Bruxism or 'Teeth Grinding' Prevents Dental Growth

Most people probably grind and clench their teeth from time to time. Occasional teeth grinding, medically called bruxism, does not usually cause harm, but when teeth grinding occurs on a regular basis the teeth can be damaged and other oral health complications can arise.

Why Do People Grind Their Teeth?

Source- http://www.flormanortho.com/

Although teeth grinding can be caused by stress and anxiety, it often occurs during sleep and is more likely caused by an abnormal bite or missing or crooked teeth. It can also be caused by a sleep disorder such as sleep apnea.

How Do I Find Out if I Grind My Teeth?

Because grinding often occurs during sleep, most people are unaware that they grind their teeth. However, a dull, constant headache or sore jaw when you wake up is a telltale symptom of bruxism. Many times people learn that they grind their teeth by their loved one who hears the grinding at night.

If you suspect you may be grinding your teeth, talk to your dentist. He or she can examine your mouth and jaw for signs of bruxism, such as jaw tenderness and excessive wear on your teeth.

Why Is Teeth Grinding Harmful?

In some cases, chronic teeth grinding can result in a fracturing, loosening, or loss of teeth. The chronic grinding may wear teeth down to stumps. When these events happen, bridges, crowns, root canals, implants, partial dentures, and even complete dentures may be needed.

Article excerpts from http://www.webmd.com/

Pediatric Dental X-ray Types

Dental x-rays are an essential part of any dental care treatment plan. They are diagnostic, but they can also be preventive, by helping a dentist diagnose potential oral care issues in a patient’s mouth before they become a major problem.

There are five types of X-rays your dentist may use for your child, depending on the goal:

* Bitewing X-rays (also called cavity-detecting X-rays) — These X-rays are used to view the areas between teeth that cannot be seen directly. They show where cavities are starting. These X-rays are needed only after the teeth in the back of the mouth are touching each other. In some children, this doesn't happen until the first permanent molar (also called the 6-year molar) has erupted.

* Periapical X-rays — These are used to view the entire crowns and roots of one, two or three teeth that are next to each other. The X-rays also will show the supporting bone structure of the teeth. This type of X-ray lets the dentist see a child's permanent teeth growing below the baby teeth. It also is used to look for abscesses and gum disease.

* Panoramic X-rays — These X-rays are used to view all of the teeth on one film. They also show the upper and lower jaws, the temporomandibular joints (TMJs) and the sinuses above the upper teeth. They are often used if a child has hurt his or her face, has orthodontic problems, or is mentally or physically disabled. Panoramic X-rays, unlike other types, do not require a film to be put in the child's mouth. This is helpful for children who gag easily or who have small mouths. This X-ray has to be exposed for 12 to 18 seconds. The patient must be able to sit or stand still for that whole time.

* Occlusal X-rays — These are used to view most of the upper or lower teeth on one film. This is useful when the dentist does not have a panoramic X-ray machine or when the child has difficulty in taking bitewing or periapical X-rays.

* Orthodontic X-rays (also called cephalometric or lateral skull) — This type of X-ray shows the head from the side. It is used to evaluate growth of the jaws and the relationship of bones in the skull. It helps an orthodontist make an accurate diagnosis and develop a treatment plan.

Dental X-rays are very safe and expose your child to a minimal amount of radiation. When all standard safety precautions are taken, today's X-ray equipment is able to prevent unnecessary radiation and allows the dentist to focus the X-ray beam on a specific part of the mouth. High-speed film enables the dentist to reduce the amount of radiation the patient receives. A lead body apron or shield will be placed over the child's body. Make sure the shield covers your child's neck to protect the thyroid gland. It also should extend all the way to the thighs to protect the genitals and reproductive organs.

Content excerpts from http://www.colgate.com/

Dental Hygiene for Autistic Children - A Mother's Perspective

Article excerpts from www.friendshipcircle.org

Autistic children can be difficult to handle. At the core of their behavior lies severe anxiety to face new and unknown situations, and exposure to new people.

While parents are often able to manage a majority of the tasks and develop a sense of familiarity, it is when meeting care providers such as a pediatric dentist or pediatrician that their behavior is severely tested.

Below is a detailed account of a mother, who has been there and done that. Although she started her 5 year old on dental visits only when he turned 5, it is important to begin this as early as possible (at age 1) to ensure familiarity and comfort with the dentist are developed at a very early age.

