Local Dental Care - California Dentistry Questions

Dental Health Care: Discolored Primary Teeth

Discoloration of the primary (baby) incisors (front teeth) is most often noticed by parents. This discoloration may be extrinsic or intrinsic. Tooth brushing or a professional cleaning can remove extrinsic discolorations or stains. Intrinsic discoloration occurs within the tooth structure.

Some apple juices and grape juice may cause staining. This type of stain can usually be brushed off the teeth at home. If your child has a tendency to stain, try diluting the juice with water. Once the enamel begins to break down, the staining may be more difficult to remove because it is deep down in the tiny holes created by break down of the enamel. This could progress on to decay. If the teeth appear to be a dull, white color in some spots, discontinue juices completely or dilute the juice with water. Juice is twenty times more decay-causing than milk. Juices should be limited to mealtime only.

Liquid and chewable medicines have a high sugar content and most are colored with dye. A light yellow-brown film may cover the teeth. This occurs most often on the bottom front teeth. Bedtime tooth brushing is especially important when your child is taking liquid or chewable medicine. Tetracycline is the only antibiotic that could cause damage to the developing permanent teeth if given before eight years of age.

Iron in chewable or liquid vitamins may cause staining of the grooves of the primary (baby) molars. This is difficult to remove, but overall is harmless.

You must brush your child's teeth until six years of age. Bedtime brushing is the most important time of day. Staining may occur if plaque remains on teeth for a long period of time. Plaque is made up of cells from the inside of the mouth, bacteria, and food residues. Teeth may appear to be discolored, but a thorough brushing may remove this stain. Do not use toothpaste until two years of age. Baking soda toothpaste seems to be best for stain removal.

Bacteria called chromogenic (colored) bacteria may cause a dark green or brown stain on the teeth. This stain is usually along the gum line. These bacteria are harmless and will one day just disappear. We do not know why they grow in some mouths and not others. A professional cleaning is usually necessary to remove this stain.

Intrinsic discoloration cannot be removed by cleaning the teeth. This occurs because the enamel on the primary teeth did not form in the usual manner. This may be inherited from one or both parents. It does not necessarily mean that the primary teeth will be more susceptible to decay or that the permanent teeth will have the same appearance.

Trauma to a primary incisor (front tooth) may cause discoloration. If the blood vessels deep inside the tooth break, the blood may be absorbed into the tiny tubes that travel from the inside of the tooth to the outer enamel layer. This is similar to a black and blue mark on the skin. Enamel is translucent, so you can see the evidence of the damage. This may resolve without treatment, but your pediatric dentist should be consulted. A procedure to remove the tissue from the inside of the tooth (pulpectomy) may be necessary.

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.

Kid's Dentist: Time For Teething

If babies could talk, they might have a few things to say about their troubles with teething: "Ooohh, do my gums ever hurt!" Since they can't, parents and caregivers must stay alert to signs of teething: drooling, fussiness, redness of gums and cheeks, sleeplessness, and maybe a loss of appetite. The first signs of teething may begin as early as three to four months of age. Baby teeth usually begin appearing between the ages of 6 to 16 months.

What Can Help My Child Feel More Comfortable While Teething?

Pay attention to the signs of teething and offer a big dose of TLC (tender loving care) and some relief of discomfort with some tried and true teething tips:

• Gently massage the baby's gums with a clean, cool, damp gauze pad or with your clean finger.
• Give your baby a cool non-plastic spoon to place into his or her mouth. Do not freeze the spoon.
• Allow your baby to chew on a cooled teething ring or moistened washcloth. Note: For safety reasons, do not leave your baby unattended while chewing on these things. Avoid plastic teething rings because a piece may break off and the baby's mouth could be cut or choking could occur. Also, teething rings should not be placed in the freezer. The frozen ring may stick to the lip, tongue, or gums and tear the tissue.
• If you apply over-the-counter topical medication, or if you use Acetaminophen (Tylenol or Tempra), follow the instructions on the label carefully and consult your doctor. Too much may cause liver damage. Over-the-counter medications should not be routinely given to an infant without a doctor's approval.

How Should I Care for My Baby's New Teeth?

As soon as your baby's teeth are visible, it's time to begin brushing! Baby teeth are susceptible to tooth decay that can lead to damage of permanent teeth. In the morning and before bedtime, brush teeth with a soft-bristled toothbrush and water only. Do not use toothpaste until your baby reaches two years of age to prevent accidental swallowing. After that, use just a dab (the size of a match-head) of fluoride toothpaste.

Be sure to schedule your child's first dental exam around the time of his or her first birthday (definitely no later than 16 months of age). Routine dental visits reveal any conditions that can be treated early as well as establish your child's dentist as a "healthy smile" partner.

By Brian J. Gray, DDS, MAGD, FICO

+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.