What to do when your child has a dental emergency

When your child needs urgent dental treatment, our team stands ready to help. Here are some helpful answers to some recent patient questions.

Q: What should I do if my child’s permanent tooth is knocked out?

A: Find the tooth and rinse it gently in milk or saliva. (Do not scrub it or clean it with soap, use just water!) If possible, replace the tooth in the socket and hold it there with clean gauze or a wash cloth. If you can’t put the tooth back in the socket, place the tooth in a clean container with milk, saliva, or water. Get to our office immediately. The faster you act, the better your chances of saving the tooth.

Q: What if a tooth is chipped or fractured?

A: Contact our practice immediately. Quick action can save the tooth, prevent infection and reduce the need for extensive dental treatment. Rinse the mouth with water and apply cold compresses to reduce swelling. If you can find the broken tooth fragment, bring it with you when you visit us.

Q: What about a severe blow to the head or jaw fracture?

A: Go immediately to the emergency room of the closest hospital. A blow to the head can be life threatening.

Q: What if my child has a toothache?

A: Call us promptly. To comfort your child, rinse the mouth with water. Apply a cold compress or ice wrapped in a cloth. Do not put heat or aspirin on the sore area.

Q: How can I best prevent a dental injury from happening to my child in the first place?

A: Oral injuries can occur from many activities.

Many oral injuries occur during physical activity such as sports. You can greatly reduce the chance of oral injury by having your child wear a mouth guard. While there are many store-bought varieties available, a custom mouth guards can often provide better protection
Always use a car seat for young children. Require seat belts for everyone in the car.
Child-proof your home to prevent falls, electrical injuries, and choking on small objects.
Help prevent your child from dental-health related toothaches with regular visits to our practice.
If you have any other questions about dental health and emergencies for your child, please contact our practice!

More than just teeth in your mouth!

Your mouth is made up of more than just teeth, so good oral health goes beyond simply brushing and flossing. In addition to your teeth, your mouth is made up of gums, oral mucosa, the upper and lower jaw, the tongue, salivary glands, the uvula, and the frenulum. All of these structures play an important role when it comes to good dental health and are routinely examined when you receive dental care.

The Oral Mucosa

When you open your mouth and look in the mirror, everything that isn’t a tooth is covered by a protective lining called the oral mucosa, which is a mucous membrane similar to the mucous membranes that line your nostrils and inner ears.

The oral mucosa plays an essential role in maintaining your oral health, as well as your overall health, by defending your body from germs and other irritants that enter your mouth. A tough substance called keratin, also found in your fingernails and hair, helps make the oral mucosa resistant to injury.

The Gums

Your gums are the pinkish tissue that surrounds and supports your teeth. Also covered by oral mucosa, gums play a critical role in your oral health. Healthy gums are firm, cover the entire root of the tooth, and do not bleed when brushed, poked, or prodded. Gum disease can ultimately lead to tooth loss, so taking care of your gums by flossing daily is just as essential to dental care as brushing your teeth.

The Upper and Lower Jaw

Your jaws give your face its shape and your mouth the structure it needs for chewing and speech. Human jaws are made up of several bones: The upper jaw contains two bones that are fused to each other and to the rest of your skull, while the lower jawbone is separate from the rest of the skull, enabling it to move up and down when you speak and chew.

The Tongue

The tongue is a powerful muscle covered in specialized mucosal tissue that includes your taste buds. The tongue is not just important to your oral health — it’s also considered an integral part of the body’s digestive system — it’s responsible for moving food to your teeth, and when chewed food is ready to be swallowed, the tongue moves it to the back of the throat so it can proceed into the esophagus. In babies, the tongue and the jaw work together to enable the infant to breastfeed.Additionally, the tongue plays an essential role in the ability to speak by shaping the sounds that come out of your mouth.

