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/

Introducing Brushing in Autistic Children

Oral health in children is a very important aspect that must never be neglected. Children are not equipped to perform this complex task, and parents therefore step in to perform it till the child reaches an age when he can do it himself. While it can be difficult for any child to get used to the process of brushing and oral hygiene, it is particularly distressing and challenging for a child with Autism Spectrum Disorder.

Autism Spectrum encompasses a wide variety of neurodevelopmental conditions, characterized by difficulty in communication, socializing and interaction across multiple contexts. It is also accompanied by repetitive behavioral patterns, impaired functions in certain cases with heightened skills in others.

Given the nature of this condition and the fact that autism is often detected within the first year of birth, it becomes essential to handle these kids, and their special needs using a softer, more considerate approach. Autistic children are hypersensitive, do not allow anyone to touch their mouths, are oftentimes unresponsive and also non co-operative. Brushing and other oral tasks when introduced gently will enable them do their tasks themselves.

Below are a few tips that will make it easier to introduce brushing to autistic children-

• To begin with, choose the right kind of toothbrush. Since there are many sizes, colors and styles, it is important to choose a brush that is just the right size for the mouth, and also one in a color that the child will love.
• Since the children experience heightened sensitivity which makes them uncomfortable, it helps to touch the brush to the child's lips or inside of the mouth for a few days to desensitize them.
• Giving the same instructions repeatedly, such as 'open mouth wide', 'show your teeth', ensures they get used to the them as a daily practice.
• It also helps when parents set an example. Brushing, gargling and flossing can become a shared activity which the child will come to learn and love.
• Brushing the teeth of an autistic child works when there are a repetitive set of procedures to follow. This will familiarize them as well as help them open up to the ritual over time.

Below are a set of steps that can be followed for brushing the child's teeth;

1. Stand behind the child with their head resting on the front of your chest

2. Put a small pea sized amount of paste on the brush

3. Use the brush as you would on your own teeth

4. Follow this 6 step procedure for brushing

- Brush the bottom back teeth inside, out and top 5 times

- Brush the top teeth inside and out 5 times

- Brush bottom front teeth inside, out and top 5 times

- Move to the opposite teeth and brush bottom teeth inside and out 5 times

- Brush the top front teeth inside and out 5 times

- Brush the top back teeth inside  and out 5 times

5. Although brushing is normally done in the bathroom, it is advisable to brush the teeth of autistic children wherever they seem comfortable. It could be either on a couch or on their bed and gradually progressed into the bathroom.

Just as with every other activity, getting the child to look after their teeth independently is the ultimate goal of a parent. When it comes to autistic kids, it needs a little more effort and attention.

Do read our next blog to understand how to ensure how teeth brushing can be made a regular task in such children.

Oral Injuries and Their Treatment in Children

Besides tooth caries and misaligned teeth, very few children make it through to childhood without mouth injuries. The appearance of teeth in children brings with it a whole set of problems. While some are predictable, some others aren't. 

Mouth injuries, even the most gory ones need immediate and good treatment to avoid any permanent kind of damage. While home treatment often suffices, medical intervention is required in certain extreme cases. Below is all what you need to know to differentiate between the two.

How they happen?

Besides scraped knees and head bumps, cuts and bleeding on lips and inside of the mouth is very common in children. Mouth tissues are soft, and often a fall or hit pushes them against hard bones of the jaw or even the teeth. In addition, slip ups, tumbles, crawling are all activities where a child's mouth is exposed, leading to cuts and bruising.

How to treat them?

Oral injuries in children look much worse than they actually are. Because the mouth and areas in the face and head are suffuse with blood vessels, even a tiny cut can cause excessive bleeding, with the exact location becoming difficult to pinpoint. Often mouth injuries are minor and the crying bouts of the child are more out of fear than actual injury.

The below steps will help you handle any kind of mouth injury in a calm manner, reduce bleeding, minimize the pain and prevent infection.

