Kids Dental Care Resources - Small Bites X Dr.Toothlittle

Part 1: The Origin of Sensory Design in Pediatric Dental Clinics

Dr.Charmaine Kenita — Sat, 14 Oct 2023 04:53:41 +0000

The world around us is defined by our senses. What we perceive with touching, seeing, feeling, hearing and tasting affects how much we like being in an environment or getting away from it. Sensory perception thus is very valuable, helping us assess what’s outside of us. It is a primary skill, inborn and learnt as babies which grows in depth and intensity as adults. The acuteness of it as children does tend to reduce with adult distractions; but like ‘gut feeling’, helps and guides a majority of our decisions.

Sensory experience is an ignored overlooked aspect of the way the world is designed around us. Design decisions in our surroundings, the way outside influences stimulate us is often never considered important enough. While public and private spaces take care of sensory perception in a general way – dim lighting in hospitals is an example, the interplay of sensory perception and space design in medical practice is not a standard part of best practice guidelines.

People are unique, and therefore their sensory perception even more so. Some are overstimulated by noise, while some others face debilitated functioning when confronted by too less of it and need it in some form always. Some like texture in touch, which calms them while others love the feel of smooth finishes to enhance their moods. This can help or hinder people’s full participation in society, since they are constantly trying to avoid their triggers and find other avenues to work around it. The design of spaces can do well with being more inclusive by taking a sensory approach. People who have to live with heightened, reduced, or complete loss of senses can then be free to work and function, thus enabling support for diverse sensory and other heightened problems.

Hospital and clinic environments especially need such sensory approach to design, given that people already walk in with a range of illnesses, impairments and emotions. At Small Bites Dental Clinic, sensory perception and inclusiveness defines our spaces and the way we approach treatment for everyone.

As one of India’s leading children’s dental clinics complete with pediatric specific methodologies, themed interiors with toys and learning materials, multimedia and technology that makes dental interventions stress-free and pleasant, and experienced pediatric dentists, Small Bites is one of the country’s leading dental experience centers to incorporate sensory design into its physical architecture. While Dr.Premila of Small Bites has been at the forefront in spearheading new innovations in treatment, including the latest ‘laughing gas’ intervention to relax children during complicated procedures, the clinic space has also been adapted to make it more open, comfotable, warm and welcoming for everyone. Created in a ‘beach theme’ complete with pebble and sand like granular textural walkways, to varied mood lighting, and soundscapes, the clinic incorporates a design that facilitates exploration, engagement and experimentation.

At Small Bites, sensory design was a key feature when the clinic was created, with a particular emphasis on making the waiting and treatment rooms engaging, warm and friendly for all children. From tactile walls and flooring to adjustable light brightness for different moods and functional interaction, everything was thought through to give the children the kind of ambience that immediately made them lighter, brighter and more open.

Sensory design also called ‘Biophilic design’ is a good healthcare practice tracing its roots to the principles of Florence Nightingale. Her concepts speak about spaces impacting treatment outcomes, how they must differ for different sets of people, and what works the best for everyone.

Dental clinics cater to some of the most stressful moments in a child’s life, and we know how a better environment can foster better dental outcomes; a more accommodating child, a child open to instructions and asks, and who then considers the space safe and the dentists’ friends they would like to meet again and again.

Like Dr.Premila shares about her idea in designing the clinic, ” A space where children can be free, outgoing, inclusive and where dental care doesn’t become a stressful experience for everyone is what I wanted to create.”

Keep reading our series on ‘Sensory Design in Dental Clinics’ and explore what has gone into our dental space and how we have gone about it.

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3 Pediatric Dental Advancements Small Bites Is Most Excited About

DR. PREMILA NAIDU, MDS — Fri, 28 Apr 2023 10:24:47 +0000

We’re already implementing them, and more to come!

And yet as we all know, pediatric dentistry is constantly evolving. Because children are at the receiving end of treatment and dealing with their dental issues is critically important from the start, every new development and every new intervention is important, and we’ve been introducing them at our clinic as some of the first critical interventions in the country since the last 15 years.

As pediatric dentists, here are 3 dental intervention and innovations that will change treatment in the coming months and years.

1. EARLY CAVITY DETECTION WITH PRECISE DIAGNOSTIC & IMAGING TOOLS

Imagine as a parent taking your child regularly for checkups, and finding cavities forming in your child’s mouth even before the physical signs – dark spots – building on them?

