Parents have been dealing with their children's teething pain for as long as parents and children have been around. Along the way, the human race has developed different ways to ease the discomfort of this natural process of dental development. While most are good, common-sense measures, one in particular needs to be avoided at all costs—applying topical oral products to the gums containing Benzocaine.
Benzocaine is a topical anesthetic often found in oral products like Anbesol, Orajel or Topex to help ease tooth pain or sensitivity. The agent can be found in gel, spray, ointment or lozenge products sold over-the-counter. As an analgesic, it's considered relatively safe for adults to use.
But that's not the case with infants or younger children. Researchers have found a link between Benzocaine and methemoglobinemia, a potentially fatal blood condition. Methemoglobinemia elevates the amount of a hemoglobin-like protein called methemoglobin, which in high concentrations can lower oxygen levels being transported to the body's cells through the bloodstream.
Because of their smaller anatomy and organ systems, younger children can have severe reactions to increases in methemoglobin, which can range from shortness of breath or fatigue to seizures, coma or even death. That's why you should never use products with Benzocaine or similar numbing agents to ease teething pain. Instead, follow these common sense practices:
- Give your child chilled rubber teething rings, wet washcloths or pacifiers to chew or gnaw on. The combination of cold temperatures and pressure from biting on them will help ease the pain. Just be sure the item isn't frozen, which could cause frost burns to soft tissues.
- For temporary relief from soreness, gently massage your baby's gums with a clean, bare finger or with it wrapped in a clean, wet cloth. The massaging action helps counteract the pressure of the incoming tooth.
- For intense episodes of teething discomfort, ask your healthcare provider about using an over-the-counter pain reliever like acetaminophen or ibuprofen. Be sure you use only the recommended dose size for your child's age.
Teething is in many ways like a storm—it too shall pass. Be sure you're helping your baby weather it safely.
Before we begin correcting a malocclusion (poor dental bite), we need to ask a few questions: How extensive is the malocclusion? How far must we move the teeth to correct it? How might the patient's jaw size impact treatment?
Answering these and other questions help us develop an effective treatment plan. And depending on the answers, we might need to look at other procedures before we install braces—like removing one or more of the teeth.
This isn't a subject to approach lightly: All teeth play an important role in dental function and smile appearance, and ordinarily we want to preserve teeth, not remove them. Sometimes, however, it may be a necessary action to achieve our goal of an improved dental bite.
For example, it might be necessary for correcting a malocclusion caused by severe teeth crowding. This occurs when one or both of the jaws hasn't grown to a sufficient size to accommodate all of the teeth erupting on it. As a result, some of the teeth could come in out of their proper alignment.
If caught early before puberty, we may be able to use other techniques to alleviate crowding, like a device called a palatal expander that influences an upper jaw to widen as it grows. If successful, it could provide later teeth more room to erupt in their proper positions.
But even if additional jaw growth occurs, it may not be enough to avoid a malocclusion or treatment with braces. Alleviating further crowding by removing teeth in little noticed areas could help with subsequent orthodontics.
Removing teeth may also be the answer for other problems like an impacted tooth, in which the tooth has not fully erupted and remains submerged in the gums. It's sometimes possible to use a technique to “pull” the tooth down where it should be; but again, that will still require jaw space that may not be available. The more effective course might be to remove the impacted tooth.
Whether or not tooth extraction will be needed can depend on a thorough orthodontic evaluation and full consideration of all the available options. Even though the ideal situation is to correct a bite with all teeth present and accounted for, it may be for the better good to sacrifice some.
If you would like more information on orthodontic techniques, 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 “Removing Teeth for Orthodontic Treatment.”
Even though coronavirus lockdowns have prevented TV hosts from taping live shows, they're still giving us something to watch via virtual interviews. In the process, we're given occasional glimpses into their home life. During a Tonight Show interview with Seahawks quarterback Russell Wilson and his wife, R & B performer Ciara, Jimmy Fallon's daughter Winnie interrupted with breaking news: She had just lost a tooth.
It was an exciting and endearing moment, as well as good television. But with 70 million American kids under 18, each with about 20 primary teeth to lose, it's not an uncommon experience. Nevertheless, it's still good to be prepared if your six-year-old is on the verge of losing that first tooth.
Primary teeth may be smaller than their successors, but they're not inconsequential. Besides providing young children with the means to chew solid food and develop speech skills, primary teeth also serve as placeholders for the corresponding permanent teeth as they develop deep in the gums. That's why it's optimal for baby teeth to remain intact until they're ready to come out.
When that time comes, the tooth's roots will begin to dissolve and the tooth will gradually loosen in the socket. Looseness, though, doesn't automatically signal a baby tooth's imminent end. But come out it will, so be patient.
