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Care
of Your Child's Teeth
Good
Diet = Healthy Teeth
How Do
I Prevent Cavities?
Seal Out Decay
Fluoride
Mouth Guards
Xylitol - Reducing Cavities
Orthodontic Topics
Care of
Your Child’s Teeth
Begin
daily brushing as soon as the child’s first
tooth erupts. A pea size amount of fluoride
toothpaste can be used after the child is
old enough not to swallow it. By age 4 or 5,
children should be able to brush their own
teeth twice a day with supervision until
about age seven to make sure they are doing
a thorough job. However, each child is
different. Your dentist can help you
determine whether the child has the skill
level to brush properly.
Proper
brushing removes plaque from the inner,
outer and chewing surfaces. When teaching
children to brush, place toothbrush at a 45
degree angle; start along gum line with a
soft bristle brush in a gentle circular
motion. Brush the outer surfaces of each
tooth, upper and lower. Repeat the same
method on the inside surfaces and chewing
surfaces of all the teeth. Finish by
brushing the tongue to help freshen breath
and remove bacteria.
Flossing removes plaque between the teeth,
where a toothbrush can’t reach. Flossing
should begin when any two teeth touch. You
should floss the child’s teeth until he or
she can do it alone. Use about 18 inches of
floss, winding most of it around the middle
fingers of both hands. Hold the floss
lightly between the thumbs and forefingers.
Use a gentle, back-and-forth motion to guide
the floss between the teeth. Curve the floss
into a C-shape and slide it into the space
between the gum and tooth until you feel
resistance. Gently scrape the floss against
the side of the tooth. Repeat this procedure
on each tooth. Don’t forget the backs of the
last four teeth.
Good
Diet = Healthy Teeth
 Healthy
eating habits lead to healthy teeth. Like
the rest of the body, the teeth, bones and
the soft tissues of the mouth need a
well-balanced diet. Children should eat a
variety of foods from the five major food
groups. Most snacks that children eat can
lead to cavity formation. The more
frequently a child snacks, the greater the
chance for tooth decay. How long food
remains in the mouth also plays a role. For
example, hard candy and breath mints stay in
the mouth a long time, which cause longer
acid attacks on tooth enamel. If your child
must snack, choose nutritious foods such as
vegetables, low-fat yogurt, and low-fat
cheese, which are healthier and better for
children’s teeth.
How Do I
Prevent Cavities?
Good oral hygiene removes
bacteria and the left over food particles
that combine to create cavities. For
infants, use a wet gauze or clean washcloth
to wipe the plaque from teeth and gums.
Avoid putting your child to bed with a
bottle filled with anything other than
water. See "Baby
Bottle Tooth Decay" for more
information.
For older children, brush
their teeth at least twice a day.
Also, watch the number of snacks containing
sugar that you give your children.
The American Academy of
Pediatric Dentistry recommends visits every
six months to the pediatric dentist,
beginning at your child’s first birthday.
Routine visits will start your child on a
lifetime of good dental health.
Your pediatric dentist
may also recommend protective sealants or
home fluoride treatments for your child.
Sealants can be applied to your child’s
molars to prevent decay on hard to clean
surfaces.
Seal Out Decay
A
sealant is a clear or shaded plastic
material that is applied to the chewing
surfaces (grooves) of the back teeth
(premolars and molars), where four out of
five cavities in children are found. This
sealant acts as a barrier to food, plaque
and acid, thus protecting the decay-prone
areas of the teeth.
Before Sealant Applied |
After Sealant Applied |
Fluoride
Fluoride is an element, which has been shown
to be beneficial to teeth. However, too
little or too much fluoride can be
detrimental to the teeth. Little or no
fluoride will not strengthen the teeth to
help them resist cavities. Excessive
fluoride ingestion by preschool-aged
children can lead to dental fluorosis, which
is a chalky white to even brown
discoloration of the permanent teeth. Many
children often get more fluoride than their
parents realize. Being aware of a child’s
potential sources of fluoride can help
parents prevent the possibility of dental
fluorosis.
Some
of these sources are:
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Too
much fluoridated toothpaste at an early
age.
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The
inappropriate use of fluoride supplements.
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Hidden sources of fluoride in the child’s
diet.
Two
and three year olds may not be able to
expectorate (spit out) fluoride-containing
toothpaste when brushing. As a result, these
youngsters may ingest an excessive amount of
fluoride during tooth brushing. Toothpaste
ingestion during this critical period of
permanent tooth development is the greatest
risk factor in the development of fluorosis.
