baby steps

Here is an amazing fact: by the time your child reaches kindergarten class, more than 5 out of his or her 20 classmates will have dental cavities! Imagine that for a moment. Your child has just started the first phase of his or her educational journey and now more than a quarter of his or her classmates have a dental cavity.  It's 28 percent to be exact, per the National Institute of Craniofacial Research.

Maybe you, as a parent, remember having dental cavities, as a child.  And you might be thinking, "What's the big deal. Don't those teeth fall out anyway?" The answer comes later in this blog.

The CDC reports that dental cavities is the most prevalent chronic disease that our children are facing.  This is more common that getting diagnosed with asthma or allergies!

What's the big deal. Don't those Baby Teeth Fall Out Anyway?

First, as a parent, I do not want to expose my child to any forms of disease, especially something that can be avoided by following a few simple steps at home.

Second, think about the time you had to have a filling at the dentist as a child. Though there are now modern advances to decrease pain and discomfort, there is still an experience that may not be all too pleasant.

Thirdly, a child who is in pain from a cavity will not be able to focus properly at school or at home.  Sleep at home can also be disturbed, not only by your child, but in everyone at home.

Finally, there is cost associated with treating dental cavities.  There is direct costs from the procedure.  Also indirect costs need to be factored in such as, loss of income from taking your child to have a filling done, travel time, and time away from school.

There are physical and psychological factors that are associated with treating dental decay.

Instead of treating a problem after it has already occurred why not prevent the problem in the first place!

According to the American College of Obstetricians and Gynecologists, 89 percent of children age one year had an office based physician visit, while only 1.5 percent had a dental office visit.

Recommendations for Oral Health Care for your Infant.

Here are some recommendations that will give your child the best possible outcome of having optimal oral health care.  Establish a dental home by age 1 for your child.  This means having your child seen by the dentist by your child's 1st birthday.  During the initial exam several areas will be discussed.  This includes:

1. Oral exam of your child's mouth.

This will include an age appropriate demonstration of gum and teeth cleaning with fluoride treatment.

2. Assessment of your child's risk for dental decay.

This will include a road map to fend off any potential risks for getting cavities and recommendations for diet, flouride use, and the frequency for checkup appointments.

3. Cavities management.

If your child does have a cavity, then your dentist can give you ways to treat the cavity at an early stage.  Most general dentists do not want to see infants, so make sure to seek out a pediatric dentist.

4. Injury prevention.

Learn how to decrease the risk to dental injury at home and also learn what to do if there is a dental injury, should that occur.

5. Teething.

Find out the signs and symptoms of teething and ways to treat it in easy steps at home.

6. Lip and tongue tie assessment.

If you child has had difficulty with breastfeeding or bottle feeding, then you would want to see your pediatric dentist as soon as you notice this issue.  You can find more information about this here.

7. Non nutritive oral habits.

If your child loves to use her pacifier, sucks her finger, grinds her teeth, or has an abnormal tongue thrust, then all of these areas can be addressed by your pediatric dentist.

Instead of worrying about cavities, give your child the best chance of having a great start by seeing a dentist by age one!  Your child will have many milestones in their future.  Having a cavity shouldn't be one of them!

All Smiles Pediatric Dentistry

At All Smiles Pediatric Dentistry, we incorporate proven techniques to share with you and your child at each dental checkup visit. Dr. Allen Job and his team are committed to providing the latest in oral health care prevention. Check out our monthly blog posts! Our practice is centrally located in San Diego, CA.

COVID-19 Precautions

Find out how we are protecting our patients and our staff with our improved safety protocol.

Get to Know Us

Get acquainted with us by watching our practice video and find out what we do.

Scheduling an appointment for your child is easy! Start here to schedule an appointment. All of our forms are online. Fill them out securely from your smartphone or tablet and hit send. On appointment day, your child will be seen at their scheduled time. For example, if you have a 9:00 AM appointment, your child will be seen at 9:00 AM.

Dr. Allen Job, DDS, MS, MPH, MS is a board certified pediatric dentist who practices in San Diego, California, where he specializes in prevention. For more than a decade, served as assistant professor for the Department of Pediatric Dentistry at Loma Linda University School of Dentistry (LLUSD). He is currently an instructor at LLUSD.

[caption id="attachment_1084" align="alignleft" width="640"] Baby and mom[/caption]

Parenthood is a season of routines that constantly change.

Parents, did you just get used to the newborn stage? Now it’s over.

Parents, did you just get through one set of teething teeth? Rest up; the next cranky, sleepless teething stage is coming soon.

And just when you have your bedtime routine set for your 6-month-old, now you have to add a dental routine to the mix?

Let’s break it down…

The American Dental Association recommends you begin a brushing routine as soon as a baby’s first tooth (or set of teeth) has erupted.

There are two reasons to begin a dental routine this early:

Get baby used to brushing.

The earlier you start, the more your baby gets used to the whole brushing (and flossing) routine. Making it a familiar part of their day means less protesting as they get older and more independent (trust us on this).  You can find out more information here.

Prevent tooth decay.

Once those cute little teeth have arrived, they can begin to decay as they interact with bacteria naturally present in baby’s mouth. And even though they will fall out eventually, it’s very important to care well for baby teeth.

