Better Oral Health = Better Sleep

Sleep may be the most important part of a child’s day. For the body to rest and the brain to recharge, a typical child aged five to twelve should get 10 to 11 hours of sleep each night. Without restorative sleep, a child may be cranky, clumsy and less attentive than usual the next day. If the pattern persists, his or her growth and resistance to immunity can be affected, too.

Oral conditions can affect sleep more severely than you might imagine. One, obstructive sleep apnea, is caused by enlarged adenoids or tonsils (which can be surgically removed if necessary); allergies (treatable with nasal steroids or other medications); and/or obesity (for which weight management is recommended). Symptoms include gasping during sleep and snoring marked by occasional pauses. Without treatment, obstructive sleep apnea can lead to developmental and learning delays, behavior issues, daytime fatigue or hyperactivity.

Sleep bruxism affects 20% to 30% of children at one time or another, although most children outgrow it. Bruxism involves teeth-grinding or jaw-clenching. Often, a child is not aware of grinding his or her teeth; the child only knows that he or she awakes with jaw or head pain and possibly a feeling of fatigue. Evidence of bruxism includes chipped tooth enamel and unusually worn surfaces.

One common cause of bruxism is the misalignment of the upper and lower teeth, which can be treated appropriately with orthodontia. Another cause, though, is emotional stress, which needs to be addressed in order to be alleviated. In any case, a night guard—a custom-molded plastic device that fits in the mouth—may help prevent permanent damage.

Finally, the pain of untreated tooth decay can seriously affect a child’s sleep. According to the California Society of Pediatric Dentistry, “Failure to identify and prevent dental disease has consequential and costly long-term adverse effects….Untreated dental disease compromises the child’s ability to eat well, sleep well, and function well at home and at school.”

If you notice that your child’s sleeping habits are unusual, let us know so we can examine his or her oral health. This no time for a parent to snooze on the job!

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Chewing Gum Can Help Your Teeth!

Your parents may have told you that chewing gum would rot your teeth, but recent research has shown that chewing certain types of gum can actually reduce cavities. And if you are an expectant mother or the mother of a newborn, chewing gum may reduce your child’s cavities.

Streptococci bacteria (that’s the same family of bacteria that causes strep throat) feed on sugars to create acids. Those acids attack tooth enamel—and that leads to tooth decay. While saliva neutralizes the bacteria, too much sugar creates an avalanche that overwhelms saliva’s effect. Chewing gum increases saliva production—that’s good. But the sugar in chewing gum creates more acid than what increased saliva can wash away—that’s bad. And that’s why your parents told you that chewing gum causes cavities.

How do bacteria get into infants’ mouths? Primarily from their mothers. In fact, transmission of streptococci from mother to child begins even before birth. Now, researchers have discovered a way to counteract the streptococci problem, and it involves chewing gum.

Xylitol is a naturally occurring sugar (much of it comes from corn cobs). Unlike regular table sugar, however, xylitol does not promote the growth of acid on the teeth. Streptococci can’t process xylitol. In fact, xylitol helps prevent acid from sticking to teeth. This means that the increased saliva generated from chewing xylitol-sweetened gum washes away most of the streptococci from the mouth—up to 90%, according to scientific studies.

Fewer streptococci in mom’s mouth means less tooth decay in baby’s mouth. Researchers had expectant mothers chew xylitol-sweetened gum during the last three months of their pregnancies. Then the researchers tested the children until age two for the presence of bacteria in their mouths. The children of mothers who chewed xylitol-sweetened gum while pregnant were less likely to have oral streptococci at every test period.

Better yet, chewing xylitol gum may actually strengthen teeth. The combination of more saliva and less acid leads to a process called remineralization that restores tooth enamel and can actually reverse the lesions that lead to cavities.

So your parents were only partially right. Chewing gum sweetened with sugar can, indeed, rot your children’s teeth. But xylitol-sweetened gum can help maintain and strengthen your children’s teeth—even before they’re born.