The Salivary Glands

You have three sets of salivary glands in your mouth and neck: the parotid, submandibular, and sublingual glands. These glands produce saliva, which contains special enzymes that help break down food, making it easier for you to swallow. Saliva is critical to good oral health, because it protects your teeth and gums by rinsing away food particles and bacteria and by helping to counteract acidic foods that can wear down the protective enamel on your teeth.

The Uvula

The uvula is the small flap of tissue which hangs down at the back of your throat. The uvula is composed of muscle fibers as well as connective and glandular tissues. Like other soft tissue structures in the mouth, the uvula is covered by oral mucosa. The uvula has long been a source of curiosity for scientists as all of its functions are not yet fully understood. However, it seems to play some role in speech and in keeping the mouth and throat moist.

The Frenulum Linguae

The frenulum is a flap of oral mucosa that connects the tongue to the floor of the mouth. This tissue allows the tongue to move about as it does its job. If an infant is born with a frenulum that is too short, or not elastic enough, he or she can have trouble breastfeeding. A short frenulum can also affect speech.

The next time you’re brushing your teeth, spend a minute looking at the parts of the mouth that lie farther inside the oral cavity. Knowing what these structures do and what they look like can help you to maintain optimal oral health.

Pregnancy and Dental Care

Carrying a child affects your entire body — and that goes for your mouth, too.

Since your teeth and gums can be affected by the hormonal changes that take place during pregnancy, you’ll need to pay special attention to your dental health when you’re pregnant.

In addition, there are a few extra safety measures you will need to be sure are followed when going to the dentist. Here’s how to stay on top of your dental care when you’re expecting.

How Pregnancy Affects Your Dental Health

Problems that women may experience with their teeth and mouth during pregnancy include:

Pregnancy gingivitis. Increased levels of the hormone progesterone can result in gingivitis, an inflammation of the gums. This, along with pregnancy-related changes in your immune system, can cause your gums to become red and swollen, and you may experience bleeding when you brush or floss your teeth. Symptoms of pregnancy gingivitis usually go away after the baby is born.Periodontal disease. Some pregnant women experience a more serious dental condition, called periodontal, or gum disease. Periodontal disease occurs when a bacterial infection develops in pockets below the gum line, which can damage the fibers that hold your teeth in place. Periodontal disease can also affect the health of the baby, since women with periodontal disease are at higher risk of having babies early and with lower birth weights.Pregnancy granuloma. A pregnancy granuloma is a red growth that usually appears along the upper line of your gums. This nodular growth bleeds easily and sometimes crusts over. While these growths are not dangerous, they can be uncomfortable and affect the way you speak and eat. Pregnancy granulomas usually occur in the second trimester and affect 2 to 10 percent of pregnant women. They usually go away after the baby is born.Dry mouth. Many pregnant women experience dryness in their mouth caused by a decrease in saliva, which can be brought on by hormonal changes. Dry mouth can increase the risk of many dental problems. Chewing sugarless gum can help.Erosion of tooth enamel. Vomiting due to morning sickness can lead to erosion of the enamel on the back of your front teeth. This is more likely to occur with frequent vomiting over a long period of time. Dental Care During Pregnancy

Since changes in oral health are common during pregnancy, you should pay special attention to dental care while you’re pregnant. To maintain good dental care during pregnancy, follow these guidelines:

Eat a healthful diet. Eating plenty of foods rich in protein, calcium, and vitamins to help support the health of your baby, as well as protect your teeth.Brush regularly. You should brush your teeth with fluoride toothpaste at least two times a day, making sure you brush for at least two minutes.Don’t forget to floss. Flossing at least one time every day can help prevent or minimize pregnancy gingivitis.Use mouthwash. Rinsing with an antimicrobial mouthwash can help control the bacteria that contribute to gingivitis.Visit your dentist. See your dentist for regular dental care while you’re pregnant. Special Dental Considerations for Pregnant Women

It is important to continue going to the dentist while you’re pregnant and to follow your regular dental care schedule; and there are certain things you need to do to protect the health of your unborn baby:

Tell your dentist you’re pregnant. No matter how far along you are, make sure that your dentist knows you’re pregnant. That way, if X-rays, sedatives, or other medications are being considered, your dentist can weigh their risks to your unborn baby.Avoid major procedures when possible. If you need to have major work performed on your teeth or mouth, it’s best to wait until your baby is born to have these procedures done, if possible. However, if you have periodontal disease, you may benefit from a special kind of cleaning called scaling and root planing, which cleans the infected areas beneath the gums and around the roots of your teeth.Plan your dental visit carefully. It’s ideal to see your dentist during your second trimester, since your baby is more vulnerable during the first and third trimesters, when major development is occurring (first trimester) and the risk of premature delivery increases (late third trimester).Ask questions. If you have any concerns or questions about the safety of a dental procedure, share them with your dentist. Also, discuss your concerns with your obstetrician-gynecologist or pregnancy health care provider. They can offer reassurance to you that what is being done is safe for your baby.

5 Embarrassing Dental Health Issues!

Stinky breath, unsightly mouth sores, and tooth decay: We’ve got a solution for all of your dental-health dilemmas

But following these oral hygiene commandments isn’t always enough. Many common oral-health problems, such as bad breath, tooth decay, erosion, receding gums, and mouth sores, can leave people feeling both physically uncomfortable and reluctant to smile. Fortunately, with the right treatments these embarrassing oral-health problems can be solved! Check out these remedies from the American Dental Association (ADA):

Bad Breath

Treatment for bad breath, or halitosis, varies depending on the cause. Brushing and flossing is crucial since it helps keep food particles from collecting bacteria and rotting in your mouth. If your dentist gives you a clean bill of health, though, you’ll need to investigate further.

Your bad breath could be the result of a medical disorder, such as a respiratory infection; chronic sinusitis or bronchitis; diabetes; a gastrointestinal disturbance, such as GERD; or a liver or kidney ailment. The use of particular medications can cause dry mouth, which can contribute to bad breath. And sometimes, the solution may be as simple as changing your diet: If you’re a garlic or onion lover, cutting down on these foods will help. So will cutting out tobacco if you’re a smoker.

Tooth Decay and Erosion

Brushing twice a day with fluoride toothpaste, flossing once a day, and visiting your dentist regularly for exams and cleanings will help fight tooth decay and erosion. Your dentist may also recommend protective plastic sealants to reduce your risk of decay. Eating a balanced diet and keeping your snacking to a minimum will also help head off plaque and erosion. If you’re particularly concerned about erosion, avoid acidic food and drinks, such as citrus fruits and juices, tomatoes, pickles, soda, and sports drinks, since studies suggest that they can strip enamel from the teeth. Gastric acid can also contribute to erosion, so if you have a medical condition like acid-reflux disease or bulimia, getting treatment is imperative.

Receding Gums

Gum recession and periodontal disease can have serious repercussions. Early stage gingivitis causes the gums to become red and swollen, and to bleed easily, while the more advanced periodontitis damages the gums and bones that support the teeth, causing them to loosen and fall out. The ADA recommends brushing, flossing, and keeping up with regular dental checkups and periodontal exams. Everyday Health’s dental expert, Dr. James E. Jacobs, adds that since gum recession can also result from aggressive tooth brushing with medium or hard bristles, malpositioned teeth, or bad habits such as clenching, grinding, or scratching your gums with foreign objects, you can also help protect your gums by using an ultrasoft toothbrush and wearing a nightguard to reduce stress on your teeth if you tend to clench or grind at night. Additionally, Dr. Jacobs recommends seeking professional dental, orthodontic, or periodontic help to get your bite comfortable, your teeth properly aligned, and if necessary, your gums grafted.

