Fluoride has been proven to strengthen tooth enamel against decay. That’s why it’s not only added to toothpaste and other dental products, but also to drinking water — in nearly three-quarters of U.S. water systems.

While research has eased most serious health questions about fluoride, there remains one moderate concern. Too much fluoride over time, especially in infants and young children, could lead to “enamel fluorosis,” an excess of fluoride in the tooth structure that can cause spotting or streaking in the enamel. While often barely noticeable, some cases of fluorosis can produce dark staining and a pitted appearance. Although not a symptom of disease, fluorosis can create a long-term cosmetic concern for the person.

To minimize its occurrence, children under the age of 9 shouldn’t regularly ingest fluoride above of the recommended level of 0.70 ppm (parts per million). In practical terms, you as a parent should monitor two primary sources of fluoride intake: toothpaste and drinking water.

Young children tend to swallow toothpaste rather than spit it out after brushing, which could result in too much fluoride ingestion if the amount is too great. The American Academy of Pediatric Dentistry therefore recommends a small “smear” of toothpaste for children under two, and a pea-sized amount for children up to age six. Brushing should also be limited to no more than two times a day.

Your child or infant could also take in too much fluoride through fluoridated drinking water, especially if you’re using it to mix infant formula. You should first find out the fluoride levels in your local water system by contacting the utility or the health department. If your system is part of the U.S. Centers for Disease Control and Prevention’s (CDC) “My Water’s Fluoride” program, you may be able to access that information on line at //apps.nccd.cdc.gov/MWF/Index.asp.

If the risk for developing fluorosis in your area is high, you can minimize your infant’s intake with a few recommendations: breastfeed rather than use formula; use “ready-to-feed” formula that doesn’t need mixing and contains lower fluoride levels; and use bottled water specifically labeled “de-ionized,” “purified,” “de-mineralized,” or “distilled.”

Fluoride can be a wonderful adjunct to dental care in reducing risk for tooth decay. Keeping an eye on how much fluoride your child takes in can also minimize the chance of future appearance problems.

If you would like more information on the possible effects of fluoride on young children, 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 “Tooth Development and Infant Formula.”

Teething is an important phase in your baby's dental maturity. During the approximate two-year process, they will acquire their first set of teeth.

It can also be an unpleasant two years as each tooth sequentially breaks through the gums. The severity of teething problems differs with each child, but there are common signs: irritability, biting and gnawing, chin rash, drooling or ear rubbing among them. Although for most babies the discomfort isn't that great, the pain can occasionally be a lot for them — and their care-givers — to handle.

Although having a very unhappy infant can be nerve-jangling, there's no real cause for concern health-wise. If, however, they begin to run a fever or experience diarrhea, that could be a sign of something more serious. In those cases, you should see a doctor as soon as possible.

Otherwise, there are some things you can do to make them more comfortable during teething episodes. One thing to remember: cold items for biting or gnawing usually work wonders. So, be sure you have chilled teething rings or pacifiers (but not frozen — the extreme temperature could burn their gums). For older children, an occasional cold food like a popsicle can bring relief.

You can also try massaging the gums with your clean finger, which will help counteract the pressure of an erupting tooth. But avoid rubbing alcohol or aspirin on the gums, and you shouldn't apply numbing agents to children less than two years of age unless advised by your doctor.

If their pain persists, it's permissible to give them a mild pain reliever like the appropriate dosage for their age of baby acetaminophen or ibuprofen. Again, you should give this by mouth and avoid rubbing it on the gums.

By the time they're three, all their primary teeth should be in and teething symptoms should have largely dissipated. In the meantime, make them as comfortable as you can â?? in no time the unpleasantness of teething will pass.

If you would like more information on coping with your child's teething, 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: How to Help Keep your Baby Comfortable.”

Are bleeding gums something you should be concerned about? Dear Doctor magazine recently posed that question to Dr. Travis Stork, an emergency room physician and host of the syndicated TV show The Doctors. He answered with two questions of his own: “If you started bleeding from your eyeball, would you seek medical attention?” Needless to say, most everyone would. “So,” he asked, “why is it that when we bleed all the time when we floss that we think it’s no big deal?” As it turns out, that’s an excellent question — and one that’s often misunderstood.

