CHILDREN

Why Baby Teeth Are Important 

Many people believe that since baby teeth fall out and are replaced by permanent or adult teeth, they may not be that important. On the contrary, baby teeth are just as important as adult teeth. Baby teeth form the foundation for a child’s speech and allow them to chew. They give the face its shape and hold space for adult teeth. It is so important to keep baby teeth healthy and well cared for! 

Decay can spread quicker in baby teeth than adult teeth because the enamel layer is not as thick as in a permanent tooth. Decay in baby teeth can affect the adult teeth also. As soon as a tooth appears in the mouth, it is susceptible to decay. Liquids or foods containing sugar will cause the decay to happen and the longer the teeth are in contact with these foods/liquids, the quicker the decay process will occur. 

Tips to protect teeth from decay: 

• ​ Never let a baby or toddler fall asleep with a bottle of sugary liquids (including milk or formula) 
• ​ Never dip a pacifier in sugar or honey 
• ​ Do not put a pacifier in your mouth to clean it and then put it in a baby’s mouth. You may pass on decay-causing bacteria to the baby 
• ​ Do not allow children to frequently sip juice or sugary drinks from bottles or sippy cups. Even watered-down juice or sugary drinks can damage teeth. For toddlers and children on a solid diet, juice and milk should be limited to mealtimes, and water should be offered between meals. 

If a baby tooth is lost too early and the permanent tooth isn’t ready to erupt, the teeth will shift and may make it difficult for the permanent tooth to come in. The permanent teeth will likely be crowded or misaligned and could be difficult to keep clean, creating a higher risk for decay to form. Crowded or misaligned teeth can also affect chewing and speech, creating a lifetime of concerns and problems if not corrected. 

Brushing Your Child’s Teeth and Gums 

From birth, it is important to clean your baby’s mouth. After nursing or bottle feeding, the gums should be wiped with a wet washcloth. As soon as the first tooth appears (typically between 4-8 months old), start brushing your baby’s teeth morning and night with a soft-bristled child-sized toothbrush and a fluoride toothpaste. 

Children under 3 need VERY LITTLE toothpaste – just a smear on the tip of the bristles is enough (think grain of rice size). 3-6-year-olds can use a little more but no larger than a pea-sized amount. It is ok to let your child brush his or her own teeth, as long as you follow up and help them finish to be sure all areas are well cleaned. A child doesn’t have the proper dexterity to thoroughly brush their own teeth until they can tie their own shoes (around age 6). It is important to supervise brushing once they are doing it on their own to ensure they aren’t “rushing brushing”. It is important for them to touch ALL surfaces of ALL their teeth with the bristles of the toothbrush!! 

Flossing your child’s teeth is a good habit to start once they have teeth touching side by side. Your dentist or hygienist can tell you when your child has contacting teeth and show you the best technique. Nighttime is the best time for flossing and thicker woven floss works best for kids’ teeth. 

Handling a Child’s Dental Emergency 

Dental emergencies are scary, especially for parents! Knowing how to handle the situation can mean the difference between saving and losing your child’s tooth. Here are some tips to help you cope quickly and calmly. 

Knocked-Out Baby Tooth 

Bring your child in to see the dentist as soon as you can for an evaluation. If the tooth has come completely out, DO NOT try to put it back in. This can damage the permanent tooth under the gums. 

Knocked-Out Adult Tooth 

Unlike a baby tooth, an adult tooth SHOULD be put back into the socket as soon as possible. Once the tooth is found, hold it by the crown (top), not the root. If it looks dirty, rinse the root briefly with water. ​Do not scrub it or remove any attached bits of tissue. 

If possible, gently insert and hold the tooth in its socket with a clean washcloth or gauze. If the tooth can’t be replaced into the socket, have the child hold the tooth under their tongue. If that is not possible, put the tooth in a container with milk, saliva, saline solution, OR an emergency tooth preservation kit. If none of those are available, put the tooth in water. 

Take your child into the dentist as quickly as you can – within 30 minutes is ideal. Bring the tooth and any pieces you can find along with you. 

Broken or Cracked Tooth 

Rinse the mouth with warm water to clean the area. Use an ice pack on the face to reduce swelling. See the dentist as soon as you can. 

Bitten Tongue or Lip 

Clean the area and place an ice pack to keep swelling down. If the bleeding doesn’t stop after a short time applying pressure to the area, take your child to a dentist or urgent care/emergency center. 

Toothache or Swollen Face 

Make an appointment with the dentist as soon as you can for a toothache. A pain reliever will help reduce the pain temporarily until proper treatment can be done. Swelling of the face can be a sign of serious infection and needs to be taken care of immediately. 

Possible Broken Jaw 

Apply a cold compress to control swelling and take your child to an Emergency Center right away. 

CROWNS

A crown covers a tooth to restore it to its normal shape, size, and function. A crown can make the tooth stronger or improve the way it looks. 

Crowns are recommended if you have a cavity that is too large for a filling, a cracked tooth, a worn down or weakened tooth, have had root canal treatment, or have a discolored or misshapen tooth. 

