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/

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,

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•       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.

Preparing Your Child For Their First Pediatric Dental Visit

A visit to the dentist must be a very important part of your child’s quarterly health checkup plan. Good oral hygiene promotes healthy teeth. Since gum problems are tied in to many other problems in the body, getting a headstart on this important aspect of health will keep your kids covered at least when it comes to their dental health.

From a child’s perspective, a trip to the dentist can be very daunting. Lying on a chair in an unfamiliar room filled with huge machines, and a doctor poking instruments into their mouth can scare even the most strong-hearted. Also, with milk teeth growing and falling off, and permanent teeth making an appearance, there might be many trips to the dentist in store for them.

As parents, it is the onus on you to make a trip to the clinic as comfortable and relaxed as possible. This will only make our work as dentists easier and quicker.

Here is what you can do to ease your child’s anxieties;

• Start very young – Children are very adaptable, and the earlier they see a dentist, the more comfortable they will be during a dental visit. Whether it is a regular checkup, preventive visit or even emergencies such as tooth impaction or Root Canal Treatment, they will be open to any procedures. We recommend bringing your child in at age 1 year, or when the first tooth erupts.

• Keep it Simple – The first time dental visit is the most important, to make kids feel comfortable. Try not to explain too many details to them. Giving unnecessary details and explaining procedures may cause anxiety, which isn’t a good frame of mind to enter the clinic. Maintain a positive attitude but don’t make it sound all rosy too. Most importantly, avoid saying everything will be fine. If your child ends up getting treatment and going through pain, he/she will distrust your judgement in the future.
• Mind your words – Putting words like ‘pain’, ‘injection’, and ‘hurt’ in their head, may make them associate such feelings with the dentist and their work. Let us at the clinic handle your kids. They will be taught specific words for such feelings that they can associate with. At Small Bites, we always begin by asking kids to show us their smile and count their teeth. Positive phrases like clean, healthy teeth sound good and do not alarm.
• Pretend Dental Visit – To get children a little accustomed to visiting a dentist, play pretend with them at home. All you need is a toothbrush and chair. Start by counting the number of teeth in their mouth, make your child look in the mirror. Ask them to pretend-play by brushing their doll’s teeth. The aim is to get them comfortable with the routine and open to a visit with us.

• Avoid taking them to your own dentist – Many parents take kids to their own dentist assuming that they can familiarize their kids with the place. Experts caution against this however. Often times your anxiety can trickle down to the kids, especially during certain procedures that your child may never really require. Also adult dental clinics are sterile, simple spaces which may scare them, while in pediatric clinics, there are kid-friendly toys, games and TV shows which will keep them relaxed.

Small Bites Dental clinic is a very kid-friendly place, where children can engage themselves with toys, rubber slides and television. The main examination room also has drawing and animated characters, including stuffed toys to keep kids engaged.

• Fuss over – Small children are oftentimes whiny, cranky, wiggly and do not open to new people. As parents, you have to keep calm and soothe your child gently to take their anxieties at bay. As dentists, we and the support staff are used to working with children and can guide you on what’s best for your child.
• Avoid bribery – Promising a special treat after being a good child at the dentist’s is a complete NO, since this only serves to increase their anxiety. Promising them a lollipop or candy, makes children wonder what they are in for, to deserve such a luxurious treat. Since we also emphasize on clean teeth and avoidance of sweets, it sends a wrong message to children. Instead, as parents you can praise your child's behavior and bravery for going through with the visit. 

• Emphasize the necessity – Teaching your child that a dental visit is a necessity not choice, from a very young age, will ensure they take care of their teeth for life. You can explain that the dentist helps keep teeth strong, prevents cavities from forming and is responsible for their beautiful smile. A calm practical and no-nonsense parental attitude will set the right premise for the child to continue with good oral health.

As parents your role in your child's dental health cannot be over-emphasized. Follow all of the above steps and it will be a breeze getting them to us. In case of any assistance or more help, do reach out to the us on pedopremila@gmail.com.  

More details can be found here.

Maintaining Children's Dental Hygiene After a Festival

After the long holiday for Diwali celebrations, it is time for the kids to get back to school. Although as parents you have taken much care to ensure that their teeth don’t suffer the damage from too many sweets, the kids will nevertheless be tempted to indulge in or buy similar stuff.

It is important to keep reminding the kids that milk teeth when not taken care of, can affect the growth of adult teeth. Gum problems and dental caries can cause permanent issues of the mouth, caries that may require medical intervention and also cause lots of absences from school and missed school and studies. Oral hygiene is important to be practiced at all times, and children should be aware of this on a daily basis.

Here is what you as parents can ensure;

• Pack lunchboxes rather than giving money to buy food – Although most parents prepare and pack their kid’s lunchboxes themselves, it does become tempting to give them money to eat outside, or grab readymade sweets and pastries while on the go for their lunch. Although this makes things easy, such foods are also high on sugar and starch. One fallout of this practice, is the expectation from the child that these foods are alright, the implicit approval from parents in indulging in them, and the other, is the damage such foods cause to the mouth and teeth. 

