children’s dental

Oral Health in Pregnancy

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During pregnancy we all know the importance of regular prenatal visits, vitamins, healthy eating and exercise but if you are expecting you may want to add trip to your dental professional to your list of things to do.

Did you know that having gum disease can place your baby at risk for preterm birth and low birth weight??

Many women experience pregnancy gingivitis because hormonal changes during pregnancy cause their gums to become inflamed placing them at greater risk of developing gum disease. Things to watch out for include tender and swollen gums, receding gums, bad breath and loose teeth.

To eliminate this risk it is important to practice good oral hygiene habits, visit your dental professional regularly and seek dental care immediately if any problems arise.

Water is important for a healthy mouth

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Having a mouth full of water through out the day is a good habit-adults and children.

After eating a small piece or large piece of candy a mouth full of water helps decrease the acid attack from the sugar. You can swish and spit or swish and drink.

After a drink of milk, juice or pop a person should have a mouth full of water to decrease the acid attack.

Children during the day should have water after eating anything, and a mouth full throughout the day helps as well. After recess and after lunch especially.

A dry mouth is more prone to cavities and gum disease. Water helps rinse off plaque and keeps the plaque from getting to0 sticky.

Lifetime Smiles Dental Hygiene Clinic

Water

Preventing tooth decay in children

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Most of the dental hygienists here at Lifetime Smiles Dental Hygiene Clinic are also “moms”. We care deeply about the oral health of all children.  In this age of doctor Google, there can be a great deal of conflicting healthcare advice easily accessed.

Our goal is to educate parents, caregivers, grandparents and anyone else who will listen, by providing facts. Research in dental health and products to combat tooth decay is ever changing, therefore we are continuously learning.

Sometimes going back to the basics is important. There is one truth that is important to understand, and that is Babies are not born with the bacteria that causes tooth decay, they pick it up from a parent, a caregiver, from someone else.

How does that happen? Shared saliva – licking a fork or spoon and sharing with a baby, testing babies food first, or licking off the pacifier instead of washing it off with water (you know you’ve done that!). You can easily see there are many ways saliva (and germs) can be transferred.  Caregivers with active dental disease and tooth decay are potentially going to be a source of significant bacteria.

A great source of information can be found on the following site-  American Pediatric Dentistry 

HOW TO PROTECT YOUR BABY’S TEETH FROM CAVITIEShttp://www.aapd.org/assets/2/7/Education_-_Caries.pdf

The results are in…decay is on the rise in Calgary

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Is there a dental topic more polarizing than water fluoridation? Supporters adamantly defend this public health initiative and opponents are just as resolute in their position.

On the fence about community water fluoridation?  An internet search on the topic can lead to hours of reading, and information that is all over the map. Adding to public perplexity is the fact that within dental health communities you will find both supporters and opponents, even though the Canadian Dental Hygienists Association and Canadian Dental Association both have position statements supporting community water fluoridation, (1,2) as do a long list of other organizations and groups. (1)

One thing that is clear, regardless of your stance on fluoride, tooth decay rates have increased among children in Calgary since water fluoridation was discontinued in May 2011. This was brought to media attention in 2014, with Registered Dental Hygienist, Denise Kokaram speaking out about significant tooth decay being treated on the Alex Dental Health Bus,

 “more than half of the children who get treated on the bus have tooth decay”, she said. “We see lower self-esteem with these kids, attention spans are affected. Loss of days at school.”(3)

At this same time, Calgary pediatric dentist Dr. Sarah Hulland said

“I’m seeing a lot more children having a lot more cavities. I’m seeing a lot of decay on 19- to 20-month babies, and this is even before they’ve got all the teeth in.

We frequently have to put them to sleep to rehabilitate them. We don’t have enough anaesthetists that actually help us to put them to sleep. We don’t have enough OR time. We don’t have enough manpower to actually do the care that needs to be given.“

What used to be a one-month wait to see a pediatric dentist in Calgary is now at least three months.” (3)

Fast forward to today, and now we have hard data thanks to a recently published study carried out in Alberta. 

Lead author Lindsay McLaren, PhD, from the Cumming School of Medicine and O’Brien Institute for Public Health revealed children in Calgary are experiencing higher rates of tooth decay compared to children of the same age in Edmonton.

