My Blog

Posts for tag: pediatric dentistry

By George H Johnson, Jr., DDS, FAGD
April 06, 2019
Category: Oral Health
AMinorProcedureCouldMakeBreastfeedingEasierforYouandYourBaby

The American Academy of Pediatrics and other healthcare organizations recommend breastfeeding as the best means for infant feeding. While bottle feeding can supply the nutrition necessary for a baby's healthy development, breastfeeding also provides emotional benefits for both baby and mother.

But there might be an obstacle in a baby's mouth that prevents them from getting a good seal on the mother's breast nipple—a small band of tissue called a frenum. This term describes any tissue that connects a soft part of the mouth like the upper lip or tongue to a more rigid structure like the gums or the floor of the mouth, respectively.

Although a normal part of anatomy, frenums that are too short, thick or inelastic can restrict a baby's lip or tongue movement and prevent an adequate seal while nursing. The baby may adjust by chewing rather than sucking on the nipple. Besides a painful experience for the mother, the baby may still not receive an adequate flow of breast milk.

Bottle-feeding is an option since it may be easier for a baby with abnormal frenums to negotiate during nursing. But the problem might also be alleviated with a minor surgical procedure to snip the frenum tissue and allow more freedom of movement.

Often performed in the office, we would first numb the frenum and surrounding area with a topical anesthetic, sometimes accompanied by injection into the frenum if it's abnormally thick. After the numbing takes effect, we gently expose the tissue and cut it with either surgical scissors or a laser, the latter of which may involve less bleeding and discomfort. The baby should be able to nurse right away.

If you wait later to undergo the procedure, the baby may already have developed compensation habits while nursing. It may then be necessary for a lactation consultant to help you and your baby "re-learn" normal nursing behavior. It's much easier, therefore, to attempt this procedure earlier rather than later to avoid extensive re-training.

While there's little risk, frenum procedures are still minor surgery. You should, therefore, discuss your options completely with your dental provider. Treating an abnormal frenum, though, could be the best way to realize the full benefits of breastfeeding.

If you would like more information on treating tongue or lip ties, please contact us or schedule an appointment for a consultation.

By George H Johnson, Jr., DDS, FAGD
December 17, 2018
Category: Dental Procedures
3ThingsYouMightNoticewithYourChildsTeethThatNeedaDentist

Dental disease doesn’t discriminate by age. Although certain types of disease are more common in adults, children are just as susceptible, particularly to tooth decay.

Unfortunately, the early signs of disease in a child’s teeth can be quite subtle—that’s why you as a parent should keep alert for any signs of a problem. Here are 3 things you might notice that definitely need your dentist’s attention.

Cavities. Tooth decay occurs when mouth acid erodes tooth enamel and forms holes or cavities. The infection can continue to grow and affect deeper parts of the tooth like the pulp and root canals, eventually endangering the tooth’s survival. If you notice tiny brown spots on their teeth, this may indicate the presence of cavities—you should see your dentist as soon as possible. To account for what you don’t see, have your child visit your dentist at least twice a year for cleanings and checkups.

Toothache. Tooth pain can range from a sensitive twinge of pain when eating or drinking hot or cold foods to a throbbing sharp pain. Whatever its form, a child’s toothache might indicate advancing decay in which the infection has entered the tooth pulp and is attacking the nerves. If your child experiences any form of toothache, see your dentist the next day if possible. Even if the pain goes away, don’t cancel the appointment—it’s probable the infection is still there and growing.

Bleeding gums. Gums don’t normally bleed during teeth brushing—the gums are much more resilient unless they’ve been weakened by periodontal (gum) disease (although over-aggressive brushing could also be a cause).  If you notice your child’s gums bleeding after brushing, see your dentist as soon as possible—the sooner they receive treatment for any gum problems the less damage they’ll experience, and the better chance of preserving any affected teeth.

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

By George H Johnson, Jr., DDS, FAGD
November 07, 2018
Category: Dental Procedures
Tags: pediatric dentistry   crown  
AStainlessSteelCrownCouldHelpaStrugglingPrimaryMolarLastLonger

Although primary (“baby”) teeth have a lifespan of only a few years, they’re still important to a child’s current and future dental health. In the present, they help a child eat, speak and smile properly. They also help create a healthy future as placeholders for developing permanent teeth yet to come in.

If, however, a child loses a primary tooth prematurely due to decay, the corresponding permanent tooth could come in misaligned. That’s why we do what we can to help a decayed primary tooth reach its full lifespan. And there are different ways to do this depending on the type of tooth.

With front teeth, which don’t encounter the same chewing forces as those in the back, we may use a tooth-colored filling. This approach is also preferable for appearance’s sake since front teeth are highly visible when a child speaks or smiles.

Primary molars, on the other hand, need a more robust solution. A filling may not be able to withstand the level of long-term chewing forces that these back teeth normally encounter. And because they’re less visible than front teeth, there’s less concern about aesthetics.

That’s why many pediatric dentists prefer stainless steel crowns for molars. Just like their permanent teeth counterparts, a primary crown fits over and completely covers a tooth. They’re typically pre-formed, coming in different shapes and sizes that can then be customized for the tooth in question. After preparing and removing any decayed material from the tooth, we can usually install the crown in one visit with local anesthesia and a sedative (if the child needs it for anxiety).