What should baby’s dental routine include?

Gently brush any teeth present with a baby tooth brush and a grain-size amount of fluoride toothpaste.

A useful technique for getting the right amount of toothpaste is gently dipping the tip of the brush in the toothpaste tube.

Make sure that baby has her own designated tube of toothpaste; it’s best not to contaminate baby’s mouth with anyone else’s mouth bacteria as this can hasten tooth decay.

After brushing teeth, rinse the toothbrush in water before gently brushing baby’s gums. This helps baby get used to the brushing sensation and also helps ease the pain as more teeth begin poking through.

For babies, brushing just once before bedtime should be sufficient; for toddlers, start brushing twice a day – in the morning after breakfast and at bedtime.

As baby gets older, they can begin taking more responsibility handling the tooth brush themselves, though they will still need help from mom or dad to brush well enough. If at any point they need encouragement, we’ve got some useful ideas to make their dental routine a pleasant experience.

As soon as you’ve got two teeth next to each other, you can introduce flossing. Disposable flossers are a great tool for little hands before they are dexterous enough for regular flossing.

Just as hand-washing can become an automatic procedure following use of the potty, introducing baby’s dental routine early on will make the whole thing second-nature.

The more familiar your child becomes with a good dental routine, the more likely they’ll continue with these healthy habits for life. That’s the hope, at least!

COVID-19 Precautions

Find out how we are protecting our patients and our staff with our improved safety protocol.

All Smiles Pediatric Dentistry

Get acquainted with us by watching our practice video and find out what we do.

Scheduling an appointment for your child is easy! Start here to schedule an appointment. All of our forms are online. Fill them out securely from your smartphone or tablet and hit send. On appointment day, your child will be seen at their scheduled time. For example, if you have a 9:00 AM appointment, your child will be seen at 9:00 AM.

Dr. Allen Job, DDS, MS, MPH, MS is a board certified pediatric dentist who practices in San Diego, California, where he specializes in prevention. For more than a decade, served as assistant professor for the Department of Pediatric Dentistry at Loma Linda University School of Dentistry (LLUSD). He is currently an instructor at LLUSD.

What is a tongue tie?

A tongue tie or ankyloglossia occurs when there is an abnormal band of thick tissue, also known as the frenum, which is located below the tongue.

How does a tongue tie affect feeding of newborn babies?

A tongue tie prevents the tongue from having the full range of motion.  This is considered a developmental problem since it arises before a baby is born.  Tongue tie restricts how a newborn nurses, often causing improper latch with the mother’s nipple.

What other problems can arise from having a tongue tie?

Having a tongue tie can create speech difficulties, malocclusion, and gum recession.¹

Is having a tongue tie pretty common?

Tongue tie occurs between 4% - 10.7% of the population.²

Are there different types of tongue tie?

Anterior Tongue Tie

Yes, there are two primary forms of tongue ties complete and partial.³  When the frenum has limited tongue movement it is considered a partial ankyloglossia.  This is known as an anterior tongue tie. Often, one can see an anterior tongue tie since it appears as a thin band of tissue under the tongue.

Posterior Tongue Tie

However, if  the tongue appears to be fused to the floor of the mouth it is then considered to be a total ankyloglossia.  This is known as a posterior tongue tie. Posterior tongue ties are much harder to visualize.  The tongue has to be elevated from the floor of the mouth in order to diagnose a posterior tongue tie.

What is a lip tie?

An upper lip tie is present when the upper lip is lifted and the band of connective tissue (frenum) is tight, causing the gums to blanch (turn white).  There are four classifications for lip tie, ranging from mild (Class 1) to severe (Class 4).

What are the 4 classifications of Lip Tie?

Class I: Mucosal

Class 2: Gingival

Class 3: Papillary

Class 4:  Papilla Penetrating

Upper Lip, Lower Lip, and Tongue Ties. Can someone have more than 1 lip tie?

A lip tie can occur on either, the upper lip, the lower lip, or both.  Often a lip tie accompanies a tongue tie.

How does a lip tie affect a baby?

Lip ties can be associated with breastfeeding difficulties in infants.⁴   They can be associated with facial cervical caries (tooth decay at the gumline), due to interference with proper oral hygiene.⁵  Moreover, they can also be associated with the gum recession. ⁶

How are tongue and lip ties treated?

Physicians, such as an ENT (Ear Nose Throat Specialist), usually will treat tongue and lip ties with a scalpel or surgical scissors.  They may also require treatment to be completed with some form of sedation, ranging from local anesthetic to general anesthesia.  Sutures or stitches may also need to be placed.

Today, pediatric dentists and some physicians trained in treating tongue tie and lip ties can perform this procedure in an outpatient setting, using a laser.  With using a laser, there is less pain, less bleeding, and no need for sutures.  This translates to faster healing and in most cases quicker resolution to the problem.  This form of treatment usually requires using just a topical anesthetic and occasionally, a local anesthetic.

How long does the procedure take?

The procedure usually takes less than 10 minutes from start to finish.  Mothers are able to nurse right after procedure with their infant.

