Pediatric Dentistry and a Child’s First Experience

With pediatric dentistry, we know each time your child visits us is another opportunity to make a great impression and keep them coming back for years to come. First impressions are critical to how we see the world, even more so when it comes to forming long-term likes or dislikes. The same is very much true for children. The first impression a child gets of pediatric dentistry will likely stay with them for most of their life. Naturally, this means we have an outstanding opportunity to ensure a child walks into the pediatric dentist clinic and walks out with a very good memory. On the other hand, if they do not have a good memory, it could prevent this child from coming back for much of their adult life. A recent study found that of the 45 percent of people who do not visit the dentist on a regular basis, a large portion can relate back to a childhood visit that was not favorable. So one of our goals is to ensure that we give the child a great experience. To do this, we need the help of you, the parent. The visit is often defined in how the child interacts with you before, during, and after the visit.

During their first pediatric dentistry appointment, a child is will naturally have some level of nervousness. Coming to a strange medical facility, lots of strange sounds and smells, and a subconscious fear of the dentist are all going to play a role in their response. To counter this, they are going to look to you for comfort and support. Children are very good at reading and imitating their parent’s emotions. So if they perceive you to be calm, composed, and very much trusting of the dentist, they will do the same. This is exactly what we need. On the other hand, if you have dental anxiety and it shows, they could manifest the same fears, which would make the visit less pleasant.

One thing pediatric dentistry does extremely well is deal with children’s natural curiosity. Children have a lot of questions, and the more they ask, the happier we are to answer because it means they are learning. At the same time, we know they will have many questions for you at home before you bring them in. We strongly recommend you have a conversation with your child before bringing them in. It doesn’t have to be long and definitely should be age-appropriate, but sharing with your child what pediatric dentistry does, what that first visit is all about, and what to expect will help them be more prepared. Using positive language, you can actually make your child excited to come in. Once you are in the clinic, you should spend some time with your child’s dentist, going over questions, concerns, and goals. This will put you on the same page as us and ensure that we will work together to give your child the great care and experience they need.

Why Your Child Should Visit a Sedation Dentistry Office

If your child is nervous about visiting the dentist, a sedation dentistry office may help ease worries. Some children are naturally anxious while others have had prior bad experiences at the dentist that cause them to avoid going. Some children are not nervous about dental appointments but have attention disorders or restlessness that can be helped by sedation methods. If your child cannot remain still, has dental phobia, needs oral surgery, or has not visited the dentist lately, you should consider visiting our sedation dentistry office for the smoothest appointment and comfortable visits in the future.

What is anesthesia?

Anesthesia is used in almost every single dentist office. At most offices, it is just administered locally to reduce discomfort during a procedure or treatment. Local anesthesia dulls discomfort in a small area during dental work, like a single tooth and the surrounding tissues. Local anesthesia is not used to cause sedation and can be used with our sedation practices at our sedation dentistry office.

General anesthesia is different from local anesthesia. It is used for surgeries and invasive procedures that require the complete stillness of the patient. General anesthesia is also used for the safety of the patient and can be used in children when needed. It alleviates any chance of discomfort and allows a dentist or doctor to maneuver around the surgical site without any complications or movements.

What is sedation?

Sedation, more accurately called conscious sedation in this situation, is used when a child cannot relax and feels anxious or when a longer appointment time is necessary. For longer treatments, it allows children to be comfortable and sit still for an extended period. Conscious sedation provides a “sleepy” and euphoric feeling that helps patients completely relax while also being able to respond to directions from a dentist. Conscious sedation is commonly used when more than one filling is needed, a child needs a tooth extraction, or a child has special needs.

How is sedation achieved?

Our sedation dentistry offers a few different types of sedation. One of the most utilized options is the inhalation of “laughing gas” or nitrous oxide. Nitrous oxide and oxygen are mixed together and administered through a small mask that is placed over your child’s nose. It is safe and does not produce worrisome side effects. It creates a relaxed and content effect.

We also offer conscious sedation through means of oral medication in the form of syrup or pill. These are normally taken 30 minutes to an hour prior to the appointment so that children arrive feeling de-stressed.

In severe anxiety cases, we offer other sedation options that produce more relaxed or sleepy effects. These are normally administered through IV (intravenously). When a child needs an invasive procedure or oral surgery like a root canal, we will provide general anesthesia that puts them into a deep sleep.

If you are looking for ways to take your child to the dentist due to the need for a root canal or an everyday appointment but your child is experiencing stress or anxiety, you should visit a sedation dentistry office for the best outcome.

How My Kid’s Dentist and Pediatric Dentistry Fight Infections

When you say that you are visiting "my kids dentist," you do so with a sense of trust that this pediatric dentistry professional will take great care of your children. We have worked hard to earn the title of “my kid’s dentist,” and to keep your trust. Part of this for pediatric dentistry is being able to treat a child quickly and efficiently when they are in a situation that is causing them pain or discomfort. Over the years, we have developed an ideology of holistic dental medicine, which focuses on many different treatment options, making sure we find the one that will work the most effectively and sometimes, the most quickly to help your child. Dental discomfort can be excruciating even for adults, so the last thing we want is for it to stick around for any length of time, causing your child distress. Perhaps the greatest tool we have in our belt to fight discomfort, often caused by infections, are antibiotics. Antibiotics were discovered in 1928 with the discovery of penicillin by Alexander Fleming. They have completely changed the way we consider infections and how we fight them. Considering that most any infection that would affect your child in the realm of dentistry is likely to be caused by bacteria, antibiotics are a critical part of our treatment regime.