Our office prepares your tooth for the crown, makes an impression, and temporary crown for you to wear and sends the impression to the lab to fabricate the crown. We typically make all-ceramic crowns but in some situations, a full gold crown is still recommended. 

Like natural teeth, crowns can break, come off, or decay at the margin. It is important to avoid sticky candies/foods and very hard foods, brush and floss well around crowned teeth, and come in for regular checkups and cleanings to maintain the health of crowned teeth.

DENTAL HYGIENE

To keep your teeth and gums healthy, routine dental checkups are essential. Of course, outside of the dental office, you should be brushing your teeth twice a day, using an antiseptic mouthwash, flossing & cleaning your tongue daily to minimize plaque and promote fresh breath. 

Standard Dental Checkup Procedures 

A dental checkup includes 5 parts. The duration and intensity of these steps vary depending on the individual and the state of their oral health. 

Step 1: Visual Exam 

Dr. Barrett or her Hygienist checks the soft tissues of your mouth, lips, tongue, gums, and throat for any signs of oral cancer or other abnormalities such as sores, growths, or plaques. 

Step 2: Digital Diagnostics 

Dr. Barrett or her Hygienist will determine what diagnostic images they will need to fully complete your exam. Digital x-rays provide instant results, have very minimal exposure to radiation, and can show problems that aren’t obvious during the visual exam. 

Step 3: Gingival Pocket Exam 

Healthy gums are equally as important as healthy teeth. This exam is used to establish the existence or risk of gum disease in a patient. A special hand-held instrument measures the depth of the pockets between your teeth and gums- the deeper the pocket, the greater risk you have for an infection that leads to gum disease. 

Step 4: Professional Dental Cleaning 

A hand or ultrasonic scaler will be used to remove the hardened plaque known as calculus or tartar from your teeth. Brushing will remove plaque that sticks on your teeth after eating, but only professional dental instruments will sufficiently remove the calculus. 

Step 5: Polishing 

A polishing paste is used on the teeth to create a smooth surface and delay plaque and biofilm formation. The paste also can remove some surface stains from the teeth. After the polishing is completed, floss is used to remove any remaining plaque or polishing paste from in between the teeth. If recommended by Dr. Barrett or her Hygienist, a fluoride treatment may be applied to aid in enamel strengthening.

DENTURES

As much as we try to maintain our own natural teeth, sometimes it is in the best interest of the patient and their overall health to remove the unhealthy teeth and replace them with a removable denture. ​Two types of dentures are available — complete and partial dentures. Complete dentures are used when all the teeth are missing, while partial dentures are used when some natural teeth remain. 

A complete denture replaces all your natural teeth with an acrylic base and plastic teeth. Denture teeth do not chew up food as natural teeth do, so there are limitations to what you can eat with plastic denture teeth. 

A partial denture can be made out of metal, acrylic, or a flexible base. They can replace anywhere from 1 single tooth to 10 or more missing teeth. 

Traditional dentures are custom-fit to sit comfortably against your gum tissue and underlying bone. If the remaining ridge isn’t ideal, it may be suggested that you consider an implant retained denture. These are made to snap onto the implant abutments and help retain the denture in place. Some options even include having the denture base screwed into the implant abutments so it would only be removed by a prosthodontist to clean on a routine basis. 

FILLINGS

Fillings (Restorations) are needed when a tooth develops decay or fractures a small piece of the tooth structure. As the enamel breaks down from acid formed from the bacteria in our mouths, cavitations (cavities) form in the tooth structure. The enamel layer is thick and strong and takes longer for the acid to break it down, but once it gets through to the softer dentin (middle) layer of the tooth, the decay spreads quicker and it is at this point a restoration is recommended. 

Dr. Barrett uses a variety of materials to restore your teeth. She will discuss with you your preference and what material would be best for the area of your mouth or size of the restoration. She uses amalgam, composite resin, resin-based glass ionomer, and a bioactive composite. 

GRINDING

Grinding, or sliding your teeth back and forth over each other, is referred to as bruxism. Clenching, or tightly holding your top and bottom teeth together also falls into this category. Both can cause the jaw muscles or joints to become painful and damage teeth. 

A lot of times, bruxism happens at night when patients don’t even realize they are doing it. You may be bruxing if you have one or more of these symptoms: 

• headache or earache 
• sore jaw 
• jaw clicking 
• frequent headaches 
• sensitive or achy teeth 
• facial pain 
• worn or cracked teeth or fillings 
• markings on the sides of your tongue from pressing against teeth 
• trouble or restless sleep 

A night guard or bruxism guard can be made to help alleviate some of the symptoms caused by bruxism. An impression of your mouth is made so it is custom fit to you. The night guard may not prevent you from grinding, but it will prevent damage to your muscles and teeth. 

IMPLANTS

Implants are an option to replace missing teeth. The implant body is placed into the bone by an oral surgeon or periodontist and once it has integrated into the bone and is ready for restoration, Dr. Barrett can make the crown or bridge that is screwed into the implant abutment. There is a lot of planning that goes into implant placement to replace teeth, so it is good to have a full treatment plan in place prior to proceeding with this treatment. 

