By the way, many people ask questions of me. I have been generally happy to give my opinion, but have also tried to get across that I cannot give dental advice that is specific to any one patient (see disclaimer). Over the past few months I have gotten very busy and cannot devote too much time to answering questions. Therefore, I will be posting most of your comments, but will not likely be able to answer any questions.
Take a look at the growth of visits to the blog. This is amazing. I can tell you since this date the stats have gone much higher than even this:
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23 comments:
I was interested in your opinion regarding extended bre*stfeeding and nightfeedings on the health of a child's teeth.
I have four children. My fourth child (19 months old) has had to have her two front teeth and laterals crowned (stainless steel nusmile type crowns), as well as her left first molar. I have nursed all of my children in exactly the same manner with the night feedings/unfortunate perpetual attachment until they reached about 2 1/2 years old. Typical teeth brushing habits intact with the occasional, but not often, "oops, I forgot to brush her teeth!" Oddly enough, my fourth does not...did not "perpetually attach" as the others did...she actually slept through the night without constantly needing to nurse. She did not (does not) consume juices or milks from sippy cups, etc. Only water, and I consider myself a "mean mommy" when it comes to allowing my children to have candy. It is truly a treat in our house...not a snack. My other children did not and do not have ANY cavities or problems with their teeth...NEVER a blemish, so when I noticed my little one's chipping enamel on the gumline and the enamel on the rear surface wearing away, I was frightened and sick.
I suppose I am interested in whether it is possible that with the others, there was a constant flow of saliva that may have prevented decay in their teeth, whereas with my fourth, she didn't have that constant flow...just the before bed nursing to sleep, and hence maybe more prone to the milk sugars just sitting on her teeth? Of course there is the argument that the act of nursing doesn't facilitate leaving sugars on the teeth (b/c the n*pple and milk actually bypass the teeth altogether). But that would only work for those "clean nursers". Some babies actually do let bre*st milk pool in their mouth, I would say that she is 50/50 on this one.
So what is your verdict on this topic? Bre*stfeeding and teeth: Ultimately good or causing too many problems?
Additionally, what is your opinion on the possibility of my child's problems stemming from a prenatal problem (I was on antibiotics for an asymptomatic UTI during the first trimester and had several viral infections at the start as well...fevers and such). In just two weeks after her molar erupted, the dentist said there was decay on it (this after I had been chasing the poor child around with a toothbrush and brushing 4 or 5 times a day and waking her up to brush her teeth after the occasional night nursing!! Two weeks! Was there decay in her tooth before it even erupted??? Is that possible? Apparently it was so bad in a matter of 12 weeks that we had to have it crowned as well! The child barely even ate any food (it seems to me that she's had sensitivity issues from VERY early on b/c she wouldn't eat from the get go!) So are her teeth coming in compromised?
As an aside: the pediatric dentist practice that we used did a terrible job of communicating information such as: here's what you can expect after her surgery. Here is what we are going to use and why. Nothing was ever discussed. I couldn't ask because I didn't know what to ask! NOW I DO!! It was simply delaying and delaying. And then waiting too long. We went in at 13 months of age (with chipping and erosion on the backs of her front teeth) and nothing was accomplished till 19 months old (and only a simple fluoride wash at one visit in between). Is this standard practice to wait this long?
I also wondered if you had pictures of what the crowns SHOULD look like after they are done. My child's right central looks twisted and crooked whereas her natural teeth were beautifully straight (I have before and after pics). Is this a complicated procedure that is difficult to get straight? It was done in a hospital under anesthesia.
I know you are busy, so I appreciate any feedback as I like to be well-educated on my children's health. Thank you
Sincerely and Respectfully,
Amy
Wow, you certainly have presented a lot of information here. I will only say a few things and maybe after looking a some other posts, your questions might be answered. Firstly, some kids are just prone to decay. Many factors beyond our control. Very young children, if they need restorations, usually need some kind of sedation or general anesthesia to get the work completed. Some very young kids , well, are just too young to safely use those kinds of medications. Fluoride varnish is a reasonable way to slow down the process till the child is a little older and he is better able to handle the procedures. Don't feel too bad about the whole thing. I know it must be frustrating. As to breast feeding, there is a thing called "baby bottle tooth decay" where the bottle does not cause the decay, but speeds it up if the kid is prone anyways. Breast feeding can do the same thing..and yes, I have seen teeth decay rapidly once they are erupted.
Thank you very much for your comments. I was curious, then, should I expect decay in her other teeth even when I am beyond diligent in brushing her teeth and in giving her healthy foods? Do you suppose that this is something that she will have regardless of how well we/she take/s care of her teeth? And if the decay is so obviously aggressive, she we then bring her in for a check up every three months instead of six? I would hate for her to lose any more teeth!
I don't think they used the "varnish", unless that is the same thing as a wash/rinse. Is the varnish supposed to last a little longer? Should I be asking for that the next time around? She just got a swab of the same stuff that an older child "swishes" with.
Respectfully,
Amy
You "paint" on the varnish. You might be able to find out more on the internet. Search: vanish or duraflor.
What great growth in your blog visitors! This is confirmation that you're publishing commentary worth reading. Congratulations.
