PEDIATRIC DENTISTRY AND YOUR CHILD:
The American Academy of Pediatric Dentistry and the American Dental Association recommend that a child’s first visit to the dental office occur at approximately six months or when the first tooth erupts. If teeth do not erupt by the end of your child’s first year, you should see a dentist.
Parents should wipe an infant’s gums and teeth after each feeding, using a moist washcloth or gauze Pad. When one or more teeth appear, parents should brush child’s teeth with a children’s toothbrush and water. Unless it is advised by your dentist, do not use fluoridated toothpaste until age 2-3. Once your child is preschool-age, start using fluoride toothpaste. Don’t cover the brush with toothpaste; a pea-sized amount is just right. Young children tend to swallow most of the toothpaste, and swallowing too much fluoride toothpaste can cause permanent stains on their teeth.
According to the National Institute of Dental and Craniofacial Research, Baby Bottle Tooth Decay, also known as “early childhood caries,” is caused by prolonged contact with almost any liquid other than water. Milk, formula, juices, and other sweet drinks such as soda all have sugar in them. Sucking on a bottle filled with liquids that have sugar in them can cause tooth decay.
TO HELP PREVENT BABY BOTTLE TOOTH DECAY:
Never put your child to bed with a bottle. By 7 or 8 months of age, most children no longer need feedings during the night. Children who drink bottles while lying down also may be more prone to getting ear infections. Only give your baby a bottle during meals. Do not use the bottle as a pacifier; do not allow your child to walk around with it or to drink it for extended periods. These practices not only may lead to Baby Bottle Tooth Decay, but children can suffer tooth injuries if they fall while sucking on a bottle.
Teach your child to drink from a cup as soon as possible, usually by 1 year of age. Drinking from a cup does not cause the liquid to collect around the teeth, and a cup cannot be taken to bed. If you are concerned that a cup may be messier than a bottle, especially when you are away from home, use one that has a snap-on lid with a straw or a special valve to prevent spilling.
Don’t put your child’s pacifiers, spoons, or other things in your mouth. Infants acquire bacteria and germs in their mouths from other people. When you clean off your baby’s pacifier or other item in your own mouth, you transfer bacteria directly it which then gets into your baby’s mouth. This bacteria makes the baby’s teeth more susceptible to tooth decay.
Fluoride is a substance used to prevent or reverse the early signs of dental caries (tooth decay). Research has shown that there are several ways that fluoride achieves its decay-preventative effects. It makes the tooth structure stronger so teeth are more resistant to acid attacks. Acid is formed when the bacteria that live in the plaque on your child’s teeth breaks down sugars and carbohydrates from your child’s diet. Repeated acid attacks can break down the tooth structure, which causes caries. There are many communities that have fluoride in their water supply. Water fluoridation can reduce the incidence of tooth decay by about 20 to 40%. You can ask your local water company if they add fluoride to the water in your community. A dentist may recommend fluoride supplements if fluoridated water is not available in your community.
Sealants are substances used in the prevention of tooth decay. It has been shown to be a very effective method to prevent cavities on the occlusal surface (biting surface) of teeth. While fluorides have been influential in the decline of decay on smooth tooth surfaces, sealants are very effective in the prevention of decay on pit and fissure (“nooks and crannies”) surfaces of the teeth. They are thin, clear or tinted plastic coatings painted on the biting surfaces of permanent posterior teeth. Sealants are particularly important for children who have a high risk for decay. The frequency for sealant placement will vary by the individual, but some standards for application of sealants are: Applied mainly on permanent molars (1st and 2nd);Teeth should be non-restored;Once per tooth every 5 years up to the age of 19.
Ask if sealants are appropriate for your child.
CROWNS, VENEERS & BRIDGES
The focus of prosthodontics is comprehensive patient rehabilitation to improve esthetics and function by replacement of missing teeth and adjacent anatomic structures. From traditional prosthodontic therapy, which includes Crowns, veneers, bridges, fixed and removable partial dentures, full dentures, implant restorations, gold and porcelain inlays and onlays to the most complex therapy approaches such as three-dimensional digital technology for diagnosis, planning, and restoration supported by dental implants, patients receive a wide variety of treatment options and high quality care.
Operative dentistry deals with the treatment of missing or malformed portions of teeth caused by tooth decay (caries), trauma, discoloration or unusual development. We use tooth-colored composite resin restorative materials.
Preventive dental care is all the things you do (or should do) to help take care of your teeth and gums: brushing, flossing, eating a healthy diet, and going to the dentist regularly to help avoid dental disease.
