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Posts for: April, 2015

ATeensMissingToothMayRequireaTemporaryReplacement

Besides reduced biting and chewing function, a missing tooth can cause an embarrassing inhibition to healthy social interaction. This can be especially so for teens who greatly value peer relationships and acceptance.

Be that as it may, we typically discourage a permanent replacement for teens with a missing tooth, particularly dental implants. While we value a patient’s psychological needs, the long-term effect on dental health may be too great to advise otherwise.

The effect we’re concerned with involves jaw growth and development. Although a person’s permanent teeth have usually all erupted by early adolescence, the jaws continue to grow until the late teens or early twenties. Natural teeth can adapt to this growth because the periodontal ligament that holds them in place allows for incremental tooth movement. The teeth move in response to jaw growth and are thus able to maintain their proper relationship and alignment in the jaw as growth occurs.

Dental implants, on the other hand, are imbedded into the jaw bone: they, therefore, can’t move like natural teeth and thus can’t adjust their position with jaw growth, particularly the upper jaw as it grows forward and down. This can result in the implants appearing as though they are left behind or retreat into the jaw. It can also affect the position of the gums and inhibit their growth around the implants.

It’s best then to hold off implants and other permanent restorations until the jaw has finished developing. That, however, isn’t always easy to determine: specialized x-ray diagnostics may help, but it’s not an exact science. Your input as a parent will also be helpful, such as whether you’ve noticed the end of growth spurts (not changing clothes or shoe sizes as often) or your child’s recent similarity in appearance to other adult members of your family. It thus becomes a judgment call, based on examination and experience, as to whether it’s safe to proceed with implants — and may require erring on the side of caution.

In the meantime, there are temporary restorations that can improve appearance while you wait for the appropriate time to undertake a permanent restoration. Two of the most useful are removable partial dentures (RPDs) or a bonded bridge, a less invasive form of the traditional bridge. With a proper assessment we can advise you on which option is your best choice.

If you would like more information on tooth restorations for teenagers, 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 “Teenagers & Dental Implants.”


OliviaNewton-JohnRecallsDaughtersTeethingTroubles

Singer Olivia Newton-John's daughter Chloe is now a lovely, grown woman, but Olivia recently recounted to Dear Doctor magazine a rather creative method she found to sooth Chloe's teething troubles many years ago.

“When Chloe was a baby and teething I remember using a frozen bagel for her sore gums,” Olivia said. “She loved it!”

Cold is often very soothing to a teething child's gums. In fact, the American Academy of Pediatric Dentistry (AAPD) recommends using a clean, chilled, rubber teething ring, or cold wet washcloth. Chilled pacifiers can also be helpful. Be sure not to freeze teething rings or pacifiers as ice can actually burn sensitive mouth tissues.

Older teethers can sometimes find relieve from cold foods such as popsicles (or bagels!) but make sure your child eats these sugar-containing foods only at mealtimes so as not to promote tooth decay.

If your baby has not yet begun the teething (or tooth-eruption) process, you can expect it to begin usually between six and nine months. It may, however, start as early as three months or as late as twelve months.

Teething symptoms vary among children, as does the length of time it takes for a tooth to make its appearance. But many parents notice the following signs:

  • Irritability
  • Biting and gnawing
  • Gum swelling
  • Chin (facial) rash
  • Disrupted sleeping patterns
  • Ear rubbing
  • Drooling
  • Decreased appetite

These symptoms are usually most bothersome during the week that the tooth is breaking (erupting) through the gums, starting about four days before and lasting about three days after the tooth appears.

Occasionally, teething discomfort can be considerable. If that is the case with your baby, you can give her or him acetaminophen or ibuprofen in the appropriate dose (check with your pharmacist if you're not sure what that is). The medicine should be swallowed — not massaged into the gums, as this can also burn. Numbing agents should not be used for children under 2, except under the advice and supervision of a healthcare professional.

If you would like to learn more about teething or any other child-related oral health issue, please contact us or schedule an appointment for a consultation. If you would like to read Dear Doctor's entire interview with Olivia Newton-John, please see “Olivia Newton-John.” Dear Doctor also has more on “Teething Troubles.”