Baby teeth are important. They pave the way for healthy and whole permanent teeth, contribute to facial shape and help in speech development. It is all about children and their confidence and thus tooth decay signs in them are very damaging. However, working extensively on dental intervention in little children comes with its own stress and anxiety. Catching delay early is thus beneficial and also easy, fast and affordable. It prevents the entire process of finding the decay, removal, surgery, restoration and more. Emerging decay can also be reversed if found early.

Getting a child examined by the dentist at the age of 1 year is the first step towards preventative dental care. Newer diagnostic tools like imaging and illumination are slowly making their way into pediatric dentistry and in the future will be able to pick changes in bone density and enamel thus identifying decay spots early, making treatment easy.

2. PAINLESS INJECTION AND TECHNIQUES

Getting children examined and treated begins from making it painless and comfortable for them. If as a parent you are stressed while taking your child to the dentist, think of how that stress will pass on to them subtly & invariably.

Injections for both adults and kids alike can be terrifying. The feel of a needle piercing into the gums can prevent children from getting the best treatment they can and in time. Painless injections and techniques can take care of it. From multimedia distractions to methods that minimize the use of anasthesia, some of the ‘pinch’ felt by kids and their stress can be greatly reduced.

Kids with severe dental phobia or neuro-atypical children or those with increased tactile & textural sensitivity can avail of safe, effective dental treatment with sedation dentistry when absolutely needed. Nitrous Oxide or Laughing gas is increasingly being used as a safe alternative to ease stress, delivered only when required in required doses by expert trained dentists.

3. BITE-SIZED DENTISTRY

Children love play, and anything that can make their surroundings less foreboding, more engaging and more child’like in size. One of ongoing and future trends of pediatric dentistry is the child-sizing of dental technology.

For years adult dental tools and tech have been used in treating children, and they can seem huge and daunting from the perspective of little eyes. But as we’re constantly updating our technology and tools, imaging and machines, at Small Bites, we’re constantly using high-tech imaging only when absolutely necessary, decreasing exposure time for kids and using smaller tools where necessary. The use of pedo sensors – bite sized digital sensors instead of bitewings is one such breakthrough, that will become increasingly common in the next few years. They make treatment comfortable and fast. Handheld x-ray machines, CT radiographs are other equipment getting more popular in use, all in the effort to be more precise, reduce exposure and make treatments quicker.

The use of Invisalign First or transparent braces is a significant endeavor to make treatment more child friendly. Re-aligning children’s teeth, improving their bite, shaping their mouth are all being done by Small Bites’ ‘Center For Invisalign’ in an effort to make it all seem gentler and more manageable for the child.

At Small Bites we make sure we’re doing whatever we can for our children, giving them access to treatment and tools that make their experience fulfilling and happy, whether for the children themselves or their parents.

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Can a Sensory Adaptive Dental Center Minimize a Child’s Pain?

DR. PREMILA NAIDU, MDS — Tue, 07 Mar 2023 16:02:49 +0000

Yes, and absolutely yes!!

Pain, something we all experience whenever we go through a health problem or when taking treatment of any kind. When it comes to teeth, it isn’t just the pain felt when teeth are caried or there’s gum problem, but the pain that we prepare for and dread much before we even visit the dentist.

Imagine this in children, and the anxiety induced pain and stress being exaggerated 5x times!

What is dental pain and how is it different from pain in other parts of the body?

Dental pain is a type of localised pain that is felt in the teeth, gums, or jaw. It is typically caused by dental problems such as cavities, gum disease, or tooth infections. Dental pain can range from mild discomfort to severe, sharp pain that makes it difficult to eat, drink, or even talk.

One of the main differences between dental pain and pain in other parts of the body is its location. Dental pain is usually localized to the mouth, whereas other types of pain can be felt throughout the body, the distribution making the pain bearable. Additionally, dental pain can be triggered by specific actions such as eating, drinking, or brushing – everyday tasks, whereas other types of pain may be more constant or occur without a clear cause.
Another difference is the type of pain. Dental pain can be throbbing, sharp, or dull, and it may be accompanied by swelling or sensitivity to hot or cold temperatures, experiences that can feel like the head will explode, exaggerated several times in children. Other types of pain may feel different depending on the cause, location, and severity.