Comparing more than 5,000 grade two children in both cities, “there was a worsening in tooth decay in Calgary since the discontinuation of fluoridation in 2011, compared to Edmonton, where water is still fluoridated. In fact, the number of tooth surfaces with decay per child increased by 3.8 surfaces in Calgary during the time frame of the study, compared to only 2.1 in Edmonton. This is a statistically significant difference. The average child has about 20 teeth with four or five surfaces per tooth.”(4)

Dr.Mclaren says, “We first of all looked at trends over time in tooth decay in the two cities and whether there was a difference and after that we systematically went through and explored a number of possible alternative explanations for those differences. Everything pointed pretty consistently to fluoridation cessation being the main reason for the difference.”(4)

You can read the full study here htttp://www.ucalgary.ca/utoday/issue/2016-02-17/study-shows-tooth-decay-worsened-calgary-children-after-fluoride-removal (5)

At Lifetime Smiles Dental Hygiene Clinic, we provide our patients with recommendations based on their individual dental health needs, which may or may not include fluoride treatments. We respect a patient’s decision regarding treatments they consent to, and treatments they decline. 

When demineralization is present, or an individual (child or adult) is a high risk for tooth decay, fluoride and re-mineralizing fluoride alternatives can be recommended. Our philosophy of care is to treat individuals on an individual basis. 

Children should be seen for their first visit with a dental health care provider 6 months after their first tooth erupts, or by age 1 year. Lifetime Smiles Dental Hygiene Clinic offers to see children for this first visit at no charge. It is an important visit, despite the myth that baby teeth are NOT important. Baby teeth are VERY important. Let’s work together to ensure a future of cavity free adults, who do not require dental filling replacement over and over throughout their lives. Tooth decay is preventable. Let’s work together to prevent it.

References

  1. http://www.cdha.ca/CDHA/The_Profession/Resources/links/position_statement_water_fluoridation.aspx
  2.  http://www.cda-adc.ca/en/about/position_statements/fluoride/
  3. http://www.cbc.ca/news/canada/calgary/dental-decay-rampant-in-calgary-children-pediatric-dentist-says-1.2864413
  4. http://www.ucalgary.ca/utoday/issue/2016-02-17/study-shows-tooth-decay-worsened-calgary-children-after-fluoride-removal
  5. http://onlinelibrary.wiley.com/journal/10.1111/%28ISSN%291600-0528 

Post Author: Sally Lloyd BScDH, Registered Dental Hygienist at Lifetime Smiles Dental Hygiene Clinic , Calgary,AB

Parents flip the lip

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I drafted this post some time ago but held back. I didn’t want parents to think I am criticizing them. I understand how many times throughout a child’s life that parenting can be difficult. I don’t want to add to any external pressure, but reading an article yesterday that “the federal government is spending a million dollars to send five chartered plane loads of Nunavut children to the hospital in Churchill, Man., for dental surgery”  pushed me into sharing this. That coupled with the fact that after discussing this with a patient of mine she stated “I wish you would tell all parents this”. This is my attempt to reach more parents.

Dental decay is preventable

Granted there is an access to care issue for these Nunavut children in this media report, but that wouldn’t explain the situation in other areas of Canada. There is no shortage of tooth decay and dental treatment being carried out in Calgary by pediatric dentists.

Parents – please flip the top lip up and have a look at your baby’s teeth. Do this often, and realize that brown spots are not normal. Flip the lip when you brush. Their tight little lips prevent thorough plaque removal. Often it is far easier to brush the side of their teeth that the tongue touches when they open wide for this task, than to brush the surface covered by their lips.

Take your child to a dental health care provider by age 1 year (6 months after 1st tooth erupts). Yes, it is a short apt if nothing is wrong, but a very important appointment. Don’t wait until there is a problem, or until age 3 years old. Do they have the appropriate number of teeth for their age? Are they tongue tied? Is their lip tied? Are you struggling to clean their teeth? Are you confused about toothpaste that is age appropriate?  This is only a fraction of what could be reviewed and discussed at this first visit. Regulated dental healthcare workers are required to attend continuing education. That phrase “when we know better, we do better” applies. Therefore, what was reviewed at your older child’s exam 9 years ago maybe be quite different than what is reviewed today with a much younger child.