I waited until my son was 5 years old before I attempted to take him to a dentist’s office.

Between his oral defensiveness and severe anxiety, I couldn’t figure out how to make it work before then.  The only reason I made that appointment was my concern over an adult tooth that erupted at an unusual angle with the baby tooth still on top of it.

The Screamer

My son was the kid who screamed uncontrollably every time he entered anything that looked like a doctor’s office.  My son was the kid who wouldn’t let me look inside his mouth when he was teething or when he had injuries.  I used to seize the opportunity to try to get a brief glimpse at his teeth whenever he was laughing at a joke or in the middle of a tantrum.  Brushing his teeth was challenging at best, and there was no way he would rinse and spit.

Eventually my husband and I were able to reduce our son’s oral sensitivity enough so that we could take care of his teeth, and we approached his anxiety from several angles to make that first visit to the dentist a success.

Here’s how we managed our son’s dental hygiene:

Establish a daily ritual

1. Be Creative

The National Institutes of Health have a guide for caregivers emphasizing the importance of creativity and a daily oral hygiene routine – and those were the keys to my family’s success.  Finger toothbrushes for infants only encouraged my son to bite my finger.  Instead, I offered him a clean, wet washcloth to chew on for a few minutes in the morning and before bedtime.  I helped him move the washcloth around his mouth so that all of his teeth were scrubbed.  Then I offered water to drink, since he didn’t know how to rinse and spit yet.

2. Brush Together

The next step was to allow my son to chew on a child-size toothbrush while I brushed my own teeth.
This desensitized him to the toothbrush’s texture while I modeled appropriate dental hygiene for him.  Sometimes it’s necessary to try several different types of brushes, such as a spin brush.  After many months, when he was accustomed to the texture, I added non-fluoride toddler toothpaste to his toothbrush so that he would get used to the idea of flavoring on the brush.

3. Don’t Miss A Day

It was important to continue with the brushing ritual every morning and evening – if I accidentally skipped one morning, my son would be uncooperative the next time I tried to clean his teeth!

4. Slow Transitions Are Better

A few years later, my son was allowing me to brush his teeth and he had finally learned to rinse and spit.  Then we switched him to fluoridated toothpaste, because the flavor is milder than adult toothpaste.

Know the causes of tooth decay

In recent years, medical studies have documented a clear connection between oral health and overall physical health.  Tooth decay is now considered a preventable infectious disease.  The bacteria that cause tooth decay are typically transferred from one person’s saliva to another person’s mouth.  Sugary foods feed the bacteria and promote decay.

Many children with special needs may continue to bottle-feed until they are 4 or 5 years old because of delays in oral-motor skills, which is another risk factor for tooth decay.

5. Prevent Cavities

To reduce the risk of cavities, I gave my son a drink of water after his bottles and made sure his teeth were brushed immediately before bedtime.

Find a dentist who has experience with special needs

6. Referrals From Families

The best way to find a dentist is to ask for a referral from other families or find those within the community who have managed dental needs of autistic kids.

Dr. Premila of Small Bites Dental Clinic has prior experience in managing such children. The office staff too have been trained to handle them. 

7. Accessible and Sensory Friendly

Not all dental offices are equipped for special needs, some offices have a harsh sensory environment.  At Small Bites, the environment and decor has been designed to incorporate play, and children are exposed to imagery and activities that helps them get more relaxed. You can check with the office staff about our experience with children of unique needs.

Get friendly with the dentist’s office

8. Make practice visits

Consider visiting the dentist’s office several times before attempting any type of examination.  One time I had my husband bring our son in to see me get my exam and cleaning.

9. Make a Social Story

Ricki Robinson, author of Autism Solutions, suggests taking photos of the equipment, staff and waiting room – then using those photos to make a storybook about going to the dentist.

10. Prepare With Books

I got a bunch of books about the dentist from the library for my son.  The only books that interested him were those that had photos of actual dentists’ offices, not cartoons or drawings.  He liked clear, concise narratives that showed him exactly what to expect.  He also liked simple, scientific explanations about the importance of oral hygiene.

