There’s a potential threat lurking in your young child’s mouth—tooth decay. This destructive disease can not only rob them of teeth now, it could also impact their dental health long into their adult years.

That’s why we focus heavily on decay prevention measures even in primary (“baby”) teeth, as well as early treatment should it still occur. It’s a straightforward treatment strategy: minimize the factors that contribute to disease and maximize those that protect against it.

We can represent the disease-causing factors with the acronym BAD. Bad bacteria top the list: they produce oral acid that erodes tooth enamel. Couple that with an Absence of healthy saliva function, necessary for acid neutralization, and you have the potential opening for tooth decay. Poor Dietary habits that include too much added sugar (a prime food source for bacteria) and acidic foods help fuel the decay process.

But there are also SAFE factors that can help counteract the BAD. Promoting better Saliva function helps control acid levels, while Sealants applied to chewing surfaces strengthen these vulnerable areas against decay. We can prescribe Antimicrobials in the form of mouth rinses that reduce abnormally high bacterial concentrations. Fluoride applied directly to the enamel bolsters its mineral content. And an Effective diet high in nutrition and low in sugar or acidic foods rounds out our protective measures.

Promoting SAFE factors greatly reduces the risk of childhood tooth decay. To keep on track it’s important to start regular, six-month dental visits beginning around your child’s first birthday. These visits are the most important way to take advantage of prevention measures like sealants or topical fluoride, as well as keeping an eye out for any signs of decay.

And what you do at home is just as important. Besides providing a teeth-friendly diet, you should also brush and floss your child’s teeth every day, teaching them to do it for themselves when they’re old enough. Playing it “SAFE” with your child’s dental health will help ensure your child’s teeth stay decay-free.

If you would like more information on dental care for your child, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Taking the Stress out of Dentistry for Kids.”

Your child’s dental care wouldn’t be the same without x-ray imaging. It’s one of our best tools for finding and treating tooth decay.

But since x-rays emit radiation, is your child in any danger when they’re exposed?

X-rays, an invisible form of electromagnetic energy, will form images on exposed film after passing through the body. Because it takes longer for x-rays to pass through dense tissue like teeth and bones, the corresponding areas appear lighter on the film than less dense tissue like the gums. We can detect decay because the diseased tooth structure is less dense and thus appears darker against healthier tooth structure.

The downside of x-rays, though, is the radiation they emit could potentially alter cell structure and increase the risk of future cancer, especially with children. That’s why we follow a principle known as ALARA when using x-ray imaging. ALARA is an acronym for “as low as reasonably achievable,” meaning the doses for an x-ray session will be as low as possible while still gaining the most benefit.

Advances in technology, particularly the development of digital processing, has helped reduce the amount of radiation exposure. We’re also careful with what types of x-rays we use. The most common type is the bitewing, a device with the film attached to a long piece of plastic that the child holds in their mouth while biting down.

Depending on the number of our patient’s teeth, we can usually get a comprehensive view with two to four bitewings.  A typical bitewing session exposes them to less radiation than what they’re receiving from natural environmental background sources each day.

Keeping the exposure as low and as less frequent as possible greatly reduces health risks while still getting the full benefit of early decay detection. Still, if you have concerns about your child’s x-ray exposure, we’ll be happy to discuss our approach and all the precautions we take using x-ray imaging.

If you would like more information on x-ray diagnostics and your child, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “X-Ray Safety for Children.”

Proactive dental care is an essential part of childhood growth. But that care can be much harder for children with chronic health issues than for healthier children.

“Chronic condition” is an umbrella term for any permanent and ongoing health issue. Asthma, Down’s syndrome, cystic fibrosis, congenital heart defects and many others fall under this umbrella, with varying symptoms and degrees of intensity. But they all have one common characteristic — a long-term effect on all aspects of a child’s health.

That includes the health of a child’s teeth and gums. Here, then, are a few areas where a chronic health condition could impact dental care and treatment.

Ineffective oral hygiene. Some chronic conditions like autism or hyperactivity disorder (ADHD) that affect behavior or cognitive skills can decrease a child’s ability or willingness to brush or floss; some conditions may also limit their physical ability to perform these tasks. Parents and caregivers may need to seek out tailored training for their child’s needs, or assist them on a regular basis.

Developmental defects. Children with chronic conditions are also more likely to have other developmental problems. For example, a child with Down, Treacher-Collins or Turner syndromes may be more likely to develop a birth defect called enamel hypoplasia in which not enough tooth enamel develops. Children with this defect must be monitored more closely and frequently for tooth decay.

