Around ages 6 to 8, a child's primary teeth will begin to loosen to make way for their permanent teeth. If all goes well, the new set will come in straight with the upper teeth slightly overlapping the bottom.

But sometimes it doesn't go that well: a child may instead develop a poor bite (malocclusion) that interferes with normal function. If we can detect the early signs of a developing malocclusion, however, we may be able to intervene and lessen its impact. You as a parent can play a vital role in this early detection.

The first thing you should be watching for is teeth spacing. Normal teeth come in straight with a slight gap between them. But there are two abnormal extremes to look for: teeth having no space between them or crowded together in a crooked, haphazard manner; or they seem to have too much space between them, which indicates a possible discrepancy between the teeth and jaw sizes.

You should also notice how the teeth come together or “bite.” If you notice the lower front teeth biting in front of the upper (the opposite of normal) it may be a developing underbite. If you see a space between the upper and lower teeth when they bite down, this is a sign of an open bite. Or, if the upper front teeth seem to come down too far over the lower, this could mean a deep bite: in extreme cases the lower teeth actually bite into the roof of the mouth behind the upper teeth.

You should also look for crossbites, in which the teeth in one part of the mouth bite abnormally in front or behind their counterparts, while teeth in other parts bite normally. For example, you might notice if the back upper teeth bite inside the lower teeth (abnormal), while the front upper teeth bite outside the lower front teeth (normal).

The important thing is to note anything that doesn't look right or seems inconsistent with how your child's teeth look or how they function. Even if you aren't sure it's an issue, contact us anyway for an examination. If it really is a developing bite problem, starting treatment now may lessen the extent and cost of treatment later.

If you would like more information on bite development in children, please contact us or schedule an appointment for a consultation.

Academy Award-winning actress Kathy Bates knows how important it is to present your best face to the world — and one of the most important features of that face is a beaming smile. But there came a point when she noticed something was a little off. “I've always had good teeth, but it seemed to me as I was getting older that they weren't looking as good,” Kathy explained in a recent interview with Dear Doctor magazine.

That's when she decided it was time to take action. Kathy had orthodontic treatment when she was in her fifties, and she keeps her smile bright with tooth whitening treatments. She uses a kit provided by her dentist with a safe, effective whitening solution.

Of course, a bright, healthy smile looks great anywhere — whether you're on the red carpet or “off the grid.” And you don't have to be a Hollywood star to have professional whitening treatments. In fact, teeth whitening is one of the most popular and affordable cosmetic treatments modern dentistry offers.

The basic options for professional teeth whitening include in-office bleaching or take-home kits. Both types of dentist-supervised treatments offer a safe and effective means of getting a brighter smile; the main difference is how long they take to produce results. A single one-hour treatment in the office can make your teeth up to ten shades lighter — a big difference! To get that same lightening with at-home trays, it would take several days. On the plus side, the take-home kit is less expensive, and can achieve the same results in a bit more time.

It's important to note that not all teeth can be whitened with these treatments. Some teeth have intrinsic (internal) stains that aren't affected by external agents like bleaches. Also, teeth that have been restored (with bonding or veneers, for example) generally won't change color. And you can't necessarily whiten your teeth to any degree: Every tooth has a maximum whiteness, and adding more bleach won't lighten it beyond that level. Most people, however, find that teeth whitening treatments produce noticeable and pleasing results.

What about those off-the-shelf kits or in-the-mall kiosks? They might work… or they might not. But one thing's for sure: Without a dentist's supervision, you're on your own. That's the main reason why you should go with a pro if you're considering teeth whitening. We not only ensure that your treatment is safe — we can also give you a realistic idea of what results to expect, and we will make sure that other dental problems aren't keeping you from having a great-looking smile.

How often does Kathy Bates see her dentist for a checkup and cleaning? “I go about every four months,” she noted. “I'm pretty careful about it.” And if you've seen her smile, you can tell that it pays off. If you would like more information about teeth whitening, please contact us or schedule an appointment. You can learn more in the Dear Doctor magazine articles “Important Teeth Whitening Questions Answered” and “Teeth Whitening.”

More than likely your child already receives fluoride from your drinking water or toothpaste. So, is it really necessary for them to receive topical fluoride during their regular office checkups?

