We've known for decades that fluoride strengthens tooth enamel and lowers the risk for decay. And while adding it to toothpaste and drinking water are the more common ways for getting it into the body, an increasingly popular way—especially for children—is to apply fluoride directly to the teeth.
But is topical fluoride really worth the effort and expense? And, are there any side effects to treating teeth this way?
As to the first question, researchers have performed numerous studies measuring fluoride's effectiveness for preventing tooth decay. The Cochrane Oral Health Research Group recently reviewed studies on topical fluoride applications involving nearly 10,000 children and adolescents between the ages of 2 and 15. The combined average for all the studies showed a 28% reduction in decayed teeth for patients who received topical fluoride compared to those who didn't.
This was especially true for children at high risk for decay: directly applying fluoride gels, foams or varnishes to teeth reduces that risk substantially. But there are also side effects to this application. Fluoride in general has only one known safety concern, a condition known as fluorosis. Too much fluoride over time can cause heavy discoloration of the teeth. This does not affect the health of the teeth, but it can look unattractive and require cosmetic treatment to reduce its effect.
There's little to no risk for fluorosis with the controlled treatments offered by dentists; the fluoride solution remains on the teeth no more than a few minutes. But there is a possible side effect during treatment due to the relatively high dose of fluoride used. If the patient accidentally swallows some of the solution, the concentration of fluoride can cause stomach upset, vomiting or headaches.
Dentists minimize the chances for this by usually using the more difficult to swallow varnish form of topical fluoride on younger patients, and using trays or other barrier devices to isolate the fluoride solution from the rest of the mouth. Under professional supervision, it's rare for an accidental ingestion to occur.
The risks for these side effects are quite low, and the benefits of topical fluoride for reducing the chances for decay can more than outweigh them. Fluoride applications are one of many ways we can protect your child's current and future dental health.
If you would like more information on decay prevention techniques like topical fluoride, 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 “Fluoride Gels Reduce Decay.”
We all know that a child's baby teeth don't last forever. So if those little teeth develop problems, like severe decay, chips or cracks, it doesn't much matter—right? Wrong! National Children's Dental Health Month, observed in February, is the perfect occasion to remember why baby teeth need the same meticulous care as adult teeth:
- Baby teeth perform the exact same jobs adult teeth do, only in little mouths. Without healthy teeth, a child can't eat comfortably, speak properly or smile with confidence. Given that the last baby tooth doesn't fall out until around age 12, children need to rely on these "temporary" teeth for a long time!
- While there often are no symptoms of early tooth decay, badly decayed baby teeth can become painful—and the problem may get worse quickly. Untreated tooth decay can lead to suffering and expense that could have been avoided with relatively simply dental treatment.
- Baby teeth help guide adult teeth into the right position. Each baby tooth helps hold the right amount of space open for the next tooth that will grow in. When a baby tooth is lost before the permanent replacement is ready to grow in, orthodontic problems can result.
As you can see, good dental health has a big impact on a child's quality of life and health—in both the present and the future. That's why it's important to treat childhood dental disease and injuries promptly and properly. Regular dental exams are the best way to keep on top of your child's dental health. If a cavity is discovered at a routine exam, prompt treatment can keep the decay from spreading to the root canals.
If your child plays sports, ask us about a custom-made mouthguard. This small device can protect your child's teeth from serious injury. And if a baby tooth does get knocked out, let us know. It may be best to fit your child with a very small dental device called a space maintainer, which will hold that empty space open until the permanent tooth beneath it grows in.
If you would like more information about children's dental health, please contact us or schedule an appointment a consultation. You can also learn more by reading the Dear Doctor magazine article “Importance of Baby Teeth.”
In her decades-long career, renowned actress Kathy Bates has won Golden Globes, Emmys, and many other honors. Bates began acting in her twenties, but didn't achieve national recognition until she won the best actress Oscar for Misery — when she was 42 years old! “I was told early on that because of my physique and my look, I'd probably blossom more in my middle age,” she recently told Dear Doctor magazine. “[That] has certainly been true.” So if there's one lesson we can take from her success, it might be that persistence pays off.
When it comes to her smile, Kathy also recognizes the value of persistence. Now 67, the veteran actress had orthodontic treatment in her 50's to straighten her teeth. Yet she is still conscientious about wearing her retainer. “I wear a retainer every night,” she said. “I got lazy about it once, and then it was very difficult to put the retainer back in. So I was aware that the teeth really do move.”
Indeed they do. In fact, the ability to move teeth is what makes orthodontic treatment work. By applying consistent and gentle forces, the teeth can be shifted into better positions in the smile. That's called the active stage of orthodontic treatment. Once that stage is over, another begins: the retention stage. The purpose of retention is to keep that straightened smile looking as good as it did when the braces came off. And that's where the retainer comes in.