Mouth Sores

Canker sores and cold sores are two of the most common sores that show up around the mouth. They can be painful, annoying, and unsightly. Cankers develop inside the mouth, while cold sores appear externally, usually on the edge of the lips. Fortunately, both of these types of sores tend to heal on their own within a week or so, and canker sores can be treated with over-the-counter topical anesthetics or antimicrobial mouth rinses to reduce discomfort. Topical anesthetics may also provide temporary relief for cold sores. If you’re embarrassed by frequent cold-sore outbreaks, talk to your doctor about getting a prescription for antiviral drugs that could help reduce infections from the herpes virus.

Are Cavities Contagious?

Colds, chickenpox, and even yawns are contagious. But did you know that cavities can be catchy too?

Despite your mother’s finger-wagging, sugar-laden candy bars aren’t the only cause of cavities. Tooth decay actually results when bacteria in your mouth feed on food debris (starchy, sticky foods are a primary culprit) and produce acid as a byproduct. This mix of food, acid, saliva, and germs clings to your teeth as a filmy substance called plaque, which can erode teeth enamel and cause cavities to form.

No matter what you eat, cavities won’t form without the help of such bacteria. These germs can spread from mouth to mouth via shared food and utensils, sneezing, kissing, and more, according to Edward “Trey” Wilson, DDS, a dentist in private practice in New York City and New Hope, Pa. — making cavities contagious.

One study in the Australian Dental Journal pegged tooth decay as one of the most common infectious oral diseases. Researchers found that 30 percent of 3-month-olds, 60 percent of 6-month-olds, and nearly 80 percent of 2-year-olds were infected with cavity-causing Streptococcus mutans bacteria, a strain that’s especially likely to cause cavities.

Researchers believe that children “caught” the germs from their mothers; those with a history of cavities were more likely to pass the bacteria along to their children.

So does this mean you should avoid smooching with someone who has a horrible track record at the dentist? Not for dental health reasons, at least: As an adult, you’re far less susceptible to bacteria spread than children because they haven’t built up immunity yet, says Dr. Wilson.

Here are Wilson’s tips for preventing cavity spread in your family:

1.Go to the dentist. Nearly half of adults skipped the dentist in 2009, according to the U.S. Centers for Disease Control and Prevention (CDC). But to keep from passing on a cavity, your first step should be to schedule a dental check-up. “Every adult needs to be screened for tooth decay,” says Wilson. While warning signs such as tooth sensitivity, pain, or visible holes in teeth are cavity clues, one of the biggest mistakes patients make is to avoid the dentist until they’re in pain. Regular cleanings (every six months) can help prevent decay from turning into cavities and reduce levels of cavity-causing (and cavity-spreading) bacteria in your mouth. According to CDC data, 23 percent of adults have untreated cavities.
2.Use a heavy-duty mouth rinse. If a cavity has formed, you’ll need a filling. But for early-stage decay, your dentist can prescribe mouth rinse with chlorhexidine, a powerful antiseptic that fights off bacteria and can prevent decay from developing into cavities.
3.Chew sugar-free gum between meals. Pick a brand with the artificial sweetener xylitol, and chew it three times a day for at least five minutes, Wilson advises. Xylitol boosts saliva production, which helps fight off bad bacteria.
4.Don’t overshare. If you have young kids, avoid sharing utensils with them or tasting food before serving it to them. Cover your mouth when you sneeze, and if you’re really concerned, “maybe kiss your kid on the cheek instead of the lips,” says Wilson.
5.Be a good dental patient. This time, heed the hygienist’s advice: Brush frequently (in the morning, at night, and after meals), floss daily, and put a cap on sugary drinks and snacks — and instill the same tooth-friendly habits in your kids. With infants, clean your baby’s teeth with a soft cloth or gauze pad as soon as they start to come in; you can switch to a soft toothbrush when more teeth emerge.
6.Forgo fancy water. You may also want to consider switching your family from bottled water to tap. Most tap water contains fluoride, which helps teeth build up resistance to plaque.

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Mouthwash or Not!

