THE SAFETY OF DENTAL X-RAYS

An article was released to the public stating that dental X-rays contribute to a type of brain cancer. After reading an article like this, your first thought may be to avoid dental X-rays, but you may want to hold off on that quick judgment. As with any treatment we offer at Wichita Pediatric Dentistry, education is your most valuable tool in deciding what is best for you.

How often dental X-rays are taken is based on risk for infection, physical symptoms, and clinical findings. The American Dental Association (ADA) is a governing body over the dental profession. The ADA states, “ . . . healthy adults receive routine mouth X-rays every two to three years. Dental X-rays are recommended every one to two years for children and every 1.5 to three years for teens. Children often require more X-rays than adults because of their developing teeth and jaws and increased likelihood for cavities.”

A "caries risk category" often determines how often dental X-rays are taken. The most recent documented resource to determine a caries risk is Caries Management by Risk Assessment (CAMBRA). This was adopted by the ADA and is used by dental professionals giving interval recommendations for X-rays.

With knowledge of your risk for dental infection, you will be informed by Dr. Mike Iseman of the interval at which dental X-rays should be taken. You can rest assured that the standards published by the ADA have been researched extensively and are there to protect your personal health and safety.

Dental X-rays are most commonly digital, which significantly reduces exposure. There is more radiation exposure from the sun or in an airplane than in a dental X-ray. It is common practice to use a lead apron with a thyroid collar for protection during X-ray exposure.

Having a cavity means having an active, potentially harmful infection. Diagnosing such infection with minimal exposure through digital dental X-rays at our Mint Kids Dentistry office does more good than harm.

GOOD DENTAL HYGIENE IMPACTS OVERALL GENERAL HEALTH

There are many ways in which your oral health has an impact on your overall general health. There are naturally occurring bacteria in the mouth. Some of those bacteria, including strep and staph, are harmful, while other bacteria are essential for the balance of intestinal flora. The healthier your mouth is, the less likely it is the harmful bacteria will travel to other parts of your body to infect it and make you sick. There is much more to good dental hygiene than brushing and flossing.

Historical Methods of Maintaining Oral Health

Ancient civilizations relied on natural remedies for maintaining oral health. Around 250 AD, the Kemetic Egyptians used myrrh and other herbs as antiseptics for treating infected gums. Two centuries later, the Nubians, who lived in the Nile River valley, drank beer to ease the pain of infected teeth. That probably sounds crazy, but their beer was effective because they used grains that were contaminated with the same bacteria that produce the antibiotic tetracycline.

Today's Biggest Dental Hygiene Challenge

In the past, tooth decay was more of an issue because there was no routine dental care, and problems that are routinely treated today went untreated. Thanks to fluoridated water, and toothpastes containing fluoride, tooth decay is far less problematic than it was a century or more ago. Gum disease has replaced tooth decay as the most serious dental problem facing people today. According to the American Dental Association, a staggering 80 percent of Americans over age 65 suffer from some form of periodontal disease.

Ironically, if that infection attacked any other part of your body, especially in a place where it was clearly visible, you would head to your doctor for treatment immediately. People tend to ignore gum tenderness and bleeding. When the tenderness and bleeding aren't treated, the inflammation can turn into periodontitis. The longer you allow the inflammation to go untreated, the greater the likelihood that it will affect other body parts. Make sure to visit Dr. Soo Jun at Mint Kids Dentistry regularly to be proactive about dental health!

Researchers are now discovering that untreated inflammation in the mouth acts as a driving force for multiple chronic illnesses, including clogged arteries, heart attacks, arthritis, and even cancer. That inflammation is one of many hypotheses that may explain how chronic infections can trigger systemic diseases, and even intensify existing ones. Bacterial overgrowth in the inflamed gum tissue can enter the bloodstream through the food you eat, and from daily brushing.

Caring for your mouth at home is just as important as visiting our office for exams!

What’s the Best Toothpaste for My Child?

One of the more common questions we are asked on a regular basis concerns choosing the right toothpaste. There are so many choices that it can be difficult to find one that is best for your child’s oral health. Here are a few quick guidelines to make sure you find one that’s right:

1) Look for the ADA seal.

When trying to find the best toothpaste, it’s important to start with one that is recommended by the American Dental Association. Their seal of approval can be found on the box and tube and ensures that the toothpaste has been objectively evaluated for safety by the ADA Council on Scientific Affairs.