11. Divide & Conquer

Keep in mind that most dentists can bill your visit in three separate parts: cleaning, exam and x-ray.  If a child becomes anxious during the cleaning, you can reschedule the exam and x-ray for a different day.  Or you can schedule each of the three parts on different days.

12. Bring Their Favorite Toy/Blanket/Object

Ruby Gelman, DMD, advises in the book 1001 Tips for the Parents of Autistic Boys, “If your child has an object that he particularly loves (a music player or a clock, for example), bring one with you to the dental visit so that the dentist can incorporate that into the appointment.”  Familiarity with the dentist not only reduces anxiety during the visit, but it also increases compliance with dental hygiene at home.

What If Nothing Works?

On top of the increased risk for tooth decay, individuals with special needs often have damaging oral habits such as grinding teeth, picking or biting inside the mouth and tongue thrusting.  The dentist then consults with the child's pediatrician and parents to suggest the next best course of action.

Success

The last time I took my son to the dentist, he confidently went into the exam room without me.  Afterwards he couldn’t wait to show his dad how clean and shiny his teeth were.  I could hardly believe this was the same child who used to protest so vehemently every time I tried to touch – or even just look at- his mouth. 

Repetition, desensitization, persistence and familiarity helped him learn a new life skill. 

For specific questions on the services we provide especially for special needs individuals, reach out to SMALL BITES DENTAL CLINIC at 08041256715.

Dental Hygiene for Autistic Children - A Mother's Perspective

Article excerpts from www.friendshipcircle.org

Autistic children can be difficult to handle. At the core of their behavior lies severe anxiety to face new and unknown situations, and exposure to new people.

While parents are often able to manage a majority of the tasks and develop a sense of familiarity, it is when meeting care providers such as a pediatric dentist or pediatrician that their behavior is severely tested.

Below is a detailed account of a mother, who has been there and done that. Although she started her 5 year old on dental visits only when he turned 5, it is important to begin this as early as possible (at age 1) to ensure familiarity and comfort with the dentist are developed at a very early age.

I waited until my son was 5 years old before I attempted to take him to a dentist’s office.

Between his oral defensiveness and severe anxiety, I couldn’t figure out how to make it work before then.  The only reason I made that appointment was my concern over an adult tooth that erupted at an unusual angle with the baby tooth still on top of it.

The Screamer

My son was the kid who screamed uncontrollably every time he entered anything that looked like a doctor’s office.  My son was the kid who wouldn’t let me look inside his mouth when he was teething or when he had injuries.  I used to seize the opportunity to try to get a brief glimpse at his teeth whenever he was laughing at a joke or in the middle of a tantrum.  Brushing his teeth was challenging at best, and there was no way he would rinse and spit.

Eventually my husband and I were able to reduce our son’s oral sensitivity enough so that we could take care of his teeth, and we approached his anxiety from several angles to make that first visit to the dentist a success.

Here’s how we managed our son’s dental hygiene:

Establish a daily ritual

1. Be Creative

The National Institutes of Health have a guide for caregivers emphasizing the importance of creativity and a daily oral hygiene routine – and those were the keys to my family’s success.  Finger toothbrushes for infants only encouraged my son to bite my finger.  Instead, I offered him a clean, wet washcloth to chew on for a few minutes in the morning and before bedtime.  I helped him move the washcloth around his mouth so that all of his teeth were scrubbed.  Then I offered water to drink, since he didn’t know how to rinse and spit yet.

2. Brush Together

The next step was to allow my son to chew on a child-size toothbrush while I brushed my own teeth. 
This desensitized him to the toothbrush’s texture while I modeled appropriate dental hygiene for him.  Sometimes it’s necessary to try several different types of brushes, such as a spin brush.  After many months, when he was accustomed to the texture, I added non-fluoride toddler toothpaste to his toothbrush so that he would get used to the idea of flavoring on the brush.

3. Don’t Miss A Day

It was important to continue with the brushing ritual every morning and evening – if I accidentally skipped one morning, my son would be uncooperative the next time I tried to clean his teeth!

4. Slow Transitions Are Better

A few years later, my son was allowing me to brush his teeth and he had finally learned to rinse and spit.  Then we switched him to fluoridated toothpaste, because the flavor is milder than adult toothpaste.

