Posts for: July, 2020
Your child could hit a speed bump on their road to dental maturity—tooth decay. In fact, children are susceptible to an aggressive form of decay known as Early Childhood Caries (ECC) that can lead to tooth loss and possible bite issues for other teeth.
But dentists have a few weapons in their arsenal for helping children avoid tooth decay. One of these used for many years now is the application of sealants to the biting surfaces of both primary and permanent teeth. Now, two major research studies have produced evidence that sealant applications help reduce children's tooth decay.
Applying sealant is a quick and painless procedure that doesn't require drilling or anesthesia. A dentist brushes the sealant in liquid form to the nooks and crannies of a tooth's biting surfaces, which tend to accumulate decay-causing bacterial plaque. They then use a curing light to harden the sealant.
The studies previously mentioned that involved thousands of patients over a number of years, found that pediatric patients without dental sealants were more than three times likely to get cavities compared to those who had sealants applied to their teeth. The studies also found the beneficial effect of a sealant could last four years or more after its application.
The American Dental Association and the American Academy of Pediatric Dentistry recommend sealants for children, especially those at high risk for decay. It's common practice now for children to first get sealants when their first permanent molars erupt (teeth that are highly susceptible to decay), usually between the ages of 5 and 7, and then later as additional molars come in.
There is a modest cost for sealant applications, but far less than the potential costs for decay treatment and later bite issues. Having your child undergo sealant treatment is a worthwhile investment: It could prevent decay and tooth loss in the near-term, and also help your child avoid more extensive dental problems in the future.
While retainers are often viewed as a nuisance, they’re crucial to protect the gains made with bite correction. Without them, all of the progress achieved through braces or clear aligners could be lost.
Here’s why: The same elastic gum tissue called the periodontal ligament that holds teeth in place also allows them to move incrementally in response to changes in the mouth. That’s why we can move teeth with braces or aligners, which put pressure on the teeth toward a desired direction of movement while the periodontal ligament does the rest.
But the mechanics can also work in reverse: With pressure relieved when the braces are removed, the teeth could revert to their original positions through a kind of “muscle memory.” The light pressure provided by a retainer is enough to keep or “retain” teeth in their new positions.
The best known retainer is a removable appliance. Initially, a patient wears it continuously and only takes it out during oral hygiene. Wear duration may later be reduced to night time only and eventually not at all, depending on a patient’s individual needs.
While effective, removable retainers do have some downsides. Like braces, they’re visible to others. And because they’re removable, they’re frequently misplaced or lost, leading to the added expense of a new one.
An alternative is a bonded retainer, a thin piece of wire attached to the back of the newly moved teeth to keep them in place. Because it’s behind the teeth it’s not visible—and there’s no misplacing it because only a dentist can take it out.
A bonded retainer is a good option, especially if a patient is immature and not as diligent about wearing or keeping up with their appliance. But it can make flossing difficult to perform, and if they’re removed or broken prematurely, the teeth could revert to their former positions.
If you decide to go with a bonded retainer, be sure you get some tips from your dental hygienist on how to floss with it. And if you decide later to have it removed early, be sure to replace it with a removable retainer. Either of these two options can help you keep your new and improved smile.
If you would like more information on bonded retainers, 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 “Bonded Retainers.”
A shingles outbreak can be painful and embarrassing. It could also interfere with many areas of your life—including your dental care.
Known medically as herpes zoster, shingles is a viral form of chicken pox. The virus can lie dormant for many years or decades in people that had chicken pox as a child, breaking out later in life (sometimes repeatedly). It's estimated about a quarter of people who had chicken pox as a child, about 90% of adults, will experience a shingles outbreak.
In the beginning, a person with shingles may notice an itching or burning skin irritation, as well as numbness or sensitivity to touch. In time, a red, crusty rash can develop, usually forming a belted or striped pattern on the torso, head or facial areas. The patterning is caused by the virus's disruption of nerves that serve those parts of the body.
Shingles could impact your dental care because it can be contagious early in an outbreak. As such, it can be transmitted to other people via contact with the rash or through airborne respiratory particles. Dental staff members or other patients who are pregnant, undergoing cancer treatment or with other conditions that compromise their immune systems can develop serious health problems if they contract the virus.
If you have an upcoming appointment, it's best then to let your dentist know you've been diagnosed with shingles. If your treatment involves physical contact that could spread the virus, they may wish to reschedule you until the outbreak clears up.
There are ways to hasten the healing process with antiviral treatments like acyclovir or famciclovir. For best results, these treatments should begin within 3 days of a shingles outbreak. There is also a shingles vaccine that can help you avoid an outbreak altogether. The U.S. Centers for Disease Control (CDC) recommend it for adults over 60.
Having shingles can be painful and stressful, and pose a major interruption of your daily life and routine. With proper management, though, it can be contained so you can get on with your life—and your dental care.
If you would like more information on managing shingles and dental care, 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 “Shingles, Herpes Zoster.”