Local Dental Care - Broken Baby Teeth

Infant Pediatric Dental Care

One question many pediatric dentists are asked most frequently is, "At what age should I bring my child in for his/her first dental checkup?" Most dentists will say between two and four years of age, because that's what they're taught in dental school. The reason dentists are taught this answer is because children have finished teething by that time and are usually more cooperative.

The only problem with this reasoning is that by age two, according to American Dental Association statistics, 30% of all children in America have a cavity or cavities! As a result, a child's first experience at the family dentist's office is often a numb lip, a rubber dam, and a filling — not the most pleasant first experience!

So, at what age should your child receive his first pediatric dental examination? At birth!

That's right — but in many pediatric and family dentistry offices they aren't just "tooth doctors." They believe in cavity prevention. And prevention starts at birth.

Some pediatric dentists would like you to bring in your baby so that they can tell you about fluorides, pacifiers, finger habits, nutrition, and oral hygiene.

There may be no charge for this appointment or for the subsequent visits they call "play" appointments. These appointments are scheduled at 1 year, 1-1/2 years, and at 2 years of age. By that time, many children may be receiving cleanings, fluoride treatments, and protective sealants.

If the child isn't ready for these treatments, they can continue "play" appointments until he is ready.

Pediatric dental care professionals never want to enforce or insist that a child have dental work unless he is ready. They want pediatric and family dentistry to be a fun and enjoyable experience for children so that they will look forward to their visits twice a year.

As a result of this approach to prevention, 95% of those children who make regular continuing care visits are cavity-free, as are 85% of adult patients who follow a similar regime. Yes, prevention starts at birth, and your family dentist's goal remains a commitment to preventive care.

+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.

Management of Injury to Children's Permanent Teeth

Recent studies indicate that 25% of Americans between the ages of 6 and 50 years have experienced traumatic injury to permanent teeth. Ninety percent of traumatized teeth involve the upper incisors. The focus of contemporary treatment of dental traumatic injuries is conservative management of the affected tissues to maximize their excellent healing potential in children. The most important element in this process is the reduction of the time interval between the traumatic episode and the dental treatment. Dental treatment should therefore be sought immediately. It is for this reason that public information on dental trauma management is so critical, particularly in the following three areas.

Coronal Fractures -- Broken Crowns of Teeth

The predominant treatment goal in tooth crown fractures includes protecting the underlying pulp (nerve tissue) within the tooth from bacterial contamination and infection. Additional goals include keeping the adjacent teeth from moving into the space created by the missing tooth portion and restoring the esthetic appearance and function of the traumatized tooth.

Dental treatment of crown fractures involves the following steps. The affected teeth and surrounding soft tissues are cleansed with an antibacterial mouthwash and the exposed dental hard tissues are protected with either an applied protective medicament or an adhesive resin material. These measures provide a seal against bacterial penetration into the porous tooth structure and subsequent infection of the underlying pulp. A resin (plastic) restoration of the lost tooth portion is placed for esthetics and function. In cases where the missing tooth fragment can be found, it can be reattached to the remaining tooth portion with dental adhesives. The treated teeth are then monitored post-operatively for signs of possible infection over a period of several months to a year.

Tooth Displacement Injury -- Loosened or Dislodged Teeth

The predominant treatment goal for displaced teeth focuses on protecting the supporting tissue known as the periodontal ligament from bacterial invasion and subsequent infection resulting from the injury. This tissue surrounds the root of the affected tooth and has the primary function of attaching the tooth to the bone.

Dental treatment includes stabilizing the excessively loosened or displaced tooth by means of short-term splinting. The splinting device consists of an orthodontic brace wire attached to the affected tooth and adjacent teeth with resin adhesive for a one to two-week period. Additional treatment may include esthetic restoration of tooth portions damaged by the injury as previously mentioned, and post-treatment monitoring for signs of healing.

Tooth Avulsion -- Teeth That Have Been Knocked Out

Treatment goals for knocked-out teeth are focused on enhancing periodontal ligament survival. The critical variable is the length of time that the tooth has been out of the mouth without any means of providing hydration and nutrition to the periodontal ligament cells attached to the avulsed root surface. This time length is known as Extra-Oral-Dry-Time (EODT). If the EODT is less than one hour, the chances for periodontal ligament survival is quite good, provided the appropriate management is started immediately.

Dental treatment of avulsion involves minimizing the EODT by immediately replacing the tooth back into the socket or immediately placing it in a transport/storage solution to hydrate and nourish the periodontal ligament cells still attached to the root. The most readily available transport media is cool milk. Special tissue culture fluids are even better, but generally are available only from a dentist, drug stores, or school health clinics. On-site tooth avulsion management includes the following:

1) Rinse the knocked-out tooth under tap water only if there is dirt.

2) Replant the tooth in its socket and keep it held in position, or place it in milk (or culture fluid, if available).

3) Immediately take the child to a pediatric dentist who will stabilize the tooth with splinting devices previously mentioned and provide the necessary treatment of the pulp and the periodontal ligament.

The more we can do to enhance the excellent healing potential of the traumatized tissues in children, the better the outcome.

By Clifton O. Dummett, Jr., 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.