By Lone Tree Pediatric Dentistry - December 30, 2022

"My child’s teeth look discolored!"

The other day, I looked at my 8-year-old son’s teeth (through the lens of his dad and not his dentist) and thought they looked discolored.  With the new year coming up, we all want a new pearly white smile for ourselves and our kids.  I get similar questions from parents in my office about the color of the child’s teeth so figured this would be a great blog topic!
Adult teeth are inherently more yellow in appearance than baby teeth.  When we have a mouth full of adult teeth, they typically appear bright, white and normal in color.  However, when a child has a mixture of baby teeth and adult teeth, the neighboring comparison of a whiter baby tooth next to a yellower adult tooth makes their differences seem more drastic.  If this is the underlying issue, waiting for more adult teeth to erupt is the preferred remedy to the color concern.

Plaque buildup is another culprit when it comes to the topic of tooth discoloration.  When a parent asks about tooth discoloration BEFORE a cleaning, in most cases the assistant, hygienist or I am able to easily remove the buildup and get the patient’s smile looking great!  When this seems to be the area of concern, we have a long talk with the patient and parent about improving brushing and flossing.

The type of bacteria in our mouth can also result in tooth discoloration.  We all have loads of bacteria in our mouth.  Bacteria is not always bad.  Broadly speaking, we have three types of bacteria – healthy bacteria, bacteria that causes cavities and bacteria that causes gum disease.  A specific family of bacteria the belongs in the healthy category is called chromogenic bacteria.  Unfortunately, this type of bacteria produces the by-product of tooth discoloration.  This discoloration can usually be removed fairly easily by the team at Lone Tree Pediatric Dentistry.  Research shows that patients who have a greater concentration of chromogenic bacteria in their mouth have a lower likelihood of developing cavities.  Effective brushing and flossing are the best ways to ward off this type of tooth discoloration.
Keep those smiles bright, white and healthy in the new year and beyond!

Dr. Nick 

Alright, alright… we’ve all heard, and I’ve repeated many times to patients and families, that it is important to brush twice a day and floss once a day.  However, I wonder if it is something that patients hear so often that the mantra begins to lose its effectiveness.  Therefore, I figured it is a good time to write a blog to dive a little deeper into this topic.

Brushing
The idea is to brush for two minutes, once in the morning and once at night.  Refer to our earlier blog entitled “Before or After Breakfast: Brushing Your Child’s Teeth” for timing of morning brushing.  Then in the evening we should be brushing either right before bed or sometime after the last time we will be eating or drinking for the night.
As for brushing technique, the idea is to form small circles with your toothbrush bristles and to focus most of the brushing along the gumline.  The gumline (or where the gums meet the teeth) is the most commonly neglected spot to brush effectively.  While brushing along the gumlines, the goal is to angle the toothbrush on the spot where your gums meet your teeth (in other words, angle the bristles up on top teeth and down on the bottom teeth).  Gentle brushing is the key – it doesn’t take much pressure to remove plaque on teeth surfaces.  Brushing too hard may cause some unnecessary damage to gums surrounding teeth.  It is also important to spend some time brushing on the chewing surfaces of the teeth to remove plaque and food debris from the grooves and crevices of teeth.

Flossing
We should be flossing our teeth once a day.  Gently rub the floss up and down each tooth between the tooth and gums and in between each tooth that contacts another tooth. Gentle is the key so as not to cause gum damage.  If you haven’t flossed for a while, your gums will be sore after the first time you floss.  Stick with the routine of flossing once daily and your gums will toughen-up and the soreness will be a thing of the past.

There is debate about whether this should be done in the morning or evening.  There is also debate as to whether it should be done before or after brushing.  I floss at night after brushing.  However, so long as it happens once a day, find a way to fit it into your routine with your preferences, and your teeth and gums will be better off for it.
Happy brushing and flossing!

-Dr. Nick
 

The New York Times posted an article “Is It Better to Brush Your Teeth Before Breakfast or After?” on November 1, 2022.  

I loved reading this article because I have wondered this same question throughout my life.  During my years of dental education and training I heard much of the debate highlighted in this article.  Allow me to begin by saying that I see both sides of the argument in this article and all points are valid.  There is definitely more bacteria in our mouth after we wake up that, in an ideal world, would not be present when we are feeding ourselves, and our children, the carbohydrates we eat during breakfast.  However, getting a good brush in after breakfast to remove the bacteria that accumulated in our mouth overnight, to get rid of any residual food debris and to apply fluoride to our teeth surfaces does make brushing after breakfast a logical choice.

In my opinion, the argument is tilted towards brushing after breakfast, which is why that is what we do in my family.  That being said, my real concern is that we are brushing at least once before we go about our daily activities.  If your mornings are so hectic that you worry that you may forget to brush before you leave, then make it a priority when you first roll out of bed.  I am a creature of habit, and we all are to a certain extent.  Make that habit and stick to it.  As far as this argument is concerned, don't get too bogged down in the details of timing, just make sure it happens at least once before leaving for the day and then again before going to bed.  Brushing your teeth after dinner or at the end of the day is just as important as brushing in the morning.  Brushing twice a day, and flossing once a day, are habits to encourage for yourself and your children.  Doesn’t much matter when it occurs, before or after breakfast or before and after dinner, as long as it happens.  Happy brushing and happy holidays!

