Children’s Dental Tips

Ever wonder what to do when?

Toothaches

Rinse the mouth with warm water, and use floss to remove any food that may be causing discomfort. Use ice to reduce the pain and swelling. Try to get to a dentist as soon as possible.

Tooth Trauma

Bumps, falls and bruises are a normal part of childhood. But any injury that causes bleeding, loosens teeth, or results in a broken tooth should be evaluated by a dentist…even if the child doesn’t complain of pain.

A tooth that is fractured or discolored may become infected. Infection in a baby tooth can cause damage to the permanent tooth. Infection of a permanent tooth can lead to tooth loss if left untreated.

Broken Teeth

If a primary tooth is knocked out, do not scrub or clean the tooth. Place the tooth in saline (contact lens solution) or milk, and call your dentist immediately. The tooth may be able to be replanted if treatment is sought promptly. Also, save any broken pieces of tooth that are found after an injury as they may be bonded back in place. If a baby tooth is broken, notify the dentist immediately, but know that primary teeth are rarely re-planted.

For many children, sealants can be helpful in getting through the candy and sugar years. These protective coatings help prevent cavities from forming on the top surfaces of the teeth.

Sealants are generally placed over the permanent molars as soon as they erupt into the mouth. This can be as young as six years of age. Baby teeth can also be sealed if your child is cooperative and at a high risk for developing decay.

Ask us if sealants on your child’s baby teeth would be appropriate.

Fillings are sometimes indicated for the restoration of primary (baby) and permanent teeth with caries, dental defects or dental trauma. There are several different types of filling materials, each material offers its own benefits.

Composite Fillings

Resin-based composite is an aesthetic material used primarily for anterior (front) teeth but can also be utilized on certain posterior (back) teeth. There are a variety of products with each having different qualities and benefits. Resin- based composites require longer time for placement and are more sensitive than amalgam (silver) fillings. In cases where patient cooperation is compromised, composites may not be the restorative material of choice. Your doctor will discuss the risks and benefits of composite fillings and will determine the best treatment option for your child.

Amalgam Fillings

Amalgam (silver) is a material used primarily for posterior (back) teeth. Dental amalgam has been reviewed and studied extensively for its safety and effectiveness. Amalgam fillings are often chosen for their durability and ease of placement. Your doctor will discuss the risks and benefits of amalgam fillings and will determine the best treatment option for your child.

Crowns have been indicated for the restoration of primary (baby) and permanent teeth with caries, dental defects or dental trauma. Crowns are sometimes completed in conjunction with pulpal therapy. Crowns are considered more successful than fillings for multi-surface restorations. There are differnet options for types of crowns. Your doctor will discuss the risks and benefits of crowns and will determine the best treatment option for your child.

Nerve treatments consist of treatment of the nerve with various medicines or techniques, depending on the age of the patient and health of the nerve tissue.

Baby nerve treatments, or pulpotomies, are performed when a large carious lesion is into or extremely close to the nerve tissue. The tissue is removed and a sedative medicine placed into the tooth. These teeth may or may not have experienced pain or discomfort up until that point.

Nerve treatment performed on adult teeth vary greatly and may be a result of trauma to the tooth or from a carious lesion that has reached the pulp. Every effort is made to allow the tooth to remain vital and new biocompatible materials are used to allow the pulp to in effect form a protective barrier. By allowing the pulp of the tooth and body to heal itself will lengthen the life of the tooth, but it still made need a full nerve treatment.

When the nerve of a permanent tooth can not be repaired conservatively with biocompatible materials, a referral to an endodontist or root canal specialist will occur to allow for the best care.

Extractions

Extractions of baby teeth can occur for various reasons. If a baby tooth becomes infected, it can negatively impact the adult tooth that is developing behind the baby tooth. If an infection or abscess of a baby tooth is not addressed, the child can develop a larger infection or cellulitis and possibly be admitted to the hospital for inpatient treatment. These infected teeth may need antibiotics prior to extraction to help lessen the infection and allow for the tooth to become numb. The antibiotic is only to serve to help lessen the infection in and around the tooth and allow the dentist to achieve better anesthesia prior to extraction. If the infected tooth is not extracted in a timely fashion, the infection will likely return.

Some teeth may become too badly broken down, have poor root structure remaining or need to be removed to allow for the adult teeth to properly grow into the mouth. The orthodontist may also request certain adult teeth be removed to allow for orthodontic treatment and a better esthetic and functional end result.

As the patient approaches the mid to late teen years we often take a panoramic radiograph to assess for the presence of absence of third molars or wisdom teeth. Depending on the angle, amount of root development and space left in the mouth for these teeth to erupt, we may or may not refer you to an oral surgeon to have these removed. It is much easier to remove these teeth at a younger age when the teeth are less developed and the root is shorter. These wisdom teeth may not have any pain or discomfort at the time, but we are sending you for an evaluation to have the teeth assessed prior to pain and problems present.

Supernumerary Teeth

In rare cases, supernumerary teeth – or true extra teeth – are found in some patients. This typically happens in specific ethnic groups, but everyone is evaluated for these. The most common area is in the upper jaw and between the front teeth and is called a mesoden. This extra tooth, and at times teeth, can negatively impact the eruption of the upper adult front teeth. Depending on the location, positioning and age of the patient will determine if we would address this in the office or refer the patient out to the oral surgeon for extraction. Supernumary teeth can occur in the lower jaw and in the back of the mouth, too. For the extraction of the front mesoden(s), a small area of the gums is opened to allow access to the extra tooth. In some cases the removal of one or more of the front teeth may be needed to help locate and access the extra tooth. We typically will wait to the age of 5 to perform these extractions, unless otherwise indicated.