ROOT CANAL TREATMENT
Root Canal (endodontic) therapy is when the space within a tooth originally occupied by its nerve is treated. The treatment is used to resolve patholigic conditions inside a tooth that have affected both is nerve tissue, and probably the tissues that surround the tooth too. It sets the stage so healing can take place. The process involves two steps, Cleaning and sealing off the tooth’s inner space. Once a tooth’s nerve tissue has started to degenerate (die), and bacteria have taken up residence inside the tooth’s nerve area, there is no way for white blood cells to effectively get at the bacteria to combat them. The blood and lymphatic vessels inside the tooth that are needed to transport them either no longer exist, or at least have been severely compromised. This means that the nerve space inside a tooth can provide a nice cozy cave-like location for bacteria to live because it’s a place where your body’s defense mechanisms have a hard time getting at them. With this scenario, at best your body will only be able to cordon off the infection caused by the bacteria living inside your tooth. At worst, this infection will overwhelm your body’s defense mechanisms and pain and swelling will ensue (an acute tooth abscess).
Endodontic therapy provides for a third outcome, one where the infection is not just cordoned off but actually cleared up. Root canal treatment assists your body’s infection-fighting process by removing or sealing off the bacteria and tissue irritants inside your tooth that it can’t effectively reach and deal with.
Temporomandibular Joint Evaluation
Temporomandibular joint dysfunction (TMD, TMJD) is an umbrella term covering pain and dysfunction of the muscles of mastication (the muscles that move the jaw) and the temporomandibular joints (the joints which connect the mandible to the skull). The most important feature is pain, followed by restricted mandibular movement, and noises from the temporomandibular joints (TMJ) during jaw movement. Although TMD is not life-threatening, it can be detrimental to quality of life, because the symptoms can become chronic and difficult to manage.
TMD is a symptom complex rather than a single condition, and it is thought to be caused by multiple factors. However, these factors are poorly understood, and there is disagreement as to their relative importance. There are many treatments available, although there is a general lack of evidence for any treatment in TMD, and no widely accepted treatment protocol. Common treatments include provision of occlusal splints, psychosocial interventions like cognitive behavioral therapy, and pain medication or others. Most sources agree that no irreversible treatment should be carried out for TMD.
About 20% to 30% of the adult population are affected to some degree. Usually people affected by TMD are between 20 and 40 years of age, and it is more common in females than males. TMD is the second most frequent cause of orofacial pain after dental pain (i.e. toothache)
Signs and Symptoms
Signs and symptoms of temporomandibular joint disorder vary in their presentation. The symptoms will usually involve more than one of the various components of the masticatory system, muscles, nerves, tendons, ligaments, bones, connective tissue, or the teeth.
The three classically described, cardinal signs and symptoms of TMD are:
• Pain and tenderness on palpation in the muscles of mastication, or of the joint itself (preauricular pain – pain felt just in front of the ear). Pain is the defining feature of TMD and is usually aggravated by manipulation or function, such as when chewing, clenching, or yawning, and is often worse upon waking. The character of the pain is usually dull or aching, poorly localized, and intermittent, although it can sometimes be constant. The pain is more usually unilateral (located on one side) rather than bilateral. It is rarely severe.
• Limited range of mandibular movement, which may cause difficulty eating or even talking. There may be locking of the jaw, or stiffness in the jaw muscles and the joints, especially present upon waking. There may also be incoordination, asymmetry or deviation of mandibular movement.
• Noises from the joint during mandibular movement, which may be intermittent. Joint noises may be described as clicking or popping.
If you have ever been diagnosed with periodontal (gum) disease, the good news is that it often can be treated successfully.
The first nonsurgical step usually involves a special cleaning, called “scaling and root planing”. This cleaning removes plaque and tartar deposits on the tooth and root surfaces. This procedure helps gum tissue to heal and periodontal pockets to shrink. When periodontal pockets do not heal after scaling and root planing, surgery may be needed to better remove inflamed tissues and reduce the damage to the bone that has formed around the teeth. As the pockets enlarge, they provide a greater place for bacteria to live and attack the bone and tissue. Surgery allows access to hard to reach areas under the gum and along the roots where tartar and plaque have accumulated. Eliminating this bacterial stronghold and regenerating bone and tissue help to reduce pockets and repair damage caused by the progressing disease. You don’t have to lose teeth to periodontal diseases. Brush, clean between your teeth, eat a balanced diet, avoid tobacco and schedule regular dental visits for a lifetime of healthy smiles.
Orthodontic care involves the use of appliances. Removable appliances are put in and taken out by the patients and can be used to straighten teeth, correct an irregular bite, close unsightly gaps and to bring tooth and lips into proper alignment. They also can help with procedures in other areas of dentistry, such as cosmetic and implant dentistry. In young children, orthodontic treatment also may guide proper jaw growth and permanent tooth eruption. Orthodontic care is not just cosmetic in nature. It also can benefit long-term dental health. Straight, properly aligned teeth are easier to brush and floss. This can help reduce the risk of tooth decay. It also can help prevent gingivitis, an inflammation that damages gums. Gingivitis may lead to infection, which occurs when bacteria cluster around the area where the teeth meet the gums. Untreated gingivitis can lead to periodontitis. This type of gum disease can destroy bone that surrounds the teeth and lead to tooth loss. Kramer dental is able to provide spring retainers for minor rotated and tipped teeth and occlusal guards. Other orthodontic needs will be discussed and referred to an Orthodontic office.
