Author: Dr. Chea Rainford

Quality Dental Care

Quality dental care is essential for your child’s lifelong oral health. It’s important that your child’s first experiences with the dentist are positive. That’s why your dentist will make every effort to help your child feel comfortable and in control during each visit. Your own attitude and example also play an important role in setting the stage for a lifetime of healthy smiles!

Your child should visit a dentist as early as six months, when the baby’s first tooth appears. A first tooth’s appearance is an excellent time to schedule a dental evaluation. At that time, your dentist will diagnose and help prevent any future oral disorders. Your dentist can also answer any questions you have about caring for your child’s teeth.

During your visit your attitude can convey the message that dental visits are pleasant adventures. Emphasize the attention that your child will get while in the chair. Try to schedule the appointment for the time of day when your child is most rested and cooperative. To prepare your child, read a story together about a trip to the dentist. You may want to play dentist and take turns looking into each other’s mouth with a flashlight. Have fun; this should be a pleasant experience!

Choosing A Toothpaste

While toothpaste [dentifrice] is a valuable adjunct to a toothbrush in oral hygiene, it is the correct brushing action that removes the plaque [sticky mixture of bacteria, food & debris] from your teeth.

 Fluoride Any brand toothpaste that contains fluoride and the ADA Seal of Approval, to attest that there is evidence of its safety, reliability and effectiveness through clinical trials, is acceptable. It makes no difference if the toothpaste is a gel, paste or powder or which flavoring agent is used. However, from an individual motivational standpoint, and assuring its use, these characteristics may be important. Other than fluoride, which strengthens the enamel and fights decay, toothpastes contain abrasives to remove stain and polish the teeth and ingredients to leave the mouth with a clean, fresh feeling.

 Sensitive Teeth If your teeth are sensitive to hot or cold, choose a desensitizing paste with either strontium chloride or potassium nitrate as an added ingredient. Expect about 4-6 weeks to see real improvement.

 Tartar Control There are brands of toothpaste that advertise “tartar control” and usually have the active ingredient pyrophosphate. While it will not remove tartar, studies have shown it will reduce tartar formation up to 36%. Tartar [calculus] can only be removed with a professional prophylaxis [cleaning].

 Abrasiveness Many toothpastes now contain baking soda, which is less abrasive. This is advantageous for reducing tooth sensitivity in people with gum recession or those who have eroded their teeth by rigorous brushing with an abrasive toothpaste.

 Whitening Bleaching teeth to make them lighter has become popular. If you desire a whitening toothpaste, look for the active whitening agents of carbamide peroxide or hydrogen peroxide. These toothpastes serve best to maintain the tooth shade after bleaching procedures. Call our office if you have bleaching questions.

 Dentures If you wear partial or full dentures, they will also stain and absorb odors. Ask your pharmacist to recommend an ADA Accepted denture cleaning paste and/or solution. When brushing, it is not necessary to overload your brush with toothpaste. Squeeze a “pea-sized” amount on the top of the bristles. Correct brushing techniques will cause the paste to foam and cover all of your teeth.

The Developing Dentition: What To Expect

Usually, a baby’s teeth are not visible at birth, but they are present under the gums. However, sometimes a baby is born with 1-2 teeth. Women who breast-feed will have to be careful, or they will be bitten. We will get two sets of teeth – 20 baby teeth [also known as primary or deciduous] and 32 permanent teeth.

As the primary teeth get ready to erupt into the mouth, the gums get hard, red and swollen. This process called “teething” can also cause discomfort, excessive drooling, runny noses, low-grade temperature and/or overall crankiness. However, each child may exhibit some differences, sot there is an average range within tooth eruption occurs [see chart]. For example, if a child is breathing in second-hand smoke from one or both parent smokers, the eruption of his/her teeth can be delayed 4-5 months.

The two lower front teeth [deciduous central incisors] are typically the first to arrive when the child is 6-8 months old. There will be periodic eruption of the rest of the primary teeth, usually in pairs on both sides of the jaws. By the time your child is 2½ years old, all of the deciduous teeth should be visible. Eventually, the primary teeth will become loose and fall out or be removed easily. Their permanent counterparts should replace all of the primary teeth. It’s important, however, to maintain a child’s primary teeth. They are necessary for chewing food properly, speech, and physical appearance. If a primary tooth decays and abscesses, it could damage the developing bud of the permanent tooth underneath. Also, premature loss of a back [posterior] primary tooth could reduce the amount of space necessary for its permanent replacement. In the primary dentition, large spaces between the teeth are normal.

Usually, the first permanent teeth to erupt are the child’s four first molars that do not replace any teeth but come in directly behind the child’s deciduous second molars. This occurs are about 5½ – 6 year old [sometime called the six-year molars]. The progression of tooth replacement/eruption follows with the four permanent front teeth [central incisors] at about age 6-7. The eruption of the permanent teeth is almost complete at age 12-13 when the second permanent molars come in. the third molars [wisdom teeth] may erupt anywhere between 1- to 21 plus years. It’s quite common for wisdom teeth to be impacted in the bone and never erupt. Sometimes other permanent teeth are congenitally missing and will never be present. This is typically diagnosed with proper x-rays [radiographs]. One of the concerns that we verify at the check-up appointment is that your child’s teeth are developing properly and taking their correct position in the mouth. If you have questions regarding your child’s teeth development or eruption pattern, please call our office.