• Stop the Bleeding - If the bleeding is from the outer lip or tongue, apply gentle pressure on the area with a clean moist cloth for a while. If inner lip bleeds, press the area gently against the child's teeth/gums.
• Distract the child during cleaning- Sing, talk or soothe the child in whichever way you can. Any treatment needs a child to sit still.
• Keep the area cool - Numbing the pain and reducing the swelling are first priority. Apply an ice pack or frozen veggies on the area. Sucking a Popsicle is also a great idea.
• Painkiller - These should be given only when the child is unable to bear the pain for long, usually under advice from the pediatric dentist
• Change diet temporarily - Although often superficial, lip cuts or injuries can be very painful. It is better to change the diet for children to liquid or semi-solid till the wound heals. Softer diets help healing faster and don't tend to irritate. Chilled treats such as Popsicle or ice cream, and a mouth rinse after food will take care of dental hygiene too for a while.

When is a pediatric dentist intervention necessary?

• When bleeding is very heavy, continuous and uncontrolled, and doesn't stop despite applying pressure and ice.
• When the cut is too deep or too wide
• When a rusted or dirt filled object has caused the wound
• When there is dirt or mud in the wound
• When a puncture wound caused due to pen/pencil gets into the roof of the mouth, or hurts deeper tissues of the jaw
• When the wound is caused by bite of an animal
• If there is suspicion of bone injury, swelling of the jaw, locked jaw, broken or impacted tooth
• Any inflammatory changes such as redness, swelling, pain, fever that lasts for more than a day

It is very common for children to have mouth injuries, almost like a rite of passage in childhood. The right kind of treatment immediately, with moral support and without anxiety will help them recover faster.

For more advice on oral injuries or to get treatment for the same, reach out to Dr.Premila of Small Bites Dental Clinic at Indiranagar by contacting her at 080 4125 6715.

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/

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.

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.

Brushing Teeth, a Wonderful Habit To Give Your Children

Brushing your babies' teeth can be quite a stressful ritual. Babies are restless and don't understand why their mothers would want to force open their mouths and insert an object like a brush, that is not just uncomfortable, but oftentimes painful.

As much as parent's may delay this or procrastinate in the hopes of getting children to be more accepting of brushing teeth when they are older, it actually works in the reverse. The older the child gets, the more difficult it is for him/her to make brushing a regular part of their routine. Truth is, the results cannot be observed immediately, and most often children find brushing unnecessary and a chore even when they are older.

Caring for your babies' teeth should begin as soon as they start to appear. Parents are also the best people to lead the way when it comes to teaching kids this important skill.

Teeth are the most vulnerable part of the mouth, do a whole lot of work....masticating, gnashing, biting, chewing, and also have to weather acids from foods that are constantly fed into the mouth. Looking after them must begin when they start to erupt. It's alright if teeth can't be brushed from the start. What matters, is introducing this habit as a part of their daily routine. Start by showing them that brushing is what you do each day, everyday and its the best example you could give.

 In addition to the above,

• Use just a little dab of paste on the finger for babies, and little more than a pea-sized amount for toddlers
• Start with light brushing, and then a little thoroughly, brushing all along the tooth sides and surfaces, twice a day, after waking up and before bedtime.
• Don't turn teeth brushing into a war, pushing and shoving, yelling and fighting which usually happens. Some children take a long while to get used to it. Make this a game, brush yours first and ask them to follow suit, or sing a little rhyme when you do.
• Place your baby in a way that both of you are comfortable. Sit them on your knee and head on your chest and clasp their chin. For older children, stand behind them and tilt their heads upwards.
• Use small circular movements when brushing teeth. This covers all the tooth surfaces, and your child can spit out the paste when they're done. Flouride free toothpastes are better to use when smaller, since kids tend to swallow them otherwise. 

• For babies, it is also important to lightly massage their gums, especially when teething. This can be done after brushing their teeth.
• Teeth brushing is a practiced art which parents need to guide their child on, till they reach an age where they can do it on their own. It has been seen that by age 5-7 years, children are able to do a great job of brushing their teeth.
• The most important aspect of introducing brushing and helping the child take care of their teeth, is the involvement of a pediatric dentist in the entire process. A dentist is not just required to fix things after the teeth are gone bad/caried, but must be a part of the process from the beginning. A regular teeth checkup will ensure that any irregularities, caries, congenital and developmental disorders of the teeth and mouth are looked into at the earliest and treated. This must ideally begin around the age of one year.

