Over the past few years, we have seen a marked increase in the number of cavities in the
three to five year age range. We find that distressing, if only because cavities are the most unwanted news a parent of a pre-schooler can hear. These cavities are almost, without exception, in the surfaces between the baby molars and those teeth will be in the child’s mouth until the age of ten to thirteen, so we must maintain their good health.

Improving the resistance of the enamel surfaces to decay is our best strategy if we hope
to reverse the trend. Of course, oral hygiene practices, including daily flossing, is helpful, but many children grow cavities in-spite of their “best efforts”. Recently we have been recommending that toddlers start using a small amount of fluoride tooth paste at their bedtime brushing.

When I say “small amount”, I mean a smear on the brush bristles barely
enough for the child to notice the taste. During this young age, the child will likely swallow all of what is on the brush, but if we are using only the recommended amount to barely register
on the taste buds, the child will get his or her daily dose of fluoride. Fluoride can be used in excess, so this routine requires careful parental supervision. This recommendation is for night time brushing only. The reason night time exposure to fluoride is important is that the fluoride mineral will remain in the mouth longer during periods of sleep. Ideally, you should brush the toddler’s teeth right before bedtime using a tiny smear of fluoride tooth paste and then make sure the child goes right to bed without anything to eat or drink.

One brand of tooth paste that is most popular with the toddlers is Tom’s of Maine Strawberry with fluoride. And, of course, try to control the sticky sweets and refined carbohydrates, and no sodas.

Can childhood breathing patterns effect the development of the mouth and lower face?

Can childhood breathing patterns effect the development of the mouth and lower face?

Breathing is something that we don’t think about. It just happens involuntarily. That’s a good thing because getting oxygen into our systems is vital to life. But because we don’t think about it, we don’t think about how we breathe. What I mean by that is breathing with an open nasal airway facilitating most of the oxygen passing through the nose is very different than breathing with the mouth open allowing most or all of the oxygen to pass through the mouth. From a growth standpoint, mouth breathing requires the tongue to drop from the roof of the mouth in order to allow for air passage through the mouth. Tongue position is a huge factor in the developing the width of the jaw bones, particularly the width of the upper jaw. What we see in children who are habitually breathing with their mouths open is a narrowing of the upper jaw so, over a period of a couple years, the upper and lower teeth fail to meet in a functional bite relationship. That altered bite relationship is referred to simply as a cross-bite of the posterior (back) teeth.
Well, cross-bites of the posterior teeth are common and can be corrected. But unless the cause of the cross-bite is changed, the cross-bite will re-develop. So in order for growth and development to proceed naturally and with optimum outcome, the child should use his or her nose for breathing purposes most of the time. That proves to be challenging for many children with chronic allergies, rhinitis conditions, or swollen adenoids. These children are the ones who snore at night and seem to gasp occasionally for air while sleeping.
Beyond the immediate growth effects to the mouth, the oxygen that reaches the lungs is actually better if brought through the nose. Air passing through the nose passes through a series of narrowing and opening flaps, called concha, or turbinates. These concha propel the air, giving it more speed as it reaches the lungs and consequently the air penetrates deeper into the lungs allowing for more oxygen absorption. The concha also regulate temperature of the air and provide important immunological functions. More healthy life giving oxygen reaches the blood if the child breathes through his or her nose.

How do children transition from mouth to nose breathing? The first thing is making sure there is an open airway through the nose. Breathing difficulties usually result from physical obstacles in the nose—swollen adenoids, swollen concha, dried mucus, rhinitis. These should be evaluated by the child’s pediatrician and treated according to the severity.

Are dental services toxic?

I asked Dr. Smith the other day... Are dental services toxic?

Here is his answer:

Yes, just about everything we do in dentistry will have some element of toxicity. It reminds of what the late nutritionist/fitness expert, Jack Lallane, once said about food choices…”if nature made it, eat it, if it’s man-made, throw it away. Carrying that into the real world, most of what our children eat is man-made. And, most of the materials we use in the patient’s mouths is also man-made in a pharmaceutical lab. And that doesn’t even include the radiation we receive from x-rays.