First of all, let’s clarify what we mean by “bleeding all the time.” As many as 90 percent of people occasionally experience bleeding gums when they clean their teeth — particularly if they don’t do it often, or are just starting a flossing routine. But if your gums bleed regularly when you brush or floss, it almost certainly means there’s a problem. Many think bleeding gums is a sign they are brushing too hard; this is possible, but unlikely. It’s much more probable that irritated and bleeding gums are a sign of periodontal (gum) disease.

How common is this malady? According to the U.S. Centers for Disease Control, nearly half of all  Americans over age 30 have mild, moderate or severe gum disease — and that number increases to 70.1 percent for those over 65! Periodontal disease can occur when a bacteria-rich biofilm in the mouth (also called plaque) is allowed to build up on tooth and gum surfaces. Plaque causes the gums to become inflamed, as the immune system responds to the bacteria. Eventually, this can cause gum tissue to pull away from the teeth, forming bacteria-filled “pockets” under the gum surface. If left untreated, it can lead to more serious infection, and even tooth loss.

What should you do if your gums bleed regularly when brushing or flossing? The first step is to come in for a thorough examination. In combination with a regular oral exam (and possibly x-rays or other diagnostic tests), a simple (and painless) instrument called a periodontal probe can be used to determine how far any periodontal disease may have progressed. Armed with this information, we can determine the most effective way to fight the battle against gum disease.

Above all, don’t wait too long to come in for an exam! As Dr. Stork notes, bleeding gums are “a sign that things aren’t quite right.”  If you would like more information about bleeding gums, please contact us or schedule an appointment. You can read more in the Dear Doctor magazine article “Bleeding Gums.” You can read the entire interview with Dr. Travis Stork in Dear Doctor magazine.

When you think orthodontics, you may instantly picture braces or clear aligners worn by teenagers or adults. But there’s more to orthodontics than correcting fully developed malocclusions (poor bites). It’s also possible to intervene and potentially reduce a malocclusion’s future severity and cost well beforehand.

Known as interceptive orthodontics, these treatments help guide jaw growth in children while mouth structures are still developing and more pliable. But timing is critical: waiting until late childhood or puberty could be too late.

For example, we can influence an upper jaw developing too narrowly (which can cause erupting teeth to crowd each other) with an expander appliance placed in the roof of the mouth. The expander exerts slight, outward pressure on the upper jaw bones. Because the bones haven’t yet fused as they will later, the pressure maintains a gap between them that fills with additional bone that eventually widens the jaw.

Functional appliances like the Herbst appliance influence muscle and bone development in the jaws to eventually reshape and reposition them. The Herbst appliance utilizes a set of metal hinges connected to the top and bottom jaws; when the patient opens and closes their jaws the hinges encourage the lower jaw to move (and eventually grow) forward. If successful, it could help a patient avoid more invasive treatments like tooth extraction or jaw surgery.

Some interceptive objectives are quite simple in comparison like preserving the space created by a prematurely lost primary tooth. If a child loses a primary tooth before the incoming permanent tooth is ready to erupt, the nearby teeth can drift into the empty space. Without enough room, the permanent tooth could erupt out of position. We can hold the space with a simple loop device known as a space maintainer: usually made of acrylic or metal, the device fits between adjacent teeth and prevents them from drifting into the space until the permanent tooth is ready to come in.

Interceptive orthodontics can have a positive impact on your child’s jaw development, now and in the future. For these techniques to be effective, though, they must begin early, so be sure your child has a complete orthodontic evaluation beginning around age 7. You may be able to head off future bite problems before they happen.

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

It’s true — thumb sucking beyond age 4 can cause bite problems for permanent teeth. But prolonged thumb sucking is just one of a number of possible contributing factors for a bad bite (malocclusion). A dentist must identify all the factors involved when a bad bite is present — their involvement is essential for a successful treatment outcome.

