Over the past several years, I've been noticing more and more parents expressing concerns over fluoride use for their children. So what's the story with fluoride, is it safe? Do we need it?...
To begin, it's important to understand that fluoride is a naturally occurring element. It exists in combination with other elements as fluoride compounds and is found as a constituent of minerals in rocks and soil. When water passes through soil and over rock formations it dissolves these compounds. This results in small amounts of soluble fluoride being present in virtually all natural water sources.
In some areas fluoride is added to the public water. Water fluoridation involves adjusting the natural level of fluoride in the water to levels recommended for the prevention of tooth decay. At optimal levels, there is no demonstrated difference in health effects between naturally occurring fluoride and that which is added to municipal drinking sources. Using fluoride for the prevention and control of tooth decay has been consistently and repeatedly well established to be both safe and effective for decades.
Next Time in Part 2 - So what's the downside...
Wednesday, May 19, 2010
Thursday, February 11, 2010
What are dental sealants and are they safe?
Dental sealants protect the grooved and pitted areas of the teeth against tooth decay. They’re thin plastic coatings that bond to the teeth to prevent plaque and bacteria from getting into areas that are difficult to brush. Depending on an individual's tooth anatomy these crevices may be more or less difficult to clean. In some cases, even the best brushers won't be able to clean these areas as the toothbrush bristles may be wider than the crevices. Typically, we seal the first permanent molars that grow into the mouth at around age 6 and also the second permanent molars that grow at around age 12.
Placing sealants requires no drilling of the teeth. The procedure involves cleaning the tooth, applying a conditioning gel or "etch", placing the sealant which has a syrupy consistency, and curing it in place (or hardening it) with a light. While the procedure is painless, we have to keep the tooth dry with cotton rolls, and some kids don’t like the feeling of the cotton in the mouth. Afterwards the sealants often have a sticky or tacky feeling. Again, some children get concerned about this, but it goes away after a day or two.
The sealants we use are tooth colored or a bit lighter than the tooth. They can be sometimes be seen in an illuminated mirror, but not from a social distance when talking or eating. Sealants can last 5 to 10 years, though I think 3 years is more the average. In our office we check the sealants at every cleaning visit. If they need replacement within the first year we do so at no cost to the patient.
While sealants are an excellent tool for cavity prevention, they don’t replace the need for a healthy diet and proper oral hygiene. In fact, sealants can’t prevent cavities in the front teeth or in between the back teeth. Sometimes we may recommend sealing baby teeth. This isn’t done routinely, but only when we see a baby tooth that looks like it’s developing the beginnings of a cavity. This would only be done if the tooth wasn’t going to be falling out soon and we wanted to avoid doing a full filling. In this case we may remove a very superficial layer of the affected tooth enamel. This sensation involves lots of vibration, but it doesn’t hurt.
Being a recent father, I’m always paying close attention to what my baby is exposed to. One of the most prevalent, and highly publicized, chemicals that I try to avoid is bisphenol-A or BPA. BPA is found in many plastic products, including a few brands of sealant. In our office, we use a brand of sealant (Ultraseal, by Ultradent) that doesn’t contain BPA. Instead it uses a much more stable Bis-GMA (see referenced link below for more info). That being said, no sealant (or any other dental restoration for that matter) is “natural”. They best way to maintain a healthy, chemical free mouth is still by eating well and having excellent oral hygiene. This is also why, in our office, we don’t seal teeth in every patient. We do so on a case by case basis only after a thorough examination and consultation.
For more information on the sealant we use see this link:
The American Academy of Pediatric Dentistry has this to say:
And the CDC:
As always, I’m happy to answer any questions here or you can reach me below at:
Tuesday, December 22, 2009
Why does my child's breath smell?
A parent just asked me this question, and it's one that I hear frequently. We usually think of bad breath, or halitosis, as an adult problem, but trust me, it's fairly common in kids too. In adults, bad breath can sometimes be a sign of periodontal or systemic disease. In children, this is rarely ever the case. Halitosis in children is often caused by poor oral hygiene. For these kids, a good cleaning by the hygienist, twice daily brushing of the teeth and tongue, and daily flossing (if their teeth touch) should do the trick.
But I also commonly see halitosis in kids who have excellent oral hygiene. In these kids, the culprit is usually the tonsils. The tonsils are folds of tissue located behind the oral cavity, in the throat, and act as part of our body's immune function. In between these folds are little pockets called tonsillar crypts. Food often gets stuck in these crypts, and over time, can start to react with the normal bacteria in our body to produce an unpleasant odor. You and I can easily remedy this issue by gargling with an over the counter mouth rinse. Young children have a tough time with this. You might want to have your child try with warm water first to see if gargling is even possible. If you decide to use a rinse, make sure it doesn't contain alcohol and supervise them to ensure that they aren't swallowing it. In my experience, kids under age 6 or 7 usually can't gargle.
Other factors that may contribute to bad breath would include things that trap food such oral appliances (braces, retainers, space maintainers, etc), loose baby teeth, and new teeth growing in. Seasonal allergies and post nasal drip can also cause halitosis. Tooth decay, sinusitis, and pharyngitis (throat infections) can also lead to bad breath. Obviously if your child is experiencing other symptoms, such as fever or a productive cough, a visit to the pediatrician would be indicated. If not, and you're just not sure what's going on, call your pediatric dentist. In my practice, I'm happy to have patients stop by for a quick peek. I welcome the opportunity to say hi, it can help anxious parents sleep better at night, and we don't charge for the quick check.