What are Sensory Adaptive Dental Experience Centres (SADE)?

A Sensory Adaptive Dental Experience Center (SADE) unlike a regular dental center, has an environment adapted to work with the sensory abilities of little children. All children when born step into a new environment. From the time they are babies till they grow into teens, they are constantly adapting and changing, each of them taking their time and stretching their abilities in the world. But all children are not the same. They perceive their sense of touch, pain, light and sound differently. This impacts the way they feel pain and react to the surroundings, some find it easy while others find it harsh. Their reaction can change the way they become, impacting any kind of external intervention, even getting teeth examined by a dentist to stop or prevent dental related issues.

SADE environments consider the growth and feelings of a child and feature many different sensorial stimuli that can be adapted to their needs. Whether it is bright or soft lights, textured walls and flooring for their feet, multimedia devices to distract them, intervention like laughing gas and other accessories that help them navigate their sensorial stimuli and help them get interventional treatment or management.

How do these tools reduce pain?

SADE centers work with patients in 2 different areas:

Surrounding environment

A sensory adaptive dental center may help to reduce pain and discomfort experienced by children during dental procedures. These centers are designed to provide a calming and supportive environment for patients with mild or severe sensory processing difficulties, such as those with autism or other developmental disorders.

By providing a quiet and low-stimulation environment, with features such as dim lighting, noise-cancelling headphones, visual and TV aids, weighted blankets, and other sensory supports, sensory adaptive dental centers can help to reduce anxiety and stress for patients, which may in turn reduce the perception of pain.

Techniques

In addition, some sensory adaptive dental centers may also use techniques such as distraction therapy, virtual reality, or other forms of cognitive behavioral therapy to help patients manage their pain and discomfort during dental procedures.

Small Bites is one of India’s top Sensory Adaptive Dental Centers designed entirely in a special ‘Beach Theme’ where the entire environment has been moulded to work with the sensory needs of different children, so they get the kind of treatment they need without feeling scared, anxious or overwhelmed.

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Why Is Small Bites Dental Clinic Such a Great Place for My Child’s Dental Checkup?

DR. PREMILA NAIDU, MDS — Wed, 21 Dec 2022 08:39:19 +0000

Has this thought ever crossed your mind?

What makes this clinic better than the others? After all, every dental clinic provides the same kind of services for little kids, right?

Yes, you are right! Most clinics provide the same dental services to everyone from the family – be they children or adults. Clinics treat the same gum and tooth problems, manage dental caries and the occasional pulpectomy and more.

Small Bites Dental Experience Center is very unique, both in the services it offers and the ambience of the space. Below are 5 reasons why.

Centered around the child’s dental needs – Medical and dental centers are spotless, sanitised spaces where a variety of medical procedures are conducted for different dental problems. But why can’t they be fun, engaging and interactive? While designing the interior spaces at Small Bites, we have created it keeping the children and their needs in mind – their wants, their engagement, their surroundings and the space to ensure they are comfortable, relaxed and feel safe at all times. The world from the eyes of a little child is very scary and overwhelming. At Small Bites that is one less scary space and instead one full of color, texture, lights and sounds, keeping them distracted and yet a place they will leave with happy memories.
Centred around the child’s sensorial needs – Small Bites is designed as a Sensory Adaptive Dental Experience Centre (SADE) – one of the first of its kind in India – and kids across all ages including those with special needs associated with developmental milestones are taken care of. The design of the clinic is especially comfortable for children with hypersensitivity issues, those with oral aversion, neurodevelopmental delays such as Asperger and Autism, and craniofacial abnormalities like malformed jaws. Our expert dentists are aware and know how to handle damage caused due to improper oral hygiene, brushing and other issues arising out of these conditions.
Themed and aligned with the senses – Research has found that children learn and imbibe from the environment based on the predominant senses they possess. While some children are visual, some others are auditory in grasping information and others are tactile; liking the feel and touch of the environment they move in. With this in mind Small Bites interiors have been designed around the themes of water and beaches. The serene calmness, mesmerizing waves and tactility of sand touching the feet can be experienced and felt everywhere in the clinic space.
Soft & subtle lighting for comfort – Ever realised the lighting that greets you in hospitals and medical centers. They can be harsh, strong and exaggerates the sterility of white-washed medical rooms. Mellow water themed lighting, ceiling starlights, gradient colors and hues help children get better adjusted to the dental clinic at Small Bites. Besides the warmth they are greeted by, it keeps them merrily engaged and distracted, inquisitive and wanting to explore more.
Doctors that know how to manage dental care needs of little ones – Children are humans unto themselves, their needs are unique, their interactions still being learnt. The way they convey pain and hurt, the way they understand and follow instructions are different. It is important for dentists trained in child dental care to manage their needs. These specialists know the mouth structure, issues that arise with growing teeth and gums, and the most painless way to treat, manage and distract little children while undergoing procedures that can scare even bigger adults. With over 15+ years of experience, the dentists at Small Bites are trained and familiar with kid’s dental care and management.

