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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.”

X-ray imaging is a routine part of a child’s dental care — and it undeniably makes a difference in preventing and treating dental disease. It’s so routine, we can easily forget they’re being exposed to an invisible form of electromagnetic radiation.  And just like other sources of radiation, too much x-ray exposure could increase the risk of cancer.

But while it’s possible for your child to be over-exposed to x-rays, it’s highly unlikely. That’s because healthcare professionals like dentists adhere to a standard known as ALARA when considering and administering x-rays. ALARA is an acronym for “as low as reasonably achievable.” In other words, we only want to expose a patient to the lowest and safest levels of x-ray dosage and frequency that will achieve the most benefit.

To achieve that standard, professional dental organizations advocate the use of x-rays only after a clinical examination of the patient, as well as a thorough review of their medical history for any usage of x-rays for other conditions. If x-rays are warranted, we then take further precautions to protect the patient and staff, and only use the type of x-ray application that’s absolutely necessary. For most children that will be a set of two or four bitewing radiographs, which are quite effective for detecting decay in back teeth.

This dosage of radiation in a session of bitewing radiographs is roughly a fifth of the background radiation in the environment a child may be exposed to every day. By spacing these sessions at least six months apart, we’re able to achieve a high level of decay detection at a safe and reasonable amount of x-ray exposure.

On top of that, the digital advances in x-ray imaging have reduced the amount of radiation energy needed to achieve the same results as we once did with film. These lower exposure levels and the ALARA standard helps ensure your child’s exposure to x-rays will be well within safe limits.

If you would like more information on the use of x-rays with 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 “X-Ray Safety for Children.”

Cavities can happen even before a baby has his first piece of candy. This was the difficult lesson actor David Ramsey of the TV shows Arrow and Dexter learned when his son DJ’s teeth were first emerging.

“His first teeth came in weak,” Ramsey recalled in a recent interview. “They had brown spots on them and they were brittle.” Those brown spots, he said, quickly turned into cavi­ties. How did this happen?

Ramsey said DJ’s dentist suspected it had to do with the child’s feedings — not what he was being fed but how. DJ was often nursed to sleep, “so there were pools of breast milk that he could go to sleep with in his mouth,” Ramsey explained.

While breastfeeding offers an infant many health benefits, problems can occur when the natural sugars in breast milk are left in contact with teeth for long periods.  Sugar feeds decay-causing oral bacteria, and these bacteria in turn release tooth-eroding acids. The softer teeth of a young child are particularly vulnerable to these acids; the end result can be tooth decay.

This condition, technically known as “early child caries,” is referred to in laymen’s terms as “baby bottle tooth decay.” However, it can result from nighttime feedings by bottle or breast. The best way to prevent this problem is to avoid nursing babies to sleep at night once they reach the teething stage; a bottle-fed baby should not be allowed to fall asleep with anything but water in their bottle or “sippy cup.”

Here are some other basics of infant dental care that every parent should know:

• Wipe your baby’s newly emerging teeth with a clean, moist washcloth after feedings.
• Brush teeth that have completely grown in with a soft-bristled, child-size toothbrush and a smear of fluoride toothpaste no bigger than a grain of rice.
• Start regular dental checkups by the first birthday.

Fortunately, Ramsey reports that his son is doing very well after an extended period of professional dental treatments and parental vigilance.

“It took a number of months, but his teeth are much, much better,” he said. “Right now we’re still helping him and we’re still really on top of the teeth situation.”

If you would like more information on dental care for babies and toddlers, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctormagazine articles “The Age One Dental Visit” and “Dentistry & Oral Health for Children.”

One of the most frequent concerns parents express to us is their child’s thumb or finger sucking habit. The good news, though, is that thumb sucking is a completely normal activity for babies and young children, and if they stop by age 4 it should have no adverse effects on their future bite.

In fact, there are positive aspects to thumb sucking: it provides babies with a sense of security, as well as a way to learn about the world. As a child grows and becomes more confident with their surroundings, the thumb sucking habit will fade and eventually stop: for most children this occurs between the ages of two and four.

If, however, the habit continues later in childhood, there is a chance the upper front teeth may be influenced to tip toward the lip during eruption and come into an improper position that could also adversely affect jaw development. The same concern exists for pacifier use — we recommend weaning a child off a pacifier by the time they’re eighteen months of age.

