Posts for tag: pediatric dentistry
It’s common for kids to be less than enthusiastic about visiting the dentist. For some, though, it’s even more of a challenge: A child with extreme anxiety and fear during dental visits could interfere with them receiving the dental care they need. The impact could even extend into adulthood.
Recognizing the need to reduce this high anxiety, dentistry has used a number of pharmacological tools for many years that relax a child during dental care. Sedatives have often been the only choice for reducing anxiety, especially during extensive procedures and treatments. But now there’s a promising new approach in dentistry that doesn’t depend on drugs.
Cognitive behavioral therapy (CBT), a psychotherapeutic method used for decades to treat depression, phobias and eating disorders, has been investigated recently as a possible approach for relieving children’s dental anxiety. During CBT, trained therapists use specific behavioral techniques to help patients develop mental and emotional strategies for dealing with stress.
During the usual course of CBT therapy, a therapist meets in counseling sessions with patients weekly over several months to help them change their routine thinking or behavior surrounding a stressful issue. Initially, the therapist guides the patient toward understanding the underlying causes for their negative reaction to the issue. They then work with the patient to devise an objective way to test whether those emotions and beliefs about the issue are true.
Using this effective method for changing behavioral and emotional responses for dental anxiety has had encouraging results from initial research. One study found CBT successfully reduced dental anxiety among a majority of a group of European children ages 9 through 16 who participated in the method.
CBT isn’t an overnight cure, often requires a number of months to achieve results. But for children who suffer from extreme fear of professional dental care, this drug-free method may provide long-term benefits that extend well past their childhood years.
"Mom, my tooth hurts" isn't something you look forward to hearing your child say. But tooth pain is as common as other childhood ailments, so you may have to face it. Here are a few simple steps to make it easier.
First, ask your child where in the mouth it hurts and, if they can, tell you how long it's been hurting. Children's memories aren't always accurate, but you can still get a general idea that you can communicate with your dentist if you take them in.
Next, look in their mouth for anything out of the ordinary: gum swelling or bleeding, or dark spots on the teeth indicative of tooth decay. Look also for hard food particles like popcorn kernels caught between the teeth, which could be causing the pain. Gently floss between the teeth (even if you can't see anything) to remove any caught particles.
You'll also want to help ease their pain. You can apply an ice pack against the painful side of the jaw. Don't place ice directly on the skin, but use a container or cloth alternately against the jaw for a minute or so, and then away for a minute. You can also give them a dose of mild pain reliever like ibuprofen or acetaminophen appropriate for their age and weight—but never rub aspirin or other pain relievers on the gums, which tend to be acidic and can burn the skin.
Finally, you'll need to decide if you need to see a dentist and how soon. It might not be necessary with situations like the trapped food particles, but most of the time it's wise to have your dentist perform an examination for an accurate diagnosis and appropriate treatment. As to how soon, try to see the dentist immediately if the pain has continued from one day to the next or has kept your child up overnight. Otherwise, book an appointment for as soon as the dentist advises, even if the pain subsides.
A toothache at any age is never pleasant, but especially for children. Knowing these steps will help ease their discomfort and get them the relief and treatment they need.
If you would like more information on dental care for 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 “A Child's Toothache: Have a Dental Exam to Figure out the Real Cause.”
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.
Although teething is a natural part of your baby's dental development, it can be quite uncomfortable for them—and upsetting to you. During teething, children can experience symptoms like pain, drooling or irritability.
Teething is the two or three-year process of intermittent episodes of the primary ("baby") teeth moving through the gums. These episodes are like storms that build up and then subside after a few days. Your aim as a parent is to help your baby get through the "stormiest" times with as little discomfort as possible. To that end you may have considered using over-the-counter products that temporarily numb irritated gums.
Some of those numbing products, however, contain a pain reliever called benzocaine. In recent years, this and similar ingredients have been found to increase the level of a protein called methemoglobin in the bloodstream. Too much methemoglobin can result in less oxygen delivered to body tissues, a condition known as methemoglobinemia.
This oxygen decrease can cause shortness of breath, fatigue or dizziness. In its severest form it could lead to seizures, coma or even death. Children and infants are at high risk for benzocaine-induced methemoglobinemia, which is why the U.S. Food and Drug Administration has banned marketing for benzocaine products as pain relievers for teething infants and children.
Fortunately, there are alternatives for helping your child weather teething episodes. A clean, chilled (not frozen) teething ring or pacifier, or a cold, wet washcloth can help numb gum pain. You can also massage their gums with a clean finger to help counteract the pressure exerted by an emerging tooth. Be sure, though, that you're not allowing anything in your child's mouth like lead-based paint that could be toxic. And under no circumstances should you use substances containing alcohol.
For severe pain, consult your physician about using a pain reliever like acetaminophen or ibuprofen, and the proper dosage for your child. With these tips you can help your child safely pass through a teething episode.
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.”