Know the causes of tooth decay

In recent years, medical studies have documented a clear connection between oral health and overall physical health.  Tooth decay is now considered a preventable infectious disease.  The bacteria that cause tooth decay are typically transferred from one person’s saliva to another person’s mouth.  Sugary foods feed the bacteria and promote decay.

Many children with special needs may continue to bottle-feed until they are 4 or 5 years old because of delays in oral-motor skills, which is another risk factor for tooth decay.

5. Prevent Cavities

To reduce the risk of cavities, I gave my son a drink of water after his bottles and made sure his teeth were brushed immediately before bedtime.

Find a dentist who has experience with special needs

6. Referrals From Families

The best way to find a dentist is to ask for a referral from other families or find those within the community who have managed dental needs of autistic kids.

Dr. Premila of Small Bites Dental Clinic has prior experience in managing such children. The office staff too have been trained to handle them. 

7. Accessible and Sensory Friendly

Not all dental offices are equipped for special needs, some offices have a harsh sensory environment.  At Small Bites, the environment and decor has been designed to incorporate play, and children are exposed to imagery and activities that helps them get more relaxed. You can check with the office staff about our experience with children of unique needs.

Get friendly with the dentist’s office

8. Make practice visits

Consider visiting the dentist’s office several times before attempting any type of examination.  One time I had my husband bring our son in to see me get my exam and cleaning.

9. Make a Social Story

Ricki Robinson, author of Autism Solutions, suggests taking photos of the equipment, staff and waiting room – then using those photos to make a storybook about going to the dentist.

10. Prepare With Books

I got a bunch of books about the dentist from the library for my son.  The only books that interested him were those that had photos of actual dentists’ offices, not cartoons or drawings.  He liked clear, concise narratives that showed him exactly what to expect.  He also liked simple, scientific explanations about the importance of oral hygiene.

11. Divide & Conquer

Keep in mind that most dentists can bill your visit in three separate parts: cleaning, exam and x-ray.  If a child becomes anxious during the cleaning, you can reschedule the exam and x-ray for a different day.  Or you can schedule each of the three parts on different days.

12. Bring Their Favorite Toy/Blanket/Object

Ruby Gelman, DMD, advises in the book 1001 Tips for the Parents of Autistic Boys, “If your child has an object that he particularly loves (a music player or a clock, for example), bring one with you to the dental visit so that the dentist can incorporate that into the appointment.”  Familiarity with the dentist not only reduces anxiety during the visit, but it also increases compliance with dental hygiene at home.

What If Nothing Works?

On top of the increased risk for tooth decay, individuals with special needs often have damaging oral habits such as grinding teeth, picking or biting inside the mouth and tongue thrusting.  The dentist then consults with the child's pediatrician and parents to suggest the next best course of action.

Success

The last time I took my son to the dentist, he confidently went into the exam room without me.  Afterwards he couldn’t wait to show his dad how clean and shiny his teeth were.  I could hardly believe this was the same child who used to protest so vehemently every time I tried to touch – or even just look at- his mouth. 

Repetition, desensitization, persistence and familiarity helped him learn a new life skill. 

For specific questions on the services we provide especially for special needs individuals, reach out to SMALL BITES DENTAL CLINIC at 08041256715.

Management of Autistic Children at The Dentist

Children with an Autism Spectrum Disorder have impaired social interaction and limited communication abilities, combined with a restricted amount of activities and interests. While parents are often able to manage them in familiar places and situations like the home, it becomes difficult to do the same outside, especially when visiting specialized healthcare providers including dentists.

Considering that 1 in ever 30 Indian children displays signs of ASD, pediatric dentists are very sensitive to their dental needs and specialized management. Even so, parents have a large role to play in ensuring all procedures go smoothly, and children come away with the least amount of stress and mental trauma.

Dentists managing autistic children are aware of them exhibiting specific observable behavior;

IMPAIRED SOCIAL RESPONSE - Children are unable to read and respond to feelings and experiences, with absolute no understanding most times

IMPAIRED COMMUNICATION - Children are unable to use and understand gestures, repetition of words (echolalia) and a rigid body stance is often displayed

Besides the atypical behavioral and impaired communication skills that are observed and need careful handling, below are often the main dental problems that such children exhibit;

* Bruxism or teeth grinding, often when asleep or the child isn't aware of it

* Tongue thrusting or repeated tongue movements

* Chewing at all odd times without presence of food

* Self-injury, where pinching gums, biting lips and creating wounds is common

* Erosion of teeth

* Caries, when teeth aren't brushed thoroughly because the child finds it unpleasant

* Poor oral care at home, because of difficulty in managing the child

* Limited dietary preferences. Autistic children have very strong likes and dislikes (Only pureed food, no vegetables, dislike of particular vegetable color, etc.)