What Can I Eat If I Am Wearing Braces?

The following substances will cause damage to the braces and should absolutely not be eaten: candy apples, caramels, hard and sticky candy, candy bars, aquarium gravel, gum balls, jaw breakers, chicklets, or other gum, popcorn, bones, nuts, ice, chips, chewable vitamins, or any other crunchy or sticky items.

Foods such as apples, carrots, celery, pretzels, French bread, bagels, waffles, and meats should be cut into small pieces and chewed with your back teeth. Keep pencils, fingernails, straws, etc. out of your mouth. Please realize that the use of sugar-containing candy, soda, gum, etc. also promotes tooth decay.

If a bracket falls off, the wire bends or anything else breaks or becomes loose, the patient needs to call right away so that an appointment may be made for the appropriate length of time (generally 30-45 minutes) that we need in order to make the repair. This is especially important even if the patient already has an appointment scheduled.

We know that loose bands, poking wires and other problems can occur with even the most careful and cooperative patients and we will work with you to accommodate your needs in every way we can.

The Right Age To Consider Orthodontics

The American Association of Orthodontics recommends that a child first be seen by an orthodontist as early as age 7 or earlier should a parent or the family dentist discover a problem. The timing of orthodontic treatment is extremely important and greatly affects the treatment result. Since no two patients are alike, there is no absolute, specific age that is best to begin treatment.

Many progressive treatments are now available for patients six to eleven years old that provide significant benefits, especially in jaw irregularities. These treatments may also prevent certain conditions from worsening. Treating children during their growth stages enables us to achieve results that may not be possible when the face and jaw bones have fully developed. This early treatment can simplify or eliminate additional treatment.

Early diagnosis and treatment by an orthodontic specialist can help guide facial growth and tooth eruption, thus preventing more serious problems from developing. Our goal is to reduce treatment time in full braces and to provide the best and most stable results possible.

Potential Benefits of Timely Treatment

 Influence growth of the jaws in a positive manner

 Improve the width of the dental arches

 Reduce the need to extract permanent teeth

 Reduce or eliminate the need for jaw surgery

 Lower the risk of trauma to protruded front teeth

 Correct harmful oral habits

 Simplify and shorten treatment time

 Increase the stability of final treatment results

 Reduce the likelihood of impacted permanent teeth

 Improve speech development

 Improve the position of the first permanent molars

 Guide permanent teeth into more favorable positions

 Improve lip closure

 Preserve or gain space for erupting teeth

 Reduce the potential for damage to the Temporal Mandibular Joint

 Better cooperation before the teenage years

Changes In Orthodontics

Orthodontic treatment has come a long way in the past ten years. Years ago, the process of placing braces could take several long, uncomfortable appointments. Braces were attached to teeth with steel bands around each tooth. Smaller braces that are bonded directly to the tooth surface, high-tech adhesives and computer-software have made orthodontic treatment a much more comfortable and simplified process. Treatment today is certainly more efficient and predictable due to the modern materials we use and the improved techniques.

NASA has contributed to orthodontics making incredible breakthroughs in technology. They developed heat activated nickel-titanium alloy wires that effectively move teeth when the wires reach mouth temperature. These new wires apply gradual, precise and gentle pressure, and yet retain their teeth-moving abilities longer than their predecessors. In contrast, stainless steel wires were less resilient and needed more frequent adjustments.

Some of today’s braces are translucent or tooth-colored. Additionally, metal brackets are now smaller and less noticeable. With multi-colored elastic ties that attach the wires to the brackets, today’s braces are also fun. Many young orthodontic patients enjoy color coordinating their rubber bands as a fashion accessory.

Bracket adhesives have also advanced. Some continuously release fluoride to help protect tooth enamel, while others are made to withstand moisture.

Aligners can now be used to precisely move teeth without the use of braces. Please ask us about Invisalign during your next appointment.

As technology advances so does our ability to diagnose, treat and enhance the quality of treatment for our patients.

Your Child’s first Dental visit: What to Expect!

The arrival of baby teeth is momentous because they allow children to graduate to a variety of new foods. In addition to celebrating this new stage in your baby’s development, you should also begin to think about a first visit to the dentist. Although parents of infants may not yet be concerned with dental care, the American Academy of Pediatric Dentistry recommends that the first dentist visit for children take place before a baby’s first birthday. Initially, dental visits are mostly informative in nature, but even at this early age, dental professionals help to establish a proper oral care routine that can last a lifetime.

Finding a Dentist

To find a dentist, check with your pediatrician or insurance company about providers in your area. Additionally, you may want to ask friends and family members for referrals. Narrow your search based on locations and office hours that fit best into your schedule. Try to interview several dental practices before selecting the one where you and your child feel most comfortable. In addition to calling for information, many dental practices also have websites with FAQs to help answer your questions.