I hope this was helpful. Feel free to post any questions or comments, and I'll be happy to respond. You can also check out my website if you want to get in touch with me.
Happy Holidays!
Dr. Jeremy Dixon
Wednesday, December 9, 2009
At what age should I make my child's first dental appointment?
This seemed like a natural way to start off our new blog. It also happens to be a question that we hear all the time in and out of the office. Unfortunately, when you ask health care providers this question you'll get a wide range of answers.
Currently, a child's first visit to the dentist often happens at around age 3. This is two years later than recommended by both the American Academy of Pediatrics (AAP) and the American Academy of Pediatric Dentistry (AAPD). What's with this discrepancy and why are so many doctors and dentists still telling us to bring our kids in at age 3? Old habits are hard to break!
Over the past decade we've noticed a few trends that have caused us to reevaluate our approach to dentistry. First, it's becoming more and more apparent that our oral health is closely linked to our overall general health (see the relationship between periodontal disease and heart disease for example). Second, dental disease is usually preventable, so the old dental paradigm of "drill and fill" oral health is shifting to one focused mainly on the prevention of disease. Finally, while dental decay rates have decreased in the population at large over the last decade, rates have actually increased in children over the same time period! Today, almost one out of every three preschool age children will develop dental decay, an increase from about one in four ten years ago! There seems to be several reasons for this (that we can talk about in future postings) including the drinking of bottled water and the prevalence of refined sugars.
Our goal for the year one visit is to provide patients with a "dental home". These early visits aren't like the dental visits you and I have, and aren't even like those that our older toddlers and adolescents have. In our office, during these early visits much of the time is spent talking to parents and caregivers. We also take a very quick look in the baby's mouth while the baby sits on their parent's lap. We keep this visit as low stress as possible. Usually the baby will cry for a few seconds (that's when we get our quick peek!), but then quickly recovers as the look is quick and painless (and there are prizes involved too!). Dental cleanings and fluoride treatments are very rarely done at this appointment.
Establishing this "dental home" accomplishes three things:
1. We can provide parents with a risk assessment for their baby based on their family history, the baby's current diet and hygiene practices, and the current condition of the baby's teeth.
2. Using this risk assessment, we can give parents anticipatory guidance. This means that, based on the visit, we can advise parents as to what they can expect from their baby's dental development. Also, we can tailor our recommendations to help guide parents and prevent their babies from developing dental disease.
3. In our experience, children who have these low stress visits regularly from a young age usually have less dental anxiety as toddlers and adolescents.
We hope this helps all of you young parents out there! Please don't hesitate to write with any comments and/or questions! And check out the following sites for more information:
www.aapd.org
www.aap.org/healthtopics/oralhealth.cfm
See you soon!
Dr. Jeremy Dixon
gramercykidsdental.com
Currently, a child's first visit to the dentist often happens at around age 3. This is two years later than recommended by both the American Academy of Pediatrics (AAP) and the American Academy of Pediatric Dentistry (AAPD). What's with this discrepancy and why are so many doctors and dentists still telling us to bring our kids in at age 3? Old habits are hard to break!
Over the past decade we've noticed a few trends that have caused us to reevaluate our approach to dentistry. First, it's becoming more and more apparent that our oral health is closely linked to our overall general health (see the relationship between periodontal disease and heart disease for example). Second, dental disease is usually preventable, so the old dental paradigm of "drill and fill" oral health is shifting to one focused mainly on the prevention of disease. Finally, while dental decay rates have decreased in the population at large over the last decade, rates have actually increased in children over the same time period! Today, almost one out of every three preschool age children will develop dental decay, an increase from about one in four ten years ago! There seems to be several reasons for this (that we can talk about in future postings) including the drinking of bottled water and the prevalence of refined sugars.
Our goal for the year one visit is to provide patients with a "dental home". These early visits aren't like the dental visits you and I have, and aren't even like those that our older toddlers and adolescents have. In our office, during these early visits much of the time is spent talking to parents and caregivers. We also take a very quick look in the baby's mouth while the baby sits on their parent's lap. We keep this visit as low stress as possible. Usually the baby will cry for a few seconds (that's when we get our quick peek!), but then quickly recovers as the look is quick and painless (and there are prizes involved too!). Dental cleanings and fluoride treatments are very rarely done at this appointment.
Establishing this "dental home" accomplishes three things:
1. We can provide parents with a risk assessment for their baby based on their family history, the baby's current diet and hygiene practices, and the current condition of the baby's teeth.
2. Using this risk assessment, we can give parents anticipatory guidance. This means that, based on the visit, we can advise parents as to what they can expect from their baby's dental development. Also, we can tailor our recommendations to help guide parents and prevent their babies from developing dental disease.
3. In our experience, children who have these low stress visits regularly from a young age usually have less dental anxiety as toddlers and adolescents.
We hope this helps all of you young parents out there! Please don't hesitate to write with any comments and/or questions! And check out the following sites for more information:
www.aapd.org
www.aap.org/healthtopics/oralhealth.cfm
See you soon!
Dr. Jeremy Dixon
gramercykidsdental.com
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