We highly recommend they do. A naturally occurring chemical, fluoride has the ability to make enamel more resistant to acid attacks that lead to tooth decay. It’s most effective when it works its way into the structure of the enamel during early teeth development.

Both fluoridated drinking water and dietary fluoride supplements (recommended by a doctor or dentist) can be the vehicle for this to occur while the teeth are still forming in the jaw before eruption (when teeth become visible). After the teeth have erupted, fluoride applied directly to the enamel surface (topically) can become infused with it as it continues to develop during early growth.

But can’t fluoride toothpaste accomplish the same result? No — the fluoride added to toothpaste and other hygiene products is relatively low, and only strong enough to maintain and protect enamel. The fluoride levels in topical applications like gels, foam or varnishes are much higher (in the tens of thousands of parts per million) and remain in contact with the teeth during a treatment session for much longer. Some fluoride varnishes, in fact, will continue to leach fluoride into the tooth surface for a month or more.

Topical fluoride applications are especially beneficial for children who are growing up in an area without fluoridated drinking water or without the proper means for good oral care and hygiene. But even for children with access to fluoridated water and oral care, a topical application can still be helpful.

A topical fluoride treatment isn’t a stand-alone application, but a regular part of your child’s dental care of daily brushing and flossing and semi-annual dental cleanings and checkups. Topical fluoride enhances the care they already receive to help produce stronger enamel for future healthy teeth.

If you would like more information on topical fluoride applications, 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 “Topical Fluoride: How Fluoride will Benefit Your Child.”

During his former career as a professional footballer (that's a soccer star to U.S. sports fans) David Beckham was known for his skill at “bending” a soccer ball. His ability to make the ball curve in mid-flight — to avoid a defender or score a goal — led scores of kids to try to “bend it like Beckham.” But just recently, while enjoying a vacation in Canada with his family, “Becks” tried snowboarding for the first time — and in the process, broke one of his front teeth.

Some fans worried that the missing tooth could be a “red card” for Beckham's current modeling career… but fortunately, he headed straight to the dental office as soon as he arrived back in England. Exactly what kind of treatment is needed for a broken tooth? It all depends where the break is and how badly the tooth is damaged.

For a minor crack or chip, cosmetic bonding may offer a quick and effective solution. In this procedure, a composite resin, in a color custom-made to match the tooth, is applied in liquid form and cured (hardened) with a special light. Several layers of bonding material can be applied to re-construct a larger area of missing tooth, and chips that have been saved can sometimes be reattached as well.

When more tooth structure is missing, dental veneers may be the preferred restorative option. Veneers are wafer-thin shells that are bonded to the front surface of the teeth. They can not only correct small chips or cracks, but can also improve the color, spacing, and shape of your teeth.

But if the damage exposes the soft inner pulp of the tooth, root canal treatment will be needed to save the tooth. In this procedure, the inflamed or infected pulp tissue is removed and the tooth sealed against re-infection; if a root canal is not done when needed, the tooth will have an increased risk for extraction in the future. Following a root canal, a tooth is often restored with a crown (cap), which can look good and function well for many years.

Sometimes, a tooth may be knocked completely out of its socket; or, a severely damaged tooth may need to be extracted (removed). In either situation, the best option for restoration is a dental implant. Here, a tiny screw-like device made of titanium metal is inserted into the jaw bone in a minor surgical procedure. Over time, it fuses with the living bone to form a solid anchorage. A lifelike crown is attached, which provides aesthetic appeal and full function for the replacement tooth.

So how's Beckham holding up? According to sources, “David is a trooper and didn't make a fuss. He took it all in his stride." Maybe next time he hits the slopes, he'll heed the advice of dental experts and wear a custom-made mouthguard…

If you have questions about restoring damaged teeth, please contact our office to schedule a consultation. You can read more in the Dear Doctor magazine articles “Trauma and Nerve Damage to Teeth” and “Children's Dental Concerns and Injuries.”

To get your child on the right track for lifelong dental health we recommend you begin their dental visits around their first birthday. You can certainly visit your family dentist, especially if you and your family feel comfortable with them. But you also might want to consider a pediatric dentist for your child's dental needs.

