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Posts for tag: tooth decay

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.”

AlthoughaChallengeChronicallyIllChildrenNeedToothDecayPrevention

Families of children with chronic conditions face many challenges. One that often takes a back seat to other pressing needs is the prevention of tooth decay. But although difficult, it still deserves caregivers’ attention because of the dental disease’s potential long-term impact on oral health.

Chronically ill children are often at higher risk for tooth decay, most commonly due to challenges in practicing effective oral hygiene. Some conditions create severe physical, mental or behavioral impairments in children’s ability to brush and floss: for example, they may have a heightened gag reflex to toothpaste in their mouth or they may not be able to physically perform these tasks on their own.

Some children may be taking medications that inhibit salivary flow as a side effect. Saliva is critical for disease prevention because it both neutralizes mouth acid (which can erode tooth enamel) and is a first line of defense against disease-causing bacteria. And a child’s diet, while designed to support treatment of their chronic condition, may conversely not be the best for supporting their dental health.

It’s best if caregivers and their dentists develop a strategy for decay prevention, which should include the following:

  • Regular dental visits beginning at Age One. Besides monitoring dental health, dental visits also provide cleanings and other preventive measures like topical fluoride or sealants;
  • Brushing and flossing support. Depending on a child’s physical and mental capacities, caregivers (or an older sibling) may need to model brushing and flossing, or perform the tasks for the child;
  • Medication and diet changes. If medications are causing dry mouth, caregivers can speak to their physicians about possible alternatives; likewise, they should see if modifications can be made to their diet to better support dental health.
  • Boosting salivary flow. It’s especially important with children who have dry mouth to drink more water or use aids (like xylitol gum or candies) to boost salivary flow.

Although it requires extra effort and time to give attention to a chronically ill child’s dental health, it’s well worth it. By working to prevent tooth decay early in life, these children will be more likely to enjoy good dental health in the future.

If you would like more information on dental care for children with special needs, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor article “Managing Tooth Decay in Children with Chronic Diseases.”

TreatingaBabyToothwithInnerDecaycanbeComplicated-butStillNecessary

Even though a child’s primary (“baby”) teeth eventually give way, it’s still important to treat them if they become decayed. Primary teeth serve as guides for the emerging permanent teeth — if they’re lost prematurely, the permanent tooth may come in misaligned.

If the decay, however, affects the tooth’s inner pulp, it poses complications. A similarly decayed adult tooth would be treated with a root canal in which all the pulp tissue, including nerve fibers and blood vessels, are removed before filling and sealing. Primary teeth, however, are more dependent on these nerves and blood vessels, and conventional filling materials can impede the tooth’s natural loss process. It’s better to use more conservative treatments with primary teeth depending on the degree of decay and how much of the pulp may be affected.

If the decay is near or just at the pulp, it’s possible to use an indirect pulp treatment to remove as much of the softer decay as possible while leaving harder remnants in place: this will help keep the pulp from exposure. This is then followed with an antibacterial agent and a filling to seal the tooth.

If the pulp is partially exposed but doesn’t appear infected, a technique called direct pulp capping could be used to cover or “cap” the exposed pulp with filling material, which creates a protective barrier against decay. If decay in a portion of the pulp is present, a pulpotomy can be performed to remove the infected pulp portion. It’s important with a pulpotomy to minimize the spread of further infection by appropriately dressing the wound and sealing the tooth during and after the procedure.

A pulpectomy to completely remove pulp tissue may be necessary if in the worst case scenario the pulp is completely infected. While this closely resembles a traditional root canal treatment, we must use sealant material that can be absorbed by the body. Using other sealants could inhibit the natural process when the primary tooth’s roots begin to dissolve (resorb) to allow it to eventually give way.

These all may seem like extraordinary efforts to save a tooth with such a short lifespan. But by giving primary teeth a second chance, their permanent successors will have a better chance of future good health.

If you would like more information on treating decay in primary 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 “Root Canal Treatment for Children’s Teeth.”