Dental disease doesn’t discriminate by age. Although certain types of disease are more common in adults, children are just as susceptible, particularly to tooth decay.
Unfortunately, the early signs of disease in a child’s teeth can be quite subtle—that’s why you as a parent should keep alert for any signs of a problem. Here are 3 things you might notice that definitely need your dentist’s attention.
Cavities. Tooth decay occurs when mouth acid erodes tooth enamel and forms holes or cavities. The infection can continue to grow and affect deeper parts of the tooth like the pulp and root canals, eventually endangering the tooth’s survival. If you notice tiny brown spots on their teeth, this may indicate the presence of cavities—you should see your dentist as soon as possible. To account for what you don’t see, have your child visit your dentist at least twice a year for cleanings and checkups.
Toothache. Tooth pain can range from a sensitive twinge of pain when eating or drinking hot or cold foods to a throbbing sharp pain. Whatever its form, a child’s toothache might indicate advancing decay in which the infection has entered the tooth pulp and is attacking the nerves. If your child experiences any form of toothache, see your dentist the next day if possible. Even if the pain goes away, don’t cancel the appointment—it’s probable the infection is still there and growing.
Bleeding gums. Gums don’t normally bleed during teeth brushing—the gums are much more resilient unless they’ve been weakened by periodontal (gum) disease (although over-aggressive brushing could also be a cause). If you notice your child’s gums bleeding after brushing, see your dentist as soon as possible—the sooner they receive treatment for any gum problems the less damage they’ll experience, and the better chance of preserving any affected teeth.
We breathe every moment of every day and we’re hardly aware of it most of the time. But if you take the time to focus, you’ll find two possible pathways for your breath: through the nose or through the mouth.
While either pathway provides the air exchange needed to live, nose breathing offers better health benefits. Air passes through the nasal passages, which filter out many harmful particles and allergens. The mucous membranes in the nose also humidify the air and help produce heart-friendly nitric oxide.
Nose breathing also plays a role in your child’s facial and jaw development: the tongue rests on the roof of the mouth (the palate) and becomes a kind of mold around which the developing upper jaw can form. With chronic mouth breathing, however, the tongue rests just behind the lower teeth, depriving the upper jaw of its normal support. This could result in the development of a poor bite (malocclusion).
To avoid this and other undesirable outcomes, you should have your child examined if you notice them breathing mostly through the mouth, particularly at rest. Since chronic mouth breathing usually occurs because of an anatomical obstruction making nose breathing more difficult, it’s usually best to see a physician or an ear, nose and throat (ENT) specialist first for evaluation and treatment.
It’s also a good idea to obtain an orthodontic evaluation of any effects on their bite development, such as the upper jaw growing too narrowly. If caught early enough, an orthodontist can correct this with a palatal expander, a device that exerts gradual outward pressure on the jaw and stimulating it to grow wider.
Another bite problem associated with chronic mouth breathing is misalignment of the jaws when closed. An orthodontist can address this with a set of removable plates worn in the mouth. As the jaws work the angled plates force the lower jaw forward, thus encouraging it to grow in the direction that best aligns with the upper jaw.
Any efforts to correct a child’s breathing habits can pay great dividends in their overall health. It could likewise head off possible bite problems that can be both extensive and costly to treat in the future.
When your braces finally come off, you’ll hopefully be astounded by what you see –once-crooked teeth replaced by a more attractive smile. But you might also see something you didn’t expect: noticeable white spots on some of your teeth.
These spots called white spot lesions (WSLs) appear lighter than the surrounding tooth enamel due to mineral loss just beneath the surface. This happens because bacterial or food acids have contacted the enamel surface for too long and dissolved the underlying calcium and other minerals. This results in a small discolored and chalky-like area in the enamel.
WSLs are common during orthodontics because wires and brackets create hard to reach places for brushing and flossing, which can accumulate bacterial plaque. The bacteria produce acid, which weakens the enamel at these places. The tiny white spots that result are more than just unattractive—they can become entry points into the tooth for decay. That’s why they should be dealt with as soon as possible—and preferably before they’re created.
To that end, you’ll need to do as thorough a job as possible brushing and flossing while undergoing orthodontic treatment. To improve your thoroughness try using an interproximal toothbrush that can maneuver more closely around braces hardware than a regular brush. You can also improve your flossing with a floss threader or a water flosser, a device that sprays pressurized water to loosen and flush away plaque.
If you do develop WSLs, there are some things we can do to treat them. We can attempt to re-mineralize the affected enamel with the help of topical fluoride (either pastes or gels for home use or with an office application) or a re-mineralizing agent. We can also use techniques like microabrasion, which restores damaged areas beneath the surface, or inject a liquid, tooth-colored resin beneath the WSL’s surface to improve appearance and protect against decay.