Special diets and medications. A child with a chronic condition may need to eat different foods at different times as part of their treatment. But different dietary patterns like nutritional shakes or more frequent feedings to boost caloric intake can increase risk for tooth decay. Likewise, children on certain medications may develop lower saliva flow, leading to higher chance of disease. You’ll need to be more alert to the signs of tooth decay if your child is on such a diet or on certain medications, and they may need to see the dentist more often.

While many chronic conditions raise the risk of dental disease, that outcome isn’t inevitable. Working with your dentist and remaining vigilant with good hygiene practices, your special needs child can develop and maintain healthy teeth and gums.

If you would like more information on dental care for children with chronic health conditions, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Managing Tooth Decay in Children with Chronic Diseases.”

X-ray imaging is a routine part of a child's dental care — and it undeniably makes a difference in preventing and treating dental disease. It's so routine, we can easily forget they're being exposed to an invisible form of electromagnetic radiation.  And just like other sources of radiation, too much x-ray exposure could increase the risk of cancer.

But while it's possible for your child to be over-exposed to x-rays, it's highly unlikely. That's because healthcare professionals like dentists adhere to a standard known as ALARA when considering and administering x-rays. ALARA is an acronym for “as low as reasonably achievable.” In other words, we only want to expose a patient to the lowest and safest levels of x-ray dosage and frequency that will achieve the most benefit.

To achieve that standard, professional dental organizations advocate the use of x-rays only after a clinical examination of the patient, as well as a thorough review of their medical history for any usage of x-rays for other conditions. If x-rays are warranted, we then take further precautions to protect the patient and staff, and only use the type of x-ray application that's absolutely necessary. For most children that will be a set of two or four bitewing radiographs, which are quite effective for detecting decay in back teeth.

This dosage of radiation in a session of bitewing radiographs is roughly a fifth of the background radiation in the environment a child may be exposed to every day. By spacing these sessions at least six months apart, we're able to achieve a high level of decay detection at a safe and reasonable amount of x-ray exposure.

On top of that, the digital advances in x-ray imaging have reduced the amount of radiation energy needed to achieve the same results as we once did with film. These lower exposure levels and the ALARA standard helps ensure your child's exposure to x-rays will be well within safe limits.

If you would like more information on the use of x-rays with children, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “X-Ray Safety for Children.”

Cavities can happen even before a baby has his first piece of candy. This was the difficult lesson actor David Ramsey of the TV shows Arrow and Dexter learned when his son DJ’s teeth were first emerging.

“His first teeth came in weak,” Ramsey recalled in a recent interview. “They had brown spots on them and they were brittle.” Those brown spots, he said, quickly turned into cavi­ties. How did this happen?

Ramsey said DJ’s dentist suspected it had to do with the child’s feedings — not what he was being fed but how. DJ was often nursed to sleep, “so there were pools of breast milk that he could go to sleep with in his mouth,” Ramsey explained.

While breastfeeding offers an infant many health benefits, problems can occur when the natural sugars in breast milk are left in contact with teeth for long periods.  Sugar feeds decay-causing oral bacteria, and these bacteria in turn release tooth-eroding acids. The softer teeth of a young child are particularly vulnerable to these acids; the end result can be tooth decay.

This condition, technically known as “early child caries,” is referred to in laymen’s terms as “baby bottle tooth decay.” However, it can result from nighttime feedings by bottle or breast. The best way to prevent this problem is to avoid nursing babies to sleep at night once they reach the teething stage; a bottle-fed baby should not be allowed to fall asleep with anything but water in their bottle or “sippy cup.”

Here are some other basics of infant dental care that every parent should know:

• Wipe your baby’s newly emerging teeth with a clean, moist washcloth after feedings.
• Brush teeth that have completely grown in with a soft-bristled, child-size toothbrush and a smear of fluoride toothpaste no bigger than a grain of rice.
• Start regular dental checkups by the first birthday.

Fortunately, Ramsey reports that his son is doing very well after an extended period of professional dental treatments and parental vigilance.

“It took a number of months, but his teeth are much, much better,” he said. “Right now we’re still helping him and we’re still really on top of the teeth situation.”

If you would like more information on dental care for babies and toddlers, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “The Age One Dental Visit” and “Dentistry & Oral Health for Children.”