Wipe off baby teeth with a washcloth or baby toothbrush

Don’t lay a baby down with any liquid other than water

Don’t let a child sip for extended times from a sippy cup – think if it this way – every time they take a sip of apple juice (even diluted) a 20 minute acid attack takes place in their mouth (approximately). If they are sipping from their sippy cup intermittently for 1.5 hours (length of a kids movie) that is almost 2 hours of acid attack

Why fruit juice?….  Why not water?

When the time is right – Have Dental Sealants Placed

I am a parent and trust me there was a period of time that it took myself and my husband to hold our son down so that we could brush his teeth –  he was about 2.5 years old when he began to hate having his teeth brushed. I mean hate it. Of course, we hated doing it just as much.   Me: ” It’s your turn”;  my husband: “No, it’s your turn”  – and usually it would take 2 of us to do it. I would put my thumb in my son’s mouth toward the back baby molars- where when he bit down it wasn’t with any amount of force. Then while my thumb was there, we could get his teeth brushed. He couldn’t close completely so I could maneuver a toothbrush around. The thumb technique sometimes allowed me to do it without help from a second adult. This nightly battle went on for about 6 months- then he was over it. He began to want to “do it himself” of course, but the deal was – he had a turn then an adult had a turn. This event takes minutes, not hours – get it done – get it over with.

Children DO NOT have the dexterity to brush and floss well enough until age 10. If you don’t believe me, have them “do it themselves”, then put disclosing liquid on their teeth. The liquid that turns plaque bacteria purple or red. You will then understand how a child who “brushes everyday” still gets cavities. They aren’t brushing well enough to remove the majority of plaque. It’s not their fault, it’s not that they aren’t trying. They don’t have the co-ordination. Sometimes once “disclosed” – it is quite evident that they are right or left handed and they have missed an entire quadrant of their mouth. Not just one or two teeth, but 5 or 6 teeth. They have spent the time in the bathroom and they report the deed is done, but an adult really needs to assist.

As far as flossing on their own? seriously? there are many adults who don’t even feel the need of this 1-2 minute activity warrants doing. A child left to their own devices may use a floss pick or floss and get a percentage of the spaces. If you actually watch them, they get one spot, skip 2 spots and so on. If this part of home care is a nightmare- consider a child’s waterpik flosser or GumChucks (much easier for a parent to use on a child).  Those tight spaces are where many cavities form.

Give some thought to yourself – did you ever have cavities? if so at what age did you have the most dental treatment? If you have never had decay – fantastic. Congratulations. You won’t have to spend time and money over your life having the dental fillings placed when you were a child drilled out and replaced several times over. Once a tooth has been cut with a dental drill and a filling placed, it is destined for future dental treatment. Fillings don’t last forever, especially the white resin fillings. All of this can be PREVENTED.

As a dental hygienist, my children are not immune to tooth decay, so I knew it had to be done, and I considered it a chore. It is important to me that I prevent what I know can be prevented. Why was I then cursed with a child who hated having his teeth brushed?

I know why. I was a dental assistant before I became a dental hygienist. I assisted a dentist with operating room privileges. We treated children under general anesthesia in a hospital. It was difficult to see such small, young children laying on an operating table – their feet going nowhere near the foot of the bed, and their eyelids taped shut during the procedure.This was not a children’s hospital – so these were adult hospital beds.  Usually, treatment involved several injections of anesthetic, pulpotomies (this is basically the equivalent to a root canal treatment but on a baby tooth), stainless steel crowns cemented to hold intact what was left of the decayed teeth, several fillings, and some extractions if the teeth were so badly decayed. As I suctioned and watched eyelids try to flutter I cast judgment on these children’s parents. In my mind I questioned to myself – “who would let their children’s teeth become decayed like this, and why don’t parents brush their kids teeth?”   This is why my son gave me grief – and of course, that is when I realized just how difficult it is to carry out dental home care at times. Often it’s not that brushing isn’t happening, it’s that it isn’t happening well. Today’s typical diet is inducive to dental decay. Let your children, or your grandchildren or any children you know be the exception.

