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Pediatric Dentistry - Dental Care for Teens

Oral hygiene may be the last thing on the mind of an adolescent or teen. During these years, decay in between the teeth may occur for the first time and hormonal changes may create more inflammation of the gums. Here are some helpful hints from pediatric dentists to avoid some of the problems that may occur in the adolescent or teen.

• If brushing is a problem, try an electric toothbrush. This will clean the teeth more efficiently. When the twelve-year molars or wisdom teeth are erupting (coming in), use a toothbrush with a longer tuft of bristles at the end. This longer tuft of bristles will reach the newly erupting teeth that are at a lower level than the other teeth. Twelve-year molars should be sealed with a dental sealant by your family dentist as soon as they are fully erupted.
• Tartar or calculus usually occurs on the tongue side of the bottom incisors (front teeth). This is the result of food not being adequately brushed away. Some people have a tendency to form calculus and others do not. The end tuft is good for cleaning this area too.
• Use a fluoride mouth rinse (usually found in stores by the mouthwash) if one is having a problem with decay. The teeth should be brushed thoroughly before rinsing with the fluoride. It will not penetrate plaque. Use this at night just before going to bed. Do not rinse with water after using the fluoride rinse.
• Do not use a mouthwash with a high alcohol content on a daily basis. This practice could predispose one to oral cancer.
• The best cure for halitosis (bad breath) is to keep the mouth clean. Brush the roof of the mouth and the tongue. Tongue scrapers, which can be purchased in the toothbrush and toothpaste section of a store, are very helpful. A certain kind of bacteria may grow on the back of the tongue near the throat. These bacteria produce sulfide, a gas that causes halitosis. Large indentations in tonsils can catch food. If the food is not rinsed away, an odor may occur. Gargling with water may help to dislodge these food particles. A sinus infection with postnasal drip, dieting, or stomach problems could also be the cause of halitosis.
• If gums bleed with flossing, or the corners of the mouth are sore and cracking, a vitamin supplement may help. Try a multi-vitamin with meals.
• Bleeding with flossing may also mean one needs to floss more! Hormonal changes may cause gums to be red and swollen at certain times. Constant effort at keeping teeth clean is the best way to avoid bleeding and discomfort.
• Ulcers in the mouth (apthous ulcers) can be very painful. These may occur more often during orthodontic treatment, stress, or with trauma. There is no quick cure. One way to decrease the pain and shorten the duration of the ulcer is to use vitamin E. Pierce the end of a capsule of vitamin E and squeeze the vitamin over the ulcer. Do this often through the day and at bedtime.
• Soft drinks contain phosphoric acid and sugar. Try to drink through a straw and do not swish soft drinks through the teeth. Lemons are very acidic. Frequent sucking on lemons will erode (wear away) the enamel layer of teeth. Enamel will not grow back.
• Chewing tobacco should be completely avoided. There is a very high incidence of oral cancer with the use of any chewing tobacco.
• Chewing gum does stimulate the flow of saliva, and that is good for the teeth. But problems may occur with excessive gum chewing. The cusp tips of the molars are being worn away and decay is occurring in the teens. Once the enamel layer is worn down, the second layer is exposed. This layer, the dentin, decays easily. Chewing gum for more than three hours each day may result in discomfort or tenderness of the muscles in the jaws or popping or clicking in the joints of the jaws (temporomandibular joints or TMJ).
• Xylitol and sorbitol sweeteners in chewing gum have been shown to reduce the incidence of dental decay.
• Leaning the head on the palm of the hand continuously and crushing ice with the teeth has also been shown to result in TMJ symptoms and jaw muscle tenderness.
• Do not share water bottles. The herpes virus causes a cold sore and it is very contagious.
• The bacteria that cause tooth decay can also be spread from one person to another in the saliva.
• Change toothbrushes as soon as the bristles are frayed or bent. Bacteria and viruses grow on toothbrushes. Toothbrushes should be rinsed thoroughly before and after brushing. Change to a new toothbrush after an illness, especially strep. Reinfection can occur with a toothbrush that is covered with strep.
• Strep can also grow on acrylic orthodontic appliances. Clean them thoroughly during a strep infection.
• Mouth guards work. They should be worn for most sports. After orthodontic treatment is completed, or all of the permanent teeth (except the wisdom teeth) are erupted, a custom made mouth guard will provide the best protection. Have a dentist check the fit of the "boil-and-bite" mouth guard. A proper fit is very important. During orthodontic treatment, the orthodontist will recommend an appropriate mouth guard.
• The presence and position of wisdom teeth should be evaluated around fifteen years of age.
• And, finally … what teeth do you have to brush and floss? Only the ones you want to keep!

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.

Pediatric Dentist and Tooth Decay FAQs

Q. Should you give a baby a fluoride supplement?

A. Babies living in areas where the water supply is fluoridated do not need fluoride supplements. If the water supply is not fluoridated, or if the baby is breastfed, the physician or pediatric dentist may recommend supplements starting at the age of six months.

Besides tap water, and often bottled water as well, fluoride also is found in juices (especially cranberry juice) and baby foods (especially chicken). These sources may provide enough fluoride without the need for supplements, so discuss the need for fluoride supplements with your child's physician and/or pediatric dentist

Q. What causes "baby bottle tooth decay"?

A. Frequent, long-term exposure of a child's teeth to sugary liquids (including breast milk, formula, and milk) causes baby bottle tooth decay. The sugars in these liquids pool around the teeth and feed the bacteria in plaque.

