Cavity and Dental Decay Resources - Small Bites X Dr.Toothlittle

How to Manage bruxism(teeth grinding) in kids?

DR. PREMILA NAIDU, MDS — Fri, 29 Oct 2021 11:56:57 +0000

It is a parafunctional, involuntary activity which can be caused due to many reasons. There can be 2 types of night grinding:

Primary: In this type, there are no specific medical causes.
Secondary: When this parafunctional oral activity is associated with disorders such as psychiatric disorders (anxiety and depression), drugs or some diseases like Parkinson or respiratory diseases like apnea. The second type can usually be resolved by the treatment of the underlying disorder.

Bruxism period
Childhood jaw clenching is often treated on its own either by growth of the jaws or entering into adolescence. In most cases, when children lose their primary teeth, bruxism will be insignificant or will be completely faded. However, a small number of children continue grinding their teeth into adulthood. If the cause is stress, this action will be continued as long as the problem is not resolved.

Causes: The effective factors causing tooth clenching also include the following:

Local factors: Occlusal interferences, high filling restorations or poor restorations, irritating dental status.
Systemic factors: Parasitic and digestive diseases, malnutrition and nutritional deficiencies, allergies, endocrine disorders
Psychological factors: Personality disorders and increased stress.
Irregular and crowded teeth and insufficient contact between the upper and lower teeth are the justified factors which explain the causes of bruxism.

Signs and symptoms
Bruxism usually has no specific symptoms but it may affect on the teeth surfaces area to that extent causes damaging the tooth enamel. The loss of tooth enamel may cause tooth sensitivities, cracked teeth and even tooth crown fractures. In the posterior teeth, attrition of the cusp is sometimes obvious. Of course, in some cases, other symptoms may occur such as headache, toothache, tooth mobility, gingival recession, atypical facial pain widening periodontal ligament, ulcers or pain in the cheeks, clicking sound upon opening and closing the mouth, TMJ pain sever tooth sensitivities and tongue’s deformation. Inflammation and swelling can be seen on the side of the lower jaw due to teeth locking on each other. Jaw problems such as temporomandibular joint diseases are another sign that can be mentioned. It should be noted that most children who have this oral parafunctional activity, do not necessarily have any TMJ disorder unless they change into sever bruxers.

What can parents do?

Reducing stress in children before bed time.
Massage and stretching exercises for muscle relaxation of children.
Reading the book before going to bed.
Avoiding digital games just before sleeping.
Listening to light and soulful music.
Preventing children from chewing pen or pencil.
Prohibiting them from chewing gum during the day.
Making night guard under supervision of pediatric dentist if it is necessary

References

Kuch EV, Till MJ, Messer LB. Bruxing and Non-bruxing children: A comparison of their personality traits. Pediatr Dent. 1979;1(3):182−7.
Sari S, Sonmez H. The relationship between occlusal factors and bruxism in permanent and mixed dentition in Turkish children. J Clin Pediatric Dent. 2001;25:191–194.
Wassell R, Naru A, Steele J, et al. Applied occlusion. London: Quintessence; 2008:26–30.
Lobbezoo F, Van Der Zaag J, Naeije M. Bruxism: its multiple causes and its effects on dental implants – an updated review. J Oral Rehabil. 2006;33(4):293–300.
Lobbezoo F, Van Der Zaag J, Naeije M. Bruxism: its multiple causes and its effects on dental implants – an updated review. J Oral Rehabil. 2006;33(4):293–300.
Manfredini D, Lobbezoo F. Role of psychosocial factors in the etiology of bruxism. J Orofac Pain. 2009;23(2):153–66.
Bruxism/Teeth grinding. Mayo Foundation for Medical Education and Research. 2009.
Yldesley WR, Field A, Longman L. Tyldesley’s Oral medicine. 5th ed. Oxford: Oxford University Press; 2003;195.
Cawson RA, Odell EW, Porter S. Cawsons essentials of oral pathology and oral medicine. 7th ed. Edinburgh: Churchill Livingstone. 2002; 6-366.
Ashroftt GW, Eccleston D, Waddell JL. Recognition of amphetamine addicts. Br Med J. 1965;1(5426):57.
Amir I, Hermesh H, Gavish A. Bruxism secondary to antipsychotic drug exposure: a positive response to propranolol. Clin Neuropharmacol. 1997;20(1):86–89.
Heasman P. Master Dentistry Vol I: Restorative dentistry, paediatric dentistry and orthodontics. 2nd ed. Edinburgh: Churchill Livingstone; 2008:177.

