Monday, June 26, 2017

Common Concerns and Questions

My child grinds her teeth and it's so loud!
Why are my kids teeth so yellow?
My kid has shark teeth.
My child often complains of his teeth being sensitive.

These are some of the most common concerns and questions we are faced with in pediatric dentistry. While these topics sound problematic, in most instances no action or intervention is required.  In this blog post, we’ll address them.
My child grinds her teeth and it’s driving me crazy!
We all cringe at the sound of crushing glass or nails running down a chalkboard.  Bruxism is the act of grinding or clenching the teeth together, and it may make a noise very similar to this.  Though the sound is what is most concerning with grinding, it is usually not evident on the teeth and unlikely to be causing any serious damage. Some causes of grinding are:
-Pain, teething, or ear infection.
-Physical pain, misalignment or overcrowding of the teeth between two arches.
-Stress or environmental change, school, divorce, death, or negative emotion.
We expect grinding to lessen between ages of 6 and 9 years and to stop between 9 to 12 years. If grinding has not stopped, or we begin to see too much damage to the teeth, we may suggest an over-the-counter or custom night guard.  A recommendation to visit the orthodontist will also be considered if appropriate.

I can not brush the yellow off!
There are many reasons for discoloration in teeth. The most common time parents ask about yellowing teeth is when the first permanent teeth begin to erupt.  The differing densities of tooth structure between the permanent and primary teeth often make the permanent teeth appear to be a fair bit yellow.  When compared to the bright white of primary teeth right next to the yellower permanent teeth, it’s obvious why there would be some concern!  Once baby teeth have all exfoliated the adult dentition is often a very normal shade of white.  Another cause for discoloration is a condition known as hypoplasia. This is a developmental defect often resulting in physically missing tooth structure or “mottled” enamel which has a brown or yellow hue to it. Hypomineralization is a decrease of mineral content in the enamel showing as bright white areas on the tooth surface.  While there are no specific known causes for hypoplasia/hypomineralization, some contributing factors may be infection or fever during pregnancy as primary tooth formation begins, premature birth, hereditary disorders, or some medications. Environmental factors would be trauma to a baby tooth causing disruption in formation of the adult tooth or systemic fluoride overingestion (fluorosis). In rare instances due to cosmetic concerns or tooth sensitivity, crowns, restorations (fillings) or sealants may be recommended.

Part child part shark you ask? 
Sometimes adult teeth will come in before their baby teeth fall out. This condition is known as ectopic eruption or "shark teeth" (the name given due to the double rows). Normally the adult tooth erupts under the baby tooth causing the baby tooth root to resorb, become wiggly, and fall out. If the permanent tooth erupts elsewhere it is usually due to inadequate space, and both primary and permanent versions are present at the same time. Most of the time no help is needed for the baby tooth to come out but we do encourage wiggling the baby tooth with clean hands. In some cases the dentist may need to extract the baby tooth.

Not being able to eat ice cream is no fun!  Tooth sensitivity can happen for a few reasons.  Often newly erupting permanent teeth can be sensitive to newfound exposures of air and foods. Fluoride treatment can help reduce the sensitivity.  Canker sores due to trauma such as cheek bites or acidity in the diet (juice, lemon, vinegar, fruit) can often be mistaken for tooth pain due to the child's inability to differentiate between the two.  Avoiding acidic foods and sodium lauryl sulfate (SLS foaming agent in toothpaste and mouth rinse) may decrease the recurrence rate of canker sores.  As previously mentioned hypoplasia is another cause of tooth sensitivity due to a disruption in the enamel formation which can expose the second layer of tooth called dentin.  Dentin is made of microscopic tubules with tiny nerves inside.  When these nerves are exposed to cold they can send a shock wave through the tooth. Tooth decay can also be a cause of tooth sensitivity in pediatric patients. When a cavity is just beginning to form a child may not experience any symptoms at all, but as the decay progresses they may experience sensitivity of mild to sharp pain when eating or drinking something sweet, hot or cold.  Routine dental care can help to diagnose smaller areas of decay before they do become sensitive.

Dr. Scholl and your child’s hygienist are here to help you. Please address any of your questions or concerns with them.

Erica - Hygienist