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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.

Kids and TMJ – Aren’t They Too Young For That?

TMJ (tempero-mandibular joint) disorder occurs when the chewing muscles and the joints of the jaw fail to work together properly causing a number of symptoms. These symptoms include: headaches, jaw pain, fatigue, clenching and/or grinding of the teeth, clicking or popping of the jaw, tinnitus, earaches and pain in the neck, back and face.

There are a number of things that can contribute to the cause of TMJ disorder:

  • Malocclusion (the misalignment of teeth),
  • Bruxism (clenching /grinding),
  • Stress and
  • Accidents with damage to the face, head or neck

Children who may be predisposed to TMJ or have malocclusion may not experience pain until later in their teen years. Early prevention and treatment is key to avoiding later dysfunction, pain and more costly treatments. Luckily there are a few simple ways to determine if TMJ may be an issue for you child. In addition to the panoramic xray your dentist will likely take of your child’s teeth, there are also the cephalometric xray, tomographic xray and CT scans that can be taken to determine the position of the jaw joints. Impressions of the teeth may be taken to allow your dentist to study your child’s bite to determine if malocclusion is an issue. The treatments may range from a simple appliance called a splint to help reposition the jaw or full orthodontics to correct the bite.

An important thing to consider is that recent research shows TMJ is often undiagnosed by medical doctors.

The reason for this is that TMJ symptoms mimic the symptoms of more serious illnesses such as aneurysms and migraines. These more harmful diagnoses should be ruled out before considering TMJ treatment.

As always, make sure your child is receiving a complete and thorough exam at every dental checkup. Early detection reduces the risk of life long pain and costly treatments. Ask your dentist if your child may be at risk.

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 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!

Does Your Child Grind Their Teeth at Night?

It is not uncommon for parents to be concerned about their child grinding their teeth at night. The involuntary action of grinding one’s teeth, often during sleep, is called bruxism. Usually, a parent’s first sign of bruxism is the noise that can be heard when the child is grinding their teeth during sleep. The parent may also notice the teeth getting shorter or wearing down to the dentition.

There are several reasons thought to contribute to this issue. One theory is the psychological component. Stress due to a new environment, divorce, changes at school; etc. may be the cause of your child’s grinding. A second reason is thought to be pressure in the inner ear. If there are pressure changes, the child will grind by moving his jaw to relieve this pressure. An example of this is an airplane flight during take off and landing when people sometimes relieve this pressure by chewing gum.

In most cases, bruxism in children does not require treatment. If you are concerned that your child exhibits signs of excessive wear of the teeth, then the need for a mouth guard may be indicated. There are drawbacks to mouth guards, however. There is the possibility of choking if the appliance becomes dislodged while sleeping or it may interfere with growth and development of the jaw.

The good news is most children outgrow bruxism. The grinding gets less between the ages 6-9 and children tend to stop grinding between ages 9-12. If you are concerned about your child’s grinding, consult your dentist. Your dentist can monitor the progress of the wear and evaluate the severity.

My Child Has a Toothache, Help!

It’s very difficult when your child is in any pain and toothaches can happen in your little ones. Let’s start by addressing what could be the cause of their toothache: their diet. If your children eat excessive candy or drink a lot of soft drinks, they may experience decay or cavities. The bacteria that live in your child’s mouth breaks sugar down into acid which then causes erosion of their teeth. Ask your child to point out where the pain is. Other causes could include mouth ulcers or swollen gums a cold sore which can affect inner mouth areas. Look inside your child’s mouth for swelling or red spots. If you see anything suspicious call your dentist and get an appointment immediately. Using home remedies could help temporarily but don’t let that deter you from making an appointment because without fixing the source, the ache will come back.

You can apply a warm damp cloth to the affected area from the outside. Try giving some Children’s Tylenol to your child and make sure they are not touching it or playing with the area. Don’t delay treatment as your child needs immediate and necessary dental care.

We suggest several things to help make your child’s first visit a pleasant one:

  • When your child has a dental appointment, make it part of a trip where they get to do something fun afterwards.
  • Don’t let your dentist wear a mask when introducing him/herself to your child.
  • Taking a favorite toy may help distract your child from fear or stress
  • Children pick up on their parents fears so if you are fearful of the dentist, don’t let your child know that.
  • Don’t use threats as a way to make your child go to the dentist because they will then see it as a punishment instead of a help.
  • Rewarding your child for being good at the dentist is always encouraging.

Most of all try not to let a toothache be the first reason your child sees a dentist. We always recommend starting young and introducing your child to good oral hygiene at a young age to develop healthy habits. As said before, the condition of your child’s baby teeth can affect that of the permanent teeth so start those good habits young!

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