What's the difference between a family dentist and a pediatric dentist? Both offer the same kind of prevention and treatment services like cleanings, fluoride applications or fillings. But like their counterparts in medicine — the family practice physician and pediatrician — the family dentist sees patients of all ages; the pediatric dentist specializes in care for children and teens only.

In this regard, pediatric dentists undergo additional training to address dental issues specifically involving children. Furthermore, their practices are geared toward children, from toys and child-sized chairs in the waiting room to “kid-friendly” exam rooms decorated to appeal to children.

While your family dentist could certainly do the same, pediatric dentists are also skilled in reducing the anxiety level that's natural for children visiting the dental office. This can be especially helpful if you have a special needs child with behavioral or developmental disorders like autism or ADHD. A pediatric dentist's soothing manner and the calm, happy environment of the office can go a long way in minimizing any related anxiety issues.

Your child may have other needs related to their oral health that could benefit from a pediatric dentist. Some children have a very aggressive form of dental caries disease (tooth decay) called early childhood caries (ECC).  If not treated promptly, many of their teeth can become severely decayed and prematurely lost, leading to possible bite problems later in life. Pediatric dentists are well-suited to treat ECC and to recognize other developmental issues.

Again, there's certainly nothing wrong with taking your child to your family dentist, especially if a long-term relationship is important to you (your child will eventually “age out” with a pediatric dentist and no longer see them). It's best to weigh this and other factors such as your child's emotional, physical and dental needs before making a decision.

If you would like more information on pediatric dentistry, please contact us or schedule an appointment for a consultation.

Even though baby teeth are not meant to last forever, they serve some very important functions for the time they are around. Healthy baby teeth allow your child to bite and chew food, articulate sounds correctly during speech, and, of course, to smile! They also help guide the permanent teeth, which will one day replace them, into proper alignment. So it’s important to take good care of them while they’re here. Let’s answer some frequently asked questions about pediatric dentistry.

Can I get my teeth cleaned while I’m pregnant?
Yes — and you should! Both the American Dental Association and the American Congress of Obstetricians and Gynecologists recommend that women keep up with their regular schedule of dental cleanings and exams during pregnancy. Not doing so can allow disease-causing oral bacterial to flourish, which can be a health risk for both the expectant mother and her fetus.

Do infants need their teeth brushed?
Yes, it’s important to start a daily oral hygiene routine as soon as the first baby tooth appears — usually sometime between six and nine months of age. Use a very soft-bristled child-sized toothbrush and just a smear of fluoride toothpaste (the size of a grain of rice). When your child turns 3, increase the amount of fluoride toothpaste to the size of a pea.

When should I take my child in for her first dental appointment?
The answer to this one may surprise you: All children should see a dentist by the age of 1. Early dental visits get children accustomed to having their mouths examined and their teeth cleaned. Establishing this healthy habit early will go a long way toward promoting a lifetime of good oral health.

Should I worry that my child sucks his thumb?
That depends on how old he is. Thumb sucking is a normal, comforting habit for babies and toddlers. Most outgrow it by the time they are 4. But kids who don’t are at increased risk for orthodontic issues later on. If your child seems unable to break the habit, let us know; we can give you more detailed recommendations at your next appointment.

What can I do to prevent my children from getting cavities?
Make sure your children have an effective daily oral hygiene routine that includes brushing with fluoride toothpaste twice a day and flossing at least once per day. If they are too young to do a good job by themselves, help them complete these important tasks. Keep their sugar consumption as low as possible; pay particular attention to beverages — soda, sports drinks and even 100 % natural fruit juices can all promote tooth decay. We can offer individualized advice on fighting cavities, and even provide fluoride treatments and dental sealants for extra protection against cavities. So don’t forget to bring your child in to the dental office for regular exams and cleanings!

If you would like more information about caring for your child’s teeth, please contact us or schedule an appointment for a consultation.

The development of your child’s teeth, gums and jaw structure is an amazing process. But while it largely occurs on its own, we can’t take it for granted—we’ll need to do our part to ensure their mouth stays free from the effects of disease and injury.

That starts first and foremost with early oral hygiene practices. And we do mean early, even before teeth begin to erupt: a simple habit of wiping their gums after feeding with a clean, damp cloth helps reduce the growth of bacteria, the leading cause of dental disease.

Once teeth do appear, you can begin brushing them every day with just a smear of toothpaste. You can increase this to a pea-sized dose around age 2, as well as begin teaching them to brush and later floss for themselves.

