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Jerger Pediatric Dentistry > About Dentistry > For Pre-Teens > Common Questions
fluoride TO PREVENT TOOTH DECAY
WHAT IS FLUORIDE?
fluoride is a mineral your body needs to grow and be healthy. fluoride makes teeth and bones strong, and it protects your teeth against decay. It can be found naturally in all soil, plants, animals and water.
HOW DOES fluoride HELP YOUR TEETH?
fluoride is needed for infants and children, when teeth are still forming under the gums. The fluoride ingested at this time, in water or the form of vitamins that contain fluoride, deposits itself into the outer part of the tooth and makes the tooth stronger and better able to fight decay.
fluoride also works after the teeth erupt and are present in your mouth. At this time, fluoride from water, food, toothpaste, mouthrinses and fluoride treatments received in a dental office washes over the teeth and helps to prevent decay or even stops small areas of decay that have already started. The fluoride makes the outer surface of the teeth stronger.
WHAT IS THE BEST WAY TO GET fluoride?
Even though natural fluoride is found in food, plants, animals and water, the amount is usually too low to provide the best protection from decay. Illiinois communities add small amounts of fluoride to their water supplies. This practice, called water fluoridation, ensures that the water contains the optimal level of fluoride. Drinking fluoridated water from birth can reduce decay by 40% to 65%.
People living in rural areas with private water wells do not have the benefits of water fluoridation. A dentist or physician can prescribe a vitamin with fluoride, in a tablet or drop form. For best results, these tablets or drops should be taken from 6 months of age through 14 years of age.
Some Illinois schools offer a fluoride mouthrinse program. The children who participate in this program swish with a fluoride mouthrinse once a week in the classroom. This program has been shown to reduce decay by 35%.
Another way to get fluoride is through dental products such as toothpastes, mouthrinses, and home fluoride tx's. We recommend Prevident and have that available in our office. These products are good for children and adults, regardless of whether they drink fluoridated water.
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WHY SHOULD BABY TEETH BE FILLED? WON'T THEY FALL OUT ANYWAY?
The first tooth is not lost until 6 years of age - on the average mouth. All of the teeth (the primary molars) serve a function until they are replaced by the permanent teeth, which usually does not occur until 12 or 13 years of age.
The primary teeth are important for a child's speech development, chewing, esthetics and learning/attention span. Neglect of the primary teeth can cause serious problems. Not only can serious infection and discomfort occur, but also the child's general health can be put in jeopardy as a result of this infection of the gums and jaws. If this is not treated, the tooth can abscess and die. A serious infection that is left untreated may cause damage to the permanent tooth and even infection in the blood stream and heart.
Primary teeth also guide the erupting permanent teeth. If the primary tooth is lost prematurely from decay, the space that would normally be reserved for the permanent tooth may be lost. This is due to shifting of the adjacent teeth. If this situation takes place, there will be indadequate space for the permanent teeth. This usually requires the need for more expensive orthodontic correction in the future.
Decay is not inherited. Decay can be controlled, but it can affect children even before the age of 18 months. Preventative efforts must begin as soon as the first tooth shows signs of eruption. These efforts must be continuous and consistent such as: diet, efficient hygiene program, proper snacking habits and the elimination of habits that may cause future problems.
POINTS TO REMEMBER
- The top front teeth are needed for speech development. The tongue rests against these teeth for proper pronunciation of sounds.
- Primary teeth are necessary for chewing and to obtain proper nutrition for development.
- Discomfort from a toothache and poor nutrition reduces a child's attention span and learning ability.
- Having a healthy smile, consisting of mouth without brown or black spots on teeth, is very important in developing a positive self-esteem.
