Posts for: July, 2019
While the prevention and treatment of tooth decay has improved dramatically over the last half century, it continues to be a major health issue, especially for children. One in four children 5 and younger will develop some form of the disease.
Although tooth decay in children stems from the same causes as in adults — the presence of decay-causing bacteria in plaque, unprotected teeth and the right mix of carbohydrates like sugar left in the mouth — the means by which it occurs may be different. We even define tooth decay differently in children as Early Childhood Caries (ECC), “caries” the dental profession’s term for tooth decay.
ECC highlights a number of cause factors specific to young children, such as: continuous use of a bottle or “sippy cup” filled with juice or other sweetened beverages; at-will breast-feeding throughout the night; use of a sweetened pacifier; or regular use of sugar-based oral medicine to treat chronic illness.
If you noticed sugar as a common denominator in these factors, you’re right. As a primary food source for bacteria, refined sugar is a major trigger for the disease especially if it constantly resides in the mouth from constant snacking or sipping. In fact, it’s the primary driver for a particular pattern of decay known as Baby Bottle Tooth Decay (BBTD). This pattern is specifically linked to sleep-time bottles filled with juice, milk, formula or other sweetened beverages, given to an infant or toddler to help soothe them through the night or during naps.
All these factors cause a cycle of decay. To interrupt that cycle, there are some things you as a parent should do: perform daily hygiene with your child to reduce decay-causing bacteria; reduce the amount and frequency of carbohydrates in the diet, particularly sugar; and protect the teeth by having us apply fluoride or sealants directly to the teeth.
Early tooth decay could affect your child's oral health for years to come. With a little care and vigilance, you improve your chances of avoiding that encounter.
If you would like more information on preventing tooth decay in 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 “Dentistry & Oral Health for Children.”
Dental implants are widely considered by both dentists and patients as the premier choice for replacing missing teeth. Unfortunately, implants aren’t the appropriate choice for teenagers with missing teeth.
That’s because their jaws won’t fully finish most of their growth and development until early adulthood. An implant placed too early could become misaligned as the jaw matures. The best approach for a teenager is a temporary restoration until they’re old enough for an implant.
There are a couple of good options. One is a removable partial denture (RPD), prosthetic (false) teeth set in an acrylic base that mimics gum tissue at the locations of the missing teeth. RPDs, which stay in place by way of metal clips that fit over other teeth, are easy to wear and maintain.
On the downside, an RPD can break if you bite into something too hard. They can lose their fit and may need to be replaced with a new one. And, some teens aren’t quite keen on wearing a “denture.”
Another option is a bonded or Maryland bridge, a kind of fixed bridge. We bond dental material to the back of a prosthetic tooth with portions of the material extending out from either side of it.Â We then bond these extending tabs to the back of the teeth on either side of the prosthetic tooth to hold it in place. Unlike traditional bridges, we can eventually remove it without any permanent alterations to the teeth it’s attached to.
Before we undertake a bonded bridge, though, we must make sure the gums and bone of the surrounding teeth are free from periodontal (gum) disease and are healthy and strong enough to support the bridge. We also need to be sure the patient doesn’t have a deep bite or a teeth grinding habit, which could cause the teeth to make contact with the tabs and break them.
The patient also needs the maturity to responsibly perform diligent oral hygiene: this type of bridge has a tendency to build up disease-causing plaque, so brushing twice and flossing once every day is critical. Not doing so increases the risk of tooth decay or periodontal (gum) disease, which could complicate a future implant.
We can discuss these options after a thorough dental examination of your teenager. Either way, we’ll be able to restore your teen’s smile until we can undertake a more permanent restoration.
If you have chronic jaw joint pain you may have heard of using Botox to relieve discomfort from temporomandibular disorders (TMD). Before you seek out this remedy, though, be sure you know the facts beforehand.
TMD is actually a group of conditions affecting the joints, muscles and overall structures of the jaw. People with TMD often experience sharp pain and reduced range of motion of the jaw joints. Although we don't know the exact causes, we believe stress (accompanied often by teeth grinding habits) is a major factor for many patients.
Treatments run the spectrum from conservative to aggressive. Conservative treatments include cold and heat packs, therapeutic exercises, and muscle pain or relaxant medication. On the more aggressive side, patients undergo surgery to reorient the lower jaw. Most people gain a significant amount of relief from conservative therapies; the results aren't as positive with surgery.
Botox falls on the aggressive side of treatments. Approved for use by the Food and Drug Administration for cosmetic uses, the drug contains botulinum toxin type A, a bacterial toxin that can cause muscle paralysis. It's often injected into facial structures to paralyze small muscles and temporarily “smooth out” wrinkle lines. Only recently has it been proposed to help relieve jaw pain.
The jury, however, is still out on its effectiveness with jaw pain. The double-blind testing performed thus far hasn't produced any relevant clinical results that the injections actually work with TMD.
And there are other complications. Some people injected with Botox encounter pain, bruising or swelling at the injection site, and some have severe headaches afterward. Botox is also a temporary solution, not a permanent cure — you'll need another injection a few months later to maintain the effect. You might even develop antibodies that diminish the drug's effect and require higher subsequent doses to compensate.
This and other concerns should give you pause before seeking out this remedy. The best strategy is to try the traditional treatments first, which are also the least invasive. If there's no significant relief, then talk to us and your physician about other options.
If you would like more information on treatment options for TMD, 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 “Botox Treatment for TMJ Pain.”