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“How to make brushing interesting for my child?”

DR. PREMILA NAIDU, MDS — Thu, 19 Aug 2021 04:32:01 +0000

Children on the whole, need special care. And children with special needs, more care!

“How to make brushing interesting for my child?” This is the most common question I get asked, for children in general and by parents of special health care needs in particular.

The few tips that parents can try and help the children:

Start early. Earlier we start brushing the child’s teeth, easier it is for them to handle the process. We should start brushing even before the teeth come in, by cleaning the gum pads.
Make it a fun routine, have an age based song or rhyme always before the brushing. As children grow older, always have a role model brushing with them, could be their parents or siblings.
For children with special needs the brushes can be modified, increasing the width or length depending on the child’s requirement. To increase the lengths a ruler can be used. Or universal cuffs can be attached to the toothbrush to hold it easy.
Drape a towel around chest or lap to help with any mess.
A clean wet washcloth could be helpful in removing excess toothpaste when a child is unable to rinse. If needed, follow with a squirt bottle or syringe of water to rinse the mouth. Catch excess in the towel or in a basin.

Sometimes a little change in the angulation of the brush can also help, run the brush under hot water and slightly bend it. 3 sided brushes are also available, which help in easily cleaning all the surfaces. The other thing is that can help children with special needs electrical or battery operated brushes. Cuffs are also to assist.

It is advisable to arrange everything that is the brush, paste, floss and towel in the same order to make it easy for the children.

“What kind of paste should I use for my child? My child doesn’t like most of the paste”

The 2 main ingredient that can help to decide are

Fluoride in the paste: This, we dentist like to examine the oral cavity, assess the risk, see how well the individual can spit and then decide on that. In general fluoride is good to fight against carries.
Sodium lauryl sulphate: It’s the foaming agent. Some individuals with special health care needs may not like it, as it can irritate the gums and teeth. In that case a SLS free paste can be opted for.

“How do I assist my child with special needs?”

Now this depends a lot on the needs of the child, but the general rule is to support the head, while assisting in brushing

Standing behind
- Sitting behind on chair, with individual sitting below
Lying down
- With child on a small bean bag and parent sitting behind
Standing behind the wheelchair

Few things that can help to keep mouth open are
- Mouth props
- Small wash cloths
- 2 brushes can also be used, one to keep the mouth open and other to brush

Few general tips to make brushing fun

Be fully prepared
Like mentioned earlier, keep everything ready.
Use verbal and non-verbal prompts (tapping on hands, cheeks)
Before starting brushing, give simple prompts, and do the same every time
Tell-Show-Do: Always talk to the child about it(Example: I am going to brush the right side first, then show the brushing motion on hand and then start brushing )
They can have something in the hand for distraction, toy, blanket or screen

And to avoid dental problems start visiting to kids’ dental clinic as early as the child is 1 year old or when the first tooth erupts. Maintain regular visits for preventive care, early diagnosis and treatment.

The Academy of Pediatric Dentistry defines special needs children as those with chronic physical, developmental, behavioral or emotional conditions. Generally special needs children have limitations on daily activities. They require more extensive dental and medical services. Few of the common medical conditions are cleft lip or palate, down syndrome, neurological disorders, cerebral palsy, and vision and hearing impairments which require special dental care, as well as learning and developmental disabilities.

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Cavities & Tooth Decay: Home Remedies and Treatment

DR. PREMILA NAIDU, MDS — Sun, 10 May 2020 02:41:43 +0000

What causes dental cavities in Children?

