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Posts for tag: pediatric dentistry

By Dr. Mark C. Pothitakis
January 07, 2022
Category: Oral Health
AMinorProcedureCouldHelpanInfantWithThisNursingProblem

Newborns come into the world eager and ready to partake of their mother's milk. But an anatomical quirk with some infants could make breastfeeding more difficult for them.

The structure in question is a frenum, a tiny band of tissue connecting softer parts of the mouth with firmer parts, like the upper lip to the gums, and the tongue to the floor of the mouth. If they're abnormally short, thick or tight, however, the baby might find it difficult to obtain a good seal around the mother's nipple.

Without that seal, the baby has a difficult time drawing milk out of the breast and as a result, they may attempt to compensate by chewing on the nipple. The sad outcome is often continuing hunger and frustration for the baby, and pain for the mother.

To alleviate this problem, a physician can clip the frenum to loosen it. Known as a frenotomy, (or a frenectomy or frenuplasty, depending on the exact actions taken), it's a minor procedure a doctor can perform in their office.

It begins with the doctor deadening the area with a numbing gel or injected anesthesia. After a few minutes to allow the anesthesia to take effect, they clip the frenum with surgical scissors or with a laser (there's usually little to no bleeding with the latter).

Once the frenum has been clipped, the baby should be able to nurse right away. However, they may have a learning curve to using the now freed-up parts of their mouth to obtain a solid seal while nursing.

Abnormal frenums that interfere with nursing are usually treated as soon as possible. But even if it isn't impeding breastfeeding, an abnormal frenum could eventually interfere with other functions like speech development, or it could foster the development of a gap between the front teeth. It may be necessary, then, to revisit the frenum at an older age and treat it at that time.

Although technically a surgical procedure, frenotomies are minor and safe to perform on newborns. Their outcome, though, can be transformative, allowing a newborn to gain the full nourishment and emotional bonding they need while breastfeeding.

If you would like more information on tongue or lip ties, 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 “Tongue Ties, Lip Ties and Breastfeeding.”

ThisMinorDentalProcedureCouldMakeBreastfeedingEasierforanInfant

Breastfeeding is nature's way of providing complete nourishment to a newborn in their first years of life. It can also have a positive impact on their emerging immune system, as well as provide emotional support and stability. But although nursing comes naturally to an infant, there are circumstances that can make it more difficult.

One example is an abnormality that occurs in one in ten babies known as a tongue tie. A tongue tie involves a small band of tissue called a frenum, which connects the underside of the tongue with the floor of the mouth. The frenum, as well as another connecting the inside of the upper lip with the gums, is a normal part of oral anatomy that helps control movement.

But if the frenum is too short, thick or taut, it could restrict the movement of the tongue or lip. This can interfere with the baby acquiring a good seal on the breast nipple that allows them to draw out milk. Instead, the baby may try to chew on the nipple rather than suck on it, leading to an unpleasant experience for both baby and mother.

But this problem can be solved with a minor surgical procedure called a frenotomy (also frenectomy or frenuplasty). It can be a performed in a dentist's office with just a mild numbing agent applied topically to the mouth area (or injected, in rare cases of a thicker frenum) to deaden it. After a few minutes, the baby's tongue is extended to expose the frenum, which is then snipped with scissors or by laser.

There's very little post-op care required (and virtually none if performed with a laser). But there may be a need for a child to “re-learn” how to breastfeed since the abnormal frenum may have caused them to use their oral muscles in a different way to compensate. A lactation expert may be helpful in rehabilitating the baby's muscles to nurse properly.

A restrictive frenum isn't necessarily a dire situation for an infant—they can continue to feed with a bottle filled with formula or pumped breastmilk. But employing this minor procedure can enable them to gain the other benefits associated with breastfeeding.

If you would like more information on tongue ties and other oral abnormalities in children, 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 “Tongue Ties, Lip Ties and Breastfeeding.”