Regular dental visits are the next pillar of preventive care. By and large it’s best to begin visits around their first birthday. Their primary teeth should be coming in at an even pace by then; and the earlier you begin visits the easier it will be for them to become used to them as a routine part of life.

Dental visits are essential for keeping bacterial plaque under control, as well as monitoring overall dental health. It’s also an opportunity to apply other preventive measures such as sealants that discourage tooth decay development on biting surfaces and topical fluoride for strengthening enamel.

Dental visits also provide frequent opportunities to detect bite problems or other situations as they’re emerging. Recognizing these early gives us a chance to intervene with less invasive treatments that could prevent or minimize more invasive treatments later.

You also don’t want to forget about the other major cause of dental problems—traumatic injuries. You can lessen this risk by limiting your child’s exposure to hard, sharp objects like furniture or some toys. And if they become involved with contact sports, it’s a good idea to invest in a custom mouthguard to protect their teeth and mouth from blunt force trauma.

As always, we’re here to support you and give you advice on other ways to keep your child’s dental development on track. Together we’ll give your child the best chance possible to enter adulthood with a healthy mouth.

If you would like more information on dental care for your child, please contact us or schedule an appointment for a consultation.

When they’re introducing a new movie, actors often take a moment to pay tribute to the people who helped make it happen — like, you know, their dentists. At least that’s what Charlize Theron did at the premiere of her new spy thriller, Atomic Blonde.

"I just want to take a quick moment to thank my dentists," she told a Los Angeles audience as they waited for the film to roll. "I don’t even know if they’re here, but I just want to say thank you."

Why did the starring actress/producer give a shout-out to her dental team? It seems she trained and fought so hard in the action sequences that she actually cracked two teeth!

“I had severe tooth pain, which I never had in my entire life,” Theron told an interviewer from Variety. At first, she thought it was a cavity — but later, she found out it was more serious: One tooth needed a root canal, and the other had to be extracted and replaced with a dental implant — but first, a bone grafting procedure was needed. “I had to put a donor bone in [the jaw] to heal,” she noted, “and then I had another surgery to put a metal screw in there.”

Although it might sound like the kind of treatment only an action hero would need, bone grafting is now a routine part of many dental implant procedures. The reason is that without a sufficient volume of good-quality bone, implant placement is difficult or impossible. That’s because the screw-like implant must be firmly joined with the jawbone, so it can support the replacement tooth.

Fortunately, dentists have a way to help your body build new bone: A relatively small amount of bone material can be placed in the missing tooth’s socket in a procedure called bone grafting. This may come from your own body or, more likely, it may be processed bone material from a laboratory. The donor material can be from a human, animal or synthetic source, but because of stringent processing techniques, the material is safe for human use. Once it is put in place your body takes over, using the grafted material as a scaffold on which to build new bone cells. If jawbone volume is insufficient for implants, it can often be restored to a viable point in a few months.

Better yet, when grafting material is placed in the tooth socket immediately after extraction, it can keep most of the bone loss from occurring in the first place, enabling an implant to be placed as soon as possible — even before the end of a movie’s shooting schedule.

Will Atomic Blonde prove to be an action-movie classic? Only time will tell. But one thing’s for sure: When Charlize Theron walks down the red carpet, she won’t have to worry about a gap in her smile.

If you have questions about bone grafting or dental implants, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Dental Implant Surgery” and “Immediate Dental Implant.”

At your child's latest dental visit, you found out one of their primary (“baby”) teeth has become decayed and in danger of loss. Of course, you may think, it's only a primary tooth — it's going to come out sooner or later.

But a primary tooth lost “sooner” rather than “later” can create long-term negative consequences for your child's dental health. For the sake of the future permanent tooth, the best treatment strategy could be to put forth the effort and expense to save it.

Besides its role in eating and chewing, a primary tooth's most important function is as a “trailblazer” for the permanent tooth developing below it. A primary tooth doesn't normally loosen and let go until the new permanent tooth is ready to erupt. Until then they hold the new tooth's space in the jaw.

But if the primary tooth is lost prematurely, nearby teeth can drift into and crowd the space so that the permanent tooth comes in out of position. This can result in a malocclusion, or poor bite.