Then again, if your child, dreaming of a few coins from the tooth fairy, is antsy to move things along, you might feel tempted to use some old folk method for dispatching the tooth—like attaching the tooth to a door handle with string and slamming the door, or maybe using a pair of pliers (yikes!). One young fellow in an online video tied his tooth to a football with a string and let it fly with a forward pass.
Here's some advice from your dentist: Don't. Trying to pull a tooth whose root hasn't sufficiently dissolved could damage your child's gum tissues and increase the risk of infection. It could also cause needless pain.
Left alone, the tooth will normally fall out on its own. If you think, though, that it's truly on the verge (meaning it moves quite freely in the socket), you can pinch the tooth between your thumb and middle finger with a clean tissue and give it a gentle tug. If it's ready, it should pop out. If it doesn't, leave it be for another day or two before trying again.
Your child losing a tooth is an exciting moment, even if it isn't being broadcast on national television. It will be more enjoyable for everyone if you let that moment come naturally.
If you would like more information on the importance and care of primary teeth, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Importance of Baby Teeth.”
Fluoride is an important part of your child's dental development. But if children take in too much of this important mineral, they could experience enamel fluorosis, a condition in which teeth become discolored with dark streaking or mottling.
That's why it's important to keep fluoride levels within safe bounds, especially for children under the age of 9. To do that, here's a look at the most common sources for fluoride your child may take in and how you can moderate them.
Toothpaste. Fluoridated toothpaste is an effective way for your child to receive the benefits of fluoride. But to make sure they're not getting too much, apply only a smear of toothpaste to the brush for infants. When they get a little older you can increase that to a pea-sized amount on the end of the brush. You should also train your child not to swallow toothpaste.
Drinking water. Most water systems add tiny amounts of fluoride to drinking water. To find out how much your water provider adds visit “My Water's Fluoride” online. If it's more than the government's recommendation of 0.70 parts of fluoride per million parts of water, you may want ask your dentist if you should limit your child's consumption of fluoridated drinking water.
Infant formula. Many parents choose bottle-feeding their baby with infant formula rather than breastfeed. If you use the powdered form and mix it with tap water that's fluoridated, your baby could be ingesting more of the mineral. If breastfeeding isn't an option, try using the premixed formula, which normally contains lower levels of fluoride. If you use powdered formula, mix it with bottled water labeled “de-ionized,” “purified,” “demineralized” or “distilled.”
It might seem like the better strategy for preventing fluorosis is to avoid fluoride altogether. But that can increase the risk of tooth decay, a far more destructive outcome for your child's teeth than the appearance problems caused by fluorosis. The better way is to consult with your dentist on keeping your child's intake within recognized limits to safely receive fluoride's benefits of stronger, healthier teeth.
If you would like more information on fluoride and your baby's dental health, 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 “Tooth Development and Infant Formula.”
After years battling disease, your troubled tooth reached its useful life's end. It's been extracted, and we've replaced it with a life-like dental implant. So now, as far as the implant goes, disease is no longer an issue…right?
Sorry, no—though not to the same degree as a natural tooth, an implant could be endangered by gum disease. Although the implant's materials can't be infected, the supporting gums and bone can.
In fact, there's a particular type of gum disease associated with implants known as peri-implantitis (“peri” around an implant; “itis” inflammation) that first affects the gums surrounding an implant. Although peri-implantitis can arise from an excess of dental cement used to affix the crown to the implant, it most commonly starts like other forms of gum disease with dental plaque.
Dental plaque, and its hardened form calculus (tartar), is a thin, bacterial biofilm that builds up on teeth surfaces. It can quickly accumulate if you don't remove it every day with proper brushing and flossing. The bacteria living in plaque can infect the outer gum tissues and trigger inflammation.
Gum disease around natural teeth can spread quickly, but even more so with implants. That's because the natural attachment of the gums helps supply antibodies that impede infection. Implants, relying solely on their connection with the bone, don't have those gum attachments. As a result, peri-implantitis can move rapidly into the supporting bone, weakening the implant to the point of failure.
The good news, though, is that peri-implantitis can be treated successfully through aggressive plaque removal and antibiotics. But the key to success is to catch it early before it progresses too far—which is why you should see your dentist at the first sign of gum swelling, redness or bleeding.
You can also prevent peri-implantitis by practicing daily brushing and flossing, including around your dental implant. You should also see your dentist twice a year (or more, if they advise) for cleanings and checkups.
Dental implants overall have a greater than 95% success rate, better than any other tooth restoration system. But they still need daily care and regular cleanings to ensure your implants are on the positive side of those statistics.
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