A fairly benign habit for infants and toddlers, thumb sucking is related to an “infantile swallowing pattern” young children use by thrusting their tongues forward between the upper and lower teeth when they swallow. Around age 4, though, they usually transition to an adult swallowing pattern in which the tongue rests on the roof of the mouth just behind the front teeth. Thumb sucking stops for most children around the same time.

Thumb sucking beyond this age, though, can put increased pressure on incoming permanent teeth pushing them forward. This could lead to an “open bite” in which the upper and lower teeth don’t meet when the jaws are closed. The tongue may also continue to thrust forward when swallowing to seal the resulting gap, which further reinforces the open bite.

Before treating the bite with braces, we must first address the thumb sucking and improper tongue placement when swallowing — if either isn’t corrected the teeth could gradually revert to their previous positions after the braces come off. Besides behavioral incentives, we can also employ a thin metal appliance called a “tongue crib” placed behind the upper and lower incisors. A tongue crib discourages thumb sucking and makes it more difficult for the tongue to rest within the open bite gap when swallowing, which helps retrain it to a more normal position.

An open bite can also occur if the jaws develop with too much vertical growth. Like thumb sucking and improper tongue placement, abnormal jaw growth could ultimately cause orthodontic treatment to fail. In this case, though, surgery may be necessary to correct the jaw structure.

With all these possible variables, our first step needs to be a thorough orthodontic exam that identifies all the cause factors for your child’s specific malocclusion. Knowing if and how thumb sucking may have contributed to the poor bite will help us design a treatment strategy that’s successful.

If you would like more information on the causes of poor tooth position, 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.”

It’s important for your child’s current and future health that we watch out for tooth decay. Taking x-rays is a critical part of staying one step ahead of this common disease.

But while x-ray imaging is commonplace, we can’t forget it’s still a form of radiation that could be potentially harmful, especially for a child whose tissues are rapidly developing. We must, therefore, carefully weigh the potential benefits against risk.

This concern has given birth to an important principle in the use of x-rays known as ALARA, an acronym for “As Low As Reasonably Achievable.” In basic terms, we want to use the lowest amount of x-ray energy for the shortest period of time to gain the most effectiveness in diagnosing tooth decay and other conditions.

A good example of this principle is a common type of radiograph known as a bitewing. The exposable x-ray film is attached to a plastic devise that looks like a wing; the patient bites down on it to hold it in place while the x-ray exposure takes place. Depending on the number of teeth in a child’s mouth, an appointment usually involves 2 to 4 films, and children are typically spaced at six months apart. Frequency of x-rays depends on your child’s tooth decay risk: lower risk, less need for frequent intervals.

Each bitewing exposes the child to 2 microsieverts, the standard unit for radiation measurement. This amount of radiation is relatively low: by contrast, we’re all exposed to 10 microsieverts of background radiation (natural radiation occurring in the environment) every day or 3,600 microsieverts annually. Even two appointments of four bitewings each year is a fraction of a percent of the background radiation we’re exposed to in the same year.

This conservative use of x-rays is well within safe parameters for children. As x-ray technology continues to advance (as with the development of digital imaging) we anticipate the exposure rate to diminish even more. Prudently used, x-rays remain one of our best tools for ensuring your child’s teeth are healthy and developing normally.

If you would like more information on the use of x-rays with children, 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 “X-Ray Safety for Children.”

For major-league slugger Giancarlo Stanton, 2014 was a record-breaking year. After the baseball season ended, he signed a 13-year, $325 million contract with the Miami Marlins — the biggest deal in sports history. But earlier that same year, Stanton suffered one of the worst accidents in baseball: He was hit in the face by an 88-mph fastball, sustaining multiple fractures, lacerations, and extensive dental damage.

After the accident, Stanton didn’t play for the remainder of the season. But now he’s back in Spring Training… and he’s got a not-so-secret weapon to help protect him against another injury: A custom-made face guard designed to absorb impacts and keep him from suffering further trauma.