Whenever you have food or drink containing sugar, it reacts with the bacteria in your mouth to produce acid. Dental plaque, a sticky layer which builds up on your teeth, contains bacteria. The acid attack lasts for at least 20 minutes, but often much longer if food becomes stuck on the teeth or snacking is continuous or frequent. In time, the acid will dissolve the outer enamel surface of the tooth.

In the early stages of decay, the enamel can repair itself by taking in minerals from saliva. Fluoride can also help to strengthen tooth enamel. However, if food and drink containing sugar or acid are consumed frequently between meals, more destruction than repair of enamel occurs. A cavity is formed when the enamel layer crumbles, bacteria enter and the decay process spreads rapidly. After this point, the cavity will not ‘go away’ without treatment.

What are home remedies to prevent Dental Decay?

Reduce the amount of time that any food containing sugar is present in the mouth. Try to make snacks and drinks between meals sugar free, as far as possible.
Do not allow babies or toddlers to fall asleep with a bottle of milk, or whilst nursing. The milk will not be washed off and will remain on their teeth during sleep. After drinking milk, teeth should be brushed before sleeping.
Fizzy drinks are best avoided. Not only do they contain a lot of sugar but the acid (even in sugar-free diet drinks) softens tooth enamel, contributing to cavity formation.
Concentrated fruit juices are also acidic, so these should be given only occasionally. Water and milk (without added sugar) are the safest drinks.
Beware of “hidden sugars” in processed foods. These may be labelled as sucrose, glucose, lactose, or fructose – these are all types of sugar.
It is not realistic to ban your child from eating sweets altogether. Instead, limit consumption of sweet treats to maximum of once a day, preferably at the end of a meal.
Sweets that dissolve and clear from the mouth quickly e.g. a milk chocolate bar are better than hard candies, lollipops or sticky caramels. Sweets should be eaten in one go, rather than continually snacking on them.
Regular, thorough tooth brushing to remove plaque. Tooth brushing is a skill which needs to be learnt, ask your dentist to demonstrate the correct technique. Young children will need parents to brush for them, and older children should be supervised.
Fluoride toothpaste can be used once your child can spit out but remember to use no more than a small pea sized amount.

Why are regular dental check-ups important?

It is very important to take you child for regular check-ups from age one year onwards. This enables the dentist to assess the risk factors for your child developing dental decay and give personalized preventive advice. Also, if early signs of dental decay are seen, it may be possible to prevent it progressing to become a cavity. It is much better for a child to visit the dentist before they have any pain or problems or need treatment.

What are the preventive treatments are available for Dental Decay?

Diet Analysis

Diet plays the most important role in the development of dental caries. The frequency with which food and drinks containing sugar are consumed is more important than the total amount of sugar in the diet. To help discover how eating patterns may be affecting a child’s risk of dental decay they may be asked to keep a diary of everything they eat or drink for at least 3 consecutive days. The dentist can then analyze the diary and give tailored advice on how to change habits and patterns to reduce the risk.

Fissure Sealants

Pits and grooves on the tooth’s biting surfaces are prone to decay, as food and plaque that get stuck in these areas are very difficult to remove even with thorough brushing.

Fissure sealants are a thin plastic coating applied to the biting surface of teeth. They have been proven to be highly effective in preventing cavities. The best time to seal the adult molar teeth is soon after they come through. Baby molar teeth can also be sealed for children who have a higher risk of decay.

Fluoride

Fluoride is a naturally occurring mineral that is found in many foods and, in varying amounts, in all natural water. Fluoride is beneficial, as it strengthens tooth enamel making it more resistant to decay – for this reason it is added to many toothpastes.

Swallowing too much fluoride can cause health risks, therefore exposure to fluoride should be controlled. If young children, whose teeth are still developing, ingest too much fluoride it can cause fluorosis, which appears as discolouration and mottling of teeth. This is also seen in areas with a high level of fluoride occurring natural in the water. Children should only use fluoride toothpaste once they can spit it out and then only a pea-sized amount under supervision.

Fluoride varnish can be applied directly to tooth surfaces. This sets quickly and sticks to the surface to minimize swallowing and maximize its effect. If a tooth has very early dental caries in enamel, it can help to stop the decay and prevent it becoming a cavity. Fluoride varnish is also beneficial for sensitive teeth.

