers should consult with their physicians about these medications or if they could be administered at mealtime to minimize their effect on the mouth.

Finally, there’s the direct effect some conditions may have on a child’s teeth and gums. Children with severe gag reflexes due to their condition may not be able to tolerate toothpaste or be able to spit it out completely. Other conditions can give rise to dental defects such as enamel hypoplasia in which not enough enamel develops to adequately protect the teeth.  Such defects call for special dental attention and closer monitoring of teeth and gum health.

The key is to see us and the other healthcare providers for your child’s chronic condition as part of an overall team. Sharing information and regarding both dental and general care as part of a comprehensive strategy will help to prevent dental problems from developing and improve their health.

If you would like more information on dental care for children with chronic conditions, 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 “Managing Tooth Decay in Children with Chronic Diseases.”

By Stephen J. Oustatcher, DDS
June 08, 2018
Category: Oral Health
ActorDavidRamseyDiscussesBabyBottleToothDecay

Cavities can happen even before a baby has his first piece of candy. This was the difficult lesson actor David Ramsey of the TV shows Arrow and Dexter learned when his son DJ’s teeth were first emerging.

“His first teeth came in weak,” Ramsey recalled in a recent interview. “They had brown spots on them and they were brittle.” Those brown spots, he said, quickly turned into cavities. How did this happen?

Ramsey said DJ’s dentist suspected it had to do with the child’s feedings — not what he was being fed but how. DJ was often nursed to sleep, “so there were pools of breast milk that he could go to sleep with in his mouth,” Ramsey explained.

While breastfeeding offers an infant many health benefits, problems can occur when the natural sugars in breast milk are left in contact with teeth for long periods.  Sugar feeds decay-causing oral bacteria, and these bacteria in turn release tooth-eroding acids. The softer teeth of a young child are particularly vulnerable to these acids; the end result can be tooth decay.

This condition, technically known as “early child caries,” is referred to in laymen’s terms as “baby bottle tooth decay.” However, it can result from nighttime feedings by bottle or breast. The best way to prevent this problem is to avoid nursing babies to sleep at night once they reach the teething stage; a bottle-fed baby should not be allowed to fall asleep with anything but water in their bottle or “sippy cup.”

Here are some other basics of infant dental care that every parent should know:

  • Wipe your baby’s newly emerging teeth with a clean, moist washcloth after feedings.
  • Brush teeth that have completely grown in with a soft-bristled, child-size toothbrush and a smear of fluoride toothpaste no bigger than a grain of rice.
  • Start regular dental checkups by the first birthday.

Fortunately, Ramsey reports that his son is doing very well after an extended period of professional dental treatments and parental vigilance.

“It took a number of months, but his teeth are much, much better,” he said. “Right now we’re still helping him and we’re still really on top of the teeth situation.”

If you would like more information on dental care for babies and toddlers, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “The Age One Dental Visit” and “Dentistry & Oral Health for Children.”

AChildsTeethGrindingisNormal-ButYouShouldStillKeepanEyeonit

When you're first startled awake in the middle of the night by a loud, gritting sound emanating from your child's room, you may have two questions: how can such a loud racket not be harmful to their teeth? And, how can they sleep through it?

While it sounds earth-shattering, teeth grinding (medically known as bruxism) is a common habit among children. It involves an involuntary grinding, clenching or rubbing of the teeth together, either during the day or during night sleep.

While certain medications or conditions could be factors, it's believed most teeth grinding arises from the immaturity of the part of the neuromuscular system that controls chewing. It's believed to trigger a night episode as the child moves from deeper to lighter stages of sleep toward waking. Older children and adults typically handle these sudden shifts without incident, but a young child's under-developed chewing response may react with grinding.

If a child's teeth are normal and healthy, teeth-grinding typically won't create any lasting damage. But because grinding does generate pressures greater than the teeth normally encounter, it can be harmful to decayed teeth or those with enamel erosion due to high acid from consumption of sports and soda drinks. And it's also a cause for concern if the habit continues into later childhood or adolescence.

To avoid these problems, it's best to keep your child's teeth as healthy as possible by practicing daily brushing and flossing, and regularly seeing a dentist for cleanings, treatments and preventive measures like topical fluoride or sealants. And be sure to limit sugar and acidic foods and drinks in their diet to protect against decay and erosion.

You can also take steps to minimize teeth grinding and its effects. Consult with your physician about any medications they're taking that might contribute to the habit. If there are psychological issues at play, seek therapy to help your child better manage their stress. Your dentist can also fashion a custom night guard worn while they sleep that will prevent their teeth from making solid contact during grinding episodes.

Most importantly, let your dentist know if your child grinds their teeth. Keeping an eye on this potentially harmful habit will help lead to appropriate actions when the time comes.

If you would like more information on teeth grinding, 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 “When Children Grind Their Teeth: Is the Habit of 'Bruxism' Harmful?



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