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LOW CARBOHYDRATE SNACKS
(for between meal nibbling)
BEVERAGES
- Milk
- Tomato Juice (100%)
- Fruit Juice (Frozen or canned - 100%)
- Water
MEATS AND OTHER HIGH PROTEIN FOODS
- Ham, pork, beef, lamb - cooked
- Cheese
- Hard cooked eggs - plain or deviled
- Chicken
- Turkey
- Tuna
- Shrimp
- Peanuts
RAW VEGETABLES
- Carrots
- Celery
- Radishes
- Lettuce
- Pickles
- Cauliflower
- Cucumbers
- Tomato
- Broccoli
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FRESH FRUIT
- Grapefruit
- Grapes
- Peaches
- Pears
- Plums
- Raspberries
- Strawberries
- Oranges
- Apples
- Bananas
HIDDEN SUGARS
- White bread
- Soda crackers
- Graham crackers
- Potato chips
SUBSTITUTE SUGARS
- Wheat crackers
- Cheese crackers
- Whole weat bread
- Popcorn
FOODS TO AVOID
Soda pop, cocoa, jams, canned sweetened fruits and juices, candy, pastries, dried fruits of all kinds, syrups, honey
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WHAT ARE DENTAL SEALANTS?
Dental sealants are thin plastic coatings that are applied to the chewing surfaces of the back teeth to prevent decay. Most tooth decay in children and teenagers occurs on the chewing surfaces where pits and grooves tend to trap food and bacteria. Sealants fill in these pits and grooves so that bacterial cannot multiply and cause decay.
How are sealants applied?
Applying sealants is quite simple and may be done by a dentist, dental hygienist or a certified dental assistant. First, the teeth are cleaned. Then the teeth to be sealed are dabbed with a very mild acid solution similar in strength to vinegar or lemon juice.
This roughens the tooth surface slightly so that the sealant will bond to it. After the tooth is prepared, the sealant is painted onto the tooth. It flows into the pits and grooves and hardens in about 60 seconds. After sealing, bacteria cannot reach the pits and grooves that cause decay.
Will sealants make teeth feel different?
Sealants will not result in any change in bite because they are very thin and only fill the pits and grooves. At first they may feel somewhat bulky, but a few days or normal chewing will wear the sealants into place.
How long will dental sealants last?
A sealant application can last as long as five years and often longer. Sealants should be checked every six months and reapplied if they wear off. Because teeth are more likely to decay when they first appear in the mouth, dental sealants are recommended for children and teenagers starting at age 6 yrs.
Why is sealing to tooth better than waiting for decay and filing a cavity?
Sealants help to keep teeth healthy by protecting them from decay. Decay destroys parts of the tooth. Each time a tooth is filled or a filling is replaced, more tooth is lost. Using sealants saves time and money and helps to keep teeth healthy. When you combine sealants and proper brushing, you have a 95% effective rate against decay.
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Q & A FOR ORTHODONTIC PATIENTS
1. What is the best time to start orthodontic treatment?
Developing malocclusions can be recognized as early as two to three years of age. Often, early steps can be taken to ease the need for major orthodontic treatment at a later age. We provide two phase orthodontics, which usually contests of appliances to widen the arches in phase one and braces to do fine tuning/straightening when all the permanent teeth erupt.
2. How long will my child wear braces?
The average case is 18-24 months upon cooperation with parents and the child. Treatment time may be more or less depending on the severity of the case. We do an orthodontic workup, which consists of impressions, measurements, photographs, and x-rays that the doctor will study to determine treatment time. The doctor will do a consult in which he will discuss treatment options and treatment time before the parents elect to proceed with care.
3. How do I floss around braces?
We recommend floss threaders, which may also be called bridge aides for patients. Floss is threaded through a thin plastic point that allows the patient to get under the wires and pull the floss through.
4. How do I keep my teeth clean with braces?
We recommend Sonicare toothbrushes because they prove superior to a manual toothbrush by removing twice as much plaque. WaterPiks are also helpful in irrigating in between brackets and under wires.
5. How does Invisalign work?
Invisalign uses computer technology to design a series of clear trays that are changed every two weeks to move your teeth gradually until you’ve reached the desire result. Trays are worn at all times except for eating and brushing.