As sports fans, we’re glad that Stanton was able to overcome his injury and get back in the game. As dentists, we’d like to remind you that you don’t have to be a major-league player to feel the harmful effects of a sports injury — and you don’t have to look far to find a way to protect yourself. In fact, you can get a custom-made mouthguard right here at the dental office.

Mouthguards have a long tradition in sports like football, boxing, and hockey. But did you know that far more Americans are injured every year playing “non-collision” sports like basketball, baseball — and even bicycling? And it doesn’t take a major-league fastball to cause a dental injury: The highest incidence of sports-related dental injuries occurs in 15-to-18-year-old males. In fact, about one-third of all dental injuries among children stem from various types of sports activities. These injuries may result in countless hours being lost from school and work, and cost significant sums for treatment and restoration.

Mouthguards have a proven track record in reducing dental and facial injuries: They are capable of absorbing the energy of a blow to the mouth, and dissipating it in a way that prevents damage to facial structures and teeth. But not all mouthguards are created equal: Custom-fabricated mouthguards, which are produced from an exact model of your mouth made right here in the dental office, offer by far the best protection. They fit better and safeguard the teeth more fully than any off-the-shelf or “boil-and-bite” type can. Plus, they’re more comfortable to wear. And let’s face it: No mouth guard can protect your teeth if you don’t wear it.

What’s more, some recent studies indicate that custom-made mouthguards may offer significant protection against concussion. An increasing awareness of the dangers that concussion may pose to athletes is one more reason why we recommend custom-made mouthguards to active people and their families.

To get his face guard, Giancarlo Stanton reportedly went to a specialist sporting-goods manufacturer in Illinois, and paid around $1,000. But you can get a custom-made mouthguard for yourself or your loved ones right at our office for a fraction of that price. And the peace of mind it can give you is… priceless.

If you have questions about custom-made mouthguards, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “An Introduction to Sports Injuries & Dentistry” and “Athletic Mouthguards.”

There are usually two moments when primary (“baby”) teeth generate excitement in your family: when you first notice them in your child’s mouth, and when they come out (and are headed for a rendezvous with the “tooth fairy”!).

Between these two moments, you might not give them much thought. But you should—although primary teeth don’t last long, they play a pivotal role in the replacing permanent teeth’s long-term health.

This is because a primary tooth is a kind of guide for the permanent one under development in the gums. It serves first as a “space saver,” preventing nearby teeth from drifting into where the permanent tooth would properly erupt; and, it provides a pathway for the permanent tooth to travel during eruption. If it’s lost prematurely (from injury or, more likely, disease) the permanent tooth may erupt out of position because the other teeth have crowded the space.

That’s why we try to make every reasonable effort to save a problem primary tooth. If decay, for example, has advanced deep within the tooth pulp, we may perform a modified root canal treatment to remove the diseased tissue and seal the remaining pulp from further infection. In some circumstances we may cap the tooth with a stainless steel crown (or possibly a white crown alternative) to protect the remaining structure of the tooth.

Of course, even the best efforts can fall short. If the tooth must be removed, we would then consider preserving the empty space with a space maintainer. This orthodontic device usually takes the form of a metal band that’s cemented to a tooth on one side of the empty space with a stiff wire loop soldered to it that crosses the space to rest against the tooth on the other side. The wire loop prevents other teeth from crowding in, effectively “maintaining” the space for the permanent tooth.

Regular dental visits, plus your child’s daily brushing and flossing, are also crucial in preventing primary teeth from an “early departure.” Keeping them for their full lifespan will help prevent problems that could impact your child’s dental health future.

If you would like more information on the right care approach for 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 “Importance of Baby Teeth.”

Fluoride is an important weapon in the fight against tooth decay. Fluoride consumption and other applications are especially beneficial during children's dental development for building strong teeth long-term.

But the truism "too much of a good thing" could aptly apply to fluoride. If a child consumes too much fluoride over an extended period of time, it could cause a condition called enamel fluorosis in which the enamel surface develops mottled or streaked staining. It's not harmful to the tooth's health, but it can greatly diminish a person's smile appearance.