Management of an Autistic Child at the dentist, can be divided into two phases;

PRE MANAGEMENT or BEFORE CHILD MEETS THE DENTIST

• It is important to plan a desensitizing appointment with the dentist to help the child familiarize themselves with the doctor and the staff
• Allow the child to bring things that can comfort them, a favorite blanket, stuffed toy or even hold the parent's hand
• Parents need to discuss with the doctor about the child's tolerance to pain and discomfort, and their threshold
• Share the child's intellectual and understanding abilities with the doctor, so that they can phrase sentences or relate with the child accordingly

POST MANAGEMENT or AFTER THE CHILD MEETS THE DENTIST

• The dentist will communicate with the child at a level he/she can understand. They use phrases such as 'Tell', 'Do', 'Show' when explaining any procedures or methods, always speaking in clear, precise tones
• Oral examination is begun with only fingers first, while the hard feel of dental instruments is brought in later
• Dental instruments are only shown later. Suddeness of movements by the dentist is kept to a minimum and light is kept away from the child's face. Sensory input of any kind is kept as less as possible to avoid distraction
• Dentists place same staff at all examinations and interruptions are kept minimal
• Child's co-operative behavior is always encouraged with positive words and nods
• The child's unusual body movements are always observed and pre-empted

Most pediatric dentists are aware of the extra care and effort it takes to manage autistic children, and are extra cautious while carrying out any kind of dental procedures. As a parent, it is important to know what to expect, understand how the process can be made easy and prepare the child for any kind of dental visit.

Braces in Children & Their Different Types

It is common to see children nowadays with braces. Some kids can't wait to get it at the earliest, while parents themselves often feel that their children may require them for reasons as varied as misaligned teeth, or for an aesthetic look.

Regardless of the reasons for wanting them, there is a clear purpose to getting your child's teeth fitted with braces, and why it should be done at a particular age. 

Below are a few details on them and their purpose;

WHY BRACES

MISALIGNED TEETH

Children may need braces for any one of the following reasons;

* Overlapping, overcrowded or crocked teeth, also called as 'bad bite' or malocclusion. Malocculsion occurs whenever the upper and lower jaws have a major difference in size, where the upper is bigger than lower (called an overbite) or lower bigger than upper (called an underbite)

* Tooth decay, accidents and thumb sucking habits

* Inherited misalignment

Not all parents realize when braces have to be put, and it is often the pediatric dentist who can advise during routine checkups if braces are required. Depending on severity of the problem and the child's age, he or she will be further advised to meet with an orthodontist to get braces fitted out as per the requirement.

TYPES OF BRACES

Braces work by correcting teeth alignment, putting pressure on developing teeth to move into a particular position. This is best done during the growth period of a child, since the jaw and muscles are still malleable. There are different kinds of braces, and the doctor decides what is apt for the child based on the lifestyle and age.

1. Wire and rubber bands - Braces like these have been used for teeth alignment since years. These traditional braces have bands or steel ties holding wires between teeth brackets

2. Damon braces - These braces do not have steel/rubber ties but brackets hold the braces in place

3. Clear braces- These braces are clear/transparent and can hold themselves in place like a mouthguard

These braces either can be inserted temporarily, wherein removable braces can be removed and cleaned as and when required. These provide gentle pressure to the teeth.

Other times, teeth are very misaligned, and therefore need to be guided more accurately. This is when fixed braces are inserted. They cannot be removed and inserted as and when one likes. These are the bracket and band braces which are stuck to the teeth, with a flexible wire joining the brackets and allowing the teeth to move.

Functional braces on the other hand, use the movement of the jaw to align the teeth, and are are fitted only in certain conditions.

Braces are made from all types of materials' metal, ceramic and even medical grade plastic.

To know whether your child really needs to be fitted with one, bring him to us at the earliest. Dr.Premila will be able to assess the teeth, and decide the plan of treatment accordingly.