6. How do I know if I qualify for Invisalign?
Invisalign requires that you have all permanent teeth erupted, which usually occurs by age twelve. You have to have a functional bite which the doctor can determine. Invisalign can correct conditions such as crowding, too many spaces, or midlines that do not match up.
7. How do I make sure my teeth stay straight after braces?
The only way to ensure that your teeth do not shift is to wear the retainers provided and follow the doctor’s directions. Usually you will wear your retainers full time for a period and progress into night use only.
8. How much do braces cost?
The cost is determined by the severity of the case. It can range from $1,000 to $5,000.
9. Do I get to pick elastic colors?
Picking colors is a privilege reserved for patients who have good oral hygiene. If a patient has poor oral hygiene it can result in cavities, scars on the teeth, which are irreversible, and gingivitis. Patients that have poor hygiene will not get to pick their colors.
10. What if a bracket comes off or an appliance breaks?
Save whatever you can find and make an appointment as soon as possible. Usually we can repair broken appliances and recement brackets. To avoid added repair fees please bring in whatever you can.
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CEMENTED APPLIANCES/SPACE MAINTAINERS
Your child's appliance is cemented and supported by bands on the molars (back teeth). It is not uncommon for the patient to complain of a little discomfort for the first day or so. But remember each child is different, one may feel no tenderness at all, where one may complain of tenderness for a couple of hours or even a couple of days. Be assured this is all normal, and it will just take time for your child to adjust.
It is very important to keep the appliance clean. Make sure there is no debris left under the wire. Good brushing habits will keep this area clean. It is also important to monitor the types of food your child is eating. Pleas avoid any foods/candies that are extremely hard and/or chewy. Fore example: caramel, taffies, ice, biting on toys, pens, pencils, etc. Foods or habits of this sort will loosen the appliance and possibly distort the wire.
If the appliance does come out, please place it in a safe container and contact the office immediately. The appliance should be recemented as soon as possible in order to prevent any tooth movement or drifting.
Teeth move very rapidly. Enough damage may occur that a new appliance will be necessary. We DO NOT accept responsibility for damage done due to neglect or failure to follow the above instructions.
If your child continues to complain of discomfort, have the child take Tylenol (or the pain relief medication of your choice) once every four hours. Keep the child on this as long as you feel necessary. If discomfort persists, please contact our office at 875-3080.
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POST-EXTRACTIONS INSTRUCTIONS
1. NUMBNESS
The jaw (plus the tongue and lip if it was a lower tooth) will be numb from the anesthetic for two to three hours. Watch your child so he/she does not bite or injure the tongue, lip and cheek while it is "asleep". Chewing, biting, sucking or pinching at the area can cause injury.
2. COTTON GAUZE
The gauze should be held against the extraction site until the oozing has stopped, which usually takes thirty minutes. We will give you some extra gauze in case one is not sufficient. If the bleeding has not stopped by then, have the child bite on an additional gauze for fifteen minutes or so. Remind your child not to allow saliva to collect in his/her mouth. If you should run out of gauze, have your child bite into a damp tea bag which will serve the same purpose.
3. EATING AND DRINKING
After the bleeding has stopped, it is okay to drink liquids. Avoid the use of a straw and NO swishing! For the first and second days, a soft diet is recommended: Jell-O, apple sauce, soup broth, ice cream, pudding, etc. By the third and fourth days, more firm foods are in order – basically whatever is comfortable for the patient. Chewing on the opposite side of the surgery site will allow the area to heal quickly. Fingers (and "non-edible" objects) should be restricted from the mouth.
4. PAIN AND DISCOMFORT
Normally, there is some discomfort when the area "wakes up". Acetaminophen, Tylenol, Tempra tablets or liquid, or whatever your family uses for pain relief can be administered. These medications are sufficient to control any discomfort that may be experienced once the anesthetic has worn off. One dosage every four hours is suggested until discomfort is gone.