If while wearing braces you do notice any white spots or other tooth discoloration let your dentist or orthodontist know right away. The sooner your dental providers can begin dealing with potential WSLs the better your chances for a healthy and beautiful outcome after braces.
If you would like more information on oral hygiene while wearing braces, 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 “White Spots on Teeth During Orthodontic Treatment.”
Some moviegoers have been known to crunch popcorn, bite their fingers or grab their neighbor’s hands during the intense scenes of a thriller. But for one fan, the on-screen action in the new superhero film Black Panther led to a different reaction.
Sophia Robb, an 18-year-old Californian, had to make an emergency visit to the orthodontic office because she snapped the steel wire on her retainer while watching a battle scene featuring her Hollywood crush, Michael B. Jordan. Her jaw-clenching mishap went viral and even prompted an unexpected reply from the actor himself!
Meanwhile, Sophia got her retainer fixed pronto—which was exactly the right thing to do. The retention phase is a very important part of orthodontic treatment: If you don’t wear a retainer, the beautiful new smile you’re enjoying could become crooked again. That’s because if the teeth are not held in their new positions, they will naturally begin to drift back into their former locations—and you may have to start treatment all over again…
While it’s much more common to lose a removable retainer than to damage one, it is possible for even sturdy retainers to wear out or break. This includes traditional plastic-and-wire types (also called Hawley retainers), clear plastic retainers that are molded to fit your teeth (sometimes called Essix retainers), and bonded retainers: the kind that consists of a wire that’s permanently attached to the back side of your teeth. So whichever kind you use, do what Sophia did if you feel that anything is amiss—have it looked at right away!
When Black Panther co-star Michael B. Jordan heard about the retainer mishap, he sent a message to the teen: “Since I feel partly responsible for breaking your retainers let me know if I can replace them.” His young fan was grateful for the offer—but even more thrilled to have a celebrity twitter follower.
If you have questions about orthodontic retainers, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Importance of Orthodontic Retainers” and “Bonded Retainers.”
Even the sweetest children don’t always have sweet-smelling breath. If your child has persistent bad breath, it may be for one of the following reasons:
POOR ORAL HYGIENE HABITS. Bad breath often results from bacteria on the teeth and tongue that is not effectively removed during brushing and flossing.
- Tip: To encourage thorough cleaning as children are developing their oral hygiene habits, try handheld flossers that are colorful and easy to use, sing or play music to make brushing time fun, or try an electric toothbrush with a timer or a tooth-brushing app that keeps kids brushing for a full two minutes.
PLAQUE BUILDUP, TOOTH DECAY AND GUM DISEASE: Plaque, a sticky bacterial biofilm, can build up on tooth surfaces, between the teeth and under the gum line and can lead to tooth decay and gum disease. These conditions may result in bad breath.
- Tip: Stay on top of your child’s oral hygiene at home, and keep up with regular dental visits for professional cleanings and checkups.
POST-NASAL DRIP: This common cause of foul-smelling breath in children results when excessive mucus is produced and drips down the back of the throat.
- Tip: Schedule an appointment with your child’s pediatrician to determine and treat the cause.
MOUTH BREATHING. Breathing through the mouth instead of the nose can cause a dry mouth. This can lead to increased oral bacteria, which can cause bad breath. If children breathe through the mouth all the time, not just because of a temporary cold or allergies, your child is at greater risk for tooth decay and gum disease.
- Tip: If your child is a chronic mouth breather, schedule a dental visit so we can check for any adverse effects on dental health. Note that over time, habitual mouth breathing may lead to poor alignment of the teeth. An ear, nose and throat (ENT) specialist can treat problems with tonsils, adenoids and sinuses — common causes of mouth breathing.
FOREIGN OBJECT IN THE NOSE. It wouldn’t be the first time a child has stuck a pea or other small object up their nose â?? or their sibling’s nose — only to find that it won’t come back out. A foreign body in the nasal passage can cause infection and lead to bad breath.
- Tip: Don’t try to remove the object at home, as part of it may remain in the nasal passage. A medical professional will have the right equipment to dislodge the object more comfortably.
MEDICATION. Children who take antibiotics for a long time may develop a fungal infection (thrush) in the mouth. Other medications can cause bad breath due to the way they break down in the body.
- Tip: Call your pharmacist if you have a question about medications and bad breath.
MEDICAL CONDITION. Infections of the throat, sinus or tonsils can cause bad breath, as can more serious health conditions.
- Tip: If your child’s breath is unpleasant for an extended period of time, get it checked out by a health professional.
If you are concerned about your child’s breath, schedule a visit. We are happy to remind your child of proper brushing techniques and check for other problems that need to be addressed.
For more on young children’s oral health, read “How to Help Your Child Develop the Best Habits for Oral Health” and “Why See a Pediatric Dentist?”
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