SEALANTS

The molar teeth (our back chewing teeth) have cusps (points) and pits/grooves (valleys) that allow us to properly chew up our food. These pits and grooves of our teeth, unfortunately, trap food particles and plaque (sticky film full of bacteria). Because these pits and grooves can sometimes be tight and deep into our teeth, this creates an area susceptible to decay. Brushing gets a majority of the plaque and food off of our teeth, but deeper grooves can hold it in. Certain foods also stick for long periods of time in these grooves and are difficult to remove, such as ​raisins, fruit snacks, or any gummy sweets!​ These foods should be avoided as much as possible!! 

A sealant is a flowable composite resin that is applied to fill in/seal the grooves and pits of our molar teeth to prevent food and plaque from getting trapped and causing decay. It is done as a preventive measure. 

It is important that no stain or decay with bacteria is sealed into the tooth, so Dr. Barrett likes to open the grooves slightly to be sure all the tooth structure is healthy and solid. A cleaning solution is applied and the composite flows into the grooves and pits. Finally, a light is shined on the tooth to harden the material.

Endodontists

These specialists are Dentists that have completed an additional two years of education and unique training that focuses on the care and treatment of the inner parts of the tooth and the tooth pulp. Your Dentist may refer you to an Endodontist for a root canal if you require one.

The Process

If you require a root canal and are referred to an Endodontist, the Endodontist will perform the actual root canal procedure and then your general Dentist will perform a permanent restoration on the tooth to finish the procedure.

• First, a local anesthetic is applied to the tooth and adjacent area.
• Then, a dental dam is used to isolate the affected tooth and keep it clean during the procedure.
• Once the anesthetic has numbed the area, an opening in the top of the affected tooth is made and the soft pulp and nerve are carefully removed before shaping the interior of the tooth for filling.
• Next, a rubber-like biocompatible material is inserted into the cleaned, medicated root canal.
• The last step for your Endodontist is to place a temporary filling in the tooth.
• Then your general Dentist will perform a permanent restoration-like a crown for example- to protect and strengthen your tooth.

SNORING

Snoring is a common problem among a lot of people, but it doesn’t mean that it should be ignored. Much research has been done on snoring and its relationship with airway obstruction and/or sleep apnea. Snoring should be considered a blessing in the fact that it is alerting you or your spouse that air is not getting through your airway without obstruction! Struggling for breath can result in many overall health issues, including an increase in blood pressure and cardiac disease which can increase the risk of stroke, or heart attack. 

During sleep, muscles and soft tissues in the throat and mouth relax, causing a narrowing of the airway. As air flows through this smaller space, it increases velocity and vibrates the tissues, creating snoring. 

Dr. Barrett can fit you for a custom snore appliance that holds your lower jaw in a forward position overnight, allowing for the airway to be maintained and snoring to be minimized or eliminated. Many patients have reported a more restful night, better relationships with their spouses, and an overall better feeling after using this device

VENEERS

If you have a tooth that is stained, discolored, worn, chipped, broken, misaligned, or irregularly shaped a veneer may be right for you. Veneers have a lifespan of 5-10 years with good oral hygiene and proper care.  There are two types of veneers: direct composite veneer or bonded porcelain veneer.  A direct composite veneer can be performed in one visit and a porcelain veneer requires a preparation and impression visit and the bonding of the veneer at a second visit.

The Procedure

• First, your Dentist will numb the proper area of your mouth with a local anesthetic.
• Next, a place will be made for the veneer by removing a little bit of enamel from the front of the affected tooth.
• Then, the front of the tooth will be cleaned & polished and the veneer will be permanently affixed to it or an impression will be made to send to the lab and your porcelain veneer will be bonded to the tooth when completed.

WHITENING

There are many options for whitening and brightening your smile. Over the Counter, products work, but to get a more controlled result, it is recommended to use a prescription product purchased through a dental office. 

Dr. Barrett makes custom whitening trays that fit comfortably over your teeth. You are able to utilize these trays in your own home at your own convenience. The whitening gel containing a remineralizing and desensitizing solution is included in your take-home kit. Dr. Barrett and her assistant make the trays in the office, ensure they fit comfortably and show you how to use them properly. 

WISDOM TEETH

3​rd molars, or wisdom teeth, usually appear during the late teens or early twenties. They form behind the upper and lower 2​nds, or 12-year molars. Because of their position in the mouth, many times these teeth won’t erupt into a healthy position. When a tooth is impacted, or blocked from erupting, several complications can arise. Pain, infection, damage to adjacent teeth, cyst formation, and in rare cases, cysts can develop into a tumor. Pressure from developing wisdom teeth can create crowding over time in permanent teeth as well. If wisdom teeth do erupt, they can be difficult to keep clean and can be more susceptible to decay in areas that are not able to be restored. 

Dr. Barrett can take a digital panoramic film to assess the position and development of wisdom teeth and can help you make an informed decision on if and when the best time would be for the removal of wisdom teeth. She does not remove wisdom teeth in her office but works with many skilled oral surgeon’s that she can refer you to.