Dr. Nick
 

By Lone Tree Pediatric Dentistry - August 9, 2021

Of course my kiddos would eat sugary treats and starchy snacks for every meal if I allowed them.  If it were up to them I would also be Willy Wonka instead of a Pediatric Dentist.  But here I am, cleaning teeth and making sure my patients have all the needed information to keep their mouth healthy.  This includes what is consumed and how it affects teeth and gum tissue.   A balanced diet with fruits, vegetables, grains, milk, meat and beans is what I encourage my patients, as well as my children, to eat.  A balanced diet will help teeth to develop properly and stay healthy.  Conversely, a diet high in certain kinds of carbohydrates, such as sugar and starches, may increase a child’s chance of tooth decay.  I am not saying completely remove sugar and starch out of your child’s diet.   This would be nearly impossible.  Instead explain to your child that bread, crackers, pasta, pretzels, potato chips, etc. are starches.  If your child chooses these items try to include these items as part of a meal with other food groups instead of a snack.   Sugar can be present in more than just your child’s candy jar.  A variety of foods, such as processed foods, contain one or more types of sugar, and all types of sugars can promote dental decay.  There are a few vegetables, along with most milk products, that contain at least one type of sugar.  These items I like to call “mother nature’s treats.”  I explain to my patients, and children, that these “sugar bugs” are easily washed away from their teeth with their saliva and/or milk and water.  However, sticky foods such as dried fruit or chewy candy are not.  Either way, it is important to brush twice a day and floss once a day to ensure your child’s mouth stays healthy and clean.

Until next time, eat healthy and keep brushing!

Dr. Nick

By Lone Tree Pediatric Dentistry - May 28, 2021

As a parent myself I know how scary it can be to see my children fall and injure their mouth, and I’m their dentist!  These incidents are not pretty.  The child is panicked, the parent is panicked, and we learn quickly that head and mouth injuries tend to bleed A LOT.  On top of all of this we can’t see the source of the injury.   Did they lose a tooth?  Is it their lip?  Did they bite their tongue?  Oh no, what if they permanently damaged their teeth and their smile, forever?!  When your child needs urgent dental treatment, I am here to help.  However, it is nice to know what needs to be done after the panicked feeling subsides.

The most common dental trauma scenarios and/or questions I address, often after office hours or on the weekends, are:   

My child bumped their mouth into their friend’s head and they are bleeding.  Do I need to go to the ER?

More than likely you do not.  Calmly have your child rinse their mouth with water so you can see what is going on.  I always have my patient’s parent’s text me a photo so I can provide better guidance and, if needed, a trip to the dental office.  The impact may loosen the tooth but that doesn’t always mean the tooth is damaged.  Loosening of the tooth is often accompanied by bleeding along the gumline and mobility of the tooth.  After a short time, we hope it will go back into place and we will elect to monitor the tooth until the adult tooth takes its place. 

My child’s baby tooth is knocked out?  Is this okay since it is not an adult/permanent tooth?

Similar to the approach above, I recommend my patients call me as soon as possible.  A baby tooth should not be replanted (or put back in the child’s gums) because of the potential damage or subsequent damage to the developing adult/permanent tooth.  An x-ray will help decipher next steps.  But baby teeth are just as important as adult teeth.  They pave the way for the eruption of a healthy adult tooth.  Without them the adult tooth doesn’t know where to go.  Also, if a baby tooth has a cavity, this may lead to a greater chance of developing cavities in adult teeth.  In other words, healthy baby teeth are very important! 

My child’s permanent tooth is knocked out, what should I do?

This is very different from dealing with a baby tooth.  You need to find the tooth and rinse it gently with water and only water!  There is no need to clean it with soap and do not scrub the tooth.  If possible, though it’s not for the faint of heart, replace the tooth in the socket/gums immediately.  You can hold the tooth in place with clean gauze or a washcloth.  If putting the tooth back in the socket is not an option, place the tooth in a clean container with cold milk or saliva (preferably the patient’s saliva).  Call your pediatric dental office immediately.  These steps, if acted upon instantly, will increase the chances of saving the tooth. 

I think my child chipped or fractured their tooth?

Again, contacting your pediatric dentist immediately is step one.  The faster you act the better chance of saving the tooth, preventing infection and/or reducing the need for extensive dental treatment.  If you can find the broken tooth fragment, place it in cold milk and bring it in with you to your pediatric dental office.  If the lip, or any other part of the mouth is injured, rinse the mouth with water and apply cold compresses to reduce swelling.  

What do I do if my child has a toothache from their injury?

Check in with your pediatric dentist and visit the office if the pain persists.  Your pediatric dentist will more than likely recommend over-the-counter children’s pain medication to ease symptoms.  You may also want to apply a cold compress or ice wrapped in a cloth directly on the site of pain.   It is not advised to put heat or aspirin on the sore area.  Aspirin is not recommended with kids and heat may increase, not decrease, swelling or inflammation.

Children will be children and there is no way to prevent them from falling or foreseeing an accident.  But there are ways to reduce risk for severe oral injury in sports by wearing protective gear such as a mouthguard.  Taking your child to regular dental check-ups provides your pediatric dentist the opportunity to discuss additional age-appropriate preventive strategies like always using a car seat for young children, child-proofing your home to prevent falls, and the use of mouthguards and helmets.  The head must be protected as much as possible.  Whether your child is going skiing, playing their favorite sport, or going for a quick bike ride, helmets are always recommended.  One of my first questions when my patient’s parent tells me their child hit their head or jaw is “were they responsive soon after impact?  Do they seem like themselves?  Do you think they suffered a concussion?”  A severe head injury can be life threatening and if you think this happened to your child they will need immediate medical attention.  This would be the time when you don’t call me, or your pediatric dentist, first but 911.  

This is a lot to take in!  I hope you are reading this as a preventive measure, in a calm state, rather than you quickly googled, “what to do when your kid hits their mouth?”  Either way I hope this helps alleviate some of your parenting stress and gives you a plan of action. 

Until next time, keep your kids smiling!

Dr. Nick