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Posts for tag: pediatric dentistry

BehavioralTherapyCouldReduceaChildsDentalAnxietyWithoutDrugs

It’s common for kids to be less than enthusiastic about visiting the dentist. For some, though, it’s even more of a challenge: A child with extreme anxiety and fear during dental visits could interfere with them receiving the dental care they need. The impact could even extend into adulthood.

Recognizing the need to reduce this high anxiety, dentistry has used a number of pharmacological tools for many years that relax a child during dental care. Sedatives have often been the only choice for reducing anxiety, especially during extensive procedures and treatments. But now there’s a promising new approach in dentistry that doesn’t depend on drugs.

Cognitive behavioral therapy (CBT), a psychotherapeutic method used for decades to treat depression, phobias and eating disorders, has been investigated recently as a possible approach for relieving children’s dental anxiety. During CBT, trained therapists use specific behavioral techniques to help patients develop mental and emotional strategies for dealing with stress.

During the usual course of CBT therapy, a therapist meets in counseling sessions with patients weekly over several months to help them change their routine thinking or behavior surrounding a stressful issue. Initially, the therapist guides the patient toward understanding the underlying causes for their negative reaction to the issue. They then work with the patient to devise an objective way to test whether those emotions and beliefs about the issue are true.

Using this effective method for changing behavioral and emotional responses for dental anxiety has had encouraging results from initial research. One study found CBT successfully reduced dental anxiety among a majority of a group of European children ages 9 through 16 who participated in the method.

CBT isn’t an overnight cure, often requires a number of months to achieve results. But for children who suffer from extreme fear of professional dental care, this drug-free method may provide long-term benefits that extend well past their childhood years.

If you would like more information on reducing dental anxiety in children, please contact us or schedule an appointment for a consultation.

By Jonathan Berns, DDS
July 29, 2019
Category: Oral Health
HowEarlyDentalVisitsCanImproveYourChildsOralHealth

Pediatricians and dentists alike recommend beginning your child's regular dental visits at an earlier age rather than later. Most say children's first visits should happen around their first birthday.

Some may question whether that's necessary given the state of a child's dental development at that age. At that stage they normally have only a few primary teeth, which will eventually give way to their permanent set soon enough.

But regular dental visits can make a positive difference even at that early age. Here are 3 oral health areas that could benefit from seeing the dentist by Age One.

Protecting primary teeth from decay. It's true that primary teeth don't last long when compared to a normal lifespan. But during their short tenure, they do play a critical role in a child's health and development. Not only do they provide a child dental function for eating, speaking and smiling, they also preserve the space for the permanent teeth that will succeed them. Without them, permanent teeth can erupt out of position to form a poor bite (or malocclusion). That's why early dental care to prevent and treat decay in primary teeth helps them remain for as long as they should.

Detecting developing malocclusions. A malocclusion doesn't form overnight—there can be subtle signs of its development during early childhood. A dentist, especially a pediatric dentist or orthodontist, can often detect those signs before the malocclusion fully develops (one reason why every child should have an orthodontic evaluation around age 6). With early detection, an orthodontist can use interventional techniques that will lessen or even stop a malocclusion from forming. As a result, later orthodontic treatment may not be as extensive—or expensive—as it could have been.

Developing a healthy dentist-patient relationship. Dental anxiety is a real problem for many adults—in some cases it can be so severe they avoid professional dental care altogether. The roots of that dental fear often go back to unpleasant experiences during childhood. Starting dental visits when a child is very young appears to minimize the development of dental anxiety. A young child, especially visiting a "kid-friendly" dental clinic, will more likely view dental care as a routine part of life and will less likely be afraid.

If you would like more information on dental care for children, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Age One Dental Visit: Why It's Important for Your Baby.”

By Jonathan Berns, DDS
June 19, 2019
Category: Oral Health
SimpleStepstoFollowifYourChildhasaToothache

"Mom, my tooth hurts" isn't something you look forward to hearing your child say. But tooth pain is as common as other childhood ailments, so you may have to face it. Here are a few simple steps to make it easier.

First, ask your child where in the mouth it hurts and, if they can, tell you how long it's been hurting. Children's memories aren't always accurate, but you can still get a general idea that you can communicate with your dentist if you take them in.

Next, look in their mouth for anything out of the ordinary: gum swelling or bleeding, or dark spots on the teeth indicative of tooth decay. Look also for hard food particles like popcorn kernels caught between the teeth, which could be causing the pain. Gently floss between the teeth (even if you can't see anything) to remove any caught particles.