To book an appointment, please visit http://www.smallbites.in/

5 Books That Prepare Your Child For Their First Dental Visit

The high backed chairs, plenty of equipment, unfamiliar space and a doctor poking around inside your mouth....this can be so very intimidating for most of us adults. Imagine what it can do to our kids?

Visiting a pediatric dentist for the first time is a new experience for little ones. They don't know what is being done, and despite parents being there, can resist the experience of a new person handling them from such close quarters.

It is very important for parents, and for us doctors to make them familiar with a few things before their first visit or during subsequent ones. While we take care of them inside the clinic, using the most gentlest way to handle their fears, as parents what you can do, is make the entire process less stressful for them.

Books we have found, are one of the ways to make things more relatable. When a child understands how his teeth work, what is happening in his mouth, through pictures and illustrations, he knows what to expect. It is also a great way to communicate to kids in their own language.

Here are 10 children books, for different ages that explain about dental health, pediatric dentist visit and some of the procedures in ways that will make them understand, relate and reduce stress.

1. Dentist (First Time)

Author, Illustrator: Jess Stockham

Age Group: 2+

First time at a dentist's can be a very nerve wracking experience. This book is part of a series of 'First Time' which rather than telling a story, shows different children experiencing treatment, and the general interaction with a dentist. There is a waiting room, a scene which shows teeth being counted, a look at the equipment, step by step on how a child undergoes dental fillings.

The text is conversational, brightly illustrated, helps children see different situations, and understand procedures.

2. Harry and the Dinosaurs say 'Rahhhh'

Author: Ian Whybrow

Illustrator: Adrian Reynolds

Age Group: 3+

Harry and all his dinosaurs have a dental appointment and everyone is nervous - especially T-Rex who has many teeth. With Harry's reassurances and a special button that makes him grow big, T-Rex lets Dr.Drake examine his teeth.

The illustrations are simple, funny and text easily understandable. It will help relieve the anxiety of this important life lesson for the little ones.

3. Dentist Trip (Peppa Pig)

Author: Lady Bird

Age Group: 3+

Peppa, George and Mr. Dinosaur visit the dentist to get their teeth checked. Although George is nervous, he does get through the procedure while having fun in the process. The story is one among a series revolving around Peppa and her family, and the challenges they face. 

The book has very relatable characters, great illustrations and a simple explanation, which helps kids connect. Since the characters are also favorites among kids, it makes it easier to connect with them.

4. Open Wide

Author, Illustrator: Laurie Keller

Age Group: 3+

32 students (8 incisors, 4 canines, 8 premolars and 12 molars) are taken through a class on how to care for teeth through questions and quizzes. Mr.Flossman, their teacher, peppers their classes with fun facts, and plenty of questions on tooth care.

The book has wonderfully vivid illustrations, is hilarious full of interesting facts and connects all the different procedures that happen during a checkup.

5. How Many Teeth?

Author: Paul Showers

Illustrator: True Kelley

Age Group: 3+

One of the oldest books (30 years), teaching kids about taking care of their teeth, the books starts from the basics, explaining to kids the number of teeth they have, what happens when baby teeth fall off and big teeth come in. The book relates their growth to the fall of the teeth.

Illustrations are older but very familiar with our childhood, text simpler and the book is very engaging. The relation of teeth with growth is simple and easily explained.

Books are the best way to teach kids about life. When it comes to their teeth, there is no better thing than books to make them relate to what their teeth go through. 

Do let us know if there are any other books related to dental health in kids that you may know of. It will help us and other parents add more to their list.

Process of Dental Caries in Children

All of us are well aware of what teeth decay actually looks like, how it manifests itself, the physical changes and the causes for it. Not many know the process of decay, and how early intervention can stop and even reverse the deterioration of teeth.

Everyone is susceptible to tooth decay. While adults can prevent it or look after their teeth better, children cannot do the same. It is left up to us parents to ensure we know the stages of caries and how we can intervene at the right time, with the right methods and prevent further damage from taking place.