Chuck McKay
This page relieved my anxiety after discovering a brown tooth on my son at 8pm. Two weeks prior to my discovery my son had a playground accident. When I seen it I flipped out. My husband and I are so cautious with our childrens teeth. I was so thankful to find this sight. I intend to tell my friends about this site. Expect the ratings to keep rising.
These stats are about double this now (end of 2008).
I recently found out both my 2 year old and 4 year old have decay when they were seen by a pediatric dentist. I'm just sick about the whole thing! Stainless steel crowns have been recommended for both of them.
My 2 year old has decay across his front 4 teeth and cavities in 4 of the molars. The front teeth would be crowned and the molars filled with white fillings and then sealants, I think.
My 4 year old's teeth looked great, but she has cavities between all her molars that I didn't notice until it was too late, and brushing must not have reached that spot. Due to the location of the cavities and the size of one of them, she will get 8 stainless steel crowns.
I have a metal sensitivity and I am worried my children may too. I would hate for them to go through all of this, and then have to go through it again. Do you know how likely it would be that these crowns would cause this problem? I was told that the nickel in the crowns sometimes causes an allergic reaction. How likely is this? Are there any good alternatives?
Also they would be going under general anesthia at a hospital surgery center, which includes a breathing tube and a machine breathing for them. Is this safer than sedation?
Thank you!
You may want to read more here on the blog about general anesthesia and sedation, but-- As far as general anesthesia in the hospital--I do it often and it is safe IMOP if certain criteria are followed like the directions the doctor gives you regarding nothing by mouth and getting a physician to do a physical just before the procedure, etc. In 20 years of ding stainless steel crowns, I have never had a probelm with nickel sensitivity. It might happen, but I have not seen it even in patients whe have expressed a concern. My reading of it is it seems to be more of a problem with partial denture frameworks. Anyways, ask your dentist for advice in your particular case--(every case is different). Good luck!
Our pediatric dentist found cavities in both our children's teeth, but the way the scheduling of their office is working out along with the hopital (general anesthesia will be used) it will probably be almost 2 months before anything is done.
Is there anything I can do to slow down the cavities until that time? The dentist used flouride varnish in the dental office, but I'm not sure if that's available without a prescription. I found Act flouride rinse, but children under 6 can't use it. Why would that be? Could a 4 year old use it?
I'm brushing 3x a day and trying to keep their teeth as clean as possible. Any other suggestions?
By the way, your blog is great. I've found a lot of great information here already! Thank you for taking the time out of your busy schedule to help us out!
I cannot advise in your particular case, but --Cavities do get worse with time without treatment. Fluoride varnish is an Rx kind of thing and does help a little but not too much in the bigger scheme of things. Brushing, flossing fluoride (like in toothpaste) helps some. ACT IMOP is ok for some children younger than 6 years, but you have to make sure they are spitting it out. Also, sometimes I suggest brushing it on (that way it's just a little bit). Brushing more than two times a day-I usually caution on using toothpaste that often in young children as the ppm of fluoride is 5 times as much as ACT rinse. Two times/day with very small amounts of toothpaste amounts is ok. Brushing with water is effective in cleaning the teeth.
Still, of course, geting teeth fixed is critical. After that the preventive measures a patient can do at home can have more effect in previnting new cavities along with regular appointments to catch things early.
My nephew is starting to grow three teeth, two on the lower gum and one on the upper. Does my sister need to do anything with regards to the baby's oral health this early ?
The American Academy opf Pediatric Dentistry recommends children have theri first visit to the Pediatric Dentist by one year of age. Babies teeth come in in odd ways sometimes. Usually the bottom central incisors erupt first.
Wow! Dr. Dean, you have great stats! May I please know how were you able to get that info? Did you use a software or a website? I'd like to check mine. I'm just starting on my websites and will soon add more. I'd like to monitor each. Thanks! :)
Great stats! Glad to see your blog doing so well.
Joe Bulger DDS
Family Dentist in Toronto, Canada
Totally agree with the people saying that some instances are hereditary and such and can't be totally prevented. Also, at a young age, its up to the PARENTS to monitor and take the initiative to bring their children in for check ups. Unfortunately, just because someone has an office and a degree on the wall, doesn't mean they have all the right answers.
unfortunately genetics play a major role in tooth decay. However, continuing to brush and fluoride treatments will slow the progression. Avoid sedation at all costs..it's really not worth the risks.
Great! I'm glad you still have time to monitor the blog stats. Anyway, do you have any update for this year?
-pia-
Well, you can extrapolate, but I'll just say we are over 50,000 per month now.
Great article American Academy of Pediatric Dentistry, we adhere to the highest standards of Family Dentist treatment and have been providing dental care to children for over 40 years.
hi! not sure if this post is in the right place and if not my excuses.. my daughter born with a teeth and a few days later she loose it. Now she is one year old and we took her to her first dentist appointment when they do an xray they told me she had a missing tooth in the same position on the one she lost when she born. which is one of her lower central incisor. There is an option that her permanent teeth grows well? or since she had this missing teeth the adult teeth will never come out? its necessary for me to see an specialist? thanks a lot!!
Astrid,
Some kids are born with teeth already erupted. They are called "natal" teeth. It is often the baby tooth just erupting too soon, so it is usually kind of loose due to an under-formed root. The permanent teeth form later on, and in my experience have no problems. Good to followup from time to time with the pediatric dentist.
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