Posts for: September, 2015
Children’s ailments come and go, and thankfully most are relatively minor. Some children, however, have impaired health caused by a more serious, chronic disease. For them, the condition impacts not only their overall well-being, but also their dental health.
This often occurs because the specific healthcare needs of children with these chronic conditions are given greater priority over dental health. Besides the treatment focus, children with special healthcare needs may have physical, mental or behavioral limitations that can make it difficult to keep up with oral hygiene and care.
Children with autism or attention deficit and hyperactivity disorder (ADHD) may have a difficult time practicing (or cooperating with) oral hygiene tasks. Some may not have the physical ability to perform effective brushing and flossing without assistance. In these cases, it’s important for parents or caregivers to seek out instruction and training that will optimize their children’s hygiene and so reduce the chance of dental disease.
Certain medications for chronic conditions can increase mouth dryness, or they’re acidic or sweetened with sugar, any of which can increase the child’s risk for tooth decay or periodontal (gum) disease. Parents or caregivers should consult with their physicians about these medications or if they could be administered at mealtime to minimize their effect on the mouth.
Finally, there’s the direct effect some conditions may have on a child’s teeth and gums. Children with severe gag reflexes due to their condition may not be able to tolerate toothpaste or be able to spit it out completely. Other conditions can give rise to dental defects such as enamel hypoplasia in which not enough enamel develops to adequately protect the teeth.Â Such defects call for special dental attention and closer monitoring of teeth and gum health.
The key is to see us and the other healthcare providers for your child’s chronic condition as part of an overall team. Sharing information and regarding both dental and general care as part of a comprehensive strategy will help to prevent dental problems from developing and improve their health.
If you would like more information on dental care for children with chronic conditions, 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 “Managing Tooth Decay in Children with Chronic Diseases.”
Fans of the primetime TV show The Middle were delighted to see that high school senior Sue, played by Eden Sher, finally got her braces off at the start of Season 6. But since this popular sitcom wouldn’t be complete without some slapstick comedy, this happy event is not without its trials and tribulations: The episode ends with Sue’s whole family diving into a dumpster in search of the teen’s lost retainer. Sue finds it in the garbage and immediately pops it in her mouth. But wait — it doesn’t fit, it’s not even hers!
If you think this scenario is far-fetched, guess again. OK, maybe the part about Sue not washing the retainer upon reclaiming it was just a gag (literally and figuratively), but lost retainers are all too common. Unfortunately, they’re also expensive to replace — so they need to be handled with care. What’s the best way to do that? Retainers should be brushed daily with a soft toothbrush and liquid soap (dish soap works well), and then placed immediately back in your mouth or into the case that came with the retainer. When you are eating a meal at a restaurant, do not wrap your retainer in a napkin and leave it on the table — this is a great way to lose it! Instead, take the case with you, and keep the retainer in it while you’re eating. When you get home, brush your teeth and then put the retainer back in your mouth.
If you do lose your retainer though, let us know right away. Retention is the last step of your orthodontic treatment, and it’s extremely important. You’ve worked hard to get a beautiful smile, and no one wants to see that effort wasted. Yet if you neglect to wear your retainer as instructed, your teeth are likely to shift out of position. Why does this happen?
As you’ve seen firsthand, teeth aren’t rigidly fixed in the jaw — they can be moved in response to light and continuous force. That’s what orthodontic appliances do: apply the right amount of force in a carefully controlled manner. But there are other forces at work on your teeth that can move them in less predictable ways. For example, normal biting and chewing can, over time, cause your teeth to shift position. To get teeth to stay where they’ve been moved orthodontically, new bone needs to form around them and anchor them where they are. That will happen over time, but only if they are held in place with a retainer. That’s why it is so important to wear yours as directed — and notify us immediately if it gets lost.
And if ever you do have to dig your retainer out of a dumpster… be sure to wash it before putting in in your mouth!
If you would like more information on retainers, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “The Importance of Orthodontic Retainers” and “Why Orthodontic Retainers?”
Our nerves serve a vital purpose, alerting us to bodily discomfort, injury or disease — we couldn’t remain in good health for long without them. But when they malfunction due to genetics or disease, they can themselves become a source of pain and discomfort.
One such nerve disorder that affects the face is known as trigeminal neuralgia (TN) or tic douloureaux (from the French for “painful”). The nerves in question are the trigeminal, a pair that travel up from the brain stem through the skull into each side of the face where they each branch into the upper, middle and lower parts of the face and jaw. The pain can radiate from one or more of these branches.
TN is characterized by recurring episodes of brief but severe pain with accompanying muscle spasms. It may begin as a short twinge recurring over weeks, months or years before becoming increasingly painful. The slightest actions can trigger a painful episode: chewing, speaking, shaving or even the wind blowing on your face.
While it may be hard to determine its exact cause, it often seems to result from an artery or vein pressing on the nerve, causing it to signal pain at the slightest stimulation and then failing to stop transmitting when the stimulation is removed. It’s also associated with other inflammatory disorders like multiple sclerosis where the protective insulation around a nerve is damaged.
Before receiving treatment you should undergo a complete examination to rule out any other facial pain causes like temporomandibular (jaw joint) disorders or a dental abscess. You may also need to undergo a neurological examination and possible MRI imaging to pinpoint the exact cause, like a tumor or blood vessel pressing on the nerve.
Although the condition may not be curable, there are several effective management treatments. The more conservative approaches usually involve medications to block the nerve’s pain signals or decrease its abnormal firing. If this isn’t sufficient to diminish symptoms, there are surgical options: passing a thin needle through the nerve to selectively prevent fibers from firing, or moving aside a blood vessel pressing on it. High-dose targeted radiation may also be effective, especially with older patients.
The best treatment approach will depend on the exact cause, your age and overall health. Whatever the approach, you can gain significant relief from the pain of TN.