To avoid fluorosis, it's important with the help of your dentist to know and regulate as much as possible the amount of fluoride your child receives. Here are 3 fluoride sources you should manage.

Toothpaste. Many manufacturers add fluoride to their toothpaste formula, usually an important way to receive this tooth-strengthening chemical. But younger children tend to swallow more toothpaste than older children or adults. Because the chemical builds up in the body over time, swallowing toothpaste every day could potentially elevate your child's fluoride levels. To avoid this, just use a "smear" of toothpaste on the brush for children under age 2, and a pea-sized amount for older children.

Your water system. About three-quarters of all public water utilities add fluoride to their water as an added measure for tooth decay prevention. The amount can vary from system to system, although the maximum amount recommended by the U.S. Government is 0.70 parts per million (PPM). You can ask your local water system how much fluoride, if any, is present or they add to your drinking water.

Bottled water. Any type of bottled beverage (water, juices, sodas, etc.) could contain various levels of fluoride. Unfortunately there are no labeling requirements regarding its presence, so the most prudent course is to carefully manage the beverages your child drinks, or stay with bottled water marked "de-ionized," "purified," "demineralized" or "distilled," which typically have lower fluoride levels. For babies feeding on milk, you can use the aforementioned bottled waters to mix powder, use ready-to-feed formula (also low in fluoride) or breast-feed.

If you would like more information on fluoride and your baby, 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 “Tooth Development and Infant Formula.”

Teething is a normal part of your baby’s dental development. That doesn’t make it less stressful, though, for you or your baby.

This natural process occurs as your child’s primary teeth sequentially erupt through the gums over a period of two or three years. The first are usually the two lower front teeth followed by the two upper front ones, beginning (give or take a couple of months) between six and nine months. By the age of three, most children have all twenty of their primary teeth.

The disruption to the gum tissues can cause a number of unpleasant side effects including gum swelling, facial rash, drooling, disrupted sleep patterns and decreased appetite. As a result a child can become irritable, bite and gnaw to relieve gum discomfort or rub their ears. Every child’s experience is different as well as their degree of pain and discomfort.

As a tooth is about to erupt, you may notice symptoms increasing a few days before and after. The symptoms will then subside until the next tooth begins to erupt. In a way, teething is much like a storm—you mostly have to ride it out. However, that doesn’t mean you can’t lessen your child’s discomfort during the teething episode.

For one thing, cold, soft items like teething rings, pacifiers or even a clean, wet washcloth your child can gnaw on will help relieve gum pressure. Chilling the item can have a pain-numbing effect—but avoid freezing temperatures, which can burn the tissues. You can also massage the gums with a clean finger to relieve pain. But don’t rub alcohol on their gums and only use numbing agents (like Benzocaine) for children older than two, and only with the advice and supervision of your healthcare provider. The use of acetaminophen or ibuprofen might also be used under the advice of your doctor.

If you notice your child has diarrhea, extensive rashes or fever, contact your physician immediately—these aren’t normal teething symptoms and may indicate something more serious. And be sure to consult with us if you have any other questions or concerns.

Teething can be a difficult time for your baby and family. But with these tips and a little “TLC” you can keep their discomfort to a minimum.

If you would like more information on caring for your baby’s developing 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 “Teething Troubles: How to Help Your Baby be Comfortable.”

While the sport of golf may not look too dangerous from the sidelines, players know it can sometimes lead to mishaps. There are accidents involving golf carts and clubs, painful muscle and back injuries, and even the threat of lightning strikes on the greens. Yet it wasn’t any of these things that caused professional golfer Danielle Kang’s broken tooth on the opening day of the LPGA Singapore tournament.

“I was eating and it broke,” explained Kang. “My dentist told me, I've chipped another one before, and he said, you don't break it at that moment. It's been broken and it just chips off.” Fortunately, the winner of the 2017 Women’s PGA championship got immediate dental treatment, and went right back on the course to play a solid round, shooting 68.