What happens after the procedure?

In order to get optimal results and to ensure proper healing, it is essential that parents complete the post treatment therapy exercises with their infant and also follow-up with a daily oral hygiene routine.  Moreover, a series of follow-up care appointments will be setup to monitor the healing process.

What about older children or adults?

Older children and adults can also benefit from lip tie and tongue tie correction.  The benefits include: improved oral hygiene, decreasing orthodontic severity especially from lip tie treatment, and improved speech.

If your child is showing signs of tongue tie or lip tie, contact Dr. Allen Job at All Smiles Pediatric Dentistry, to for a comprehensive evaluation to see if your child will be a good candidate for laser treatment.

References

1. Segal L, Stephenson R, Dawes M, Feldman P. Prevalence, diagnosis, and treatment of ankyloglossia. Can Fam Physician 2007;53(6):1027-33
2. Boutsi EZ, Tatakis DN. Maxillary labial frenum attachment in children. Int J Paediatr Dent 2011;21(4):284-8.
3. McDonald RE, Avery DR, Weddell JA. Gingivitis and periodontal disease. In: Dean JA, Avery DR, McDonald RE, eds. McDonald and Avery’s Dentistry for the Child and Adolescent. 9th ed. Maryland Heights, Mo: Mosby Elsevier; 2011:389-91.
4. Coryllos E, Genna CW, Salloum A. Congenital tongue-tie and its impact on breastfeeding. Breastfeeding: Best for baby and mother. Am Acad Pedia (newsletter) 2004; Summer:1-7.
5. Kotlow L. The influence of the maxillary frenum on the development and pattern of dental caries on anterior teeth in breastfeeding infants: Prevention, diagnosis, and treatment. J Hum Lact 2010;26(3):304-8.
6. Minsk L. The frenectomy as an adjunct to periodontal Compend Contin Educ Dent 2002;23(5): 424-6, 428.

*This blog is part of the Baby Steps Series. Look for future blogs in this series.

Dr. Allen Job, DDS, MS, MPH, MS is a board certified pediatric dentist who practices in San Diego, California, where he specializes in prevention.  He is also an assistant professor at Loma Linda University Department of Pediatric Dentistry.

[caption id="attachment_217" align="alignleft" width="500"] Baby and mother[/caption]

With the arrival of your adorable baby, there are lots of new tasks that are new for you as a parent. Feeding or nursing time with your baby is important. Here are some recommendations of taking care of their oral health.

1. Use a Washcloth

Yes, using a clean wet washcloth after feeding times will keep your baby's gums healthy. Make this a habit for you to do with your baby.  Doing this will also stimulate your baby's gums, which will help promote good bloodflow. Here's an additional benefit, massaging the gums with a clean wet washcloth may aid when your baby starts teething!

2. Avoid Juices in the Bottle

Juices generally do not provide much nutritional value for your baby.  These drinks are filled with sugar and have empty calories.  Milk and water are good fluids for your baby to consume.  Want more information about diet?  Here are some additional recommendations from the National Maternal & Child Oral Health Resource Center.

3. First Dental Visit by First Birthday

Schedule your baby's first visit by their first birthday.  Why? As your baby's new teeth start coming in, your baby's diet and eating habits will change. Seeing a pediatric dentist by the first birthday will help you get more ways of keeping those teeth cavity free and pain free.

Dr. Allen Job and his team at All Smiles Pediatric Dentistry look forward to meeting you and your baby.

Check out more information, about how to take care of your baby's teeth.

*This blog is part of the Baby Steps Series. Look for future blogs in this series.

Dr. Allen Job, DDS, MS, MPH, MS is a board certified pediatric dentist who practices in San Diego, California, where he specializes in prevention.  He is also an assistant professor at Loma Linda University Department of Pediatric Dentistry.

One question our team at All Smiles Pediatric Dentistry hear all the time is, “When should I start brushing my baby’s teeth?”

You should begin regular cleanings even before your baby has teeth. After each breast feeding (or bottle-feeding) use a clean, damp washcloth to gently rub your baby’s gum tissue. You may wrap the material around one finger to make it easier to remove any food bits from your baby’s mouth.

When your baby’s first tooth comes in, switch to a baby toothbrush. Look for special baby toothbrushes in your drugstore; they have just a few bristles and are very soft. There are even brushes shaped like finger puppets that fit over the tip of your pointer finger! All you need at this point is water (no toothpaste yet).

After a few more teeth appear, you may start using toothpaste, but you only need a tiny bit, and make sure it doesn’t contain fluoride for the first two years. From the beginning, have your little one practice spitting the toothpaste out after brushing. That way, he or she will already have the good habit of spitting when you switch to fluoride toothpaste, which should never be swallowed.

If you have any questions about caring for your baby’s teeth, then schedule an appointment at our convenient San Diego, CA office. Please contact All Smiles Pediatric Dentistry.

*This blog is part of the Baby Steps Series. Look for future blogs in this series.

Dr. Allen Job, DDS, MS, MPH, MS is a board certified pediatric dentist who practices in San Diego, California, where he specializes in prevention.  He is also an assistant professor at Loma Linda University Department of Pediatric Dentistry.