dental cavities

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

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.

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”….