Visit us with your kids, whether for the first time or to explore other treatment modalities and see for yourself how a dental clinic designed exclusively for your child can make such a big difference to them and their moods.

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Why do children have baby teeth? Why not grow permanent teeth in the first place?

DR. PREMILA NAIDU, MDS — Tue, 22 Nov 2022 15:18:43 +0000

This question might have come to you perhaps or may have crossed the minds of parents bringing their child to us at Small Bites. It’s a valid question considering baby teeth tend to fall off at some point of time. Having them seems pointless for little children, not to mention the associated teething pain, irritability, fever and so much more accompanying it.

Yet it is important to understand why baby teeth grow and what’s so different about them. Before that, understanding the teeth and its structure is an absolute must.

The tooth is basically composed of two tissue types;

Structures that make up the tooth itself which are the enamel, dentine, pulp and cementum.
Tissues that form and support the tooth in the mouth, which include gingiva, periodontal ligament and alveolar bone.

Of all these tissues, the enamel, dentine and cementum are hard tissues enclosing the soft tooth pulp. The enamel has no cells and unlike bone cannot grow or undergo repairing once damaged. Therefore, teeth when once formed cannot grow or change in size.

However, the surrounding tissues such as gingiva, periodontal ligament and alveolar bone keep growing as the child grows. From infancy to adulthood, the body and its structures, particularly the mandible and maxilla grow continuously. This increases the space in the jaw which does not get filled with existing milk teeth.

To accommodate the space in the jaw and help in masticating larger food particles as the body and jaws grow, deciduous or milk teeth are resorbed and fall off, and in their place, new bigger teeth grow to fill up the larger space.

Humans therefore have two sets of teeth – the deciduous or milk teeth and the succeedaneous or permanent teeth. It is interesting to know that most rodents, squirrels and rabbits teeth keep growing as they grow.

Do you want to know some other teeth facts to share with your kids?

Dolphins don’t use teeth for chewing food, because their jaws have no muscles.
Blue whales have no teeth at all. Instead, they have plates of baleen on both jaws used to catch small animals like krill when swimming.
Giraffes have no upper front teeth, because their tongues do the grabbing of leaves and eating.
Cats have additional tiny teeth on the roof of their mouth to grip their prey.
Frogs have teeth but toads don’t.

Humans are diphyodont creatures, with two sets of teeth in our lifetime. It is essential that we look after both of them well, given that healthy milk teeth also mean a healthier set of permanent teeth. Bring your child to us for regular dental checkups starting from the age of 1. We’ll ensure they always remain healthy.

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3 Dental Reminders That We As Parents Must Be Aware Of!

DR. PREMILA NAIDU, MDS — Thu, 27 Oct 2022 12:21:36 +0000

Navigating our child’s oral health can be overwhelming and stressful on a daily basis. Despite it being a hygiene issue and non-negotiable, what we must also understand as parents is that this activity can also appear like an intrusion into their private space.

Children resist activities like brushing and cleaning for several reasons. Some of the commonest are below;

Putting a brush into a child’s mouth can seem alien to a little one who is used to biting down on foreign objects, but not familiar with the objects remaining in the mouth for a longer time
Having a parent brush a toddler’s teeth is an activity fraught with resistance, playfulness and procrastination either due to irritability, anxiety or stress
Brushing seems like an added chore to children who don’t understand the reasoning behind it since they don’t see the immediate effects of not doing the activity
Carious teeth, bleeding gums, bad breath often don’t register unless they become serious and cause the child discomfort

Resistance to brushing and regular dental visits by their wards is one complaint many parents have. But it is also these times where we must re-visit what kind of practices we are enforcing regarding their dental health.

