Taking a Bite Out of Tooth Problems
Seeing that tiny nub of a tooth appearing in your baby’s mouth is an exciting moment for new parents. It is a sign that your child is developing normally, that he or she will someday enjoy a fresh juicy apple, a hot dog at the ball park and grandma’s special chocolate chip cookies. That tooth and all the others that come after require special care. Here’s what parents and caretakers need to know about dental and orthodontic care.
“It is currently recommended that children begin visiting the dentist when that first tooth erupts or age one,” says Evan Clothier, D.D.S., of Family Smiles Dentistry in Broken Arrow. “We can then catch possible developmental problems before they get started.”
Brushing is the first defense for preserving teeth. For babies that includes wiping their tiny teeth with a soft damp cloth or using a gentle finger brush made specifically for baby teeth. Dr. Clothier recommends that parents brush their child’s teeth at least until the child has the coordination to tie his or her own shoes—age 5 to 6.
“But even when they start taking responsibility for their own teeth, they should report back to mom or dad,” says Clothier. He recommends that parents inspect each brushing job in strong light. “If there is still a cheesy film on the teeth or around the gums, send them back for a more thorough brushing or brush them yourself,” says Dr. Clothier.
Dr. Clothier likes the “spin” or electric toothbrushes for children as he believes they help children do a more thorough job. He also recommends that children use ACT fluoride rinse to strengthen the teeth against decay. “The rinse can be started at age 6 or whenever a child is capable to rinse and not swallow,” says Dr. Clothier.
Though he would like to see all children brush their teeth three times a day, he knows that is not always practical. According to Dr. Clothier, nighttime is the most important time to brush because saliva production is low when we sleep, allowing bacteria to rapidly multiply.
After brushing, flossing is the next most important defense of healthy teeth. “Flossing allows us to reach areas our toothbrush and fluoride rinse can’t reach,” says Dr. Clothier.
“Cavities that develop between teeth require more intensive dental intervention than cavities on biting surfaces.” Dr. Clothier encourages parents to floss children’s teeth for them until they are about age 12. “It’s a good habit to start early.”
While Clothier believes that sealants are a useful tool in preventing tooth decay, he warns parents that they are not a cure all.
“Sealants can be effective in preventing decay in permanent teeth if they are monitored and maintained through regular dental check ups,” says Dr. Clothier. “But if sealants go unchecked, decay can develop around them.”
X-rays are an important tool in the dental profession, allowing the dentist to spot early decay, malformations and other problems. According to Dr. Clothier, panoramic X-rays, which give a broad view of the entire mouth including the teeth, upper and lower jawbone, sinuses, and other hard and soft tissues of the head and neck, should be done every three years, while bitewing X-rays (for revealing cavities between teeth) should be taken every six months during routine dental check ups.
Positive Dental Experience
According to Dr. Clothier one of the most important things to consider when thinking about your child’s dental care is that the child have a good experience. He has seen patients who have harbored life-long phobias about dental care because of bad experiences in childhood.
“The dental practice should be welcoming and friendly,” says Dr. Clothier, who has stocked his kid-friendly office with video games, toys, plasma TVs with cartoons, and a soft-play area for little ones.
Though he believes the toys and cartoons help children relax, he says the biggest element in helping children feel safe at the dentist is “a caring staff.”
“A good dental staff will use the ‘tell, show, do’ plan for treating children,” says Dr. Clothier. “First you tell them what you are going to do, then you show them what you are going to do, then you actually carry out the procedure.” This method helps the child understand what is happening and prevents scary surprises.
According to Dr. Robert Herman, a Tulsa orthodonist, orthodontists are dentists who have completed two to three more years of education beyond dental school, specializing in “straight teeth and making great smiles.” “The full name of our specialty is orthodontics and dental/facial orthopedics,” says Dr. Herman. “We are actually moving bones, and the best time to move bones is when they are still growing.”
Early Evaluation and Treatment
Current recommendations are that every child receive an orthodontic evaluation by age 7. “We want to catch problems early,” explains Dr. Herman. “Most orthodontists don’t do a lot of treatment at that age, but we like to monitor the child’s growth annually.
Treatment starts if we notice the child is developing a skeletal imbalance.” He says that early treatment usually focuses on developing the jaws through the use of expanders. “Expanders make the jaws wider, giving a bigger, broader smile and reducing the need for tooth extractions later.”
If braces are needed they are usually applied when a child is between the ages of 11 and 13. “The new technology [in orthodontics] is significant,” says Dr. Herman.
“We no longer band every tooth. Instead we glue braces to the teeth and gently glide teeth into position using lighter forces and requiring fewer office visits. Total treatment also takes less time.” Best of all, says Dr. Herman, “patient comfort is vastly improved.”
In addition to improvements in traditional braces, patients now have the option of ceramic braces and clear liners that move teeth.
While moving the teeth into place generally takes 18-30 months, retention of the teeth in the new position is another matter. “New research has taught us that retention is for a lifetime,” says Dr. Herman. “You need to wear a retainer [after braces are removed] as long as you want straight teeth.” Retainers include a permanent metal band on the back of teeth and/or a plastic fitting worn at night.
The good news for today’s teens is that the dreaded headgear is rarely used in current practices. “We do our best to treat patients without the headgear!” says Dr. Herman.