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Getting Braces: How to Find an Orthodontist You Can Trust

Beautiful braces smileFirst things first: I hope you had a wonderful holiday. My 9-year-old daughter, Kate, believes in Santa, so the last couple of weeks at the end of the year were filled with wonderful anticipation (“Will he bring me a Harry Potter wand?”) and good behavior (the Santa card is better than any time-out chair). Speaking of magical creatures that leave presents, Kate is also fond of her visits from the tooth fairy. And that brings me to what I’d love to share with you today.

I wasn’t prepared for what happened at her pediatric dentist’s office recently during a routine cleaning. Her dentist checked the teeth for cavities (none – yay!), put on a couple of sealants, told her she needs to floss a little better (we’re working on that), and then the surprise: She handed me a couple of business cards for local orthodontists. I must have stood there with my mouth wide open, but words weren’t coming out. What was in my head: My kid has lots of baby teeth left! Why on Earth would she need to see an orthodontist now? The dentist suggested that Kate get a consultation before her next visit – and then got called away for an emergency.

I’m sure I could have phoned the dentist the next day to follow up, but I hit the Web instead. And I found out that the American Association of Orthodontists recommends that kids see an orthodontist by age 7 to check for crowded teeth or misaligned bites. The crowded-teeth issue actually rang a bell; I remember from previous visits that Kate’s dentist suspected that her mouth might be too small for her big-kid chompers. But I was still feeling uneasy because I’ve heard from my friends who have older kids that you can go to three orthodontists and get three different opinions. So I decided to call Ted Sherwin, a family dentist in Orange, Va., and spokesman for the Academy of General Dentistry, for some straight answers.

Sherwin acknowledged that it can be difficult for parents to reconcile the treatment recommendations from various orthodontists, but he also pointed out: “There is more than one path to successful results.” Hmm. Sherwin added that an orthodontist recommendation from a family dentist you trust is golden. And you don’t have to stop there. After a little more digging, I found that HealthGrades.com, an independent website, allows patients to comment on the medical or dental care they receive from a particular practitioner.

As it turned out, one of the business cards Kate’s dentist handed me was for an orthodontist that my friend had also recommended. With two thumbs up, it seemed smart to try him first. We’ve got an appointment in a few weeks.

In the meantime, Kate is eagerly anticipating another visit from the tooth fairy. “Do you think that instead of giving me money, she can get Daniel Radcliffe to call me?” asked Kate. My response: “No, sweetie, the tooth fairy doesn’t take special requests.”

Is Endodontics Right for Your Child…Do Root Canals & Kids Mix?

When a child feels pain in a tooth at random for no reason, has hot or cold sensitivity or breaks their tooth and exposes what we call the pulp, he or she may need endodontic treatment. Endontic treatment consists of several types of procedures. They are classified in two groups: vital pulp therapy (where the tooth can be saved) and non vital pulp therapy ie. a root canal (where the tooth is essentially considered “dead”).

Endodontics are necessary when the pulp and nerve of the tooth are affected by decay or some sort of damage. The pulp of your tooth not only houses the nerve, it also contains blood vessels that supply your tooth with nutrients and oxygen it needs to stay healthy. Endodontic treatment is performed essentially to save the tooth.

Endodontic treatment can be done on both baby and permanent teeth.

It can be performed by any trained dentist general or specialist but be discriminating. Parents often think that because baby teeth fall out eventually that it’s not important to perform these types of procedures on them.

Contrary to that popular belief, baby teeth have several crucial functions. They hold spaces for permanent teeth and are also very important for chewing and speaking.

Because there are several types of pulp therapies (described above), you should consult your dentist to ensure this type of treatment is right for your child. The other option you have is to get your child’s tooth extracted. There are several things to consider when you are weighing these two options: which tooth is affect, approximately how long until it falls out on its own, how damaged it is and whether or not gum or bone have been affected.

Another factor to consider is whether or not your child has any serious medical conditions. In these cases, infection can be more serious. If the tooth is infected there is the possibility that the surrounding bone and gum tissue could also develop an infection after endodontic therapy.

Finally, we want to assure you that some soreness is normal after endodontic therapy and should be manageable with over the counter pain relievers that are safe for children.

Can a Toothbrush Make You (or Your Family) Sick?

Toothbrushes should be clean: After all, their whole purpose is to scrub all the germs out of your mouth. But as it turns out, a dirty toothbrush could make you sick.