Prepare in Advance

Ensure that your child is well rested and not hungry around the time of the appointment. It may be helpful to write down a list of questions ahead of time to ask the dentist. Very importantly, check with your dental insurance provider about copays and coverage before the day of your child’s first dentist visit. Most dental providers ask for proof of dental and medical insurance at time of service. Last, bring a list of your child’s current medications, and be prepared to fill out a health history form.

Although it is not necessary to prepare extremely young children in advance of a dental appointment, you may want to discuss the first visit with an older child. If your child experiences some anxiety over a dental appointment, try to ease his worries by reading books about dentists or by watching television shows to help to visualize what the visit will be like.

What to Expect during Your Child’s First Dentist Visit

During the first visit, the dentist will typically educate parents on proper gum and tooth care for babies. You may also discuss pacifier use and how proper nutrition helps to maintain healthy teeth. The dental professional should also demonstrate brushing techniques for parents so that they are able to knowledgeably assist young children with oral care. At the end of the appointment, the dentist should also provide you with the opportunity to ask questions.

By establishing a good working relationship with a childdentist, parents will ensure that their child receives proper dental care beginning at an early age. Setting a precedent for dental appointments at an early age helps children to become accustomed to a proper oral care routine.

The Science And Art Of Smile Design

Patients have asked why this office puts an emphasis on cosmetic dentistry. The answer is easy. Cosmetic dentistry involves some of the more creative aspects of dentistry, rather than the simple, straightforward and routine mechanical side. There are so many things to evaluate when trying to remake someone’s smile. The challenge of figuring out the puzzle so that the patient will look their best is really intriguing and fun, and the results are highly satisfying.

The finished product of a smile design is the result of a lot of work with excellent communication and cooperation between our dental office, the lab and the patient. Please call our office, if you would like to evaluate or discuss your smile.

The Instant Makeover

More and more these days, instant sorts of makeovers are shown on television shows and in the news. It seems that once a person makes the commitment to proceed, they want to get moving quickly. Our practice has noticed that too, and we are doing many more “makeovers” where we finish the entire treatment in a short period of time.

It seems like many people just hit a point where they have “had it” with their smile or their appearance, and decide it’s time to look better. The next steps are important, because how happy a person is with the results, depends on how the treatment is approached and accomplished.

Here is what we do when someone presents with some true esthetic concerns and is ready to do something about them:

 First of all, we interview the patient to determine their true desires, needs and wants. Everything starts with getting a good understanding of what the patient wants and expects.

 We have to do a complete exam to understand the underlying health of the teeth, gum and bone, and how the bite, or occlusion, is working.

 We take photographs, and impressions of the teeth for what we call study models. Sometimes we ask the dental lab to create the desired appearance in an ideal wax smile. It is a fun process.

Once we know where we want to be at the finish, the process of getting there is usually just a couple of long and relaxed appointments.

In the First Visit the teeth are prepared and impressions are taken; the patient leaves with plastic temporary restorations that are an actual preview of the desired end point. These provisional restorations allow us to personalize shape, size and color so that before the final porcelain restorations, we know that the patient is going to love their smile. This works really well, relieving much of the anxiety of someone not knowing how they will look.

The patient generally receives the final restorations in the Second visit, where we take off the temporary crowns/veneers and try in the permanent ones. If they are fitting and looking like we want, these restorations are permanently bonded to the teeth. Subsequent visits are made as necessary for any follow up or adjustments.

Sippy Cup: Friend Or Foe?

The sippy cup is a spill proof, lid-covered drinking cup designed to help parents teach their toddlers how to drink without spilling. Children can toss it, drop it and turn it upside down, but they can’t spill its contents. That’s thanks to a valve in the top that releases liquid only when a child puts his lips around the tip and sucks. Day after day countless parents reach for that sippy cup their toddlers love so well, proud that the bottle is a thing of the past, and thrilled that their car seats and living room carpets will be spared! These parents though, should think twice before resorting to extended use of the sippy cup.

Many parents operate under the mistaken impression that the sippy cup is better than allowing the child to sleep with a bottle. The damage done by the bedtime bottle is fueled by the fact that no saliva flows during sleep to clear liquids from the mouth or dilute them. Liquids bathe the teeth all night. The sippy cup filled with sweetened liquids can cause the same damaging effects. The child’s teeth are immersed in the liquid during drinking and many parents allow unlimited access to the sippy cup.

The American Academy of Pediatric Dentistry recommends that children be weaned from the bottle by 12-14 months of age and be encouraged to drink from a cup. Parents are cautioned however that the repetitive consumption of liquids that contain fermentable carbohydrates (milk, juice, soft drinks etc.) from a bottle or sippy cup should be avoided.

 Be very selective about the liquids that you give your child from the sippy cup. Avoid milk, juice, and soft drinks. Try water or sugar free beverages instead.

 Use the sippy cup only as a transition to a regular cup or adult drinking glass with no lid.

 Consider cup design carefully. A pop-up straw reduces the amount of time the liquid is in contact with the teeth.

 Some speech pathologists have expressed concern about over use of the sippy cup and liken its use to a thumb-sucking habit, the effects of which are well documented.