Dental caries in children unfolds over a prolonged period of time. Below is the process by which this happens,

·        

•       The mouth is a cavity that is exposed to germs all day, everyday. Bacteria grow in the gut and help in the process of digestion, with the process beginning in the oral cavity. Bacteria also enter the oral cavity with food. The breakdown of food causes the formation of plaques, sticky whitish deposits that collect around the gum line, grooved surfaces of teeth and edges of fillings. Plaque allowed to collect for a prolonged period of time, hardens into 'tartar'.
•       Plaque also uses the remnants of food in the mouth to produce 'acids'. Some foods like beverages and meat are already acidic and affect the teeth.
•       Acid attacks the outer layer of teeth, the enamel and dentine, and erodes them gradually over a period of time. Gradually a small hole or cavity begins to appear on the surface of the tooth or the enamel. This stage is usually painful.
•       Once holes are formed in the enamel or outer lining of the teeth, it becomes easier for plaque and bacteria to reach the dentine (layer just below the enamel). Dentine is usually softer and gets eroded faster. 
•       If treatment doesn't begin at this stage, the bacteria reach the tooth pulp, where nerves are exposed to them, resulting in a excessive pain.
•            When bacteria infect the tissue within the pulp and this isn't treated, it leads to the formation of a dental abscess.

It is often seen that tooth decay typically occurs with molars and pre-molars, large back teeth used for grinding, which have irregular surfaces, making it easier for food to stick and cause infection. These are also unreachable and not cleaned regularly.

Tooth decay in children, can manifest in any number of ways;

•      Breakage of teeth
•      Toothache or pain    
•      Infection of nerve or pulp
•      Death of nerve and numbness 
•      Swelling of face
•      Vomiting, headache and other general symptoms

It is important to remember that dental intervention in children, can save them from pain and many other future problems. It can also help save their milk teeth, in turn ensuring that their permanent teeth grow properly and giving them good oral health for life.

A pediatric dentist not just treats caries once they have begun, but also looks for signs and symptoms of impending tooth damage in children. Beginning a child's dental check-up as early as age 1, can go a long way to ensure that our children don't suffer as much as we do.

Choosing the Right Toothbrush for Your Children's Teeth

Toothbrushes are one of the most important tools in dental hygiene, and yet they are often taken for granted. While adults choose toothbrushes based on ease of use and other fancier requirements - dual bristles or unusual shape, with children we often buy what we assume is best for them in terms of their looks.

Toothbrushes have come a long way - from 'chew sticks with frayed edges', still used in rural areas, to those crafted with bone or wood. Nylon bristled plastic toothbrushes, as we see them today, were only introduced in the 1930's.

Why Brush?

Toothbrush plays an important role in a child's oral health. Brushing removes accumulated food, plaque found between teeth and even the yellowish stain on them (a sticky film of bacteria). If plaque is left untouched, it leads to tartar formation or whitish deposits between teeth. When this tartar hardens, brushing becomes difficult, leading to gum tissue swelling or bleed. This is when periodontal or gum disease actually begins.

Which is the best toothbrush to choose for your child's teeth?

The toothbrush market is bursting with them in various sizes, colors and shapes. It is often difficult to choose which is the perfect one. Below are a few pointers about what you can look out for;

·        

•       Soft Bristled - Children have small teeth, and their gums are sensitive. Soft bristles help remove plaque and food from the gum line, as well as are gentle on gums. It is better to choose toothbrushes that have a rounded end or are polished. 
•       Comfort matters - It doesn't matter what toothbrush you choose for your child's teeth, it must be comfortable. Long toothbrushes can cause injuries and short ones may not reach certain areas of the mouth. The only criteria you should look for, is whether the brush fits their mouth and reaches the back of it as well.

•       Regular or Powered Toothbrushes - Electric powered toothbrushes are very popular abroad, but haven't yet caught the fancy of Indians in a big way. While powered have been thought to clean teeth better, regular ones are just as good, safer and also cost-effective.

Age specific brush use;

1. Babies and Toddlers - Using a damp cloth or gauze, rubbed gently in circular motions is sufficient to clean baby's teeth. Toothbrushes are available for babies, which are small and convenient. Beginning their use early, makes the child get used to the ritual and removes accumulation of milk and food.

By 2 years of age, toddlers are eager to brush themselves, and longer toothbrushes with small heads and soft grips can keep them busy with their teeth.

2. Five to Eight - At this age, the child shows his readiness to brush independently. The toothbrushes although similar to adult ones, are still small with large handles. Manual and powered are often available for pre-adolescent children.