There are a couple of things to remember about antibiotics, however. First, they are not a cure-all, which is what many people tend to treat them as. We can certainly appreciate how a parent could see these medications as a wonder drug. A child with a severe infection will be in pain, and antibiotics will work to permanently relieve this pain. The child may have some swelling at the site of the infection, which will also be tender to the touch. Antibiotics can, and will, reduce this swelling. Finally, a child may even have a fever that antibiotics can take away. Essentially, the antibiotics prescribed by "my kids dentist" are effective in controlling all aspects of the infection, because that is what they are designed to do.

On the other hand, you must trust the person you call "my kids dentist" to provide your child with a complete range of options that include, but are not exclusive to, antibiotics. Pediatric dentistry knows that there is an inherent risk of overusing antibiotics, because it has already happened in numerous places. The result of over-prescribing antibiotics has been the rise in cases where the organisms are resistant to the antibiotics and more severe measures have had to be taken. We do not want this. As the person trusted to be "my kid’s dentist" and a pediatric dentistry professional, our goal is to use the medication in a sparing, but highly targeted manner. This means that when we prescribe a dose of antibiotics, it will be limited, but highly effective, so balance can be restored and your child’s body can use its own antibodies to remove and kill any traces of the infection.

We Are the Best Pediatric Dentist for Sedation Dentistry

As the best pediatric dentist around, we offer sedation dentistry to keep your children comfortable during dental procedures.  In our office, we only treat children and we are passionate about their oral health and building a foundation for them to maintain it for a lifetime.  We understand the vital role we play in their future.  If their dental experiences are positive now, they will be more likely to continue visiting the dentist as they grow.  If they are negative, stressful, or even painful, they may begin to develop a fear of visiting the dentist and dental anxiety that will be stressful and unproductive as they become adults.  Our job is, therefore, very important as we set the tone for their future oral health.  With that in mind, we use sedation to ensure that they are as comfortable as possible.

The important role of a positive attitude.

We are the best pediatric dentist for a reason – we pay attention to our young patients.  While we are experts in dental care, we have also learned a lot from our patients.  They have demonstrated time and time again how important a positive attitude can be.  We have learned that when our young patients are relaxed and positive, they are less likely to experience any pain or discomfort where children that are scared, anxious or in a bad mood, tend to feel every little thing – even if it should not hurt.  This is why we work to keep the atmosphere in our office light and positive and encourage parents to participate in helping us to get kids excited about oral health.  When they walk in, happy to be here they are far less likely to need any type of sedation.

The role of sedation dentistry.

There are times where sedation is necessary.  If a child is having cavities treated or a root canal, restoration, etc. the procedure may be longer than normal and more uncomfortable.  Sedation dentistry is ideal in this situation because it allows a child to relax and stay relaxed, even if they are here for a couple of hours.  We can even use it to gently put them to sleep so that the time goes by faster and they do not feel anything.  This goes a long way in ensuring that they continue to have positive feelings about dental care.  Sedation options range from a mild pill or laughing gas that simply helps them feel calm, to sedation that makes them fall asleep and stay that way throughout the procedure.  We offer several solutions in between so that your child can remain comfortable and so that we never over-medicate.

The importance of partnering with parents.

As the best pediatric dentist, we aim to provide your child with the best possible dental care.  However, we also understand that a partnership must exist between parents and us as a provider.  We will make recommendations related to sedation dentistry, but it is ultimately up to you to decide what is best for your child.

Visit Our Kid Dentist Office and Learn How to Keep Their Teeth Healthy

As a kid dentist, the largest single challenge that we face does not come in the form of rare disease or children’s special developmental needs. The largest problem that most kid dentists face is the idea, which too many parents have, that children do not need to visit the dentist on a regular basis. The same parents that are often incredibly diligent about visiting the doctor, getting shots, and going in for regular checkups tend to forget that much of your health begins in the mouth. In a recent study, children of or under the age of one were studied; the study found that parents had taken their children to the pediatrician, at least once, in 89% of the children studied. When you look at oral health, only 1.5% of these kids had been in to a kid dentist. This is an alarming statistic as there are a growing number of cases of children with childhood decay, also known as pediatric dental disease. We have found that in children between the ages of two and five, decay can be found at a rate of 25%. When you increase the age of the children to between twelve and fifteen, the percentage of cases jumps to 50%. Half the children in middle school suffer from pediatric dental disease: something that is completely preventable with the right kind of care and allowing us to see your children’s teeth at a young age.