Kang’s unlucky “chip shot” is far from a rare occurrence. In fact, chipped, fractured and broken teeth are among the most common dental injuries. The cause can be crunching too hard on a piece of ice or hard candy, a sudden accident or a blow to the face, or a tooth that’s weakened by decay or repetitive stress from a habit like nail biting. Feeling a broken tooth in your mouth can cause surprise and worry—but luckily, dentists have many ways of restoring the tooth’s appearance and function.

Exactly how a broken tooth is treated depends on how much of its structure is missing, and whether the soft tissue deep inside of it has been compromised. When a fracture exposes the tooth’s soft pulp it can easily become infected, which may lead to serious problems. In this situation, a root canal or extraction will likely be needed. This involves carefully removing the infected pulp tissue and disinfecting and sealing the “canals” (hollow spaces inside the tooth) to prevent further infection. The tooth can then be restored, often with a crown (cap) to replace the entire visible part. A timely root canal procedure can often save a tooth that would otherwise need to be extracted (removed).

For less serious chips, dental veneers may be an option. Made of durable and lifelike porcelain, veneers are translucent shells that go over the front surfaces of teeth. They can cover minor to moderate chips and cracks, and even correct size and spacing irregularities and discoloration. Veneers can be custom-made in a dental laboratory from a model of your teeth, and are cemented to teeth for a long-lasting and natural-looking restoration.

Minor chips can often be remedied via dental bonding. Here, layers of tooth-colored resin are applied to the surfaces being restored. The resin is shaped to fill in the missing structure and hardened by a special light. While not as long-lasting as other restoration methods, bonding is a relatively simple and inexpensive technique that can often be completed in just one office visit.

If you have questions about restoring chipped teeth, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Porcelain Veneers” and “Artistic Repair of Chipped Teeth With Composite Resin.”

A child's toothache is no fun for either the child or the parent. But if you're faced with this situation, don't panic — unless they have a fever or you notice facial swelling, it's unlikely an emergency.

 Instead, take the following steps:

Find out where it hurts and for how long. Tooth pain can stem from a lot of causes, including decay or a localized area of infection called an abscess. See if your child can tell you if it's coming from one particular tooth or from a general area. Although children can't always judge how long they've hurt, try to get a general idea so you'll know if you need to call us sooner rather than later.

Look for problem signs in the mouth. As you look where they say it hurts, see if you can see brown spots or cavities on any teeth — this would indicate tooth decay. Look also at the gums or inner areas of the mouth for sores or swelling. Unless they've had an injury, this could indicate an abscess.

Try to dislodge any food shards between teeth. It's also possible the pain is coming from a piece of hard food like a popcorn kernel wedged between their teeth. Help them gently floss between the teeth to see if you can dislodge any.

Try to ease the pain. Although you may not need to see us immediately, your child's mouth still aches. You can help relieve it temporarily with a child's dose of ibuprofen or acetaminophen. You can also apply an ice pack to the outside cheek for swelling, but don't apply the ice directly to the skin, which can burn it. And don't rub aspirin or other pain relievers on the gums — they're acidic and can irritate soft tissue.

See us for a full examination. It's wise to have any tooth pain checked — the question is often how soon. You should see us the same day or first thing in the morning if the pain has persisted for more than a day or night, pain relievers haven't eased the pain or they have fever or facial swelling. If the pain is short-lived you can usually wait until the next day — but do get it checked out.

If you would like more information on treating your child's toothache, 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 “A Child's Toothache.”

Have you heard about dental sealants? These preventive treatments have been available for many decades, and more and more children are taking advantage of them. The National Institutes of Health (NIH) estimates that around 30% of kids from 6 to 11 years of age have had sealants applied to their molars (back teeth). Sealants are designed to reduce the incidence of cavities by filling in or eliminating the pits or crevices found in all molars, where decay-causing bacteria can hide and your brush can't reach. But do they really work?

Now, the research is in, and the answer is clear — YES!

Two major studies, each of which reviewed the results of thousands of patients over several years, recently came to the same conclusion: Dental sealants are effective at reducing cavities, and their benefits can last for four years (or more) after application. In general, the studies showed that kids who didn't get sealants were twice, three times, or even more likely to get cavities, compared to kids treated with sealants.