Buying the right toothbrush for your child's teeth, isn't where it all begins and ends. For clean and healthy teeth, brushing must be done twice a day, after breakfast and before bed at night. Flossing must be done whenever possible, to remove food accumulated between teeth. When toothbrush bristles fray or after a period of three months - whichever earlier - new toothbrushes have to replace the old ones. Brushes for kids are to be replaced more frequently than that of adults.

It is always important to involve your child when buying toothbrush for themselves, so that they grow to love the entire process of cleaning their teeth lifelong.

9 Ways of Handling Your Child's Thumb Sucking Habit

As adults, all of us have our ways of relaxing. While we may indulge in reading or a sport, our children have their own ways of unwinding. Of the many things we observe in our babies as they learn and grow, Thumb Sucking is one of the commonest habit that is also the way for them to cope and relax.

Thumb sucking signifies so many things; that the baby is feeling hungry, that he or she is teething, and often it also shows insecurity. This is a normal and healthy part of an infant’s growth.

Infants often suck on thumbs, fingers, pacifiers, toys and even food during play and sleep. Sucking on an object gives them a sense of security and comfort. This habit usually lasts till the age of 4, often even up till 6 years.

If thumb sucking continues beyond 6 years, especially at the time permanent teeth are beginning to be formed, then it is a cause for concern, since the habit often leads to a whole host of dental problems.

Often after 5 years, children develop language skills that help them cope. Therefore the habit when continued beyond this age, may indicate children’s inability to cope or convey what they feel.

Depending on the intensity of the thumb sucking, frequency and duration, teeth can gradually get pushed out of their original position, can become misaligned, making them protrude and resulting in an ‘overbite’, a condition in which teeth don’t clamp down properly.

In addition, the misaligned teeth don’t close the mouth fully, causing malformed jaws as the years go by.

Thumb Sucking therefore has to be observed and stopped before it becomes a habit that causes harm and irreversible dental damage. If your child is approaching preschool and still shows signs of not overcoming the habit, then parents will have to intervene to know why it I so.

Below are 9 ways that you can help your child wean themselves off this habit;

•      DO try to gradually limit the time and place where your child sucks their thumb, either to the bedroom or house itself. Try to prevent them doing it outside in public. Explain that the activity must be restricted only to bedtime.
   
•      DON’T make it a tussle of wills. Thumb sucking is an involuntary habit, so ordering the child to ‘Stop’ won’t get you anywhere. He or she may hide and do it or turn hostile which doesn’t solve the problem. Try to praise them whenever you see them not doing it, rather than criticizing when he is. This is positive reinforcement. 

•      DO take time every now and then to talk to them about the habit. Help them understand why the habit isn’t good, and tell them you will be there whenever they want to stop. 

•      DON’T prevent them from thumb sucking after a stressful time or when they are injured. The child usually does it to seek comfort, and preventing them from doing it will traumatize them further. 

•      DO practice self-awareness with your child. If they are sucking their thumb, make them aware of what they are doing. Try to make them find other ways to soothe themselves, like hugging a stuffed animal or a toy.

•      DON’T replace the thumb sucking habit with handing them chocolates or lollipops. It is cruel to remove one habit and replace it with something worse.  
   
•       DO practice role play to make your child understand that he/she is growing up and there are some habits he cannot carry with him as he grows. Showing them how other grown-ups like their uncles and aunts, or the neighborhood policeman behave, can help them process whether they want to continue with the habit. 

•      DON’T try shoving a glove or mitten into their hands, whenever you catch them sucking their thumbs. When this is done as babies, it might not matter much, but when older, this will frustrate them and cause them to suck on their fingers more. 

•      DO remember, that although thumb sucking is worrying, the child will eventually grow out of it when he is ready. You may have tried everything you can, and yet do understand that your kid will grow out of it.

Thumb Sucking is a habit practiced by every child, but it starts to get worrying when it causes dental problems which can last a lifetime. Ensuring the child gets positive reinforcement to let go off the habit, rather than a harsh approach will help them understand and get rid of it sooner. It will also help in preventing some common dental problems that can develop later in life.

If you are seeing some teeth problems in your child due to this habit, please don't delay showing your pediatric dentist at the earliest, or reach out to the Small Bites Dental Clinic at
+918041256715 or +918025272614.