What are we doing or not doing that is causing more harm than relief to our children, while working towards their dental health?

Here’s 3 important dental reminders to put things into better perspective for us parents.

White teeth don’t always mean healthy teeth

Have you ever looked at your child’s teeth and thought all is good? You or they are brushing regularly, teeth look gleaming and nice, and their dental health seems perfect. But unbeknown to you, often times, caries or black spots may be lurking in the most unsuspecting areas of the teeth. Molars and grinders, back of the teeth, upper teeth can begin infection which if not identified or checked can slowly destroy the tooth or spread to adjoining ones.

White teeth being healthy teeth is a misconception to be constantly aware of. As parents, putting in a weekly schedule of examining all the teeth with a torch, making note of discolorations and regular pediatric dental checkups can avoid serious tooth complications and serious dental interventions.

Brushing harder doesn’t clean better!

True. Brushing harder, applying more force, using hard-bristled toothbrushes in an attempt to remove stubborn or stuck plaque between teeth can cause more damage than good. Although our natural human tendency is to use more force, in reality, brushing vigorously is like applying blunt force to the teeth, causing the outer enamel to be eroded faster, injuries to the gums, shaking the root of the tooth. This in children with milk teeth and growing adult teeth, can impact the way they form and the pace at which they grow.

Brushing must be done gently, with a soft-bristled age-appropriate brush and adequate quantity of fluoride paste rubbed in circles around the teeth. This removes all the loose food stuck around the teeth as well provides massaging for the gums in children.

Agitated, irritable children at the dentist can also mean sensory overload

Irritable, agitated children can mean several things – he or she is hungry, teething, has colic or indigestion, is restless and so much more. This behavior at the dentist can often exaggerate and get out of hand. At such times tried and tested means to pacify them don’t suffice. However, have you ever thought that children can be overwhelmed by large number of people, machines, strangers touching and prodding them, lights and sounds too? Many children act up not because they are just being irritable but are trying to convey how much the environment is overwhelming and affecting them. They become non-cooperative, throw tantrums, keep crying and whining, and usual forms of pacifying too don’t help.

This fact is something we at Small Bites have realized during the course of our work with children. To address that, our dental experience centers feature beach themed walls and play toys, sensorially designed lights and walls that can be felt and touched, providing the distraction that will ease them into much needed treatment.

As parents we are pre-conditioned to behave, react and pre-empt a certain way and practice tasks accordingly. But at every step we need gentle reminders that will help us relearn, for the better treatment of our children.

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4 Surprising Reasons For Bad Breath In Children

DR. PREMILA NAIDU, MDS — Wed, 21 Sep 2022 11:38:09 +0000

If you’re waking up every morning tussling with your kids while they groan to get to the bathroom, brush their teeth and get ready for school, then you’re not alone. Battling with the brush is a dreaded experience most parents go through. It isn’t just to give them white or clean teeth that this is done. Bad breath is very common in children, and we become aware of it only when it gets very overpowering. There are surprising reasons for bad mouth odor which you as a parent must know to give your child the right kind of care.

DRY MOUTH

Most of us know babies have dry mouth when they can’t speak or articulate, or we know it is serious only when the child asks for water repeatedly. Drinking water regularly is a must for growing children, which if not done can cause scratchy throat but gradually progresses to dehydration symptoms. Dry sallow skin, pale countenance is seen eventually, but first observed in the mouth. Active children need water, which when reduced, causes reduction of saliva production, resulting in bad breath in even babies. Less saliva doesn’t clean the mouth adequately, causing acids from milk and food solids gradually damaging teeth and consequently producing bad breath.

Tip: Check your baby’s mouth and look for dryness, constant swallowing, irritation and weak speech which can suggest low water intake.

BLOCKED NOSE

Blocked nose and sinusitis are known for causing bad breath. Sinuses are air-filled spaces in the skull, above the forehead & in the cheeks which when filled with phlegm due to cold and not allowed to drain out, accumulate, causing the mouth to smell. No amount of brushing or gargling takes care of it. A doctor’s intervention with antibiotics can help take care of postnasal drip, sore throat and any accompanying symptoms.