There are several different kinds of retainers, but all have the same purpose: To hold the teeth in their new positions and keep them from shifting back to where they were. We sometimes say teeth have a “memory” — not literally, but in the sense that if left alone, teeth tend to migrate back to their former locations. And if you've worn orthodontic appliances, like braces or aligners, that means right back where you started before treatment.
By holding the teeth in place, retainers help stabilize them in their new positions. They allow new bone and ligaments to re-form and mature around them, and give the gums time to remodel themselves. This process can take months to years to be complete. But you may not need to wear a retainer all the time: Often, removable retainers are worn 24 hours a day at first; later they are worn only at night. We will let you know what's best in your individual situation.
So take a tip from Kathy Bates, star of the hit TV series American Horror Story, and wear your retainer as instructed. That's the best way to keep your straight new smile from changing back to the way it was — and to keep a bad dream from coming true.
If you would like more information about orthodontic retainers, please contact us or schedule an appointment for a consultation. You can learn more about this topic in the Dear Doctor magazine articles “Why Orthodontic Retainers?” and “The Importance of Orthodontic Retainers.” The interview with Kathy Bates appears in the latest issue of Dear Doctor.
Dental disease doesn’t discriminate by age. Although certain types of disease are more common in adults, children are just as susceptible, particularly to tooth decay.
Unfortunately, the early signs of disease in a child’s teeth can be quite subtle—that’s why you as a parent should keep alert for any signs of a problem. Here are 3 things you might notice that definitely need your dentist’s attention.
Cavities. Tooth decay occurs when mouth acid erodes tooth enamel and forms holes or cavities. The infection can continue to grow and affect deeper parts of the tooth like the pulp and root canals, eventually endangering the tooth’s survival. If you notice tiny brown spots on their teeth, this may indicate the presence of cavities—you should see your dentist as soon as possible. To account for what you don’t see, have your child visit your dentist at least twice a year for cleanings and checkups.
Toothache. Tooth pain can range from a sensitive twinge of pain when eating or drinking hot or cold foods to a throbbing sharp pain. Whatever its form, a child’s toothache might indicate advancing decay in which the infection has entered the tooth pulp and is attacking the nerves. If your child experiences any form of toothache, see your dentist the next day if possible. Even if the pain goes away, don’t cancel the appointment—it’s probable the infection is still there and growing.
Bleeding gums. Gums don’t normally bleed during teeth brushing—the gums are much more resilient unless they’ve been weakened by periodontal (gum) disease (although over-aggressive brushing could also be a cause). If you notice your child’s gums bleeding after brushing, see your dentist as soon as possible—the sooner they receive treatment for any gum problems the less damage they’ll experience, and the better chance of preserving any affected teeth.
While orthodontists can effectively correct most poor bites (malocclusions), some can be quite complex requiring much time and expense. But there's good news—we often don't have to wait on a malocclusion to fully develop if we catch it in time. Thanks to interceptive orthodontics, we may be able to intervene much earlier and eliminate or reduce the degree of difficulty with treatment.
Interceptive orthodontics is a group of techniques and devices used in early childhood to help deter a possible malocclusion. Here are 3 ways this approach could make a difference in your child's bite development.
Guiding jaw growth. On a normal-sized upper jaw, the permanent teeth usually have ample room to erupt. Not so with a smaller jaw: incoming teeth become crowded and may erupt out of alignment or too close to each other. Orthodontists often use a device called a palatal expander to aid an under-sized jaw in its development. The device fits along the roof of the mouth between the teeth and applies gradual outward pressure on them. This encourages the jaw to widen as it grows, thus providing more room for erupting teeth to come in properly and decrease the chances of obstructive sleep apnea in the future.
Reshaping and repositioning jaw bones. An overbite can occur when the jaws aren't properly aligned, often due to poor muscle and bone development. This is where devices like the Herbst appliance are useful. Its hinge mechanism encourages the lower jaw to grow further forward. The jaws can thus develop in a more normal way, minimizing the development of a malocclusion.
Maintaining space. Primary ("baby") teeth are important for dental development because they help guide future permanent teeth to erupt properly; they also keep nearby teeth from drifting into the intended space. But when a primary tooth is lost prematurely due to disease or trauma, the space can become vulnerable to this kind of "drift." With a simple mechanism called a space maintainer we can hold open the space created by a prematurely lost primary tooth until the permanent tooth is ready to erupt.
These and other techniques can help stop bad bites from developing in young children, minimizing or even eliminating the need for future orthodontic treatment. That means a healthier mouth for your child and less impact on your wallet.
If you would like more information on interceptive orthodontics, 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 “Interceptive Orthodontics: Timely Intervention can make Treatment Easier.”
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