In the blossoming world of cosmetic dentistry, teeth whitening reigns supreme. Universally valued by men and women alike, whitening (or bleaching) treatments are available to satisfy every budget, time frame and temperament. The long and the short of it is that teeth whitening works. Virtually everyone who opts for this cosmetic treatment will see moderate to substantial improvement in the brightness and whiteness of their smile. However, teeth whitening is not a permanent solution and requires maintenance or “touch-ups” for a prolonged effect. Two teeth whitening options are available.
Significant color change in a short period of time is the major benefit of in-office whitening. This protocol involves the carefully controlled use of a relatively high-concentration peroxide gel, applied to the teeth by the dentist or trained technician after the gums have been protected with a paint-on rubber dam. Generally, the peroxide remains on the teeth for several 15 to 20 minute intervals that add up to an hour (at most). Those with particularly stubborn staining may be advised to return for one or more additional bleaching sessions, or may be asked to continue with a home-use whitening system.
Professionally Dispensed Take-Home Whitening Kits
Take-home kits incorporate an easy-to-use lower-concentration peroxide gel that remains on the teeth for an hour or longer (sometimes overnight). The lower the peroxide percentage, the longer it may safely remain on the teeth. The gel is applied to the teeth using custom-made bleaching trays that resemble mouth guards.
SNORING APPLIANCES & SLEEP APNEA
A mouthpiece, sometimes called an oral appliance, may help some people who have mild sleep apnea. Your doctor also may recommend a mouthpiece if you snore loudly but don’t have sleep apnea. The mouthpiece will adjust your lower jaw and your tongue to help keep your airways open while you sleep.
Sleep apnea (AP-ne-ah) is a common disorder in which you have one or more pauses in breathing or shallow breaths while you sleep. Breathing pauses can last from a few seconds to minutes. They may occur 30 times or more an hour. Typically, normal breathing then starts again, sometimes with a loud snort or choking sound. Sleep apnea usually is a chronic (ongoing) condition that disrupts your sleep. When your breathing pauses or becomes shallow, you’ll often move out of deep sleep and into light sleep.
As a result, the quality of your sleep is poor, which makes you tired during the day. Sleep apnea is a leading cause of excessive daytime sleepiness.
Most people who have sleep apnea don’t know they have it because it only occurs during sleep. A family member or bed partner might be the first to notice signs of sleep apnea. The most common type of sleep apnea is obstructive sleep apnea. In this condition, the airway collapses or becomes blocked during sleep. This causes shallow breathing or breathing pauses. When you try to breathe, any air that squeezes past the blockage can cause loud snoring. Obstructive sleep apnea is more common in people who are overweight, but it can affect anyone. For example, small children who have enlarged tonsil tissues in their throats may have obstructive sleep apnea.
Untreated sleep apnea can:
- Increase the risk of high blood pressure, heart attack, stroke, obesity, and diabetes
- Increase the risk of, or worsen, heart failure
- Make arrhythmias (ah-RITH-me-ahs), or irregular heartbeats, more likely
- Increase the chance of having work-related or driving accidents
- Sleep apnea is a chronic condition that requires long-term management. Lifestyle changes, mouthpieces, surgery, and breathing devices can successfully treat sleep apnea in many people.
Major Signs and Symptoms
One of the most common signs of obstructive sleep apnea is loud and chronic (ongoing) snoring. Pauses may occur in the snoring. Choking or gasping may follow the pauses. The snoring usually is loudest when you sleep on your back; it might be less noisy when you turn on your side. You might not snore every night. Over time, however, the snoring can happen more often and get louder. You’re asleep when the snoring or gasping happens. You likely won’t know that you’re having problems breathing or be able to judge how severe the problem is. A family member or bed partner often will notice these problems before you do.
Not everyone who snores has sleep apnea.
Another common sign of sleep apnea is fighting sleepiness during the day, at work, or while driving. You may find yourself rapidly falling asleep during the quiet moments of the day when you’re not active. Even if you don’t have daytime sleepiness, talk with your doctor if you have problems breathing during sleep.
Other Signs and Symptoms
- Morning headaches
- Memory or learning problems and not being able to concentrate
- Feeling irritable, depressed, or having mood swings or personality changes
- Waking up frequently to urinate
- Dry mouth or sore throat when you wake up
In children, sleep apnea can cause hyperactivity, poor school performance, and angry or hostile behavior. Children who have sleep apnea also may breathe through their mouths instead of their noses during the day