We've known for decades that fluoride strengthens tooth enamel and lowers the risk for decay. And while adding it to toothpaste and drinking water are the more common ways for getting it into the body, an increasingly popular way—especially for children—is to apply fluoride directly to the teeth.
But is topical fluoride really worth the effort and expense? And, are there any side effects to treating teeth this way?
As to the first question, researchers have performed numerous studies measuring fluoride's effectiveness for preventing tooth decay. The Cochrane Oral Health Research Group recently reviewed studies on topical fluoride applications involving nearly 10,000 children and adolescents between the ages of 2 and 15. The combined average for all the studies showed a 28% reduction in decayed teeth for patients who received topical fluoride compared to those who didn't.
This was especially true for children at high risk for decay: directly applying fluoride gels, foams or varnishes to teeth reduces that risk substantially. But there are also side effects to this application. Fluoride in general has only one known safety concern, a condition known as fluorosis. Too much fluoride over time can cause heavy discoloration of the teeth. This does not affect the health of the teeth, but it can look unattractive and require cosmetic treatment to reduce its effect.
There's little to no risk for fluorosis with the controlled treatments offered by dentists; the fluoride solution remains on the teeth no more than a few minutes. But there is a possible side effect during treatment due to the relatively high dose of fluoride used. If the patient accidentally swallows some of the solution, the concentration of fluoride can cause stomach upset, vomiting or headaches.
Dentists minimize the chances for this by usually using the more difficult to swallow varnish form of topical fluoride on younger patients, and using trays or other barrier devices to isolate the fluoride solution from the rest of the mouth. Under professional supervision, it's rare for an accidental ingestion to occur.
The risks for these side effects are quite low, and the benefits of topical fluoride for reducing the chances for decay can more than outweigh them. Fluoride applications are one of many ways we can protect your child's current and future dental health.
If you would like more information on decay prevention techniques like topical fluoride, 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 “Fluoride Gels Reduce Decay.”
One of the biggest concerns we hear from parents is about their child's thumb sucking habit. Our advice: if they're under age 4, there's no need for concern — yet. If they're older, though, you should be concerned about the possible effect on their bite.
Thumb sucking is a universal habit among infants and toddlers and is related to their swallowing pattern during feeding. As they swallow, their tongue thrusts forward to create a seal with the lips around the breast or a bottle nipple. Many pediatricians believe thumb sucking replicates nursing and so has a comforting effect on infants.
Around age 4, though, this swallowing pattern begins to change to accommodate solid food. The tongue now begins to rest at the back of the top front teeth during swallowing (try swallowing now and you'll see). For most children, their thumb sucking habit also fades during this time and eventually stops.
But for whatever reason, some children don't stop. As the habit persists, the tongue continues to thrust forward rather than toward the back of the top front teeth. Over time this can place undue pressure on both upper and lower front teeth and contribute to the development of an open bite, a slight gap between the upper and lower teeth when the jaws are shut.
While late childhood thumb sucking isn't the only cause for an open bite (abnormal bone growth in one jaw is another), the habit is still a prominent factor. That's why it's important that you start encouraging your child to stop thumb sucking around age 3 and no later than 4. This is best accomplished with positive reinforcement like rewards or praise.
If they've continued the habit a few years after they should have stopped, we may also need to check to see if their swallowing mechanism has become stunted. If so, we may need to use certain exercises to retrain their tongue to take the proper position during swallowing.
While you shouldn't panic, it's important to take action to stop thumb sucking before it becomes a long-term problem. A positive, proactive approach will help avoid costly orthodontic problems later in their lives.
If you would like more information about thumb or finger sucking, 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 “How Thumb Sucking Affects the Bite.”
From birth to young adulthood, your child's teeth gums and other mouth structures steadily grow and mature. Sometimes, though, problems arise and get in the way of their oral health. It's important we detect when that happens and take action.
We can sort these potential problems into three broad categories: developmental, disease and injury. The first category includes such problems during their childhood years as teeth erupting out of position or the jaws growing improperly and becoming abnormally long, short, wide or narrow.
The possibility of developmental problems is a primary reason for regular dental visits, beginning around your child's first birthday. If we can detect a growing problem early, we may be able to minimize or even reverse its impact to your child's oral health.
Regular dental care also helps control disease, particularly tooth decay and cavity formation. Our primary aim is to treat decay, even in primary (baby) teeth: losing a primary tooth to decay could adversely affect the incoming permanent tooth's jaw position. Besides treatment, we can also help prevent decay with topical fluoride treatments (to strengthen enamel) and sealants.
