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Posts for tag: pediatric dentistry

By Randal Bourjaily, D.D.S. P.C.
October 10, 2018
Category: Oral Health
HowtoMaximizeYourChildsDentalHealthPotential

There’s a potential threat lurking in your young child’s mouth—tooth decay. This destructive disease can not only rob them of teeth now, it could also impact their dental health long into their adult years.

That’s why we focus heavily on decay prevention measures even in primary (“baby”) teeth, as well as early treatment should it still occur. It’s a straightforward treatment strategy: minimize the factors that contribute to disease and maximize those that protect against it.

We can represent the disease-causing factors with the acronym BAD. Bad bacteria top the list: they produce oral acid that erodes tooth enamel. Couple that with an Absence of healthy saliva function, necessary for acid neutralization, and you have the potential opening for tooth decay. Poor Dietary habits that include too much added sugar (a prime food source for bacteria) and acidic foods help fuel the decay process.

But there are also SAFE factors that can help counteract the BAD. Promoting better Saliva function helps control acid levels, while Sealants applied to chewing surfaces strengthen these vulnerable areas against decay. We can prescribe Antimicrobials in the form of mouth rinses that reduce abnormally high bacterial concentrations. Fluoride applied directly to the enamel bolsters its mineral content. And an Effective diet high in nutrition and low in sugar or acidic foods rounds out our protective measures.

Promoting SAFE factors greatly reduces the risk of childhood tooth decay. To keep on track it’s important to start regular, six-month dental visits beginning around your child’s first birthday. These visits are the most important way to take advantage of prevention measures like sealants or topical fluoride, as well as keeping an eye out for any signs of decay.

And what you do at home is just as important. Besides providing a teeth-friendly diet, you should also brush and floss your child’s teeth every day, teaching them to do it for themselves when they’re old enough. Playing it “SAFE” with your child’s dental health will help ensure your child’s teeth stay decay-free.

If you would like more information on dental care for your child, 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 “Taking the Stress out of Dentistry for Kids.”

By Randal Bourjaily, D.D.S. P.C.
August 21, 2018
Category: Oral Health
TreatingaChildsToothInjuryMayRequireSpecialConsideration

Often as children grow older, their participation in sports or similar activities increases. While generally encouraged, this greater activity does increase injury risk, especially to the mouth.

In fact, the late childhood to early adulthood demographic is the most prone portion of the population to incur dental injuries. To complicate matters, their dental development is often incomplete, posing a number of treatment obstacles for an injured tooth.

For example, the primary means for preserving an injured adult tooth is a root canal treatment: damaged or diseased tissue within the pulp, the tooth’s innermost layer, is removed and the empty chamber and root canals filled and sealed to prevent infection. But while a fully matured tooth can function without the nerves and blood vessels of the pulp, a developing tooth needs these tissues for continued tooth formation. Otherwise, tooth development can stall and cause problems later on.

The most common solution for younger teeth is to remove any damaged tooth structure without disturbing the pulp if at all possible followed by a filling. That’s contingent, though, on whether we find the pulp unexposed or undamaged—if it is, we’ll try to remove only damaged or diseased pulp tissue and leave as much healthy tissue intact as possible. To aid with healing and tissue re-growth, we may also place medicinal stimulators between the pulp and the filling.

Jaw development may also pose a challenge if the injured tooth is too far gone and must be removed. Our best choice is to replace it with a dental implant; but if we install the implant while the jaw is still growing, it may eventually appear out of place with the rest of the teeth. It’s best to postpone an implant until full jaw maturity in early adulthood.

In the meantime we could provide a temporary solution like a removable partial denture or a modified bonded bridge that won’t permanently alter nearby teeth. These methods can adequately restore the function and appearance of missing teeth until the jaw is mature enough for an implant.

While injuries with young permanent teeth do pose extra challenges, we have effective ways to address them. With the right approach, the outcome can be just as successful as with a mature tooth.

If you would like more information on dental care in the formative years, 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 “Saving New Permanent Teeth after Injury.”

SavingaDiseasedPrimaryToothCouldMeanBetterOralHealthLaterinLife

It’s often best health-wise to preserve even the most troubled tooth—including a child’s primary (“baby”) tooth. If that sounds like too much effort for a tooth that lasts only a few years, there’s a big reason why—if it’s lost prematurely, the incoming permanent tooth above it could erupt out of position.

Preserving a decayed primary tooth could include procedures similar to a root canal treatment, commonly used in adult permanent teeth with inner decay. However, we may need to modify this approach to protect the primary tooth’s pulp. This innermost layer plays a critical role in early dental development.

Because an adult tooth has reached maturity, removing diseased pulp tissue has little effect on its permanent health. But the pulp contributes to dentin growth (the layer between it and the outer enamel) in primary and young permanent teeth, so removing it could ultimately compromise the tooth’s long-term health.

Our goal then with a child’s tooth is to remove as much diseased tissue as possible while involving the pulp as little as possible. What techniques we use will depend on how much of the pulp has become infected.

For example, if decay has advanced to but hasn’t yet penetrated the pulp, we may remove all but a small amount of the decayed structure just next to the pulp to avoid its exposure. We may then apply an antibacterial agent to this remaining portion and seal the tooth to curb further infection.

If on the other hand the pulp has become infected, we may try to remove only the infected portion and leave the remaining pulp intact. We’ll only be able to do this, however, if we deem the remaining pulp healthy enough to remain infection-free after the procedure. If not, we may need to remove the entire pulp as with a traditional root canal. This option, though, is a last resort due to the possible effect on dentin growth and the tooth’s long-term health.

As you can see attempts to preserve a primary tooth can be quite involved. But if we can help it reach its full life span, it could mean better dental health for a lifetime.

If you would like more information on caring for primary teeth, 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 “Root Canal Treatment for Children’s Teeth.”