So I sympathize with new parents, parents of multiple kids, tired and overworked parents – but please, as tired as you are, please get through this chore at night before bed – at least, and monitor what it is in contact with their teeth throughout the day. Do what you feel is in the best interest of your child.

Early Childhood Cavities – why be concerned?

Feds spend $1M to fly Inuit children south for dental surgery

Cavities on the increase for kids

Sedatives Cited in Toddler’s Dental Office Death 

Anesthesia in young kids may carry developmental risks

If you live in Calgary or Claresholm, bring your kiddies in for a no charge first visit.

If you have young children at home, or children who you feel would do better in their home environment – a mobile dental hygienist is a great option – they bring their equipment to you.

Autism In The Dental Hygiene Chair

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autism ribbonApril is Autism Awareness month, and this week is National Dental Hygienists week, so I decide to blog about both. I dedicate this blog post to my friend Allison and all families who know Autism and Aspergers well. During my time as a dental hygienist I have been exposed to clients of all ages and backgrounds including those with unique needs. After recently meeting Allison I became aware that I did not have any experience with autistic children.

How is that possible? Did I in fact treat autistic children but didn’t know it? Would a parent not indicate that on a medical chart? Could I treat clients in a city with a population of 1 million and not see 1 autistic child when the stats from Centers for Disease Control and Prevention (CDC) identify that 1 in 88 children is diagnosed with autism? Was I so oblivious that I may have chalked up a child’s behaviour to “high maintenece” when really it was typical behaviour of an autistic child?

I don’t know the answer. I knew that after reading Allison’s blog post “Life with Liam“, about an orthodontic appointment for her 9 year old son that I was certain I may not know how to make a dental hygiene visit for an autistic child a positive one, an experience that both child and caregiver look forward to as opposed to viewing it as one more necessary but unpleasant life task. This was disturbing to me because I sincerely want to make dental hygiene visits a great, educational experience for both children and their caregivers. It is with children I feel hygienists have the opportunity to make the greatest impact – sharing  preventative dentistry knowledge – ensuring a life of “no drilling & filling”.

Of course I studied “special needs” in dental school, but how much could I recall of dealing with autism? not much. I was feeling very inadequate with my limited knowledge of the unique challenges associated with dental hygiene home care, best time of day for dental hygiene appointments, and management in the clinic. I was also certain my dated knowledge wouldn’t hold a candle to the reality of today for these families. Continuing education throughout life is a reality.

I have since learned that Autism is a general term, and there are various functioning levels – each individual is just that –INDIVIDUAL.  Autism Speaks Canada has an informative website and states that “Autism spectrum disorder (ASD) and autism are both general terms for a group of complex disorders of brain development. These disorders are characterized, in varying degrees, by difficulties in social interaction, verbal and nonverbal communication and repetitive behaviors. They include autistic disorder, Rett syndrome, childhood disintegrative disorder, pervasive developmental disorder-not otherwise specified (PDD-NOS) and Asperger syndrome. ASD can be associated with intellectual disability, difficulties in motor coordination and attention and physical health issues such as sleep and gastrointestinal disturbances. ”

It is best for the caregiver to outline the functioning level of the child (where they are on the spectrum)- as well as details about sensory issues that may arise and discuss how to best handle them when at a dental hygiene appointment. If this conversation can happen prior to the child’s appointment that would be best. The dental hygienist will welcome any information that can facilitate an enjoyable visit. You know your child best, and know what sensory stimuli could be avoided or reduced. A dental hygiene clinic can have some advantages in terms of sensory stimuli when compared to a traditional dental clinic. There will be no dental drilling noises, smell of root canal mediciments, or dental materials like monomer being used in a hygiene clinic. Lighting may be an issue, so best to discuss this ahead of time. Caregivers can practice a visit at home before going to the clinic so the child has some familiarity with what may happen – practicing laying back, looking in the mouth, and counting teeth.

From the dental hygienists perspective be prepared to book a longer appointment so it isn’t rushed, the child has the time needed, you can answer all of the caregivers questions, and you can review techniques for oral home care. Repetition and routine can be very reassuring for autistic children. Establishing a relationship with one particular dental hygienist, rather than seeing someone different each visit can achieve this. Like appointments with all children, what works one day may not work the next, so be prepared with knowledge and do not hesitate to ask for recommendations from caregivers, and have patience. The first appointment may end up being a familiarity time, and perhaps no treatment carried out. Stretch your mind and skills and grow with the child & family.