Although not as common as disease, dental problems due to injury still occur all too frequently. Blows to the mouth can chip teeth, loosen them or even knock them out. For any type of visible tooth injury you should visit us or an emergency room immediately — time is of the essence especially to save a knocked out tooth. Be sure you recover and bring any knocked out teeth or chip fragments.
We can also help you on the injury prevention front as well. For example, if your child participates in contact sports or similar activities, we can fashion a custom-fitted mouth guard to protect their teeth and soft tissues.
Keeping a vigilant eye for these potential problems will help ensure your child's future oral health is the best it can be. The sooner these problems are detected, the better and less costly their outcome.
Like many other families, you may use formula instead of breast milk as a safe and healthy alternative to feed your infant. But, if you use a powdered form that you mix with water your child may be taking in more fluoride than they require.
Fluoride is a natural chemical that can strengthen tooth enamel and help prevent decay. After decades of study it's also been shown to pose no serious health risks. Because of fluoride's benefits and safety, many water utilities add tiny amounts to their drinking water supply.
But it can have one side effect called enamel fluorosis. If a child ingests too much fluoride during early development it can cause discoloring mottled spots or streaking in permanent teeth. Although it doesn't affect their health, the teeth can be unattractive and require cosmetic attention.
That's why it's best to keep fluoride consumption to a healthy minimum for children. That, however, is often easier said than done, since we can encounter hidden fluoride in a variety of places. Besides hygiene products and fluoridated drinking water, you may find fluoride in prepared juices and other beverages, bottled water or in foods processed with fluoridated water. There are no labeling requirements for fluoride, so you'll have to research to find out if a product contains fluoride.
There are, however, some things you can do to control your child's fluoride intake. First, know as much as you can about known sources your child may encounter like your water supply. You can find out if your utility adds fluoride and by how much by contacting them or visiting My Water's Fluoride online at https://nccd.cdc.gov/DOH_MWF/.
If you use fluoride toothpaste apply only a “smear” on the end of the brush for children under two and a pea-sized amount for older children. If you have fluoridated drinking water, consider breastfeeding your infant, use ready-to-feed formula or mix powdered formula with bottled water labeled “de-ionized,” “purified,” “demineralized” or “distilled.”
And, do feel free to discuss your concerns with us during your child's regular checkup. We'll help you adjust their diet, water intake and hygiene habits to be sure they're receiving the right amount they need for developing strong teeth — and no more.
If you would like more information on appropriate fluoride levels for children, 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 “Tooth Development and Infant Formula.”
When you’re expecting a new baby, there’s a lot to prepare: outfitting the nursery, stocking up on diapers or choosing a pediatrician. It’s also not too early to consider how to protect your new child’s dental development.
From birth through adolescence, a child’s mouth goes through a whirlwind of growth. Hopefully, it all follows a normal track, but detours can arise like tooth decay or bite problems.
Here are 4 things you can do to keep your child’s dental development on track.
Start oral hygiene before teeth. Daily oral hygiene is essential toward helping your child avoid tooth decay. And don’t wait for teeth to come in—begin wiping their gums with a clean, damp cloth right after nursing. When teeth do appear, switch to brushing with just a smear of toothpaste and then add flossing as more teeth come in.
Begin regular dental visits. The American Dental Association recommends pediatric dental visits around the first birthday. The possibility of tooth decay becomes a concern around this time as the primary teeth are steadily erupting. Starting earlier rather than later may also help your child adjust to the routine of dental visits that they’ll most likely carry on as they get older.
Control their sugar consumption. Because sugar is a prime food source for disease-causing bacteria, you should keep your child’s sugar consumption as controlled as possible. For example, don’t put a baby to bed with a bottle filled with a sugary liquid (including juice and breast milk)—the constant presence of the liquid during nap time encourages bacterial growth and acid production.
Get an orthodontic evaluation. While we often associate orthodontic treatment with the teen years, it may be possible to head off bite problems earlier. So, see an orthodontist for a bite evaluation when your child is around age 6. If there are signs of a developing problem, certain techniques could help stop or slow them from getting worse, helping you avoid extensive and expensive treatment later.
With a newborn coming, you and your family have a lot on your plate. Be sure, though, not to forget making plans for keeping their teeth and gums healthy.
If you would like more information on dental care for your child, 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 “Age One Dental Visit.”
This website includes materials that are protected by copyright, or other proprietary rights. Transmission or reproduction of protected items beyond that allowed by fair use, as defined in the copyright laws, requires the written permission of the copyright owners.