Q. When should an infant's oral hygiene begin?

A. Even without teeth, oral hygiene should begin soon after birth. After each feeding, wipe your baby's gums, inside the cheeks, tongue, and roof of the mouth with a clean, damp washcloth or wet gauze pad. This removes plaque, the sticky film containing decay-causing bacteria.

Q. What are the white patches sometimes found in a newborn's mouth?

A. Yeast infections in the mouth occur frequently in newborns. White patches can spot the tongue, cheeks, gums, or roof of the mouth. If they are removed, some bleeding will occur. Treatment is usually unnecessary; however, your doctor should be notified of this condition.

Q. What is the condition known as "tongue-tie"?

A. A piece of tissue connects the tongue to the bottom of the mouth, and if it's too short, a condition known as ankyloglossia results. This is common in newborns and usually resolves itself over time. The only reason to have the tissue cut is if the infant cannot nurse.

Q. When do babies start getting primary teeth?

A. The average age for the first primary tooth is five to six months; however, there is great variation.

Q. What are the signs of teething?

A. Fussiness, excessive drooling, rash, diarrhea, changes in sleep and feeding patterns, and fever can signal a baby's discomfort. However, don't assume that a fever or these changes are caused just from teething. They also can be symptoms of other health conditions. Check with your doctor to ensure your baby receives proper medical care.

Q. What remedies are recommended for teething pain?

A. Your children's dentist or pediatrician may recommend a pacifier, teething ring, or a special numbing ointment for the gums. Some teething rings and pacifiers can be chilled to extend their numbing effect. Older children will enjoy the soothing relief that popsicles provide.

Q. How can you help your child's teething pain?

A. To help your child's teeth pain, gently massage the infant's gums with a clean, wet finger, a small, cool spoon, or a clean, wet gauze pad. This often soothes the child's teeth pain and irritation. A cold rubber teething ring also helps.

Q. Can decay-causing bacteria be passed to an infant?

A. Yes, babies are exposed to bacteria from a variety of sources, such as a caregiver blowing on food to cool it, tasting food, sharing utensils, kissing the infant on the mouth, sharing a cup, or sucking on the baby's fingers. Care should be taken not to expose the infant to bacterial exposure from these sources.

Q. How should you care for a child's primary teeth?

A. As soon as the first tooth erupts, with a clean, wet washcloth or wet gauze. The gums also should be gently wiped. If a toothbrush is used, it should be an appropriate size.

Q. When should you start caring for your child's teeth?

A. As soon as primary teeth appear, they are at risk for decay and need to be brushed twice daily with a soft-bristled brush. Do not use toothpaste until your child is two years old.

Q. How can you prevent baby bottle tooth decay?

A. You can prevent baby bottle tooth decay by wiping the child's teeth and gums with a clean, moist washcloth after each feeding to remove plaque. You should never let your child go to sleep with a bottle containing a sweetened liquid. Among these are milk (including breast milk), formula, fruit juice, and other sweetened liquids. Constant use of a sipping cup containing sweetened liquids also can cause baby bottle tooth decay.

Q. Why is it important to care for primary (baby) teeth, since they will fall out anyway?

A. Primary teeth serve as the foundation for a healthy mouth, including the gums and the proper positioning of permanent teeth. They serve as natural space maintainers, holding the space open until the permanent teeth are ready to take their place.

If primary teeth become broken or decayed and are not properly treated, problems can occur with permanent teeth, which may contribute to other health problems. The result can be costly orthodontics and other pediatric dentistry treatments.

Q. Can juices hurt your child's teeth?

A. Because of the sugar content, juice and juice products have much greater potential to cause decay. Apple juice may cause staining of the teeth and should be diluted with water. Any beverage other than water has the potential to cause tooth decay, especially if the child drinks it frequently.

Q. What problems occur from baby bottle tooth decay?

A. To repair the decay, extensive treatment or extraction of the teeth may be required. Because the children are usually around 18 months to 2 years of age, hospitalization with general anesthesia is often required to perform these procedures.

Q. Is sucking harmful for teeth?

A. While sucking is a natural reflex, sucking on thumbs and pacifiers can cause problems after the permanent teeth erupt. Continued sucking after this time affects the proper growth of the mouth, alignment of teeth, and the development of the roof of the mouth that can result in the need for orthodontic treatment and other pediatric dentistry treatments in the future.

Q. How can parents encourage a child to stop thumb sucking?

A. Set a positive tone and praise the child when they're not sucking. Thumb sucking is a stress-reliever and offers comfort. Look for any factor that might be causing discomfort or anxiety and seek solutions to correcting them, rather than focusing on sucking as the issue.

Reward the child when he or she doesn't fall back into the habit, especially during stressful situations. Schedule an appointment with the child's pediatric dentist to talk about what is likely to happen if the habit continues.

Q. What can parents do if a child has difficulty breaking a thumb sucking habit?

A. Finding ways to take away the pleasure of thumb sucking reduces or eliminates the satisfaction gained from it. Bandage the thumb or put a sock over the hand at night. A pediatric dentist or pediatrician can prescribe a bitter-tasting medication to coat the thumb. A mouth appliance can be used to block the ability to suck.