Are you a dental hygienist looking for a resource to use? Dental hygienist and mother, Karen Raposa devoted six years of her life to writing “Treating the Dental Patient with a Developmental Disorder”. She cited her autistic son as her inspiration for writing the book. This book shares information on how to provide dental health services for patients with developmental disorders. You will also find the best information comes directly from parents and caregivers. Keep an open mind…. we are always learning.

Signed, SEALED, & Delivered : For Children & Adults

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Seal Out Tooth Decay before It Happens!

How can you prevent yourself or your children from getting cavities? it’s easy SEAL THEM OUT… with Sealants!

Do you remember why your dental hygienist or dentist put sealants or more commonly known as “white coats”, “clear paint” or “protective paint” on your back teeth when you were younger? Has your dental hygienist or dentist recommended having them placed? If so, you might be asking; what are sealants anyway?

The main and most important reason for getting sealants is to avoid tooth decay. They are thin, plastic coatings painted on the chewing surfaces of the back teeth… because our back teeth are primarily used for chewing; the chewing surfaces are rough and uneven surfaces with pits and grooves. Toothbrush bristles cannot get into the tiny pits and grooves of these teeth so germs and food can get stuck for a long time causing a cavity to form if not prevented.

Sealants are put on in dentists’ offices, dental hygiene clinics, and sometimes in schools. They are painted on as a liquid and quickly harden to form a shield over the tooth. A special light is often used to “cure” the liquid.

 

Do you know if you have any sealants now? Are they in good condition? Do you or your children need sealants?

Visiting your dental hygienist and/or dentist can help determine and exam when, and on whom will need sealants. Going in for your regular dental cleanings and check-ups will let us and YOU informed.

 

Having sealants placed on teeth before they decay will also save time and money in the long run by avoiding fillings,root canal treatment, and  crowns (also called caps) used to fix decayed teeth. Sealants are simple and painless and can last many years!!

Some dental insurance plans cover the cost of sealants. Check your dental health care booklet or call your insurance company for details!

 

What else can you do to protect against decay?

Yep, you guessed it… with proper oral hygiene care of daily tooth brushing and flossing which can help prevent tooth decay. Pit and fissure sealants are most commonly placed on molar teeth. These back teeth are harder to get at, especially with toothbrush they need the extra protection to keep the germs out! That is why sealants cover the chewing surfaces of the back teeth and help making our daily routine of proper oral home care a bit easier.

Call us to ask questions about preventative sealants- we are happy to share information to prevent tooth decay! (403)457-2044

test saliva and prevent dental cavities…who knew?

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Saliva, aka SPIT – is very important. Your may have even been complimented at your dental cleaning appointment by your dental hygienist on your saliva. It usually goes something like this:

dental hygienist “wow, you have a lot of saliva”   

patient (who is now wondering is that good or bad) “what does that mean?”

Saliva is very important :

– helps to wash food particles off the teeth and surfaces inside the oral cavity

– contains antibacterial components – comes in handy when babies are putting everything in their mouths

– contains minerals that can help repair tooth enamel that has started to break down

– helps to buffer acids and restore neutral pH when you’ve consumed foods that have created an acidic environment

– can be tested for presence of drugs in the body

-Japan’s Keio University and University of California, have been working on developing saliva testing technology that can detect pancreatic cancer, breast cancer and oral cancer

– dental hygienists can perform saliva testing in the clinic to determine if there is a high level of the strains of bacteria that play a role in the initiation of dental decay

Lifetime Smiles Dental Hygiene clinic in efforts to assist in preventing dental decay can perform saliva testing. If it is determined that you are at a high risk (large population of decay causing bacteria), recommendations can be made to help change amounts of bacteria and treat the infection.   Yes, dental decay is caused by bacteria and is a bacterial infection. Dental decay is the most common chronic infection of early childhood.

Should an adult be concerned? yes, as dental decay is the leading cause of tooth loss in adults.

Prescribed medications and other health problems can decrease the amount of saliva produced, or dimish the neutralizing properties, thus creating a higher risk of dental decay.