2) Avoid harsh abrasives.

Many toothpastes, especially those advertised as “whitening” often contain abrasives that can damage young tooth enamel.

3) Check for fluoride.

Fluoride is a naturally occurring mineral that has been shown to dramatically reduce tooth decay. But you should remember to have children spit out toothpaste and avoid swallowing it. Too much fluoride can cause a condition known as fluorosis. For children too young to spit out toothpaste, you may consider using a fluoride free toothpaste or only a small “pea size” amount.

4) Consider the flavor.

While not a health related issue, you want to make sure that a toothpaste doesn’t taste bad to your child. Many children often find traditional flavors like mint to be “spicy” and they often prefer the more kid friendly options available today.

Dr. Soo Jun
Board Certified Pediatric Dentist
Mint Kids Dentistry
1500 145th PL SE, 
Bellevue, WA
http://www.mintkidsdentistry.com
425-321-0833

Why Choose a Pediatric Dentist?

As I determined my career path I specialized in Pediatric Dentistry specifically, I had a strong desire to be able to make a change in children's lives. I knew I could do that by making that connection for children, that going to the dentist is fun! 

As a Fellow of the American Academy of Pediatric Dentistry I can say that I am a “Big Authority on Little Teeth”.

The AAPD website serves as a great resource for parents!  www.aapd.org 

Ages When Baby Teeth Come In and Fall Out

Most babies get new teeth and lose their teeth at expected times. The exact order and timing may vary.

By Healthwise Staff
Primary Medical Reviewer John Pope, MD - Pediatrics
Specialist Medical Reviewer Thomas M. Bailey, MD - Family Medicine
 

WebMD Medical Reference from Healthwise

This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.
© 1995-2014 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.

National Children's Dental Health Month!

February is National Children’s Dental Health Month!   WP would like to take the opportunity to remind you about good dental health and practices…

*It is never too early to start brushing – Even if your child is still awaiting their first tooth, going through the motions of brushing, rubbing and stimulating the gums is important.

*2 minutes twice a day! – Set a timer or come up with a song or game to keep your child engaged during the brushing process.  Two times a day is the minimum frequency suggested, but getting children to brush after meals as an early habit will help reduce risk of decay and help implement good life long dental care.

*“I want to do it!” – If your child is showing signs of independence and wants to brush their own teeth, support and encourage that! Be sure to check out their handy work at the end and do touch ups as needed. While touching up, teach your child about caring for all the types of teeth they have “their smiling teeth, their biting teeth and their chewing teeth” – especially those hard to reach ones.

*Make it fun – Let your child pick out their toothbrush and toothpaste. It will make the process more fun and desirable for everyone.

*Toothpaste tastes good – Fluoride in toothpaste is beneficial but it’s important to use the right amount. Recommendations are to use a smear about the size of a grain of rice for children under age 3 and a pea-sized amount for children 3-6 years.  Remind your child that toothpaste is for swishing and spitting and not to be swallowed.

*Besides brushing – Feed your child healthy foods that do not have a lot of sugar, and when they do partake in a treat, remember to brush right after. Check teeth periodically looking for discoloration or stains, and prevent tooth decay by not putting baby to bed with a bottle filled with formula or milk. Remember to visit the dentist twice a year and discuss the need for fluoride supplementation based on your water supply. Happy Brushing!!!


Are cavities “genetic” in families?

The hope and purpose of this blog was to be topical on issues related to pediatric dentistry, specifically related to all of us out here in Katy, Texas!

Today’s topic:  Are cavities genetic?  Are some people destined to have cavities because of the family and genetics they are born into?

I love this question.  I get parents often telling me, “cavities just run in our family” or “our family just has bad teeth”!  I’ve even have had parent’s tell me, “bottle rot runs in our family”.

So here’s the deal:

Most cavities are NOT genetic.  What we pass down from generation to generation are habits and bacteria.  Today’s blog will focus on the bacteria aspect of cavities.  Children are born with a “sterile” mouth, if you will.  Until the teeth erupt, there is not a “host” for the bacteria that cause cavities.  The tooth is the host.  So at about the age of 6 months when the first tooth erupts, until about the age of 2.5 years old, the child is in the “window of infectivity”.  What this means is that as the child’s teeth erupt, the child’s mouth will colonize with bacteria.  This is normal and it happens to all of us.  There is no way to avoid a child colonizing with bacteria.  The question is, with what bacteria will they colonize?  This relates to the primary caregiver.  Who blows on the hot food?  Who wipes the pacifier clean with their own mouth when it drops in a weird place and baby needs it NOW?  Who gives daily doses of kisses to baby?  This person or persons would be considered the primary caregiver/s.