Sealants themselves are protective coatings made of plastic resins or glass-like materials. They are applied in liquid form, and then hardened by a special light. When “painted on” to the chewing surface of a molar, sealants fill in the tiny crevices, or “pits and fissures,” that are found there. Uneven tooth surfaces form a perfect breeding ground for the bacteria that cause tooth decay; worse yet, the bristles of a tooth brush can't usually reach them. That's what makes these areas highly susceptible to tooth decay.

Applying sealants is a quick and painless procedure that doesn't require any numbing shots or drilling. Many kids start getting sealants when the first permanent molars come in, around age 5 to 7; they may have more sealant treatments when additional molars emerge, between the ages of 11 and 14.

Sealants are recommended by the American Dental Association and the American Academy of Pediatric Dentistry, and have only a modest cost per tooth. On the other hand, having a cavity filled generally costs substantially more, and may result in more trouble (and expense) down the line — so sealants can make sense economically, as well as preventively. This is especially true for those at high risk for tooth decay.

If you have questions about dental sealants, please contact us or schedule a consultation. You can read more in the Dear Doctor magazine article “Sealants for Children,” and “Top 10 Oral Health Tips for Children.”

Taking care of your child’s teeth is a high priority, not only for their health now but for the future too. And that means dealing with their teeth’s most common and formidable enemy, tooth decay.

Your focus, of course, should be on preventing decay through good oral hygiene practices, a healthy diet low in foods with added sugar and regular office visits for cleaning and checkups. But some children at higher risk or who’ve already encountered tooth decay may also need a little extra help in the form of dental sealants.

The most common use of sealants addresses a weakness in young teeth that disease-causing bacteria exploit. Deep grooves known as pits and fissures form within the biting surfaces of developing back teeth and in the rear of front teeth.  It’s very difficult to reach these areas with daily brushing, so some plaque may be left behind (hence the importance of semi-annual office cleanings).

Inside the mouth, these pits and fissures are in a warm and moist environment and are a haven for bacteria that feed on plaque and produce high levels of acid as a by-product. The acid softens enamel to eventually create a hole, or a “cavity” in the tooth. Children’s young enamel is highly susceptible to this process — it hasn’t developed enough strength to resist the adverse effects of acid.

A “pit and fissure” sealant made of resin fills in the grooves in the teeth to inhibit the buildup of plaque — a kind of “mini” filling. It’s an added layer of protection that complements other prevention efforts. But applying them isn’t an automatic practice — we only recommend it for children at high risk, especially where decay is beginning or it appears the conditions are conducive for it. When needed, though, it can be quite effective in preventing decay or minimizing its effects.

The best way to know if your child could benefit from a sealant is to have them undergo a complete dental exam. From there we can advise you on whether a sealant application is an important investment in their current and future health.

If you would like more information on dental disease prevention for children, 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 “Sealants for Children.”

Can you have healthy teeth and still have gum disease? Absolutely! And if you don’t believe us, just ask actor David Ramsey. The cast member of TV hits such as Dexter and Arrow said in a recent interview that up to the present day, he has never had a single cavity. Yet at a routine dental visit during his college years, Ramsey’s dentist pointed out how easily his gums bled during the exam. This was an early sign of periodontal (gum) disease, the dentist told him.

“I learned that just because you don’t have cavities, doesn’t mean you don’t have periodontal disease,” Ramsey said.

Apparently, Ramsey had always been very conscientious about brushing his teeth but he never flossed them.

“This isn’t just some strange phenomenon that exists just in my house — a lot of people who brush don’t really floss,” he noted.

Unfortunately, that’s true — and we’d certainly like to change it. So why is flossing so important?

Oral diseases such as tooth decay and periodontal disease often start when dental plaque, a bacteria-laden film that collects on teeth, is allowed to build up. These sticky deposits can harden into a substance called tartar or calculus, which is irritating to the gums and must be removed during a professional teeth cleaning.