“Bathrooms are moist and steamy: the conditions that bacteria love,” says Carol Wooden, a dental surgeon and spokesperson for the Academy of General Dentistry. Research from the University of Birmingham School of Dentistry in the United Kingdom found as many as 1.2 million bacteria on a single toothbrush, while a recent study in the New York State Dental Journal that examined used toothbrushes discovered that 70 percent were heavily contaminated with different microorganisms.

 

The Filthy 5

These are five of the nastiest germs scientists have found hanging out on a toothbrush:

  1. Flu: Influenza causes fever, chills, coughing and achiness.
  2. Staph: Staphylococcus aureus is responsible for common skin infections (such as boils and styes) and can be more problematic if it enters your bloodstream.
  3. E. coli: Certain strains of these fecal bacteria can cause diarrhea and abdominal cramps.
  4. Yeast: Candida albicans (the fungus that causes yeast infections) was found on 70 percent of toothbrushes examined in a recent study from the University of Adelaide in Australia.
  5. Strep: Some kinds of streptococci bacteria lead to tooth decay; others (you guessed it) cause strep throat.

Healthy Toothbrush Tips

Fortunately, you probably don’t need to toss your toothbrush just yet. Even though certain germs have been identified on toothbrushes, that doesn’t mean you’ll catch something simply from polishing your pearly whites, according to the Centers for Disease Control and Prevention.

“As long as you practice proper hygiene habits, it’s unlikely that bacteria on your toothbrush will make you sick,” says Dr. Neil Schachter, medical director of the respiratory care department at Mount Sinai Medical Center in New York City and author of The Good Doctor’s Guide to Colds and Flu. Follow these four rules to stay healthy:

1. Swap your brush. Replace your toothbrush (or the changeable head if you use an electric one) every three months, whenever you have a cold or the flu, or when the bristles look worn, suggests Wooden.

2. Flush carefully. Microorganisms go airborne when you flush the toilet — and they can land on your toothbrush. Keep your brush as far from the loo as possible and always close the lid before flushing.

3. Keep it to yourself. “Sharing toothbrushes can spread bacteria and viruses,” says Schachter. Even storing your toothbrush too close to someone else’s is unwise because bacteria can jump from one brush to another.

4. Wash away germs. Since bacteria from your mouth are transferred to your toothbrush every time you brush, you should always rinse your brush thoroughly afterward. “My main health concern is that small amounts of food can remain in the bristles, and if they’re not removed, they can spoil and cause gastrointestinal problems,” says Schachter. “It’s best to rinse your toothbrush in hot water after each use.” Want something stronger than water? Try dunking your brush in hydrogen peroxide or mouthwash, rinsing it with water and letting it air-dry, says Wooden.

What to Do if Your Child’s Teeth Get Injured

It’s inevitable that your child will fall or somehow injure himself at some point. Sometimes these accidents result in injuries to the mouth or teeth. How do you know when a trip to the dentist is warranted? How do you know if permanent damage has been done? Here are a few helpful hints on what to do to deal with this sometimes scary occurrence.

  1. Always remain calm and assure your child that everything will be okay.
  2. If there is bleeding present, place a clean piece of gauze over the site and have your child bite down or hold it place.
  3. Place a cold compress to reduce swelling.
  4. If the tooth is chipped, check the lips, gums and tongue for possibly embedded pieces.
  5. If a tooth is loose, have your child avoid movement of that tooth.

Any or all of theses occurrences warrant a trip to the dentist. There your dentist can assess and determine the best course of action. Loose, broken/chipped or otherwise injured teeth can often be repaired or stabilized. If permanent damage isn’t immediately apparent, it is often times difficult to determine if or when the trauma may result in something more extensive. In these cases, depending on the child’s age, children are put in a sort of holding pattern to determine the future vitality of the tooth. It can often take months or years for a trauma to manifest into future breaks or nerve damage.

If your child falls or is hit in the face but does not show any of these symptoms, the decision to go to the dentist may become questionable. First and foremost, we as parents know our children better than anyone. If you believe seeing your dentist is necessary, then go. I don’t know a single dentist who has ever been unwilling to take a look at a child after an injury no matter how minor. If you decide that your child does not need immediate attention, you should monitor the area at home or a few days. Symptoms may become evident later. If the area becomes painful, swollen or the teeth become discolored or loose, a trip to the dentist is recommended.