Discuss this with your dental hygienist or other dental providers. Dental hygienists love to assist in prevention, as I have indicated in previous blogs, dental hygienists love to talk “prevention”.

 

Home is where the heart is….and the toothpaste, and the floss..

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 I guess you could say a life of good dental hygiene starts at home. More specifically it starts with young children at home. That means parents, listen up. You have the power to provide your child with the tools and habits that can lead to a cavity free life. That’s right…no cavities. 

Kids love “cavity-free dental check ups“. It means no appointments requiring sleepy juice (freezing by injection with a needle) for a dental filling. No watching them after a dental appointment to ensure they don’t chew on their cheeks because they can’t feel it.

What?  Your kid loves to go to the dentist and doesn’t mind any of this?   That’s good because if they have a filling as a child, chances are that filling will need to be replaced more than one time in the future. When it is replaced, more natural tooth structure is lost, and every time this tooth is treated there is risk to the nerve in the tooth. What does that mean? This means the nerve could become damaged and root canal treatment required.  Then what? After a tooth has had  root canal treatment it is recommended that a crown be placed. It doesn’t end there, as a crown doesn’t last forever.  

But the good news is, you can spend a few minutes each day helping to prevent cavities. Dental hygienists  recommend toothbrushing for 2-3 minutes. Thus the timer on electric toothbrushes is 2 minutes long.  So, 3 times a day at 2 minutes = 6 minutes per child. More if they snack often. Piece of cake right?

 Now in reality, and having children of my own I know it is not 6 minutes per child. When my son was 2 -3 yrs old , it was 6 minutes of brushing and 10 minutes for my husband and I to hold him down. Thank goodness that stage didn’t last forever, as it was not something we looked forward to each day. 

This difficult stage I believed was pay back. Prior to having children I was a dental assistant and helped place fillings in children’s teeth. I once worked in a hospital setting with a dentist that placed many fillings, extracted decayed baby teeth, and placed stainless steel crowns on children’s teeth. Due to the amount of dentistry they required, and their young age, they were treated under general anesthesia in the OR. I remember thinking “why doesn’t someone just brush these kids teeth?”. Then I had children.

You can have the best intentions and limit sugary snacks, but essentially most foods can contribute to cavities. Fruit for example, contains natural sugars that supply bacteria in the mouth with fuel. The bacteria release acids, and the acids break down enamel, causing a cavity. Fermentable carbohydrates as well as sugars in children’s medicines are also fuel for bacteria. Bacteria love it, but tooth enamel doesn’t. 

Teeth need to be cleaned properly of food particles after eating to prevent or cut short this “acid attack”. One’s own saliva can neutralize the acid after approximately 20 minutes.  If a child is snacking frequently add up the minutes per day an acid attack is occurring to their teeth. In other words, for children that have a sippy cup – water is a great choice for drinking throughout the day, otherwise their teeth could be exposed to acids for a majority of the day.

 Children love to exhibit their independence at an early age, and despite their best negotiating don’t give in and let them brush their teeth “by themselves”. Don’t break down even if they use the puppy dog eyes…stand firm. If really young, they are likely only chewing the toothbrush, but that good let them have “a turn”, then its “parents turn”. Children do not have the manual dexterity to reach all the surfaces throughly. Thus, parents need to help until they are 8 or 9 years old.

Flossing is another story, they really can’t master this technique until they are 10 or 11 years old. I know I have seen some adults in the dental chair who haven’t mastered their own flossing despite their own self confessed once a week attempts for 30 years , so seriously, can your children do it?     Plastic floss handles are a great tool for both parents and children.

So if you have been at a loss because you thought that  brushing EVERY night was all that was required for your children, and yet they have had a cavity, consider how often they are snacking, and how many minutes their teeth could be under acid attack.

Remember to prevent children from getting a cavity (also called tooth decay) one must :

– brush and floss after eating   (only brushing at night  2 – 3 hours after last eating doesn’t cut it)

– adults need to help with toothbrushing until age 8 -9 yrs old

– adults need to help with flossing until 10-11 yrs old

Often children are taking medications, or using inhalers for medical conditions that can create a higher risk for cavities, if this is the case, ask for suggestions from your dental hygienist….. dental hygienists love to talk “prevention”….