Depending on the state of your child's jaw development, it may be advisable to attempt saving the tooth through a filling or, in the case of deep decay, a modified root canal treatment. If the tooth can't be saved, then placing an orthodontic appliance known as a space maintainer might be necessary. Cemented to a tooth next to the empty space, this appliance has a looped band of metal that butts against the tooth on the other side of the gap, and prevents both teeth from drifting into the space.

Intervening for a decayed primary tooth can seem a waste of time and money since it has a limited lifespan to begin with. But for the health of its companion permanent tooth, as well as possibly avoiding orthodontic treatment, it could be well worth it for your child's long-term dental health.

If you would like more information on 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 “Importance of Baby Teeth.”

A lot happens in your child’s mouth from infancy to early adulthood. Not surprisingly, it’s the most active period for development of teeth, gums and jaw structure. Our primary goal as care providers is to keep that development on track.

One of our main concerns, therefore, is to protect their teeth as much as possible from tooth decay. This includes their primary (“baby”) teeth: although your child will eventually lose them, a premature loss of a primary tooth to decay could cause the incoming permanent tooth to erupt out of proper position. And we of course want to protect permanent teeth from decay during these developmental years as well.

That’s why we may recommend applying topical fluoride to your child’s teeth. A naturally occurring chemical, fluoride helps strengthen the mineral content of enamel. While fluoride can help prevent tooth decay all through life, it’s especially important to enamel during this growth period.

Although your child may be receiving fluoride through toothpaste or drinking water, in that form it first passes through the digestive system into the bloodstream and then to the teeth. A topical application is more direct and allows greater absorption into the enamel.

We’ll typically apply fluoride in a gel, foam or varnish form right after a professional cleaning. The fluoride is a much higher dose than what your child may encounter in toothpaste and although not dangerous it can cause temporary vomiting, headache or stomach pain if accidentally swallowed. That’s why we take extra precautions such as a mouth tray (similar to a mouth guard) to catch excess solution.

The benefits, though, outweigh this risk of unpleasant side effects, especially for children six years or older. Several studies over the years with thousands of young patients have shown an average 28% reduction in decayed, missing or filled teeth in children who received a fluoride application.

Topical fluoride, along with a comprehensive dental care program, can make a big difference in your child’s dental care. Not only is it possible for them to enjoy healthier teeth and gums now, but it could also help ensure their future dental health.

If you would like more information on topical fluoride and other dental disease prevention measures, 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 “Fluoride Gels Reduce Decay.”

While they're resilient, your child's teeth aren't invincible. Daily hygiene and regular dental visits are important, but you should also be alert for problems and take action when they arise.

Here are 4 areas that could cause problems for your child's teeth, and what you should do — or not do — if you encounter them.

Teething. This is a normal experience as your child's first teeth erupt through the gums. The gums become tender and painful, causing constant gnawing, drooling, disturbed sleep and similar symptoms. You can help relieve discomfort by letting them bite on a chilled (not frozen) teething ring or a cold, wet washcloth. Pain relievers like ibuprofen in appropriate dosages can also help — but don't apply ice, alcohol or numbing agents containing Benzocaine directly to the gums.

Toothache. Tooth pain could be a sign of decay, so you should see us for an examination. In the meantime you can help relieve pain with a warm-water rinse, a cold compress to the outside of the face, or appropriately-dosed pain relievers. If the pain is intense or persists overnight, see us no later than the next day if possible.

Swollen or bleeding gums. If you notice your child's gums are red and swollen or easily bleed during brushing, they could have periodontal (gum) disease. This is an infection caused by bacterial plaque, a thin film of food particles that build up on the teeth. You can stop plaque buildup by helping them practice effective, daily brushing and flossing. If they're showing symptoms, though, see us for an exam. In the meantime, be sure they continue to gently brush their teeth, even if their gums are irritated.

Chipped, cracked or knocked out tooth. If your child's teeth are injured, you should see us immediately. If part of the tooth has broken off, try to retrieve the broken pieces and bring them with you. If it's a permanent tooth that was knocked out, pick it up by the crown (not the root), rinse it with clean water and attempt to place it back in the socket. If you can't, bring the tooth with you in a container with clean water or milk. The sooner you see us, the better the chances for saving the tooth — minutes count.