Chances are you won’t be able to prevent every fall or injury but here are a few precautions:

  • Take childproofing steps that discourage slipups and soften those inevitable falls. Stash slippery throw rugs (and make sure all area rugs have non-skid pads or backing) and pad table edges and anything else that’s sharp.
  • To cut down on trips and falls, let your cruising baby or fledgling walker practice those skills barefoot or in nonskid socks or slippers, when possible.
  • Don’t let your child walk or run while holding toys or eating.
  • Make sure your child has the proper protection while engaged in sports- i.e. athletic mouth guards and/or helmets.

How Important is Orthodontics When They’re Young…Really??

The ability to treat your child using a technique called “expansion” is one of the biggest benefits to early orthodontics. As its name suggests “expansion” means expanding the bone with orthopedics to allow room for the teeth. When you have a cross bite or severe crowding it often affects other normal processes. When we are able to expand the arches, it helps create a bigger airway, normal swallowing and better aesthetics.

There many other reasons why it is important to have your son or daughter’s orthodontic expansion work done early in their childhood

  • Their self esteem is certainly a factor to consider early on as this can be a source of teasing with their peers.
  • Beyond the emotional factors there are many physical and health factors that make an even better argument for having expansion orthodontics at a young age.
  • There are also times where expansion can prevent the necessity of orthodontic treatment later in your child’s life. When we can successfully expand the upper and lower arches, it often reduces the amount of time kids have to be in treatment or may even prevent the need for braces down the road.

Signs that your child might need expansion:

  • When lower teeth are on the outside of the upper teeth while biting
  • Over crowding of teeth
  • Even thumb-sucking

Dentists can typically start this type of treatment as early as 6 and it is commonly done up to the ages of 12 or 13. Don’t put off asking your dentist important questions about your child’s teeth. It could change the course of their treatment saving you money and your child extensive orthodontic work down the line.

Happy New Year!

How Mouthwash Can Benefit You and Your Family

A mouthwash is a mouthwash is a mouthwash – or so you may think. Sure, some may be green or blue or extra-minty, but really, how different could they be?

Turns out there’s a key difference: Some rinses help you more than others, and some even contain ingredients you should avoid, says Ingvar Magnusson, D.D.S., Ph.D., a research professor in oral biology at the University of Florida College of Dentistry in Gainesville. For example, many rinses have sodium lauryl sulfate, which tends to dry and irritate the mouth – especially if you suffer from canker sores. And some studies have found a link between rinses with a high alcohol content (25 percent or more) and oral cancers.

It’s smart to ask your dentist for rinse recommendations that suit your family’s specific dental hygiene needs. But in the meantime, here’s a cheat sheet for your next trip down the mouthwash aisle:

WANT TO …

Help prevent cavities?

  • LOOK FOR….Fluoride. Its ability to prevent tooth decay is well-established.

Fight gum disease?

  • LOOK FOR….Cetylpyridinium chloride (CPC) or chlorhexidine gluconate. Recent research has shown these ingredients help prevent gingivitis and dental plaque.

Moisten the mouth?

  • LOOK FOR….Carboxymethylcellulose or hydroxyethylcellulose, both of which simulate natural saliva. Bonus points if the rinse also contains fluoride, since dry mouth contributes to cavities.

Soothe canker sores or mouth abrasions?

  • LOOK FOR….Hydrogen peroxide. It’s a safe bet because it’s antimicrobial without being overly abrasive.

Freshen breath?

  • LOOK FOR….Methyl salicylate and chlorhexidine gluconate. These antiseptics help fight the bacteria that contribute to bad breath. Additional herbs, scents and flavorings help mask odor.

Finally, remember that no rinse can take the place of flossing and brushing, which physically scrapes the plaque off your teeth. Rinses may have some impact on preventing gingivitis or tooth decay, but only if used as part of a solid dental-health routine, says Magnusson.


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Editor’s Note: Mouth rinses can be great for kids. Our pediatric dentist recommended adding a mouthwash to my 9-year old son’s dental routine for added protection, especially on those days when he rushes the brushing (because, hey, we know it’s happening!). But they specifically recommended a rinse like Crest Pro-Health because it contains the cetylpyridinium chloride (CPC) mentioned above. It’s working great for him and I’ve started using it too. It is quite minty/spicy, but he handles it by making it into a game – jumping or dancing after he’s rinsed, until the spice eases!

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