Local Dental Care - Baby Teething Problems

Dental X-Rays For Your Child

Parents often question the need for dental X-rays (radiographs or films). Just as a broken bone or lung disease require a radiograph for a diagnosis, dental decay or other pathology (disease) of the oral cavity may require a radiograph for diagnosis. Tooth decay in children spreads rapidly in primary (baby) teeth.

Bitewing Radiograph(s)

These films, usually two, identify the presence of decay between the back (posterior) teeth. Decay between the teeth is called interproximal decay. By four and one-half years of age, the baby (primary) molars usually touch or contact each other. Interproximal decay can spread to the adjacent tooth if the teeth are in contact. If there are spaces between the primary molars, and there is no other evidence of decay, these films may not be necessary until later. A lack of spacing between the primary teeth predisposes a child to a much higher incidence of interproximal decay. Early detection permits your dentist to restore (repair) the tooth in less time and preserve tooth structure.

Periapical x-Ray

This film is used to examine the area around the tip of the root(s) or in between the roots. Primary teeth have long roots before they are resorbed (dissolved) by the pressure of the erupting permanent tooth. A root fracture after trauma, deep decay, infection, the need for root canal treatment, the presence of extra teeth, or absence of developing teeth are some of the findings with this film.

Occlusal Radiograph

This film evaluates the presence or absence of the upper and lower front teeth (incisors). It may also be used to diagnose fractures of teeth or bone and extra or missing teeth.

Panoramic x-Ray

Some pediatric dentists request this film around seven or eight years of age, when all eight permanent incisors have erupted. Although this not as accurate in diagnosing decay, it may provide an alternative if a child has a gag reflex that has prohibited taking a periapical or bitewing radiograph. The film is outside the mouth in a machine that revolves around the head. A view of the entire upper and lower jaw is obtained. This is commonly obtained by orthodontists prior to treatment. The panoramic radiograph may reveal or evaluate:

• Missing teeth
• Extra teeth
• Tumors, cysts, or other disease
• Improper position of teeth
• Broken bones after trauma
• Development of the permanent teeth
• Future crowding
• Wisdom teeth

Cephalometric Radiograph

This film ordinarily is obtained by an orthodontist in order to make a diagnosis of a child's bite (occlusion) and to determine the best treatment plan. It measures the relationship of the bones of the head and jaws.

Now, you are "in the know" for your child's next dental X-rays!

by Jane A. Soxman, DDS

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.

Tooth Care: Space Maintainers

What happens when a primary (baby) tooth is lost too early? An appliance called a space maintainer will be recommended by your pediatric dentist. The area of the mouth and the age of the child will determine the need for and type of space maintainer.

The primary teeth save the space for the permanent teeth. The 20 primary teeth are replaced by 20 permanent teeth. The six-year molars, twelve-year molars, and wisdom teeth will erupt (come in) in the back of the jaw. The bone will begin to grow around five years of age to make room for these teeth. If a primary tooth is lost before the permanent tooth is ready to erupt, other teeth will drift or tip into the empty space. This may block out the spot for the permanent tooth that replaces the primary tooth. The space maintainer will hold the teeth in their proper position.

Primary teeth may be lost early because of decay, crowding, injury, or improper eruption of the permanent teeth. Most space loss occurs during the first six weeks after the loss of the tooth. This may continue over the next six months. A space maintainer should be placed before this loss occurs. Sometimes, space loss cannot be avoided and your dentist can only attempt to preserve the remaining space.

There are many types of space maintainers, but two are most often used. The band and loop is used to hold the space for one tooth. The lingual arch is used to hold the space for two or more teeth that have been lost from both sides of the jaw.

If a primary molar is prematurely lost and the six-year molar has not yet erupted (come in), the parent must watch closely for the eruption of the six-year molar. This is very important because the six-year molar will rapidly tip or drift forward causing space loss. The teeth that replace the first and second primary molars ordinarily do not erupt until between nine and eleven years of age. The six-year molar must be partially erupted to make the space maintainer for early loss of a second primary molar.

Space maintainers are usually made with orthodontic bands and wires. Two appointments are necessary. During the first dental appointment, an orthodontic band is fitted on the tooth next to the space. An impression is taken. Next, the band is removed from the tooth and placed in the impression. A mold of the teeth is made with the band on the tooth. A laboratory will custom make an appliance to exactly fit the space. During the second appointment, the appliance is cemented in place.

The space maintainer is not removed until the permanent tooth begins to erupt. The parent must be sure to tell the dentist when the permanent tooth is erupting. If the space maintainer is not removed at the proper time, the permanent tooth may come in improperly. Your dentist will inform you of the age when your child's permanent tooth will likely appear. Early tooth loss may cause the permanent tooth to be delayed in its eruption or to erupt earlier than expected.

by Jane A. Soxman, DDS

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.