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Posts for tag: pediatric dentistry

By Drs. Mellovitz & Grumet Dental Associates, L.L.C.
July 08, 2019
Category: Oral Health
PrimaryTeethareCriticaltoFutureDentalHealthandWorthPreserving

Ask any kid and they'll tell you just how valuable "baby" teeth really are—out of the mouth, of course, and under their pillow awaiting a transaction with the Tooth Fairy. But there's more to them than their value on the Fairy Exchange Market—they play a critical role in future dental health.

Primary teeth provide the same kind of dental function as their future replacements. Children weaned from nursing can now eat solid food. They provide contact points for the tongue as a child learns to speak. And they play a role socially, as children with a "toothsome" smile begin to look more like what they will become when they're fully mature.

But primary teeth also serve as guides for the permanent teeth that will follow. As a future tooth develops below the gum line, the primary tooth preserves the space in which it will erupt. Otherwise, the space can be taken over by other teeth. This crowds out the intended tooth, which may erupt out of position or remain impacted below the gum line.

In either case, the situation could create a poor bite (malocclusion) that can be quite costly to correct. But if we can preserve a primary tooth on the verge of premature loss, we may be able to reduce the impact of a developing malocclusion or even prevent it.

We can help primary teeth last for their intended lifespan by preventing tooth decay with daily oral hygiene or clinically-applied sealants and topical fluoride. If they do become infected, it may be worth the effort to preserve them using procedures similar to a root canal treatment.

If a tooth can't be preserved, then we can try to reserve the empty space for the future tooth. One way is a space maintainer, which is a stiff wire loop attached to metal band bonded around an adjacent tooth. This keeps other teeth from drifting into the space until the permanent tooth is ready to erupt, at which time we can remove the appliance.

Your child may be anxious to get another tooth to put under their pillow. But helping that primary tooth go the distance will be more than worth it for their future dental health.

If you would like more information on the care and treatment of baby teeth, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Importance of Baby Teeth.”

AChildsTeethGrindingisNormal-ButYouShouldStillKeepanEyeonit

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

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

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

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

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

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

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

If you would like more information on teeth grinding, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “When Children Grind Their Teeth: Is the Habit of 'Bruxism' Harmful?

InstillinYourChildtheDailyHabitofBrushingandFlossing

There are a lot of things we do without much conscious thought — habits we've developed over time. Some habits help streamline our lives for the good; others, though, hold us back or even harm us. A lot of these habits, both good and bad, form during our childhood years.

That's why it's important for you to guide your children into forming good habits. The goal is that when they're adults they'll “own” these habits, and their life will be healthier and happier because of them.

One particular area of habit-forming focus is dental care. It's essential your children develop good habits caring for their teeth and gums. The most important is a daily routine of brushing and flossing.

Brushing and flossing has one primary aim: to remove bacterial plaque, a thin film of food particles that builds up on tooth surfaces. Bacteria in plaque are the main cause for two potentially devastating diseases, tooth decay and periodontal (gum) disease. Allowing plaque to build up over just a few days can trigger an infection that inflames the gums or softens enamel leading to tooth decay. Left untreated these diseases can ultimately cause tooth and bone loss.

A daily habit of brushing and flossing, along with semi-annual professional cleanings, can drastically reduce a person's risk for these diseases. It's best to instill these habits and their importance as soon as your child's teeth begin to erupt in the mouth.

In the beginning, you'll be performing the habit for them: for children two and younger use a slight smear of toothpaste on the brush. As they get older, you can increase it to pea size. Eventually you'll want to help them learn to brush on their own. In this case, modeling the behavior — both of you brushing your teeth together — will have the biggest impact and help them see how important the habit really is.

Before you know it, brushing and flossing will become second nature, a habit they'll begin doing on their own without being told. Once instilled, it'll be a habit they'll practice long after they leave your care — and one they'll hopefully pass on to their own children.

If you would like more information on proper dental care for your child, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “How to Help Your Child Develop the Best Habits for Oral Health.”

By Keith Mellovitz, DDS
January 21, 2016
Category: Oral Health
ActorDavidRamseyDiscussesBabyBottleToothDecay

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

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

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

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

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

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

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

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

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

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

By Keith Mellovitz, DDS
September 08, 2014
Category: Oral Health
SavingaBabyToothistheBestOptionforPermanentToothDevelopment

Our “baby” teeth begin appearing around six months of age — by age 10 or 13, they’ve largely been replaced by our permanent teeth. Though their lifespan is relatively short, baby teeth play an important role in our dental development. In fact, saving a damaged baby tooth is an extremely important treatment goal even though they will be eventually lost.

Baby teeth perform a number of functions as our mouth and facial structure develops during our formative years (infancy to early adulthood). Besides providing a means to chew food, baby teeth aid speech by providing contact points for the tongue while speaking. They help us relate to others socially through smiling and other facial gestures. And, in relation to our long-term development, they serve as both guides and “placeholders” for our permanent teeth until they’re ready to erupt.

Thus, a permanent tooth’s development could be stymied if its counterpart baby tooth is lost prematurely. It could come in misaligned or not erupt fully if adjacent teeth have drifted into the open space. The resulting malocclusion (bad bite) could require long-term orthodontic treatment with higher costs than treatments to save the baby tooth and avoid the misalignment.

There are various treatments to prevent and save at-risk baby teeth. Even a badly decayed tooth might be saved with a pulpotomy, a similar treatment to a root canal but less invasive. This is often followed with a stainless steel crown to cover the remaining tooth and restore some of its form and function.

If it’s not feasible to save a baby tooth, we may recommend installing a space maintainer that prevents other teeth from drifting into the resulting space until the permanent tooth is ready to erupt. This orthodontic appliance usually consists of a metal band cemented to an adjacent tooth with an attached stiff wire loop that extends across the gap and rests against the tooth on the other side. Although effective, space maintainers can break or become dislodged, require extra monitoring and are often cosmetically unappealing.

In any event, the primary goal should be to save a baby tooth, if possible. Doing so will prevent more serious long-term problems for permanent teeth.

If you would like more information on the importance of baby teeth, please contact us or schedule an appointment for a consultation.