Excessive and inappropriate intake of
fluoride supplements may also contribute to
fluorosis. Fluoride drops and tablets, as
well as fluoride fortified vitamins should
not be given to infants younger than six
months of age. After that time, fluoride
supplements should only be given to children
after all of the sources of ingested
fluoride have been accounted for and upon
the recommendation of your pediatrician or
pediatric dentist.
Certain foods contain high levels of
fluoride, especially powdered concentrate
infant formula, soy-based infant formula,
infant dry cereals, creamed spinach, and
infant chicken products. Please read the
label or contact the manufacturer. Some
beverages also contain high levels of
fluoride, especially decaffeinated teas,
white grape juices, and juice drinks
manufactured in fluoridated cities.
Parents can take the following steps to
decrease the risk of fluorosis in their
children’s teeth:
-
Use
baby tooth cleanser on the toothbrush of
the very young child.
-
Place only a pea sized drop of children’s
toothpaste on the brush when brushing.
-
Account for all of the sources of ingested
fluoride before requesting fluoride
supplements from your child’s physician or
pediatric dentist.
-
Avoid giving any fluoride-containing
supplements to infants until they are at
least 6 months old.
-
Obtain fluoride level test results for
your drinking water before giving fluoride
supplements to your child (check with
local water utilities).
Mouth Guards
When a
child begins to participate in recreational
activities and organized sports, injuries
can occur. A properly fitted mouth guard, or
mouth protector, is an important piece of
athletic gear that can help protect your
child’s smile, and should be used during any
activity that could result in a blow to the
face or mouth.
Mouth
guards help prevent broken teeth, and
injuries to the lips, tongue, face or jaw. A
properly fitted mouth guard will stay in
place while your child is wearing it, making
it easy for them to talk and breathe.
Ask
your pediatric dentist about custom and
store-bought mouth protectors.
Xylitol - Reducing Cavities
The American Academy of
Pediatric Dentistry (AAPD) recognizes the
benefits of xylitol on the oral health of
infants, children, adolescents, and persons
with special health care needs.
The use of XYLITOL GUM by
mothers (2-3 times per day) starting 3
months after delivery and until the child
was 2 years old, has proven to reduce
cavities up to 70% by the time the child was
5 years old.
Studies using
xylitol as either a sugar substitute or a
small dietary addition have demonstrated a
dramatic reduction in new tooth decay, along
with some reversal of existing dental
caries. Xylitol provides additional
protection that enhances all existing
prevention methods. This xylitol effect is
long-lasting and possibly permanent. Low
decay rates persist even years after the
trials have been completed.
Xylitol is
widely distributed throughout nature in
small amounts. Some of the best sources are
fruits, berries, mushrooms, lettuce,
hardwoods, and corn cobs. One cup of
raspberries contains less than one gram of
xylitol.
Studies suggest xylitol intake that
consistently produces positive results
ranged from 4-20 grams per day, divided into
3-7 consumption periods. Higher results did
not result in greater reduction and may lead
to diminishing results. Similarly,
consumption frequency of less than 3 times
per day showed no effect.
To find gum or
other products containing xylitol, try
visiting your local health food store or
search the Internet to find products
containing 100% xylitol.
Orthodontic Frequently
Asked Questions
What age
should my child have an orthodontic
evaluation?
The American Association of Orthodontists
(AAO) recommends an orthodontic screening
for children by the age of 7 years. At age 7
the teeth and jaws are developed enough so
that the dentist or orthodontist can see if
there will be any serious bite problems in
the future. Most of the time treatment is
not necessary at age 7, but it gives the
parents and dentist time to watch the
development of the patient and decide on the
best mode of treatment. When you have time
on your side you can plan ahead and prevent
the formation of serious problems.
Why is it
important to have orthodontic treatment at a
young age?
Research has shown that serious
orthodontic problems can be more easily
corrected when the patient’s skeleton is
still growing and flexible. By correcting
the skeletal problems at a younger age we
can prepare the mouth for the eventual
eruption of the permanent teeth. If the
permanent teeth have adequate space to erupt
they will come in fairly straight. If the
teeth erupt fairly straight their tendency
to get crooked again after the braces come
off is diminished significantly. After the
permanent teeth have erupted, usually from
age 12-14, complete braces are placed for
final alignment and detailing of the bite.
Thus the final stage of treatment is quicker
and easier on the patient. This phase of
treatment usually lasts from 12 - 18 month
and is not started until all of the
permanent teeth are erupted.
Doing orthodontic treatments in two steps
provides excellent results often allowing
the doctor to avoid removal of permanent
teeth and jaw surgery. The treatment done
when some of the baby teeth are still
present is called Phase-1. The last part of
treatment after all the permanent teeth have
erupted is called Phase-2.
What causes
crooked teeth?