If the primary caregiver has untreated dental disease such as periodontal disease, or gum disease, or cavities, they have an advanced, aggressive oral flora.  These bacteria transferred to child are more aggressive.  Primary caregivers who are cavity free, and without gum disease have a healthier, less aggressive oral flora and pass these healthier bacteria onto their children.  So comparing two children from two different homes, one with healthy mouths, the other with lots of untreated dental disease, the child from the latter is much more likely to get cavities, all other things being equal.

This is not to say that there are no circumstances of genetically poorly formed teeth.  I will say that genetic issues with teeth are rare, almost always easily diagnosed, and often genetically traceable and accompanied by other issues related to the same gene.  It is just not as common as people think.

This is good news.  What it means is that even if you had/have a lot of cavities or gum disease in your family history, it doesn’t have to continue with your children.

Do I have to cut out all sugars to keep my child cavity-free?

In continuation of the last blog, “Are cavities genetic”?, we discussed how often “genetics” or “just bad teeth” are blamed for children’s cavities when the real culprits are habits and bacteria.  First let me say this is not an indictment on parents who have children with cavities or any form of judgement.  It is about having good information and reducing the risk for cavities in our children.

Cavities are predictable and preventable in almost all circumstances.  Today’s blog will focus on diet and what two primary factors in the diet affect a child’s risk for cavities (or adults for that matter), frequency of intake and consistency of food.

Frequency of intake is one of the most important factors in risk for cavities and it is often something that is not on anyone’s radar.  What do I mean by frequency of intake?  Well, in the dental world we call it the “demin/remin” cycle.  Basically every time you eat or drink anything the PH of your mouth dips to an acidic level.  The reason for this is because the mouth is where digestion of food begins.  While you are eating, and 30 minutes after the last bite or sip, your mouth is acidic.  This helps to begin the breakdown of the food, but it also breaks down the teeth.  The acid pulls minerals out of the enamel during this phase.  About 30 minutes after the food is cleared the PH rises to a more neutral level.  During this time, your saliva has minerals in it and these minerals get re-deposited into the enamel.  So how this affects your risk for cavities is how often your mouth is “acidic” and how long it gets to be in the “remin” phase during the day.  For “grazers”, or kids who have a little sip of milk, go play legos for an hour, come back, have another sip of milk, go play for a while, come back an hour later for a few goldfish…etc…their mouth is acidic much of the day!  That means that their teeth aren’t having time to recover and are getting chalkier and chalkier, or weaker and weaker, until ultimately they “cavitate” and have a hole.

What is the goal then with frequency of food, especially for toddlers or picky eaters?  I recommend striving for scheduled eating and aiming for 2-3 hour breaks between meals and snacks.  During this time, NOTHING but water is consumed.  So lets take a sample schedule, 7AM-breakfast, 10AM snack, 12:30PM-lunch, 3:00PM snack, 6PM dinner.  When lunch is over for example, and your child says they are all full and want to play, everything is put away.  Nothing but water is offered until snack time at 3:00PM.  For kids used to sipping and snacking all day, there may be a big fuss at first.  With nutrition as my background degree, I think eating often is healthy.  I also think 5 meals/snacks per day is plenty of times to get proper nutrition in and some sweets if you want.  The key is getting those rest times in for the teeth to repair.

The other key component is consistency of the food.  How long does it take you after eating a dried fruit roll up to clear all the sticky stuff from your molars and teeth?  Well guess what, kids don’t clear!  They let it sit and say, “Yum, my mouth still tastes good an hour later!”  I have a great photo in my office I like to show kids who eat lots of sticky foods.  It is of a 7 year old’s teeth who ate a dried fruit roll up.  The picture was taken 1 hour after the child ate it.  It shows all the grooves and between spaces filled with the sugary snack.  The next page shows all the cavities in the very same areas.  Kids catch on quick, especially if they have cavities.  If you want desserts in your home or some sweet treats but don’t want cavities here are some ideas.  Offer sweet treats that clear faster, like ice cream, pudding, jello, popsicles, chocolate and the like.  Avoid things that stick in the teeth for a long time like dried fruit roll ups, airheads, oreos and the like.  Or, if you want to enjoy the sticky foods occasionally, make the house rule to brush or at least rince your mouth after the treat.  Also, try to keep the sweets, juices, sodas, etc with the meal or snacks, not in those 2-3hour down times.