Ahhh — who doesn’t love that minty kick that comes from a swig of mouthwash?

And your oral rinse could be doing more than just giving your breath a makeover, according to many mouthwash makers — it could be chockfull of health benefits, too. Just check out the label on your mouthwash container, and you may find that it’s a plaque zapper, a teeth whitener, perhaps even a gum-disease fighter.

But are the claims true? Is mouthwash really good for your mouth? Turns out, the answer is yes and no.

4 Important Mouthwash Pros
Mouthwash may:

Cut down on cavities. “It is absolutely true that rinsing with a fluoride rinse can help reduce cavities,” says Nicholas Toscano, DDS, a diplomate of the American Board of Periodontology, co-editor-in-chief of the Journal of Implant and Advanced Clinical Dentistry. “There are countless studies on the benefits of fluoride in reducing demineralization and cavitations of the teeth.” Fight gum disease. With periodontal disease (such as gingivitis), gums and tooth sockets can get inflamed or infected because of plaque from bacteria and food that lingers on teeth. An antibacterial mouthwash, like one with alcohol or chlorhexidine, may help prevent periodontal disease. Soothe canker sores. “Mouthwash can ease a canker sore by detoxing the area — reducing the amount of bacteria that can irritate the site,” says Dr. Toscano. In many cases, a simple saltwater rinse will do. Safeguard your pregnancy. Periodontal disease is actually a risk factor for giving birth to preterm, low-weight babies — the bacteria from a gum infection can get into a pregnant woman’s bloodstream and increase inflammatory markers, which in turn can stimulate contractions. And a recent study published in the American Journal of Obstetrics and Gynecology (which received funding from Proctor and Gamble) found that moms-to-be who used mouthwash throughout their pregnancy were less likely to go into early labor. Mouthwash clearly offers certain benefits — but it’s important to know that not all mouth rinses are the same. Saltwater rinses can be made at home with warm water and salt, whereas store-bought types contain a variety of ingredients ranging from fluoride (Act) to alcohol (Listerine) to chlorhexidine (Peridex).

3 Mouthwash Cons You Should Know
Mouthwash is by no means a cure-all. In fact, mouthwash gets bad marks because it:

Irritates canker sores. If the alcohol content of your mouth rinse is too high, it may actually end up irritating the canker sore more than helping it. Masks bad breath. “Mouthwash can lead to fresher breath, but it may be short-lived,” says Toscano. “If a patient has poor oral hygiene and doesn’t brush effectively, there is no amount of mouthwash that can mask the effects of poor health. Just using mouthwash would be equivalent to not bathing and using cologne to mask the smell.” Has been linked to oral cancer. The debate over whether alcohol-containing mouthwashes are linked to oral cancer continues — it’s an issue that has been discussed since the 1970s with no definitive answers. One stumbling block has been the way the studies have been designed, according to the American Dental Association (ADA). As of now, the ADA has put its Seal of Acceptance on some mouth rinses containing alcohol after it extensively reviewed their effectiveness and safety. Toscano says to keep this in mind: “Using a rinse is very different than drinking alcohol, and usually there is a synergistic effect with smoking. The ADA only puts its seal of approval on proven research and would not put people in harm’s way by having them use a product that would have such negative side effects.”

The Bottom Line on Your Oral Rinse
“Mouthwashes should not be used as a substitute for toothbrushing,” says John Ictech-Cassis, DDS, DMD, a clinical professor at Boston University’s School of Dental Medicine. Even when they can be helpful in lessening the risk of periodontal disease and cavities, they should always be used in conjunction with good hygiene habits.

Ultimately, what is right for your best friend may not be the best choice for you, so consider your personal situation. For people with periodontal disease, Toscano recommends Listerine because it reduces the bacteria that causes the disease. For those who are cavity-prone, he tends to recommend a high-fluoride rinse like Act. And he always emphasizes the importance of good dental hygiene.