For a kid’s dentist, we are able to build on the work we start early to ensure that they have fewer problems as they age. Effort towards holistic preventative care allows your child to come in for a quick 15 minute checkup and cleaning rather than have discomfort and emergency dental treatment. On the whole, we have found, and studies confirm, that parents who chose to spend the money on preventative care tend to spend less in emergency care later on. The ratio of savings is quite significant: parents who spent $1 on preventative care later save up to $50 in emergency costs later in the child’s life. In addition to the monetary savings, we found that each year, school children in the United States miss 2.26 million days of school because they are in the dentist chair for an emergency or restorative procedure. This is a situation that can be completely avoided by following simple rules like the 2-2-2 rule and bringing your child in as soon as they turn one or as soon as they get their first tooth.

The 2-2-2 rule is simple, and should be followed by parents and children alike. You need to brush your teeth at least two times per day, for a minimum of two minutes each time you brush, and you should visit your dentist at least 2 times per year for cleaning and maintenance. We also recommend that your child eat a healthy diet that includes lean protein, green leafy vegetables, dairy products, and nuts.  This will help to strengthen their teeth.  Also, your child should drink plenty of water to keep their teeth clean and healthy.

Call Us if You Need an Emergency Dentist

As an emergency dentist, we understand that it is impossible to control when you will have a dental emergency.  Even those who are fastidious about oral health can still end up in a car wreck, hurt while playing sports, slip and fall down, etc., all of which can lead to a damaged tooth and dental emergency.  In fact, according to the National Fall Safety Institute slip and falls account for 9 million trips to the emergency room every year.  With that in mind, you truly never know when you may need emergency dentist care.  Fortunately, we are here when you do.  Regardless of how you hurt yourself or how damaged your teeth are, give us a call.  If we do not answer, we will get back to you right away so that you can receive the dental care that you need.

Solutions Offered by an Emergency Dentist

As an emergency dentist, we offer extended hours that are far beyond what you can find with a traditional dentist.  Many local dentists restrict their hours of operation to Monday through Thursday from 9 am to 5 pm.  While this works for many people, it can make it difficult for those with busy work schedules or a dental emergency to get the care that they need.  As a result, many people seek dental care from the emergency room of a local hospital.  This is unwise because general physicians are not trained in how to diagnose or treat dental problems.  They can triage the problem and provide medication, but that’s it.  This leads to repeat visits because the health issue is never actually addressed.  When you visit our dental office, your experience will be entirely different.  Even though we are available 24 hours a day, we still provide the same comprehensive dental care that you can receive during normal business hours.  This means that we can examine your teeth, take x-rays, diagnose the problem and provide you with immediate care.  If you have damaged your tooth, we may restore it with a bonding procedure, dental veneers, or dental crowns.  If you have lost a tooth, we can try to save it or provide you with a denture, dental bridge, or dental implant as a replacement solution.  Finally, if your tooth is infected, we can typically save it by performing a root canal.

When you visit our dental office, you can be confident knowing that you will receive the highest quality of dental care from a team of experts.  We are equipped to handle whatever your dental needs may be.

Tips for Staying Healthy

If you want to decrease the chance that you will ever need an emergency dentist, it is important to take care of your teeth and gums. While you cannot prevent most accidents, if you play sports you can decrease your risk for getting injured.  We recommend that you wear a mouthguard while playing or practicing sports so that your teeth will not be damaged if hit.  Simultaneously, if you receive ongoing dental care, the chance of you developing a sudden toothache will also be reduced.

Ways to Make Brushing Fun for Your Child

According to the American Academy of Pediatric Dentistry, your child should visit a dentist, like Dr. Soo Jun, when his or her first tooth pops through the gum, or by time they are one year old.

Children do not always want to brush their teeth. In fact, the average child has three cavities by the time they reach their third birthday. However, if you make brushing fun for them, they will look forward to it, and develop a lifelong habit of good oral hygiene.

How to Make Brushing Fun

• Let them pick out their own toothbrush, like one with their favorite cartoon character.
• Allow your child to choose their own special toothpaste, as long as it adheres to AAPD guidelines for safety.
• Brush to a fun song that is two to three minutes long. When the music stops they are done brushing.
• Brush your teeth with them. Make it a family affair!
• Toddlers may be afraid of having their teeth brushed or brushing them by themselves. Allow them watch as you brush your teeth; this will help them to see that brushing their own teeth will not hurt them.
• Reward systems are great incentives for children, just don’t overdo it. You’re trying to instill good brushing habits, not simply reward them for something they need to do.
• Try an app on your phone; you’ll be surprised how many there are and how much fun your child will have using them.
• It’s important to make sure every tooth gets brushed, so as you child brushes their teeth, count them. Then when they are finished ask them how many teeth they have. You can switch it up a little by giving each tooth a silly name or make up a short rhyme about each tooth as your child brushes.
• Use educational tools, such as the movie “The Adventures of Timmy the Tooth.”
• Read books to your child about brushing their teeth and good oral hygiene.

All you need is a little imagination to help your child learn to love brushing their teeth!

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.

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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.

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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!!!

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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.

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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

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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!

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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.

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