This video, explains the act of brushing teeth, and can be shown to your child to make them understand better.

Teeth brushing is as important as eating food, and teeth disorders are linked to various other health and body disorders which can strike later in life. A healthy and regular brushing schedule when started young, will lay the foundation for strong teeth that will last your children for the rest of their life.

TONGUE TIE And How It Affects Children's Teeth

Teeth and their well-being is what many of strive to give our kids from a very young age. While we follow general oral hygiene and practice the necessary steps that are required for general oral care, not all of us are aware of the many congenital and developmental problems that affect the mouth, and in turn the growth and care of teeth.

TONGUE TIE is one such congenital oral condition that is often overlooked or misunderstood. Also called ‘Ankyloglossia’ or ‘anchored tongue’, it is observed very often by parents at a very late stage, once the child has started talking or eating and this condition is hampering normal oral functions.

Ranging from a mild form to a severe state, tongue tie is seen at birth and causes many different difficulties that affect kids in myriad different ways. This condition is caused by the structural abnormality of the lingual frenum. The frenum is the cord that extends from under the tongue to the mouth floor. When this lingua frenum is short or restricts tongue movements, this is the condition that results. 

Normally the frenum is elastic and does not interfere with eating, sucking, clearing food duing swallowing or speech. But if it is short, thick or broad, it can attach the tongue to the mouth floor causing problems with speech, eating and even tooth growth.

While mild tongue tie sometimes goes unnoticed and does not affect the day to day life of the child, severe tongue tie can cause lifelong debilitating effects.

Untreated tongue tie can have wide ranging effects, affecting the structure and appearance of face and teeth, and also interfering with oral function. Breastfeeding, eating, swallowing, digestion, teeth and speech can be affected when they are little, and kissing and social skills are affected further into adulthood.

Infants and Babies face the below challenges that include;

• ·         Impact on the milk supply
• ·         Stoppage of breastfeeding
• ·         Loss of weight
• ·         Sleep deprivation
• ·         Chewing and swallowing especially intake of solids being affected

As babies grow, the problems only persist and gradually increase

• ·         Inability to chew age-appropriate foods
• ·         Gagging, vomiting of foods
• ·         Dribbling of saliva and delayed speech development
• ·         Loss of self-confidence

 Oral hygiene and Dental Health -

Besides these obvious problems, the main impact of tongue tie is in the growth and development of teeth in children. If the frenulum is attached very high on the gum line, it can pull down the gums from the central incisors. The tongue tie can also cause the tongue to become misshapen which can cause teeth to grow haphazardly or at an angle. 

The reduced tongue mobility and habitual wrong tongue posture that results from tongue tie is accompanied by messy eating habits, resulting in food debris remaining in the mouth and teeth, and causing caries. Salivary profusion caused due to the inability to swallow manifests itself in different ways. Younger child dribble profusely, while older kids adapt, either by slurping frequently, keeping the mouth small during speech, or reducing speech altogether. They also face an involuntary and embarrassing dribble of saliva.

Treatment

 

   

Tongue tie is a barely recognized but serious problem, because of the way it generally goes unnoticed, yet can cause potentially serious and life long damage to teeth and the oral cavity. It can be manifested in a variety of ways, and a pediatrician or pediatric dentist will be able to identify this cause if they notice any significant increased salivation, dribbling of saliva, mouth odour or damage/caries to teeth.  
 

Parents who find the child having difficulties, should then go in for treatment if there has been any malocclusions caused by tongue pressure on the front or side teeth. Since the tongue has a limited range of movements, there are many resultant effects which include:

• Poor swallowing and a resultant risk of anterior open bite
• Mouth breathing and allergies/issues due to this
• Permanently open mouthed posture due to continued imbalance in skeletal structure
• Restriction in the development of the dental arch and facial bones

Minor surgery is required to correct this condition when diagnosed at an earlier stage. If there are significant and serious oral and articulating issues, the child will need additional speech therapy and preventive measures for treating caries and other teeth issues.