Causes of Bad Breath

If you’re constantly popping mints or chewing gum to cover up bad breath, you’re not alone. One in four Americans has halitosis and is cursed with smelly breath.

Why? Most cases of halitosis are caused by improper dental hygiene. If you don’t brush and floss your teeth after every meal, bits of food that get stuck in your teeth and gums and on your tongue will begin to decay and emit foul odors.

An unclean mouth also means that bacteria can grow, potentially leading to gum disease, which is also one of the causes of bad breath. In addition, certain foods and drink are more likely to cause bad breath, including:

Garlic
Onions
Cheese
Orange juice
Soda, including diet varieties
After these foods or drinks are digested, their oils make their way into your bloodstream and are then carried into your lungs. The odor is then released through your breath.

Other Causes of Bad Breath

Aside from what you eat and drink, bad breath can also be linked to:

A dry mouth. Saliva is your mouth’s natural cleanser, so when your mouth is dry, dead cells can build up, which is what causes morning breath. This is an even bigger problem if you sleep with your mouth open. Smoking and certain medications can also cause dry mouth. In more extreme cases, you could have a problem with your salivary glands that leaves your mouth unusually dry. Chronic diseases. Sometimes underlying health conditions can cause bad breath. Lung infections, cancers, kidney or liver failure, diabetes, and gastroesophageal reflux disease (GERD), for example, are all associated with halitosis.Respiratory, mouth, throat, and nose conditions. These conditions are also often associated with bad breath. For example, discharge from a sinus infection is known to cause bad breath. If you have an upper respiratory infection such as bronchitis, the sputum coughed up can also cause halitosis.Tobacco products, particularly smoking. Tobacco products can dry your mouth and result in bad breath. People who use tobacco are also at greater risk of developing gum disease, poor general oral health, and oral cancers.Malnutrition. Starvation or intense dieting can result in bad breath due to ketoacidosis, which is a breakdown of chemicals that occurs during fasting. Beating Bad Breath

To combat bad breath, try the following:

Avoid foods and beverages that you know cause bad breath; this may also mean minimizing your intake of alcohol.
Brush for two to three minutes after every meal and floss your teeth at least once a day.
Brush your tongue gently to remove dead cells, including the back of your tongue, because that’s where bacteria often collect.
Drink lots of water to keep your mouth moist and clean. And water really is what’s best here: Other beverages, particularly caffeinated beverages, don’t work as well as water for halitosis treatment and prevention.
Eat less meat and more vegetables and fruits each day.
Get dental checkups at least twice a year that include an exam and cleaning.If you wear dentures, bridges, or removable braces, clean them thoroughly at least once a day.
Suck candy or chew gum (preferably sugarless) to stimulate saliva production, which helps wash away food particles and bacteria.
When to See Your Dentist About Bad Breath

If you still feel like you have bad breath after trying these tips, ask someone who is close to you for confirmation. Sometimes, you really are your own worst critic. If it is indeed an issue, make an appointment with your dentist to try to uncover what could be causing your bad breath.

Avoid drinking, eating, chewing gum, or brushing your teeth before your dental appointment. Skip the perfume or other scented products too, so that your dentist can truly assess your halitosis. Your dentist will likely ask you a number of questions, ranging from your dental hygiene habits to your general health.

In some cases, halitosis may be due to a buildup of plaque, which is a layer of bacteria on your teeth. If this is the case, the dentist may have you use a special antimicrobial mouth rinse.

If your dentist determines that the bad breath is due to gum disease, you’ll be treated or referred to a gum disease doctor, called a periodontist. Also called periodontal disease, gum disease causes your gums to recede from the teeth and leaves pockets that gather bacteria and plaque. A periodontal cleaning, or more extensive treatment, may be needed.

If your dentist isn’t able to uncover the reason for your bad breath, a trip to your primary care doctor for a physical exam would be the next step to determine the underlying causes of your bad breath.