At Small Bites, we provide the highest quality preventive dental care and tooth filling treatments at an affordable cost. To know more about our Dental Decay Management Treatments or to book an appointment, click here. Use below form to request a callback

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These hidden sugars in ‘healthy foods’ could be harming your Kids Teeth

Charmaine Rathish — Fri, 01 May 2020 02:50:06 +0000

Hidden sugars. Most of us as parents know that sugars damage the teeth and cause caries, but we still don’t know much about hidden sugars that are lurking in unexpected foods and places that constantly come in contact with children’s teeth.

Do we do anything about it? Do we ensure our children rinse their teeth after every meal or are even brushing properly?

Apart from the obvious sugars in chocolates and health drinks, there are traces of sugars getting into your child’s mouth, sticking to their teeth and causing irreversible damage. Below are some of the foods through which these sugars sneak into their mouth,

JUICES

Fruit juices are healthy. Period. They contain plenty of vitamins and minerals, they contain fibre but they also contain plenty of sugar. When comparing their health quotient and sugar, the former always trumps. But as parents we cannot ignore what that sugar is doing to our children’s teeth. Besides, juices have enamel softening acids which stick and erode teeth.

What can you do?

Juices stick to a larger surface area of teeth when they come in contact with them, and that’s why children must drink them with a straw. Paper straws are easily available and this is good for the environment too. After drinking the juice, have your children rinse their mouth or brush their teeth. Wait for atleast 45 minutes to do this, to ensure the softening of the acids wears out.

CHEWABLE TREATS

Chewable treats are a big hit with kids. These are popsicles, gum sticks and lollipops that often linger in their mouth for hours. When consumed occasionally it is alright, but imagine the damage to teeth when they linger in the mouth all the time? Gum candies and anything chewable by their very nature, stick to teeth, allowing bacteria to grow and causing decay.

What you can do?

Chewable candies are again not good all the time. It is better for children to get their sweet fix from fruits and juices rather than candies and chocolates. After consuming anything, brushing and rinsing teeth is an absolute must.

SAUCES, CANNED ITEMS

Almost all kinds of sauces and canned products contain sugar, even trace amounts. This isn’t natural but may have been artificially added to enhance the taste. The next time you visit the grocery store and make a beeline for the processed food and pre-packaged section, make it a point to read the labels carefully. Even though kids have these occasionally on the side, this sugar isn’t good when left in the mouth.

What you can do?

Prepare food from scratch for kids as much as possible. Although pre-packaged foods are easier to rustle up, it also means that you are giving kids something that you don’t know much about. Sauces can be prepared from scratch and whenever possible involve kids in preparing meals. There is no better way to teach them about food, especially sugars and other nutrients than when cooking with them.

Dental hygiene is definitely considered important, but a majority of us slacken when it comes to doing it properly and consistently for our children. Holidays, trips and occasions is when the teeth are much exposed, yet there isn’t time to look at them properly. If you haven’t set out to see your child’s paediatric dentist yet, don’t wait anymore. The earlier any caries gets detected, the better for us at Small Bites to intervene.

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Understanding the 5 Stages of Tooth Decay & Treatment

Dr.Charmaine Kenita — Tue, 14 Jan 2020 09:21:58 +0000

Tooth decay is seen in most children today. Their exposure to all kinds of foods, snacking, erratic time schedules and more importantly – the fact that they don’t clean/gargle their mouth after every meal, makes them prone to disease and damage. Tooth decay is a gradual process. It can be stopped and regressed at any stage provided you know what these stages are. If you understand these five stages and intervene with the right remediation, it will save you and your child from a lifetime of dental pain.

The 5 Stages of Tooth Decay

Stage 1: White Spots.
Stage Two: Enamel Decay.
Stage Three: Dentin Decay.
Stage Four: Involvement of The Pulp.
Stage Five: Abscess Formation.
Stage Six: Tooth Loss.
Stage Five: Abscess Formation.
Stage Five: Abscess Formation.

