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Jerger Pediatric Dentistry > About Dentistry > For Teenagers > Common Questions
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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ORAL PIERCING AND HEALTH
Not too long ago, teens wanted to avoid the moniker "metal mouth," but the oral piercing trend seems to have overshadowed that social fear. Now piercing the tongue, lip or cheeks is a fairly popular form of self-expression.
People interested in this trend, however, should be aware that it is not without health risks.
PROCEDURE-RELATED RISKS
Infection: Infection is a possibility with any opening in skin or oral tissues. Given the mouth is teeming with bacteria, oral piercing carries a high potential for infection at the site of the piercing. Handling the jewelry once it has been pierced also increases the chance of developing an infection.
Prolonged bleeding: Damage to the tongue's blood vessels can cause serious blood loss.
Swelling and possible nerve damage: Swelling is a common symptom experienced after oral piercing. Unlike an earlobe that is pierced, the tongue is in constant motion, which can slow and complicate the healing process. There have been some reports of swelling subsequent to tongue piercing that has been serious enough to block the airway.
Bloodborne disease transmission: Oral piercing also has been identified by the National Institute of Health as a possible factor in transmission of hepatitis B,C,D and G. Although no cases of tetanus or tuberculosis transmission have been reported with regards to oral piercing, both have been documented in association with ear piercing.
Endocarditis: In addition, oral piercing carries a potential risk of endocarditis, a serious inflammation of the heart valves or tissues. The wound created during oral piercing provides an opportunity for oral bacteria to enter the bloodstream, where they can travel to the heart. This presents a risk for people who have cardiac abnormalities, or which the bacteria can colonize.
JEWELRY-RELATED COMPLICATIONS
Injury to the gums: Not only can the metal jewelry injure the gums, but also, it is placed so that it makes constant contact with the gums, it can cause the soft tissues to recede.
Damage to the teeth: Contact with the jewelry can chip or crack teeth. Likewise, teeth that have restorations can be damaged if jewelry strikes them.
Interference with normal oral function. Oral jewelry can stimulate excessive saliva production, can impede the ability to pronounce words clearly, and may cause problems with chewing and swallowing food. Furthermore, metal alloys used in the manufacturing of oral jewelry can potentially sensitize susceptible people, resulting in allergic contact dermatitis.
Interference with oral health evaluation: Jewelry in the mouth can block the transmission of X-rays. Clear radiographs, what you know as "X-rays," are essential to a complete oral health evaluation. Jewelry can prevent a radiograph from revealing abnormalities like cysts, abscesses or tumors.
Aspiration: There is always a possibility that the jewelry can come loose. As with any loose object in the mouth, unfastened jewelry becomes a choking hazard. The jewelry also could be ingested, which could result in injury to the digestive tract.
WANT TO KNOW MORE?
There is a wealth of information regarding dental care at your fingertips. Just go to the America Dental Association's Web site at www.ada.org and click on the Public content area for more discussion about dental hygiene, oral health and the ADA Seal of Acceptance.
Prepared by the ADA Division of Communications. Unlike other portions of JADA, this page may clipped and copied as a handout for patients, without first obtaining reprint permission form ADA Publishing, a division of ADA Business Enterprises Inc.
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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 consists 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 and Oxycare 3000 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. Please avoid any foods/candies that are extremely hard and/or chewy. For 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 them take Tylenol (or the pain relief medication of your choice) once every four hours. Keep them 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 happen to 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.
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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