By Lone Tree Pediatric Dentistry - September 19, 2019

We see many patients with Cerebral Palsy (CP) at Lone Tree Pediatric Dentistry.  Often, patients with special needs remain with pediatric dentists into their older years since we are accustomed to managing behavior, which may become more unpredictable in these populations.  In fact, our oldest patient with CP is in her 40s!

A frequent characteristic of CP is an increase in salivation due to a decrease in muscle tone of the oral musculature that normally keeps saliva in the mouth.  I have spoken with parents of patients with CP who occasionally find the amount of salivation frustrating.  This article reviews some of the treatment modalities available to patients with CP and their family members to help mitigate the amount of salivation.  Covered in this article is surgical management (removal of salivary glands), management with medication and management with Botox.  Each of these treatment options will act to decrease salivation by decreasing salivary flow or saliva production.

Saliva has a tremendous effect in reducing the amount of cavities that develop.  The reason being is that as saliva flows through our mouth it essentially washes food debris or bacteria from the surfaces of our teeth.  Saliva also possesses nutrients that help maintain the mineralization content of our teeth, thereby reducing cavities. 

The article reports that surgical management is the only treatment option out of the three that will increase a patient’s risk of developing cavities.  However, I would exercise caution to any parent considering any of these options to manage salivation.  A thorough discussion with the physician of the person with CP is certainly in order.  Impeccable oral hygiene is also a must if there is any possibility of increasing the risk of developing cavities.

https://cerebralpalsynewstoday.com/2019/04/10/salivary-glands-removal-linked-to-dental-issues-in-young-cp-patients/

By Lone Tree Pediatric Dentistry - September 12, 2019

My wife and I have three young children.  One was born while I was buried in literature to read and memorize during my pediatric dentistry residency; the other two were born soon after we moved across the country, became small business owners and lost virtually all of our free time (the life of parents, am I right?!).  Our eldest refused the pacifier but our two younger ones loved their binkies and we loved the peace and quiet that the pacifiers provided.  This begs the question when can too much of a good thing (pacifier use and its associated peace and quiet) create a bad thing (unfavorable changes to the way their teeth fit together)?

Nonnutritive sucking behaviors is a blanket term that refers to any oral habits not associated with eating or drinking.  Two very common nonnutritive sucking behaviors in infants are pacifier use and thumb-sucking.  These behaviors are typical and not worrisome in most children.  In fact, they are helpful in developing and strengthening the muscles that surround and involve the mouth.  These behaviors can become problematic; however, when a child engages in them for an extended period of time because of the forces that they exert on the teeth and jaw structures.

Prolonged nonnutritive sucking behaviors may unfavorably affect the way children’s upper and lower teeth fit together; the dental term for this is malocclusion.  Factors that ultimately determine the type and severity of malocclusion that may develop are the magnitude, duration and frequency of the behavior.  Generally speaking, the duration of the habit is the most predominant predictor of whether a malocclusion will develop; therefore, earlier cessation of these behaviors decrease the chance that it will affect the way your child’s teeth fit together.  In my practice, we recommend that parents help their kids eliminate these behaviors by the age of 3 years.  Continuing these behaviors beyond the age of 3 years will increase the odds that changes to their teeth or jaws may become permanent. 

If you are concerned any of these behaviors with your child, I recommend you have a consultation with a pediatric dentist to discuss the implications of their specific behavior and to discuss ways to prevent them from continuing.  We have found success with a variety of different ways to discourage these behaviors.  Most importantly, employing positive reinforcement by simply talking with your child and telling him or her that big boys/girls don’t do these sorts of things and that continuing to do it can hurt their teeth.  To discourage thumb sucking, some ideas are wrapping tape or a band aid around your child’s thumb.  Another idea is to paint a nail polish that doesn’t taste great on the nails that your child sucks (one such brand of this is Mavala).  To discourage pacifier sucking, we recommend gradually cutting the pacifier back such that one day it becomes a nub that your child can no longer suck on or keep in his/her mouth.  Alternatively, some parents have found success with cutting the pacifier in half and having their child find it “broken” (it’s important psychologically to use this word) and having him or her throw it away.  Finally, if your child seems to have any sort of physical dependence to the pacifier, parents have also reported success with building it into a stuffed animal.  This way your child will still be able to feel it but not place it in his or her mouth.  Ultimately, the method of quitting the behavior is child-dependent and the parents should decide which avenue will likely be the most successful for their child. 

Aside from the effect on your child’s jaw and teeth development, other implications of pacifier use has long been mired in controversy.  There have been studies performed that have concluded that early pacifier use leads to an infant having less ambition to breastfeed.  Other studies have claimed that pacifier use is associated with an increased development of a type of ear infection known as otitis media.  Another area of research has indicated that pacifier use decreases a child’s risk of developing SIDS.  As you can see, the implications of pacifier use extend beyond the development of your child’s teeth and jaws.  My personal opinion with regard to these studies is that although there may be an association between pacifier use and the above mentioned conditions, no direct cause cause-and-effect relationship can be established at this time.  I’m sure that we will all hear about more research being conducted on these topics with time. 

The following link provides more information with what was discussed above:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2791559/

I hope you enjoyed reading!

Dr. Nick

By Lone Tree Pediatric Dentistry - September 9, 2019

My name is Dr. Nick Miner and I have owned Lone Tree Pediatric Dentistry for 4 years!  Needless to say, it has been a whirlwind; however, I wouldn’t trade it for anything.  My wife and I moved from Boston to Lone Tree with our then 16-month-old son, rented a home that would be big enough for our soon to be family of 5.  Yes – we welcomed twin girls January of 2016!  So why not purchase an awesome dental practice to add to all of this chaos?!  It’s like the saying, “when it rains it pours” and we wanted it to pour knowing that we would experience some lows but mostly highs!  I always like to focus on the positives and that has been being part of this amazing Lone Tree community.  I enjoy not only seeing you in my office but also out and about.  The Highlands Ranch, Centennial, Parker, Castle Rock, Castle Pines and Littleton communities, just to name a few, have also provided much support in my journey.  I have learned a lot from being a business owner.  Furthermore, I cherish all the information I have learned in my many (13!) years of dental training and experience.  Knowledge is intended to be shared.  One of the many things we take pride in at Lone Tree Pediatric Dentistry is educating our families about good oral hygiene.  This information is not only for our toddler-aged patients but also for those through college and beyond.  Along with being a pediatric dentist, business owner, father of 3, and husband to a wife that will forever beat me at tennis, I’ve decide to blog!  My topics will range from dentistry to being a business owner with insight to the dental world.  I hope you enjoy what I have planned!
 

March 22, 2017

Brushing your child's teeth is not an easy task. Sometimes your child is uncooperative, they are tired, you are tired, but you will be thankful when they have healthy teeth at their next appointment. Dr. Nick talks his three year old into brushing his teeth and provides tidbits on how much toothpaste you should put on your child's toothbrush or whether your child should use a manual or electric toothbrush. Good information for a healthy smile!

 

March 16, 2017

Bedtime routine, part 2!  After Dr. Nick catches his second twin, he provides more information on toothpaste and fluoride consumption.  If you have questions on whether or not your infant should use a pacifier or not, you should definitely watch!