By Dr. Mark C. Pothitakis
February 10, 2021
Category: Oral Health
WhyEarlyDentalVisitsCouldBrightenYourChildsDentalHealthFuture

By the time your child reaches their first birthday, they may have only a handful of primary teeth. So, should you schedule their first dental visit or wait until they're older?

Absolutely schedule it—a dental visit at age one is one of the most important steps you can take to protect and promote your child's dental health. Starting routine dental care at this early stage can help ensure they enjoy healthy teeth and gums now and in the future. Here's why.

Keeps you a step ahead of tooth decay. Children can experience a rapidly advancing form of tooth decay called early childhood caries (ECC). If not prevented—or treated promptly should it occur—ECC can quickly destroy primary teeth. If they're lost prematurely, future permanent teeth may not erupt properly. Regular dental visits can help prevent or diagnose decay before it causes major damage.

Intercepts problems before they grow. Dental problems, especially bite-related, usually appear in late childhood or early adolescence. But they can start much earlier with signs only a dentist might be able to detect. Early treatments can correct or minimize a developing bite problem, saving you and your child more extensive treatment later.

Reduces your child's dental visit anxiety. The dental office can be an unfamiliar environment for a child that can trigger anxiety. But children who start dental visits sooner rather than later are more apt to adapt and view visiting the dentist as a routine part of life. You may also want to consider a pediatric dentist who not only specializes in children's dental care and development, but may also promote a “kid-friendly” treatment environment.

Promotes the importance of dental care. Beginning regular dental visits shines the spotlight on your child's dental needs and development. As a caregiver, you can gain important insight and support from your dentist toward ensuring your child's teeth stay healthy and develop normally. As a side benefit, increased attention on your child's dental care may increase the same for your entire family.

The first years of a child's life sets the foundation of their dental health for the rest of their lives. You can help make sure that foundation is as sound as possible by beginning early dental visits.

If you would like more information on effective dental care for children, 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 “Age One Dental Visit.”

By Dr. Mark C. Pothitakis
November 10, 2020
Category: Oral Health
HeresWhatToDoIfYourChildComplainsofaToothache

Perhaps the only thing worse than having a toothache of your own is when your child has one. Tooth pain can be a miserable experience, especially for children. It can also be confusing about what to do to deal with it.

Fortunately, a toothache usually isn't a dental emergency, so take a deep breath. Here's what you should do if your child is experiencing tooth pain.

Get the 411 from them. Before you call the dentist, find out more first about the tooth pain from your child with a few probing questions: Where exactly does it hurt? Do you feel it all through your mouth or just in one place? Is it all the time, or just when you bite down? When did it start? You may not get the same level of detail as you would from an adult, but even a little information helps.

Take a look in their mouth. There are a lot of causes for toothache like a decayed tooth or abscessed gums. See if any of the teeth look abnormal or if the gums are swollen. You might also find a piece of food or other particle wedged between the teeth causing the pain. In that case, a little dental floss might relieve the problem.

Ease the pain. While you're waiting on your dental appointment, you can help relieve some of their discomfort by giving them a child-appropriate dose of ibuprofen or acetaminophen. You can also apply an ice pack on the outside of the jaw for five minutes on, then five minutes off to decrease swelling. Under no circumstances, however, should you give your child aspirin or rub it on the gums.

See the dentist. It's always a good idea to follow up with the dentist, even if the pain subsides. In most cases, you may be able to wait until the next day. There are, however, circumstances that call for a visit as soon as possible: if the child is running a fever and/or has facial swelling; or if the tooth pain seems to be related to an injury or trauma.

It can be unsettling as a parent when your child has a toothache. But knowing what to do can help you stay calm and get them the care they need.

If you would like more information on pediatric dental care, 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 “A Child's Toothache.”

By Dr. Mark C. Pothitakis
October 11, 2020
Category: Oral Health
KeepYourChildsFluorideIntakeataSafebutEffectiveLevel

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.”