If your child still has a thumb or finger sucking habit as they prepare to enter school, it’s quite appropriate to work on getting them to stop. Punishment, shaming or similar negative approaches, however, aren’t the best ways to accomplish this: it’s much more effective to try to modify their behavior through reward, praise or some creative activity.

Another factor that may help is to begin regular dental visits around their first birthday. Regular checkups give us a chance to monitor the development of their bite, especially if thumb sucking continues longer than normal. We can also assist you with strategies to encourage them to stop thumb sucking or pacifier use.

Thumb sucking that continues later than normal isn’t a cause for panic, but it does require attention and action. Helping your child “grow” past this stage in their life will improve their chances of developing a normal and healthy bite.

If you would like more information on thumb sucking, please contact us to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Thumb Sucking in Children.”

When Cat Cora is not doing battle as the first female chef on the Food Network’s hit series Iron Chef America, she is busy caring for the needs of her four active young sons. This includes monitoring the food they eat and their oral hygiene habits.

The busy chef, restaurateur, author, philanthropist and television personality recently revealed in an interview with Dear Doctormagazine that it all started when her four sons were little. She got rid of bottles and sippy cups as soon as possible to prevent tooth decay. She also started exposing her boys to a wide variety of spices and foods when they were infants — for example, by putting cinnamon in their baby cereal. Cat limits the amount of sugar in their diet by using fruit puree in baked goods and BBQ sauces, or the natural sugar substitute Stevia. Furthermore, Cat reports, “my kids have never had fast food.”

Cat is right on target with her approach to her children’s oral health. In fact, we are often asked, when is the right time to schedule a child’s first dental appointment? Our answer surprises some people — especially those expecting their first child.

The ideal time to take your child to the dentist is around age 1. Why so young? A baby’s first visit to the dentist sets the stage for lifelong oral health. Besides, tooth decay can start very early. Baby Bottle Tooth Decay (BBTD), as the name suggests, impacts children who often go to sleep sipping a bottle filled with a liquid containing natural or added sugars, such as formula, fruit juice or a fruity drink mix. Another condition, Early Childhood Caries (ECC), is often found in children who continuously use sippy cups (again, filled with sugary liquids), children who breast feed at will throughout the night, children who use a sweetened pacifier, and children who regularly take sugar-based oral medicine to treat chronic illness.

To learn more about this topic, continue reading the Dear Doctor magazine article “Age One Dental Visit.” Or you can contact us today to schedule an appointment. And to read the entire interview with Cat Cora, please see the article “Cat Cora.”

As a parent, the task of guiding your children through their physical, mental and social development can sometimes seem overwhelming. That doesn’t have to be the case with their dental development — that’s because we’re one of your most reliable support partners for oral health. We’re available not only to treat problems as they arise, but to also offer expertise and resources that can help you help your children establish life-long oral health.

Here are just a few ways we can help guide you along the path to a brighter dental future for your children:

Age One Dental Visit. A healthy life is built on healthy habits — and there’s no better habit for great dental health than regular checkups. We recommend your child’s first visit with us around their first birthday. Beginning this early not only helps us identify any emerging dental problems, it can also help the child — and you — become more comfortable with visiting the dentist. As they grow older they’ll think nothing of their regular visits in the dentist’s chair.

Help! While your child’s first teeth coming in are exciting milestones, the teething process can be extremely frustrating. And, when those same primary teeth give way to their permanent versions, you’ll develop a new set of concerns about their development. By establishing a long-term trust relationship with us, we can offer a wealth of knowledge and tips (as well as needed reassurance) concerning the various stages of your child’s dental development.

“Do as I Do.” Dental visits are important — but the greatest contribution to long-term dental care is a daily habit of proper brushing and flossing, which should start as soon as your child’s first teeth begin to appear. “Modeling” is the best approach for instilling this habit in your child — performing hygiene tasks together and allowing them to learn how to do it from you. To be sure you’re passing on the proper technique, we’ll be glad to provide you with instruction on brushing and flossing — for your sake as well as theirs.

Although rewarding, raising a child is a tough job. When it comes to their oral health, though, we can help make that job a little easier.