You'll also want to help ease their pain. You can apply an ice pack against the painful side of the jaw. Don't place ice directly on the skin, but use a container or cloth alternately against the jaw for a minute or so, and then away for a minute. You can also give them a dose of mild pain reliever like ibuprofen or acetaminophen appropriate for their age and weight—but never rub aspirin or other pain relievers on the gums, which tend to be acidic and can burn the skin.

Finally, you'll need to decide if you need to see a dentist and how soon. It might not be necessary with situations like the trapped food particles, but most of the time it's wise to have your dentist perform an examination for an accurate diagnosis and appropriate treatment. As to how soon, try to see the dentist immediately if the pain has continued from one day to the next or has kept your child up overnight. Otherwise, book an appointment for as soon as the dentist advises, even if the pain subsides.

A toothache at any age is never pleasant, but especially for children. Knowing these steps will help ease their discomfort and get them the relief and treatment they need.

If you would like more information on dental care for children, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “A Child's Toothache: Have a Dental Exam to Figure out the Real Cause.”

HeresHowYouCanProtectYourChildsTeethfromToothDecay

While dental diseases tend to be a greater concern as we get older, they also pose a potential threat to children. A particular type of tooth decay called early childhood caries (ECC) can severely damage children's unprotected teeth and skew their normal dental development.

Fortunately, you can protect your child's teeth from disease with a few simple practices. First and foremost: start a hygiene habit as soon as possible to remove disease-causing bacterial plaque. You don't have to wait until teeth appear, either: simply wipe the baby's gums with a clean wet cloth after nursing to minimize the growth of oral bacteria.

When their teeth do begin to erupt, you can switch to brushing (you can add flossing as more teeth erupt—but until the child shows appropriate dexterity, you'll need to do it for them). For infants, brush gently but thoroughly with a soft-bristled brush and a smear of fluoride toothpaste. When they grow older you can increase the toothpaste to a pea-sized amount. And as soon as you can, get them involved with learning to perform these vital habits on their own.

You should also limit your child's consumption of sugar. Our favorite carbohydrate is also a favorite of bacteria, who consume any remnants in dental plaque as a primary food source. So, keep sugary snacks and foods to a minimum and limit them mainly to mealtimes. And don't put a baby to sleep with a bottle filled with a liquid containing sugar (including formula and breastmilk).

Finally, begin taking your child to the dentist regularly by their first birthday for routine cleanings and checkups. Besides removing any hard to reach plaque, your dentist may also apply sealants and topical fluoride to help protect and strengthen tooth enamel. Regular visits make it more likely to detect the early signs of decay, before it does extensive damage. And beginning early makes it less likely your child will develop a fear of dental visits that could carry on into adulthood.

These and other steps will go a long way in protecting your child's teeth and gums so they develop normally. A little prevention and protection will help ensure a happy, healthy smile later in life.

If you would like more information on helping your child develop healthy teeth and gums, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Top 10 Oral Health Tips for Children.”

DontUseBenzocaineProductstoEaseYourBabysTeethingPain

Although teething is a natural part of your baby's dental development, it can be quite uncomfortable for them—and upsetting to you. During teething, children can experience symptoms like pain, drooling or irritability.

Teething is the two or three-year process of intermittent episodes of the primary ("baby") teeth moving through the gums. These episodes are like storms that build up and then subside after a few days. Your aim as a parent is to help your baby get through the "stormiest" times with as little discomfort as possible. To that end you may have considered using over-the-counter products that temporarily numb irritated gums.

Some of those numbing products, however, contain a pain reliever called benzocaine. In recent years, this and similar ingredients have been found to increase the level of a protein called methemoglobin in the bloodstream. Too much methemoglobin can result in less oxygen delivered to body tissues, a condition known as methemoglobinemia.

This oxygen decrease can cause shortness of breath, fatigue or dizziness. In its severest form it could lead to seizures, coma or even death. Children and infants are at high risk for benzocaine-induced methemoglobinemia, which is why the U.S. Food and Drug Administration has banned marketing for benzocaine products as pain relievers for teething infants and children.

Fortunately, there are alternatives for helping your child weather teething episodes. A clean, chilled (not frozen) teething ring or pacifier, or a cold, wet washcloth can help numb gum pain. You can also massage their gums with a clean finger to help counteract the pressure exerted by an emerging tooth. Be sure, though, that you're not allowing anything in your child's mouth like lead-based paint that could be toxic. And under no circumstances should you use substances containing alcohol.

For severe pain, consult your physician about using a pain reliever like acetaminophen or ibuprofen, and the proper dosage for your child. With these tips you can help your child safely pass through a teething episode.

If you would like more information on helping your child cope with teething discomfort, please contact us or schedule an appointment for a consultation.