 

• Give water rather than juices or soda – Water is the only liquid that the body requires in plenty. Replacing it with soda and juices loaded with sugar not just harms health, but affects the enamel of the teeth. These liquids are also acidic, causing teeth to rot and discolor. Juices and soda contain chemicals, artificial sweeteners and preservatives that damage gums, and cause other health problems in the long run.

• Provide a potable dental kit for school and travel – Good oral hygiene when started at home, can carry on to school as well as everywhere else the child goes. A potable grooming kit with a small toothbrush and toothpaste can be sent with the child to school in case of particularly long hours, when kids travel, stay overnight with friends or indulge in too much of sugar laden foods.

It is difficult for children to get into a routine, especially after coming out of a festival and the accompanying celebratory mood. By ensuring they follow strict dental hygiene, they become equipped to deal with their teeth both within the home and outside it.

Fillings for baby teeth

Maybe you have just found out that your child has one or more cavities in their baby teeth?

It is normal for parents to have concerns and questions. 

In this blog, we hope to give some answers and reassurance about fillings for baby teeth.


Children can develop tooth decay soon after their baby teeth come through. Prolonged bottle feeding with sweetened drinks, or frequently falling asleep with a bottle of milk or whilst nursing are the most common causes of decay in babies. Cavities usually do not cause pain in the early stages and young children may be reluctant to open wide to let their parents see or brush their teeth. So, it can come as a surprise to find out that your child has a cavity at a young age. 

Why should we fill baby teeth, won't they fall out later anyway?




Baby teeth are important for normal eating and speech development. A healthy smile is also beneficial for a child's self-esteem once they reach school age. 





Once a cavity has formed it usually progresses resulting in pain and infection. If an abscess on a baby tooth is not properly treated the infection can spread to and affect the developing adult tooth underneath.



Baby teeth also maintain the spaces for permanent teeth to erupt into. Although front baby teeth can start to fall out from around 6 years old, the back teeth need to last until around 12 years old. If baby teeth are lost too early other teeth may tilt or drift into the vacant space, forcing the adult teeth to come through crooked. 

If my child has a cavity what are the treatment options?

Fillings

If the decay is in the enamel or dentine layer only (not close to the nerve of the tooth) the decay can be removed and a filling placed in the cavity. 

Basic procedure:

• Smaller cavities in baby teeth can often be cleaned without using local anaesthetic. If the cavity is deep or the tooth is particularly sensitive, a small injection may be required to numb the tooth. For more information, see this blog post: Questions about local anaesthetic
• The decay is removed and the cavity is washed. There will be some mild vibrations and noise at this stage. A suction tip is used to remove water from the mouth, or your child may spit out when required. 
• The clean cavity is dried by blowing air onto it and then the filling is placed.

At Small Bites, we keep up to date with the latest filling materials and techniques. The two most commonly used filling materials for children’s teeth are:

Glass Ionomer Cement  

• Bonds directly to the tooth surface and so helps prevents leakage around the edge of the filling.
• Releases fluoride which can help prevent further decay.
• It is relatively quick and easy to place and is therefore popular for use with young children where cooperation for treatment is sometimes difficult.
• It  is quite brittle and prone to wear and so it is usually used in areas which are not under a lot of pressure from chewing.
• Reinforced Glass Ionomers have recently been developed which can be used in higher stress areas, such as the biting surfaces of the teeth.
• Glass Ionomer is white in colour but, unlike composite, it does not come in various shades to match the teeth more accurately. It also available in other bright colours for use in back teeth, if children prefer this.

Composite filling

• Composite fillings come in many shades which match and blend in well with the tooth. Therefore, it may be advised for front teeth where appearance is important.
• Composite is stronger and more wear resistant then glass ionomer.

• A blue etching gel, used to prepare the cavity surface, is painted onto the cavity surface and washed off after about 30 seconds. 
• A bonding agent painted onto the cavity surfaces. This adheres the filling material to the tooth.
• Next, the filling is placed in the cavity.
• A blue light is often used to give faster setting of the filling.
• The filling procedure takes a bit longer than for glass ionomer.

Your dentist will check the filling, and polish it, if required. Please follow instructions for looking after your teeth following treatment. It is usually advisable to wait half an hour before eating and drinking and to avoid hard, sticky and chewy foods on the same day. 

Pulpectomy

If the decay has started to affect the area containing the nerve of the tooth (the pulp), a pulpectomy is often required. For more information, see this link: Pulpectomy - Root canal treatment for baby teeth

Crowns

Teeth which are too broken down to adequately hold a filling or which have undergone pulpectomy usually require a crown to strengthen the tooth. This will be covered in a future post.

At Small Bites, the exclusive dental care centre for children in Bangalore, we have plenty of experience with young children and work to put them (and their parents!) at ease. If you have any questions or concerns, please contact us.



Don't forget to read our other posts for advice on preventing dental decay:

It's Never to Early to Start Preventing Tooth Decay
What Causes Dental Cavities?
Top Toothbrushing Tips