If you would like more information on what to do when your child has dental problems, please contact us or schedule an appointment for a consultation.

It's no secret that many of Hollywood's brightest stars didn't start out with perfectly aligned, pearly-white teeth. And these days, plenty of celebs are willing to share their stories, showing how dentists help those megawatt smiles shine. In a recent interview with W magazine, Emma Stone, the stunning 28-year-old star of critically-acclaimed films like La La Land and Birdman, explained how orthodontic appliances helped her overcome problems caused by a harmful habit: persistent thumb sucking in childhood.

“I sucked my thumb until I was 11 years old,” she admitted, mischievously adding “It's still so soothing to do it.” Although it may have been comforting, the habit spelled trouble for her bite. “The roof of my mouth is so high-pitched that I had this huge overbite,” she said. “I got this gate when I was in second grade… I had braces, and then they put a gate.”

While her technical terminology isn't quite accurate, Stone is referring to a type of appliance worn in the mouth which dentists call a “tongue crib” or “thumb/finger appliance.” The purpose of these devices is to stop children from engaging in “parafunctional habits” — that is, behaviors like thumb sucking or tongue thrusting, which are unrelated to the normal function of the mouth and can cause serious bite problems. (Other parafunctional habits include nail biting, pencil chewing and teeth grinding.)

When kids develop the habit of regularly pushing the tongue against the front teeth (tongue thrusting) or sucking on an object placed inside the mouth (thumb sucking), the behavior can cause the front teeth to be pushed out of alignment. When the top teeth move forward, the condition is commonly referred to as an overbite. In some cases a more serious situation called an “open bite” may develop, which can be difficult to correct. Here, the top and bottom front teeth do not meet or overlap when the mouth is closed; instead, a vertical gap is left in between.

Orthodontic appliances are often recommended to stop harmful oral habits from causing further misalignment. Most appliances are designed with a block (or gate) that prevents the tongue or finger from pushing on the teeth; this is what the actress mentioned. Normally, when the appliance is worn for a period of months it can be expected to modify the child's behavior. Once the habit has been broken, other appliances like traditional braces or clear aligners can be used to bring the teeth into better alignment.

But in Stone's case, things didn't go so smoothly. “I'd take the gate down and suck my thumb underneath the mouth appliance,” she admitted, “because I was totally ignoring the rule to not suck your thumb while you're trying to straighten out your teeth.” That rule-breaking ended up costing the aspiring star lots of time: she spent a total of 7 years wearing braces.

Fortunately, things worked out for the best for Emma Stone: She now has a brilliant smile and a stellar career — plus a shiny new Golden Globe award! Does your child have a thumb sucking problem or another harmful oral habit? For more information about how to correct it, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine article “How Thumb Sucking Affects the Bite.”

The arrival of your child’s first set of teeth is a natural and expected process. But that doesn’t mean this period of development, commonly known as teething, is an easy time: your baby will endure a fair amount of discomfort, and you, perhaps, a bit of anxiety.

Knowing the facts about teething can help you reduce your child’s discomfort — as well as your own concern — to a minimum. Here are a few things you need to know.

Teething duration varies from child to child. Most children’s teeth begin to erupt (appear in the mouth) between six and nine months of age — however, some children may begin at three months and some as late as a year. The full eruption sequence is usually complete by age 3.

Symptoms and their intensity may also vary. As teeth gradually break through the gum line, your baby will exhibit some or all normal teething symptoms like gum swelling, drooling and chin rash (from increased saliva flow), biting or gnawing, ear rubbing, or irritability. You may also notice behavior changes like decreased appetite or disrupted sleep. These symptoms may be a minimal bother during some teething episodes, while at other times the pain and discomfort may seem intense. Symptoms tend to increase about four days before a tooth emerges through the gums and about three days afterward.

Diarrhea, rashes or fever aren’t normal. These symptoms indicate some other sickness or condition, which can easily be masked during a teething episode. If your child exhibits any of these symptoms you should call us for an exam to rule out a more serious issue.

Keep things cool to reduce discomfort. There are a few things you can do to reduce your child’s discomfort during a teething episode. Let your child chew on chilled (but not frozen) soft items like teething rings, wet washcloths or pacifiers to reduce swelling and pain. Gum massage with your clean finger may help counteract the pressure from the erupting tooth. And, if your doctor advises it, pain relievers in the proper dosage may also help alleviate discomfort. On the other hand, don’t use rubbing alcohol to soothe painful gums, or products with the numbing agent Benzocaine in children younger than two unless advised by a healthcare professional.

