Dental Tidbits

Cutting Teeth on Pediatric Dentistry

 I recently attended a seminar on Pediatric Dentistry given by  K. Slayton, D.D.S. of the University of Iowa.  It was very interesting to me.  I thought I would share some highlights with you.  The biggest news to me was that topical fluoride (the fluoride that touches the teeth) is more important in cavity prevention than systemic fluoride (the fluoride that one ingests by a pill or drop).  The good news is that the public water in our area is fluoridated.  The bad news is that many of us have wells with low levels of fluoride.  The use of filters and water purifying systems will remove the fluoride from the water.  Bottled water usually does not contain fluoride.

To make things more confusing, many of the processed drinks we buy, for example many juice drinks, contain significant levels of fluoride!  An increasing number of children are showing signs of fluorosis: white spotting of the molars and secondary or “adult” teeth due to too much fluoride exposure.  It sounds like the recommendations for fluoride supplementation for those not on public water may be changing in the future.  In the meantime, make sure your child who is over the age of one year, is using a fluoridated toothpaste twice daily.  A tiny amount of toothpaste (less than pea-sized) is sufficient.  Not all toothpastes contain fluoride, so check the label.   Toothpaste is generally not recommended for children under one year.  Consider a fluoride rinse to swish and spit after brushing at bedtime for a child over 5 years of age who is not on fluoridated water.

In general, pediatricians recommend a visit to the dentist between the ages of three and four years once a child is able to sit still.  However, many dentists would like to see a child at one year to identify risk factors for early childhood cavities.  Ask your dentist for their preference.  Visible plaque, which persists after brushing, is a big risk factor for cavities.  Any child with visible plaque should see a dentist sooner rather than later.  Flossing teeth as soon as they make contact with one another can discourage cavity formation between the teeth.

NEVER allow your child to sleep with a bottle containing calories, such as milk or juice.  The slow, intermittent exposure of the teeth to the sugar over a long period of time will promote cavities.  If a child must sleep with the bottle, water only!  Intermittent sipping of juice during the day is a problem too.  Soda pop erosion is a big problem.  Not only is there no nutritional value to this drink, it quickly promotes erosion of the enamel on teeth as well as interfering calcium deposition in bone due to its acidic nature and high phosphate content.  (This is important for us ladies too, facing a future of potential osteoporosis).

Foods which may promote tooth decay include candy, cookies, crackers (because they stick in teeth), raisins, fruit roll-ups, sweet drinks, juice and soda.  Habitual sucking of lemons and limes can promote enamel erosion of the teeth.  A healthy diet including fresh fruits, vegetables, meats, water, nuts (in appropriately aged children), cheese and milk promotes healthy teeth.

Finally, a word on dental injury.  If a primary or “baby” tooth is lost prematurely due to trauma, it is gone forever.  These teeth can be forcefully pushed up into to the gum and damage the secondary behind it.  If you are not sure if the tooth fell out or was pushed into the gum, see your dentist.  They can get an Xray if needed to locate the tooth.  A primary tooth, which is knocked loose by trauma, may turn grey.  This is usually a stable condition, but your dentist will want to follow the tooth closely for signs of decay. 

If a secondary or “adult” tooth is knocked out, rinse the tooth gently in tap water to remove debris, and place the tooth into the socket.  The prognosis of saving the tooth decreases significantly if left out of the mouth for more than one hour.  Contact your dentist on his emergency line.  Hours count here.  Blood clot formation in the socket will interfere with re-implantation.  Emergency rooms are often not equipped to handle dental emergencies, so contact your dentist first.