Tip: During the first few days of a cold, keep constant watch on the mouth odor. Not only does bad breath tell you that further treatment is required, but quick intervention can stop infection from getting worse and moving to the lungs.

INFECTED TONSILS

Persistent bad breath that just doesn’t go away, and even picked up by anyone near the child should be looked into more keenly. Infected and swollen tonsils are red, inflamed and swollen, looking very different from healthy ones which are pink and healthy. Tonsillitis causes the worst bad breath because pockets of infection are very deep and difficult to reach and treat.

Tip: Check your child’s mouth if mouth odor is particularly bad and persistent, observe for swollen tonsils and get it treated immediately.

TOOTH DECAY & GUM DISEASE

Tooth decay can cause bad odor coming from the mouth, which no brushing will take care of. Sugary treats, milk in the mouth for a long time, food pouching or storing food in the cheek for long are some of the reasons for teeth deterioration. These release acids which erode tooth enamel, leading to cavities, gum disease and eventually bad smell in the mouth.

Tip: It is best to have a regular pediatric dentist visit scheduled so such little things are nipped when they begin, and don’t go on to become something big. Regulate the kid’s eating habits, check their mouth and tonsils regularly and never ignore any kind of bad odor from the mouth.

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All You Need To Know About ‘Sensory Adaptive Dental Environment (SADE)’

DR. PREMILA NAIDU, MDS — Thu, 25 Aug 2022 14:44:40 +0000

Oral care isn’t restricted to only chewing and masticating, making sure the teeth and gums are taken care of. Oral care is very important for the psychological and physiological health and well being of children. While children in general become anxious with any kind of dental intervention, children with special needs find it particularly hard to undergo any treatment. As a result, they face continuous ongoing poor dental hygiene, and find it very difficult to get the right kind of oral treatment. The reasons for this are many;

Lack of access especially when such specialty dental clinics are in major cities
Non cooperation by the child. Neuro-diverse children find it very difficult to let someone near them, and any kind of dental intervention is fraught with fear and anxiety
Children in the autism spectrum with impaired social interaction, restricted and repetitive patterns of behavior and activity, don’t let anyone near them except parents

WHY DOES THIS HAPPEN

Children on the autism spectrum suffer from difficulty in sensory processing. Anything outside their environment that is unfamiliar, too loud visually or auditorily can overwhelm them. They are used to familiarity in the people they interact with and the kind of stimulations they experience. Any break from this makes them react and overpowers their sensory processing.

Dental care centers too are unfamiliar with handling of such children. Designed and set up like a typical dental clinic, they treat patients generally without specifically looking into the needs of the child. This results in being unprepared to address the specific sensorial needs of neuro-diverse children, and inability to give them adequate oral care. Sensory over-stimulation that can occur in a dental clinic can be as simple as bright fluorescent lights to touching in and around the mouth, the smell and taste of oral care products which all have the potential to negatively impact such children. Once a fear of the place sets in, it becomes impossible to provide adequate oral care unless the child is sedated – in extreme cases – to get some critical dental intervention done.

Identifying innovative solutions to address such children and provide them the essential dental hygiene and care they need is critical. This is what Small Bites Dental Experience Centre provides at its newly opened center in Bhartiya Mall of Bengaluru, Bhartiya City – North Bangalore.

By modifying the sensory characteristics of the dental office for children with developmental and intellectual disabilities and to provide decreased physiological anxiety and behavioral distress, the dental care center hopes to put such children at ease the minute they walk into the clinic.

A Sensory Adapted Dental Environment (SADE) as found at Small Bites does the below for your children;

Brings down the physiological pain and distress and sensory discomfort during routine checkups and dental cleaning
Pre-empt and plan for the dental checkup of the child minus the stress and fear of a regular dental environment
Distract the child from the machines, sounds and chaos that accompany a regular dental environment
Ensure shorter dental cleaning time, fewer staff to manage the children and reduced need for anesthesia to perform even routine examinations

With experienced dentists and medical staff who know how to handle children with sensory issues, our clinic provides them with all the comfort they need so as to make the dental experience calm, soothing and less stressful.

Visit our clinic at #6/2, Lower Ground Floor, Bhartiya Mall of Bengaluru, Bhartiya City, Thanisandra Main Road, Bangalore – 560064

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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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