If you would like more information on dealing with teething issues, 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 “Teething Troubles.”

Once they learn to walk, there's no stopping most children. Sometimes it can be a little jarring, as when you discover your toddler on top of the kitchen counter reaching in the cupboard on tip-toes for a snack!

Fortunately, children are fairly resilient. Unfortunately, they're not invincible — some of their adventures could result in physical injuries, especially to the highly vulnerable area of the mouth.

Even if you've carefully “child-proofed” your home, it's still best to be prepared for mishaps. Here are 3 common dental injuries and how to handle them.

Soft tissue injuries. Making contact with the ground or hard objects like furniture can injure the lips, tongue, cheeks or gums and cause bleeding, cuts or bruising. First, clean the area with clean water and a cloth or gauze as best you can, making sure there aren't any trapped pieces of tooth or dirt. Apply gentle, continuous pressure with a clean cloth to control bleeding, and apply ice packs or cold compresses for swelling. Don't apply bleach, aspirin or similar medications to open wounds. If the bleeding won't stop or the wounds look serious or deep, go to an emergency room.

Chipped or displaced tooth. A blunt force mouth injury can chip or push (displace) teeth out of position. In this case try to save any chipped pieces you find — your dentist may be able to re-bond them to the tooth. A displaced tooth is a dental emergency, so contact your dentist immediately. Don't try to re-position the tooth yourself unless it's completely knocked out.

Knocked-out tooth. Actions to take with a knocked-out tooth depend on whether it's a permanent or primary (baby) tooth. If permanent, rinse the tooth with clean water. Handle it by the crown (never by the root) and gently place it back in the empty socket. If that's not possible, place the tooth between your child's cheek and gum (if the child is old enough not to swallow it by mistake. You can also place it in a glass of cold milk. Get to a dentist or an emergency room as soon as possible — minutes count for a successful reattachment. Conversely, don't try to put a primary tooth back in its socket — you could damage the developing permanent tooth beneath the gum line. But do see a dentist as soon as possible for an examination.

If you would like more information on responding to mouth injuries in children, please contact us or schedule an appointment for a consultation.

There's something universal about thumb sucking: nearly all babies do it, and nearly all parents worry about it. While most such worries are unfounded, you should be concerned if your child sucks their thumb past age of 4 — late thumb sucking could skew bite development.

Young children suck their thumb because of the way they swallow. Babies move their tongues forward into the space between the two jaws, allowing them to form a seal around a nipple as they breast or bottle feed. Around age 4, this “infantile swallowing pattern” changes to an adult pattern where the tip of the tongue contacts the front roof of the mouth just behind the front teeth. At the same time their future bite is beginning to take shape.

In a normal bite the front teeth slightly overlap the bottom and leave no gap between the jaws when closed.  But if thumb sucking continues well into school age, the constant pushing of the tongue through the opening in the jaws could alter the front teeth's position as they erupt. As a result they may not fully erupt or erupt too far forward. This could create an open bite, with a gap between the upper and lower teeth when the jaws are closed.

Of course, the best way to avoid this outcome is to encourage your child to stop thumb sucking before they turn four. If, however, they're already developing a poor bite (malocclusion), all is not lost — it can be treated.

It's important, though, not to wait: if you suspect a problem you should see an orthodontist for a full evaluation and accurate diagnosis. There are even some measures that could discourage thumb sucking and lessen the need for braces later. These include a tongue crib, a metal appliance placed behind the upper and lower incisors, or exercises to train the tongue and facial muscles to adopt an adult swallowing pattern. Often, a reward system for not sucking their thumbs helps achieve success as well.

Thumb-sucking shouldn't be a concern if you help your child stop before age 4 and keep an eye on their bite development. Doing those things will help ensure they'll have both healthy and straight teeth.

If you would like more information on thumb sucking, 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 Thumb Sucking Affects the Bite.”