5. CARE OF MOUTH
It is important that the teeth be cleaned the first few days following dental surgery. Often a toothbrush on raw or sore gums is difficult for the child to tolerate. You should gently rub the gum line with a soft toothbrush. Running warm water over the toothbrush to soften the bristles also helps.
6. MISCELLANEOUS
Saline rinses (salt water) may be used the following day after surgery. This will help to keep the extraction site clean. Something cold like ice cubes, crushed ice or popsicles can help to relieve soreness and bleeding.
If you have any questions regarding post-extraction care, please call our office at 875-3080.
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WHAT DO I DO IF MY CHILD HAS A DENTAL EMERGENCY?
First call our office with any type of dental emergency. If your call is after hours you will receive a message stating Dr. Bret's contact number or a dentist on call. For families who live out of town it is a good idea to contact a local dentist in case of emergency. Please describe the emergency to the best of your ability and include time and location. If a permanent tooth is chipped or knocked out, please keep any piece you can find and place in milk.
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WHAT IF MY CHILD'S GUMS BLEED UPON BRUSHING AND FLOSSING?
This is a sign that your child's gums are infected and asking to be cleaned more. Do not stop brushing and flossing; but instead do even more in the area of the bleeding. If you are brushing properly the bleeding will stop in 3 to 4 days.
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HOW MUCH FLUORIDE IS TOO MUCH?
There are two types of fluoride, topical and systemic. Topical fluoride is in toothpastes, brush-on fluorides and rinses such as ACT. This protects the teeth that are already in the mouth. Systemic fluoride is in water ingested and some foods such as fish, tea, and infants foods. This fluoride strenghthens developing teeth. We recommend a balance of one fluoride from each type. Families with well water should use supplements prescribed by their pediatrician or dentist. Excess fluoride can result in mottling of tooth enamel (fluorosis) which appears as brownish teeth. Three to four times the amount necessary causes this deformation. A lack of fluoride results in increased cavities and brittle bones.
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HOW OFTEN SHOULD MY CHILD BRUSH AND FLOSS?
Your child should brush after every meal and right before bedtime. Your child should floss once a day. Children require help brushing until approximately age seven, and flossing until age nine. If you notice red or swollen gingiva this is a good indication that your child still needs help.
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WHAT ARE DENTAL SEALANTS?
Dental sealants are thin plastic coatings that are applied to the chewing surfaces of the back teeth to prevent decay. Most tooth decay in children and teenagers occurs on the chewing surfaces where pits and grooves tend to trap food and bacteria. Sealants fill in these pits and grooves so that bacterial cannot multiply and cause decay.
How are sealants applied?
Applying sealants is quite simple and may be done by a dentist, dental hygienist or a certified dental assistant. First, the teeth are cleaned. Then the teeth to be sealed are dabbed with a very mild acid solution similar in strength to vinegar or lemon juice.
This roughens the tooth surface slightly so that the sealant will bond to it. After the tooth is prepared, the sealant is painted onto the tooth. It flows into the pits and grooves and hardens in about 60 seconds. After sealing, bacteria cannot reach the pits and grooves that cause decay.
Will sealants make teeth feel different?
Sealants will not result in any change in bite because they are very thin and only fill the pits and grooves. At first they may feel somewhat bulky, but a few days or normal chewing will wear the sealants into place.
How long will dental sealants last?
A sealant application can last as long as five years and often longer. Sealants should be checked every six months and reapplied if they wear off. Because teeth are more likely to decay when they first appear in the mouth, dental sealants are recommended for children and teenagers starting at age 6 yrs.
Why is sealing a tooth better than waiting for decay and filling a cavity?
Sealants help to keep teeth healthy by protecting them from decay. Decay destroys parts of the tooth. Each time a tooth is filled or a filling is replaced, more of the tooth is lost. Using sealants saves time and money and helps to keep teeth healthy. When you combine sealants and proper brushing, you have a 95% effective rate against decay.
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HOW OFTEN SHOULD MY CHILD SEE THE DENTIST?
Every six months. Once a year we take x-rays to assess for cavities in between teeth.
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