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Crowns Protect Little Teeth, Too

Most people are surprised to learn that young children can have dental problems that may be treated with crowns—even on baby teeth. A crown is a cover placed over the entire tooth. It is fabricated to look like a tooth and is usually used on teeth that are badly damaged or so decayed that there is not enough tooth structure left to support a large filling.

Although baby teeth eventually fall out and are replaced by permanent teeth, it is important to try to save them until they fall out on their own. Primary teeth enable the child to chew food and develop normal speech patterns, and help to guide emerging permanent teeth into place.

If your child has broken, decayed or severely discolored baby teeth or discolored permanent teeth, we may recommend treating the problem with a crown. There are several kinds of crown treatments, and we will take into consideration the type and extent of your child’s dental problem, as well as his or her biting patterns, when recommending treatment.

Crowns protect the problem tooth, but their placement requires that the tooth be ground down to accommodate the adhesive needed to attach the crown firmly.  Conventional crowns are usually made of stainless steel, which is very durable and works very well on the back teeth.  For a more esthetically pleasing result, White crowns can be made from plastic or porcelain for the front teeth.  Sometimes stainless steel crowns can have a resin plastic bonded to them as well to improve the esthetic appearance.  In addition, injury to the tooth can break, loosen or dislodge a crown. Their durability may depend on how much tooth structure was left in the treated tooth and how prone the child is to cavities.

If your child needs a crown, we will recommend the option that is best suited to your child’s oral health and overall well-being.

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When Teeth Hurt from Seasonal Allergies

When is your child’s toothache not really a toothache? When the pain results from a seasonal allergy. In the spring and fall, natural allergens such as flower and tree pollens and molds can seriously affect some children (and adults, too). Other allergens that can spark similar reactions year-round include dust mites and animal dander.

Once an allergic child inhales allergens from the air, the child’s body senses that these substances are foreign and “need” to be eliminated. So the body produces a response—but that response is imperfect. It includes the production—and often overproduction—of thick mucus.

If there is more mucus than necessary and it can’t be easily discharged, it pools in head cavities called sinuses. These spaces are normally filled only with air, but they become receptacles for mucus when it’s produced. The pressure from the overabundant mucus can lead to a sinus headache.

What does this have to do with the teeth? The maxillary sinuses are located just above the roots of the back top teeth (premolars and molars). When these sinuses are swollen and overflowing, they exert pressure on the roots, causing pain that feels exactly as a toothache would feel if there were something wrong with a tooth. Symptoms include oversensitivity to cold, throbbing and pain when biting down or if the tooth is tapped from the outside.

However, no dental problem actually exists. Adults have a difficult time telling the difference between a sinus-induced problem and a true tooth issue; it’s even more difficult for a child.

So, if your child complains of a toothache but is also susceptible to seasonal allergies, try to address the allergic symptoms first and see if the tooth pain lessens. In consultation with your pediatrician, you may want to try an antihistamine, decongestant and/or nasal spray.

In some cases, the toothache may be gone faster than that new box of tissues.

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Brush Your Way to Healthier Gums

It is important that you brush your teeth and gums at least twice a day—even better, after every meal, if you can. Brushing removes plaque, a film of bacteria that clings to teeth. When bacteria in plaque come into contact with food, they produce acids. These acids lead to cavities.

Although brushing your teeth seems like a very easy thing everyone can do, you should teach your children the most effective way to brush by modeling your own behavior. Here are ten tips to accomplish this task:

• Place a pea-sized dab of fluoride toothpaste on the bristles of a soft toothbrush.
• Place the toothbrush against the teeth at a 45º angle to the gum line.
• Move the brush across the teeth back and forth gently in short strokes, cleaning one tooth at a time, using a small, circular motion. Keep the tips of the bristles against the gum line. Avoid pressing so hard that the bristles lie flat against the teeth; only the tips of the toothbrush clean the teeth. Let the bristles reach into the spaces between the teeth.
• Brush the outer surfaces, the inner surfaces and the chewing surfaces of all the teeth. Make sure the bristles get into the grooves and crevices.
• Use the same small, circular motion to clean the backsides of the upper and lower teeth—the sides that face the tongue.
• To clean the inner surface of the bottom front teeth, angle the head in an up-and-down position toward the bottom inside of the mouth and move the toothbrush in several up-and-down strokes.
• For the inside of the top front teeth, angle the brush in an up-and-down position with the tip of the head pointing toward the roof of the mouth. Move the toothbrush in several up-and-down strokes.
• Give your tongue a few gentle brush strokes, brushing from the back forward. Do not scrub. This helps remove bacteria and freshens your breath.
• After brushing your teeth for two to three minutes, rinse your mouth well with water.
• Replace your toothbrush with a new one every three to four months.

In addition to brushing, it is important to floss teeth once a day. Flossing gets rid of food and plaque between the teeth, where the toothbrush cannot reach. If plaque stays between teeth, it can harden into tartar, which must be removed with a professional cleaning. Antibacterial mouth rinses (there are fluoride mouth rinses, as well) can also reduce bacteria that cause plaque and gum disease, according to the American Dental Association.

Taking care of your teeth and gums on a regular daily basis will keep breath fresh and teeth clean, while holding cavity-causing bacteria at bay.

Ease your child's dental pain

Ease Your Child’s Dental Pain

When your child complains of a toothache, it does not always mean there is a cavity. Many toothaches occur when a tooth temporarily becomes overly sensitive. Knowing how to relieve the pain—and when to call the dentist—are important factors in helping your child overcome tooth discomfort.

If your child develops a toothache, you can take several simple steps that may relieve the pain. At first complaint,

• ask your child to identify the tooth causing the pain.
• check for food or other objects which may have lodged between teeth.
• even if nothing is visible, very gently use dental floss on either side of the painful tooth to dislodge any tiny particles that may be causing the discomfort.
• have your child rinse his or her mouth with warm salt water, which may help reduce swelling and relieve accompanying pain.
• give your child an over-the-counter medication like acetaminophen if pain persists.
• use an icepack on the cheek or jaw for 20 minutes.

However, not all toothaches can be treated at home. We can determine the cause and treat your child if . . .

• the pain is accompanied by fever.
• the pain is very severe.
• your child’s face is swollen.
• your child continues to complain of tooth pain after a day or so.
  
  
  As always, we're happy to answer questions about your child's oral health. Give us a call at 509-891-7070.
  
  

The Surprising Ear-Nose-Tooth Connection

The link in children between dental malocclusion—condition in which upper and lower teeth are not correctly aligned—and the common middle-ear infection (otitis media) remains unclear. A child with ear infections appears to be more likely to have a posterior crossbite (a kind of malocclusion), but no significant connection between any kind of malocclusion and ear infection has been determined.

However, a child who has dental malocclusion—or its beginnings—and a tendency to develop ear infections may actually have an underlying problem that causes both: mouth breathing. Just as the name suggests, mouth breathing occurs when the nasal passages experience chronic blockage, and because the child can’t breathe well out of his nose, he breathes primarily through his mouth.

So, what can cause chronically blocked nasal passages? Seasonal allergies, surely. Another major cause is swollen tonsils and/or adenoids.

The change from nasal to mouth breathing often results in chronic middle ear infections, sinusitis, upper airway infections and sleep disturbances such as apnea and snoring. And mouth breathing has been shown to affect the growing face, causing not only the teeth and jaw to be mismatched but, over time, significant abnormal facial development that can affect a child emotionally and socially, especially if it occurs during the critical growing years.

If a child sleeps poorly, he may well act tired, behave poorly and have difficulty concentrating, especially at school—all of which can lead to a (mis)diagnosis of ADHD. In many such children, when the enlarged tonsils and/or adenoids are removed, “behavior, attentiveness, energy level, academic performance, and growth and development” all improve, according to Yosh Jefferson, DMD, in an article he wrote for the journal General Dentistry in 2010.

Once mouth breathing is resolved, dental malocclusions and craniofacial issues can then be addressed—leading to a happy, if often initially unexpected, ending.