Is a chipped tooth big news? It is if you’re Justin Bieber. When the pop singer recently posted a picture from the dental office to his instagram account, it got over 2.6 million “likes.” The snapshot shows him reclining in the chair, making peace signs with his hands as he opens wide; meanwhile, his dentist is busy working on his smile. The caption reads: “I chipped my tooth.”

Bieber may have a few more social media followers than the average person, but his dental problem is not unique. Sports injuries, mishaps at home, playground accidents and auto collisions are among the more common causes of dental trauma.

Some dental problems need to be treated as soon as possible, while others can wait a few days. Do you know which is which? Here are some basic guidelines:

A tooth that’s knocked out needs attention right away. First, try and locate the missing tooth and gently clean it with water — but avoid holding the tooth’s roots. Next, grasp the crown of the tooth and place it back in the socket facing the correct way. If that isn’t possible, place it between the cheek and gum, in a plastic bag with the patient’s saliva or a special tooth preservative, or in a glass of cold milk. Then rush to the dental office or emergency room right away. For the best chance of saving the tooth, it should be treated within five minutes.

If a tooth is loosened or displaced (pushed sideways, deeper into or out of its socket), it’s best to seek dental treatment within 6 hours. A complete examination will be needed to find out exactly what’s wrong and how best to treat it. Loosened or displaced teeth may be splinted to give them stability while they heal. In some situations, a root canal may be necessary to save the tooth.

Broken or fractured (cracked) teeth should receive treatment within 12 hours. If the injury extends into the tooth’s inner pulp tissue, root canal treatment will be needed. Depending on the severity of the injury, the tooth may need a crown (cap) to restore its function and appearance. If pieces of the tooth have been recovered, bring them with you to the office.

Chipped teeth are among the most common dental injuries, and can generally be restored successfully. Minor chips or rough edges can be polished off with a dental instrument. Teeth with slightly larger chips can often be restored via cosmetic bonding with tooth-colored resins. When more of the tooth structure is missing, the best solution may be porcelain veneers or crowns. These procedures can generally be accomplished at a scheduled office visit. However, if the tooth is painful, sensitive to heat or cold or producing other symptoms, don’t wait for an appointment — seek help right away.

Justin Bieber earned lots of “likes” by sharing a picture from the dental office. But maybe the take-home from his post is this: If you have a dental injury, be sure to get treatment when it’s needed. The ability to restore a damaged smile is one of the best things about modern dentistry.

If you have questions about dental injury, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Repairing Chipped Teeth” and “Porcelain Crowns & Veneers.”

“What can I do about my child's teeth grinding habit?”

It's a common question we get from many concerned parents. Their exasperation involves more than having to wake every night to the annoying sounds coming from their child's bedroom: they're also worried about any potential damage occurring to their teeth.

Teeth grinding and similar habits fall under the umbrella term “bruxism.” In basic terms, bruxism is the involuntary movement of the teeth and jaws not engaged in regular functions like chewing, speaking or swallowing. Bruxism is actually common among pre-adolescent children, considered by many healthcare professionals as normal behavior like thumb sucking.

It's not fully known why children grind their teeth, especially during sleep. Stress can play a part, but many believe it could also be related to immaturity on the part of the neuromuscular system that controls chewing. In some cases it could be linked to sudden arousals from sleep, particularly if the child is prone to airway obstruction causing sleep apnea. And there may be a link with certain medications, especially for hyperactivity disorders like attention deficit hyperactivity disorder (ADHD).

Most children eventually outgrow the habit. If it persists, though, it can contribute to teeth problems. Teeth can withstand a lot of biting force, but when chronically exposed to the higher than normal forces produced during teeth grinding they can begin to wear. Sodas, fruit juices, sports drinks or similar acidic beverages complicate matters because they increase mouth acid that can soften enamel. And besides dental issues, teeth grinding can also cause jaw problems, ear pain and headaches.

If symptoms begin to appear, we can take steps to reduce the effect of teeth grinding, such as a mouth guard worn at night to reduce biting forces and protect against wear. We can also look at curbing consumption of acidic foods and beverages, addressing possible airway obstructions, changing medications or counseling for psychological stress.

As with thumb sucking, there's no cause for immediate alarm if your children grind their teeth. But if it continues on into their later childhood years or begins to affect their health and well-being, we'll need to intervene to prevent further harm.

If you would like more information on teeth grinding and similar habits, 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.”