Longer than I expected this blog to be, but I hope it was helpful.  Cavities are predictable.  Research says 2 out of 3 children who show up with a cavities, then get them all fixed, will be back within 18months (sometimes less) with new cavities!  That happens if we just “fill the holes” but don’t get to the root cause.  Cavities are preventable.  These are two of the most common issues I am able to help parents identify in children with cavities.  I see families who make the change from grazing to scheduled eating and who give up or brush after the sticky snacks come back with no new cavities, and it feels great!   I see other families who can’t make the changes for whatever reason, and the kids just keep getting cavities.

Dr. Soo Jun
Board Certified Pediatric Dentist
Mint Kids Dentistry
1500 145th PL SE, 
Bellevue, WA
http://www.mintkidsdentistry.com
425-321-0833

Sealants

If you have children and take them to the dentist, at some point you are going to hear about sealants.  I think sealants are one of the most effective services dentists can provide their young patients to prevent a common type of cavity. 

Pictures are worth a thousand words, so here is a great image that explains why sealants are so effective.  (photo was taken from Dentistry 2000 website)

This photo shows a cross-section of an adult molar tooth.  What it reveals is how adult molars form with deep “grooves” or “crypts” that are more narrow at the depth than one toothbrush bristle.  Because of this fact, biting surfaces cavities are one of the types of cavities that people over the course of history have consistently gotten.  With sealants, these deep grooves are filled with a liquid monomer, and a light is used to cause this material to polymerize and harden.  These are bonded to the tooth and are very effective in sealing out tooth decay of this type.

Parents often ask me if we should seal baby molars as well as the permanent molars.  Without going into great detail this is my response.  Baby molars do not typically have these deep grooves, though some do.  If I see a child getting decay on this surface of baby molars and I need to do a filling on one or more of these baby molars, then yes, sealants would be a good preventative measure in these children.  If the child is low risk for getting decay, meaning they have never had a cavity and have not got factors in their history indicating they will likely get cavities, than sealants on baby teeth are not indicated.

Insurance usually pays for sealants on adult molars because insurance companies have reviewed the research themselves and know paying for a less expensive preventative procedure is financially better for them.  They know if they provide this benefit for their clients they are much less likely to have to pay for more expensive fillings later.  Only a few insurance companies pay for sealants on baby molars.  Medicaid is one of those insurance providers that do and this is the reason.  Low income children have more cavities and they know that in low income populations they are going to save money in the long run for these children by providing as much prevention as possible.

Some dentists will always recommend sealants on all molars, baby molars, etc.  My philosophy is assessing the child’s risk for decay at their first visit to my office by taking a good history, diet evaluation and by the exam itself.  Some children should have every nook and cranny possible sealed because of their high risk for decay; on bicuspids, deep groves on the tongue side of front incisors, and all molars.  Some children only need sealants on permanent molars.  Some families feel “If insurance doesn’t pay, then I’m not doing it.”  Unfortunately not all insurance companies provide the same level of coverage, and no insurance company can replace the evaluation and recommendation by a pediatric dentist for your specific child.  

Hope this helps you decide what is best for your sweet little one!

Why are my child’s new teeth so yellow?

This is a question, as a Pediatric Dentist, I am asked almost everyday.  As the first baby teeth fall out, and the first permanent teeth come in, parents grow concerned because the new teeth appear to be very yellow or dark.  

I love to get to tell parents the good news.  What they are seeing is an optical illusion.  The new permanent teeth are a normal shade, but they look darker because baby teeth are almost always bright white and opaque in color.  When you see the new teeth next to the bright, white baby teeth, they appear very dark.  Once all the new teeth are in, you’ll see that they are a healthy, light shade.

Of course, sometimes teeth are actually a darker shade than is ideal, but those are few and far between.  If the teeth are a dark shade, they can be lightened later, when all the adult teeth are in the mouth.  There have been great advances in the safety and ease of bleaching teeth, but the teeth have to be mature enough and all erupted to get the best result.

Look for our next blog to be about either: white, metal-free crowns for baby molars (only when a filling cannot save the tooth) or new laser technology that allows for cavity detection without x-rays.