STAGE 1 – WHITE SPOTS :

During the first stage, the tooth begins to gradually show the effects of acids and sugar attacks. Light white spots begin to appear just below the enamel surface. In children they most often occur on the molars (at the back of the mouth) and suggest initial demineralization of teeth. Dental examination catches these spots, which regular parental examination cannot. Treatment can intervene at this stage, without further irreversible damage.

STAGE 2 – DECAY OF ENAMEL :

The upper surface of teeth also called the enamel, begins to be attacked during this stage. Contrary to what people think, erosion of the enamel happens from inside outwards, so damage isn’t visible on the teeth at the start. Once the black cavity breaks through the enamel is when damage is visible, and there’s no alternative except for correcting the damage with clean-up and filling.

STAGE 3 – DECAY OF DENTIN

The cavity in a child’s tooth often becomes obvious now. If for some reason all the previous stages have been missed by you, at this stage is when slight pain begins to start. This means that the cavity is beginning to eat away at the second level of dental material; the dentin. A filling at this stage can still stop spread of bacteria going towards the dental pulp, which is the most crucial component of teeth.

STAGE 4 – PULP INVOLVEMENT

Cavities that reach the tooth pulp cause much pain and discomfort. Missing all the previous signs and stages and landing up in this stage means, you will be confronted with a child screaming their lungs out in pain. This stage is serious and just cannot be ignored any longer. Root canal and cleaning up of the pulp is the only option to ensure remainder of the tooth is intact, and to prevent a full extraction.

STAGE 5 – PUS FORMATION

The most critical stage and one that is fraught with immense pain, the fifth stage means that the infection has breached the root and exited outside the tooth structure. It may then get into surrounding soft tissue or eat up the bone. Pain is very severe, accompanied by swelling, sensitivity and difficulty in eating or swallowing. In children, because bones are softer this pus/abscesses can be dangerous if not treated immediately. Delay is not an option. Root canal or even complete tooth removal may be the only resort.

Cavities aren’t therefore harmless damage and never happen suddenly. They build up and break tooth structure over a period of time. Taking your child to the dentist is the key in ensuring any damage is picked up and immediately reversed. Regular dental checkups over intervals can keep their teeth healthy.

At Small Bites Kids Clinic Bangalore , we provide the highest quality Dental Decay Management Treatments at an affordable cost. To know more about our Dental Decay Management Treatments or to book an appointment, click here.

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Tooth Decay : Foods that damage your kids Teeth

Charmaine Rathish — Sat, 16 Nov 2019 01:53:26 +0000

Your child’s diet is one of the most important factors in developing dental decay and small changes can make a big difference.

In the previous blog post we looked at how foods containing sugar combine with bacteria in plaque to produce acid. If the teeth are subjected to frequent or long periods of acid attack, decay becomes likely to occur.

Most people are aware that children who eat too many sweets and candies are likely to get cavities. However, any foods that are are high in refined carbohydrates (starch), such as crackers and chips, can cause decay if the foods remain stuck to the teeth for long periods of time, as the starch breaks down into sugar. In fact, one good way to determine if a snack is good for a child is to check their teeth 20 minutes after consumption. If the teeth are still filled with food, the risk for dental decay will be higher. These foods should be eaten only rarely and teeth should be brushed afterwards.

There are a lot of “hidden sugars” in processed food. If you read the ingredients, they may be labelled as sucrose, glucose, lactose, or fructose – these are all types of sugar. In addition to containing high levels of sugar, many children’s breakfast cereals also stick onto the teeth. Even diet soda drinks and concentrated fruit juices can cause decay as they are acidic.

It is not realistic to ban your child from eating sweets. altogether. Instead, limit consumption of sweets and candy to maximum of once a day, preferably at the end of a meal. Those treats that dissolve and clear from the mouth quickly eg. a milk chocolate bar, are better than hard candies, lollipops or sticky caramels. Sweets should be eaten in one go, rather than continually snacking on them.

Children do get hungry and need to snack. Choose healthy snacks such as fresh fruit and vegetables, nuts, cheese. For drinks in between meals go for water or milk without added sugar.

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