While a steel crown isn’t the most attractive restoration, it typically handles the higher chewing forces in the back of the mouth better and longer than a filling. That’s especially critical for primary molars, which are some of the last teeth to fall out (as late as ages 10-12).  And besides preserving it as a permanent tooth placeholder, a crown also helps the tooth function effectively in the present.

Regardless of what method we use, though, preserving primary teeth is a primary goal of pediatric dentistry. And with a stainless steel crown, we can keep those important back molars functioning for as long as they’re intended.

If you would like more information on caring 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 “Stainless Steel Crowns for Kids.”

By George H Johnson, Jr., DDS, FAGD
October 28, 2018
Category: Oral Health
HowtoHelpYourKidsFormGoodOralHygieneHabits

October is National Dental Hygiene Month. It comes as no surprise that good dental hygiene habits are best acquired early in life—and with good reason, as tooth decay is the most common disease among children. In fact, a full 43 percent of U.S. children have cavities, according to a 2018 report from the U.S. Centers for Disease Control. So how do you start young children on the path to a lifetime of good oral health? Here are five tips for instilling good dental hygiene habits in your kids:

Set a good example. Good—and bad—habits often start at home. Research shows that when young children notice other family members brushing their teeth, they want to brush, too. So let your child see you brushing and flossing your teeth, and while you’re at it model good nutritional choices for optimal oral health and use positive language when talking about your own dental visits. The example you set is a powerful force in your child’s attitude toward oral care!

Start early. You can start teaching children brushing techniques around age two or three, using a toothbrush just their size with only a pea-sized amount of fluoride toothpaste. If they want to brush by themselves, make sure you brush their teeth again after they have finished. Around age six, children should have the dexterity to brush on their own, but continue to keep an eye on their brushing skill.

Go shopping together. Kids who handpick their own oral hygiene supplies may be more likely to embrace the toothbrushing task. So shop together, and let them choose a toothbrush they can get excited about—one in their favorite color or with their favorite character. Characters also appear on toothpaste tubes, and toothpaste comes in many kid-friendly flavors.

Make dental self-care rewarding. Why should little ones care about good dental hygiene?  Young children may not be super motivated by the thought of a long-term payoff like being able to chew steak in their old age. A more tangible reward like a sticker or a star on a chart each time they brush may be more in line with what makes them tick.

Establish a dental home early on. Your child should start getting regular checkups around age one. Early positive experiences will reinforce the idea that the dental office is a friendly, non-threatening place. Children who get in the habit of taking care of their oral health from an early age have a much better chance of having healthy teeth into adulthood.

If you have questions about your child’s dental hygiene routine, call the office or schedule a consultation. You can learn more in the Dear Doctor magazine articles “Do Babies Get Tooth Decay?” and “How to Help Your Child Develop the Best Habits for Oral Health.”

By George H Johnson, Jr., DDS, FAGD
September 28, 2018
Category: Oral Health
Tags: pediatric dentistry   sugar  
3SurprisingSugarSourcesYourBabyMightbeConsuming

Tooth decay is an ever present danger for your baby’s developing teeth. It begins with disease-causing bacteria feasting on leftover sugar, producing high levels of oral acid that slowly dissolves the teeth’s protective enamel. The softened enamel then becomes an open door for decay to infect the tooth.

Meanwhile, those bacteria continue to eat and produce acid….

So how can you stop this devastating cycle? Besides daily oral hygiene and regular dental visits, the most important thing you can do is deprive bacteria in your baby’s mouth of sugar through limiting their consumption of it. This means you’ll first need to identify the different sources of sugar available to your baby—and some of them might surprise you.

Here, then, are 3 not-so-obvious sugar sources your baby might be consuming.

During feeding. If you’re breast-feeding, you may not think this is causing a sugar problem for your baby. True, breast milk by itself doesn’t promote decay: it’s the combination of it with other sugar-rich foods and liquids the baby might be consuming as they get older. Together this could significantly increase their risk of pediatric tooth decay (also known as early childhood caries or ECC). So, be careful to limit sugar in other things they’re eating or drinking in addition to nursing.

24/7 Baby bottles and pacifiers. To calm infants at nap or sleep time, parents or caregivers often use bottles filled with sweet liquids or pacifiers dipped in jam, syrup or sugar. This practice increases decay risk from both the added sugar and its constant availability to bacteria in the mouth around the clock. Instead, avoid this practice and limit any sugary foods or liquids to mealtimes.

Medications. Some medications an infant may be taking for a chronic illness may contain small amounts of sugar. Additionally, medications like antihistamines can reduce the production of saliva that’s needed to neutralize acid after meals. If your child is on medication, ask your healthcare provider about its dental effects and if there are any sugar-free alternatives. Be sure to keep up daily brushing and flossing and regular dental visits too.

Limiting your baby’s sugar intake is critical in preventing tooth decay. It’s one of the most important things you can do to protect their dental health.

If you would like more information on helping your child avoid tooth decay, 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 “Age One Dental Visit: Why It’s Important for Your Baby.”