If you would like more information on building the right foundation for your child’s dental health, 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 “Dentistry & Oral Health for Children.”

Not long ago, a certain Royal Baby made his first major public appearance. At a “crawl-about” in New Zealand, young Prince George (the 8-month-old son of Prince William and Kate Middleton) was formally introduced to the world, along with a group of adorable tots and their proud parents. The press was quick to note not only the future King of England’s cute expressions and his determined crawling — but also the appearance of his first two tiny bottom teeth.

Congratulations, William and Kate — and now, it’s time to think about the taking care of those royal baby teeth. In fact, before you know it, it will be time for the age one dental visit. Why is this so important? Essentially, because proper dental care in the early years helps to establish routines that will lead to a lifetime of good oral health.

It’s a misconception to think that baby teeth aren’t important because they will be shed after a few years. In fact, not only do they have a vital function in a child’s ability to eat and speak properly — they also serve as guides for the proper development of the permanent teeth that will follow. So caring for a tot’s primary teeth is just as important as it is for grown-up teeth.

What’s the best way to do that? To prevent tooth decay, clean an infant’s gums after each feeding with a soft cloth moistened with water — and don’t let your baby go to sleep with a bottle in his or her mouth! When teeth appear, gently brush them with a soft-bristled toothbrush and a tiny dab of toothpaste. At around age two, your child can begin to learn how to brush — with your careful supervision and follow-up, of course.

Avoiding sugary and acidic drinks (including some fruit juices) is another excellent way to keep those tiny teeth healthy! If you do allow any sugar, limit it to mealtimes; this gives the saliva plenty of time to do its work of neutralizing the sugar and acid that can cause tooth decay.

And don’t forget the first visit to the dentist, which should take place by age one! Even at that early age, we’ll make sure your child (and you) feel comfortable in the dental office, and help you get started with the best oral hygiene practices. We will also check for signs of cavities, watch for developmental milestones, and screen for potential future problems.

If you have questions about caring for your young child’s teeth, please contact us or schedule an appointment. For more information, see the Dear Doctor magazine articles “Top 10 Oral Health Tips For Children” and “Age One Dental Visit.”

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’sentire interview with Olivia Newton-John, please see “Olivia Newton-John.” Dear Doctor also has more on “Teething Troubles.”

When it comes to dental procedures, not everybody has the same comfort level; what’s easily tolerated by some can be a major source of anxiety and stress for others. In fact, by some estimates perhaps 10 to 15 percent of Americans avoid visiting the dentist entirely because of the fear factor — and this applies to kids as well as adults. So what should you do if your child needs dental work but is seriously scared of the chair? Here are the top five reasons for considering conscious sedation to relieve your child’s dental anxiety.

1. It allows dentists to treat children and teens who would otherwise be too fearful to come in. This can be especially useful when invasive treatments like root canals or extractions are needed. When problems are treated at an early stage, it’s often possible to prevent more extensive work from being required later; this can reduce the overall cost of treatment — and also help to preserve the natural teeth!
2. Dentists who use pediatric conscious sedation are specially qualified to do so.Advanced training and continuing education are part of the qualification process. In addition, emergency life support equipment is kept on hand, and practitioners are familiar with its use.
3. The medications used are safe and effective. New, fast-acting drugs get the job done and then leave the body quickly. They are commonly administered by mouth (orally), so there is no need to fear the needle. While any type of sedation comes with a slight risk, minimal conscious sedation is a lower-risk alternative to deeper levels of sedation, or general anesthesia.
4. A designated staff member monitors your child at all times. Vital signs such as heart rate, blood oxygen level, respiration rate, blood pressure and temperature are constantly under observation. This helps ensure that the level of sedation remains effective, yet safe.
5. It can form a foundation for stress-free dental treatment in the years to come. No one wants to put their child through a terrifying experience — especially when the fearful memories could prevent them from getting necessary treatment in the future. With conscious sedation, that’s not an issue. In fact, with many of the medications currently in use, your child may not even remember the procedure when it’s over.

Dental anxiety can be a serious problem — but it’s good to know there are ways to control it. If you would like more information, call our office to arrange a consultation. You can learn more in the Dear Doctor magazine article “Sedation Dentistry for Kids.”