Brushing teeth is one way to remove soft plaque, but it is not effective at reaching bacteria or food debris between teeth. That’s where flossing comes in. Floss can fit into spaces that your toothbrush never reaches. In fact, if you don’t floss, you’re leaving about a third to half of your tooth surfaces unclean — and, as David Ramsey found out, that’s a path to periodontal disease.

Since then, however, Ramsey has become a meticulous flosser, and he proudly notes that the long-ago dental appointment “was the last we heard of any type of gum disease.”

Let that be the same for you! Just remember to brush and floss, eat a good diet low in sugar, and come in to the dental office for regular professional cleanings.

If you would like more information on flossing or periodontal disease, please contact us today to schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Understanding Gum (Periodontal) Disease.”

Your child’s teeth and gum development is truly a wonder. In just a little more than two decades they’ll gain and lose one set of teeth, while the subsequent permanent set will grow in coordination with other facial and oral structures. All of these structures will finally reach maturity sometime in early adulthood.

Sometimes, though, obstacles can arise: disease, trauma or even genetics can derail normal development and endanger future health. So although nature does most of the heavy lifting, there are things you should do to keep your child’s dental development on track.

For instance, begin oral hygiene practices before their first teeth come in. By wiping their gums after feeding with a clean damp cloth, you can help reduce the numbers of disease-causing bacteria in the mouth. Once teeth appear switch to brushing.

There are also habits to avoid. Don’t kiss your baby directly on the lips—you may transfer to them your own mouth bacteria, which their young immune system can’t yet adequately handle. Also, avoid putting them to bed with a sleep-time bottle filled with sugary fluids (including milk or formula) because the constant contact between the sugar and their teeth could increase their risk for tooth decay, the number one dental disease in young children.

Of course, not all prevention efforts depend on you alone—we’re your partner in helping to keep your child’s dental development progressing normally. We can provide preventive treatments like sealants or topical fluoride to reduce the risk of tooth decay, while continually monitoring for signs of the disease that may require treatment. We also look for signs of emerging bite problems that may require intervention before their effects worsen.

This is all part of regular dental visits, usually at six-month intervals, which are best begun around your child’s first birthday. Not only does this enable us to stay ahead of dental problems, it also helps your child become more comfortable with dental visits and increase the likelihood they’ll continue the habit in adulthood.

As we said, nature is responsible for most of this amazing development without any help from us. But we can assist development and hopefully prevent issues that could diminish their dental health in years to come.

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

Teeth grinding is one childhood habit that sounds worse than it usually is: often the most harm done is to your night’s sleep. That said, though, it’s still a habit to keep your eye on.

Also known as bruxism, teeth grinding is so common among children that it’s considered normal behavior by many healthcare professionals. As for causes, some suggest a child’s immature neuromuscular chewing control may trigger it, while others point to the change from deeper sleep to a lighter stage as a possible cause. Problems like airway obstruction, medications or stress also seem to contribute to the habit.

For most children, teeth grinding usually fades by age 11 with no adverse effect on their teeth. If the habit extends into adolescence, however, there’s an increased risk for damage, mainly tooth wear.

This can happen because grinding often produces chewing forces 20-30 times greater than normal. Over time this can cause the biting surfaces of the teeth to wear and reduces the size of the teeth. While teeth normally wear over a lifetime, accelerated wear can pose a significant health risk to your teeth. Any sign of tooth wear in a child or adolescent is definitely cause for concern.

If your child’s tooth grinding habit appears to be developing into a problem, your dentist may recommend a few treatment options. The most common is a thin, plastic night guard worn in the mouth during sleep that prevents the upper and lower teeth from making contact. If the suspected cause is airway obstruction, they may refer you to an ear, nose and throat (ENT) specialist to seek treatment for that, as well as other professionals to help with managing stress or medications.

Like thumb sucking, the habit of teeth grinding usually ends with no permanent ill effects. But if you notice it continuing late into childhood or your dentist finds tooth wear or other problems, take action to avoid problems long-term.

If you would like more information on childhood bruxism, 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.”