The question is not whether or not we are exposing ourselves to unsafe levels of toxicity, but whether the toxicity is outweighed by the benefits of the services we provide. Dental health in America is by far the best in the world. Maybe some of what we do as routine practice can be modified for individual patients, and we try to do that. But, overall, the product of modern American dentistry is the highest standard of dental health on the planet. That doesn’t mean it can’t improve, but using the knowledge and tools of the early 21st century is a safe choice.
Now, I have other things to say about Jack Lallane’s food choices, but that’s for another day.

Wish Rocks!

Our make a wish rocks are going down like, well, rocks. If you haven’t seen them, stop by and check them out. Dr. Smith’s 7 yr old niece makes these rocks, we sell them for $2 and all the proceeds go to the Make a Wish Foundation. The rocks are real. They are flat rocks that Dr. Smith collects at the beaches he frequents and then sends them off to his niece who lives in Venice Beach to decorate. They’re pretty cool.

Xylitol

www.toothclub.com

Childhood dental caries (cavities) continues to plaque the profession of pediatric dentistry and remains the most common contagious disease in the civilized world.  Those of you with young children know the challenge that dental caries presents to many aspects of daily life.  Fluoride applications have dominated preventive dental research and practice for the past half century.  In combination with good oral hygiene and dietary restrictions of refined sugars, fluoride applications can offer significant reduction in dental caries.  

Now, there is a growing body of evidence that a sugar, natural in many fruits and fibrous foods, can help us control dental caries by reducing dental plaque and acid production in the mouth.  What we find in mouths that are exposed to Xylitol is a reduction of dental plaque by about half within 24 hours.   A child’s dental brushing habits rarely match that kind of plaque reduction.  Acid production is also reduced and since acid is the cause of surface demineralization, caries incidence is reduced.  

Xylitol is available in many sources.  It has the same sweetness quality as table sugar, so it can be purchased in 8 ounce (227 grams)  containers and used in home food preparation.  It is available in tooth pastes, oral wipes for infants, mouth rinses, nasal and oral sprays, chewing gums, breath mints, and candies.  

Although xylitol comes from nature in the form of a vegetable sugar, remember to use it in moderation.  A maximum daily dose for young children is about 6 grams.   The frequency of use is important.  Using xylitol just once or twice daily may be ineffective.  It is best if used four or five times a day and in a medium that holds it in the mouth for extended periods.  Chewing gums, lollipops, and mints provide maximum benefits.  Brushing or using wipes for infants before bed or nap time is ideal as the xylitol will remain in the mouth for a longer period during sleeping hours when saliva production is at its lowest.

Be sure to look at the ingredients of the products you purchase.  Some products will claim to be a xylitol product, but in reality xylitol is near the bottom of the list of ingredients and other less expensive sweeteners.  Never use a xylitol product that also contains sucrose, fructose, corn syrup, or citric acid.  Chewing gums and mints should list xylitol first.  Toothpastes will probably list it third or fourth.  Below is a list of manufacturers of the products we recommend.  An excellent web site for more information is www.Xylitol.org. 

XLear: this company probably has the largest product line and uses effective levels of xylitol in their tooth pastes, oral rinses, oral sprays, mints, and chewing gums.  Their website is www.xlear.com

Bling tooth pastes—the tooth paste we sell in the office.  You can also purchase these directly on-line at www.tannerstastypaste.com

Spiffy wipes—these wipes are perfect for infants and can be used for oral cleansing any time during the day, but best right before sleep time.  You can purchase these at www.spiffies.com

Dr.John’s—the maker of the lollipops we distribute in the office and available at www.drjohns.com

Welcome to the Tooth Club Blog!

Hi, everybody! Welcome to our blog! Stop by often to see updates on office happenings and upcoming events.