Crowded teeth, thumb sucking, tongue
thrusting, premature loss of baby teeth, a
poor breathing airway caused by enlarged
adenoids or tonsils can all contribute to
poor tooth positioning. And then there are
the hereditary factors. Extra teeth, large
teeth, missing teeth, wide spacing, small
jaws - all can be causes of crowded teeth.
How do teeth
move?
Tooth movement is a natural response to
light pressure over a period of time.
Pressure is applied by using a variety of
orthodontic hardware (appliances), the most
common being a brace or bracket attached to
the teeth and connected by an arch wire.
Periodic changing of these arch wires puts
pressure on the teeth. At different stages
of treatment your child may wear a headgear,
elastics, a positioner or a retainer. Most
orthodontic appointments are scheduled 4 to
6 weeks apart to give the teeth time to
move.
Will it hurt?
When teeth are first moved, discomfort
may result. This usually lasts about 24 to
72 hours. Patients report a lessening of
pain as the treatment progresses. Pain
medicines such as acetaminophen (Tylenol) or
ibuprofen (Advil) usually help relieve the
pain.
Orthodontic Terms
Arch Wire
The part of your braces which actually
moves the teeth. The arch wire is attached
to the brackets by small elastic donuts or
ligature wires. Arch Wires are changed
throughout the treatment. Each change brings
you closer to the ideal tooth position.
Brackets
Brackets are the “Braces” or small
attachments that are bonded directly to the
tooth surface. The brackets are the part of
your braces to which the dentist or
assistant attaches the arch wire.
Occasionally, a bracket may come loose
and become an irritation to your mouth. You
can remove the loose bracket and save it in
an envelope to bring to the office. Call the
office as soon as possible and make an
appointment to re-glue the bracket.
Elastics (Rubber
Bands)
At some time during treatment, it will be
necessary to wear elastics to coordinate the
upper and lower teeth and perfect the bite.
Once teeth begin to move in response to
elastics, they move rapidly and comfortably.
If elastics (rubber bands) are worn
intermittently, they will continually
"shock" the teeth and cause more soreness.
When elastics are worn one day and left off
the next, treatment slows to a standstill or
stops. Sore teeth between appointments
usually indicate improper wear of headgear
or elastics or inadequate hygiene. Wear your
elastics correctly, attaching them as you
were told. Wear elastics all the time,
unless otherwise directed. Take your
elastics off while brushing. Change elastics
as directed, usually once or twice a day.
Headgear
Often called a “night brace”. The
headgear is used to correct a protrusion of
the upper or lower jaw. It works by
inhibiting the upper jaw from growing
forward, or the downward growth of the upper
jaw or even by encouraging teeth to move
forward, if that is the case.
Malocclusion
Poor positioning of the teeth.
Types of Malocclusion
Class I
A Malocclusion where the bite is OK
(the top teeth line up with the
bottom teeth) but the teeth are
crooked, crowded or turned.
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Class II
A Malocclusion where the upper teeth
stick out past the lower teeth.
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Class III
A Malocclusion where the lower teeth
stick out past the upper teeth. This
is also called an "underbite".
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Occlusion
The alignment and spacing of your upper
jaw and lower teeth when you bite down.
Types of Occlusion:
Openbite
Anterior opening between upper and
lower teeth. |
Overbite
Vertical overlapping of the upper
teeth over the lower. |
Overjet
Horizontal projection of the upper
teeth beyond the lower. |
Crossbite
When top teeth bite inside the lower
teeth. It can occur with the front
teeth or back teeth. |
O Rings
O rings, also called A-lastics, are
little rings used to attach the arch wire to
the brackets. These rings come in standard
gray or clear, but also come in a wide
variety of colors to make braces more fun.
A-lastics are changed at every appointment
to maintain good attachment of the arch wire
to the bracket, enabling our patients to
enjoy many different color schemes
throughout treatment.
Separator
A plastic or rubber donut piece which the
dentist uses to create space between your
teeth for bands.
Fixed and Removable Appliances
 Band
& Loop (B & L)
A Band & Loop is routinely used to hold
space for a missing primary (baby) posterior
(back) tooth until the permanent tooth can
grown in.
 Herbst
An appliance designed to encourage the
lower jaw to grow forward and “catch up” to
upper jaw growth.
Lower Lingual Arch (LLA)
 A
lower lingual arch is a space maintainer for
the lower teeth. It maintains the molars
where they are, it does not move them. This
is fabricated by placing bands on the molars
and connecting them to a wire that fits up
against the inside of the lower teeth. It
keeps the molars from migrating forward and
prevents them from blocking off the space of
teeth that develop later. This is used when
you have the early loss of baby teeth or
when you have lower teeth that are slightly
crowded in a growing child and you do not
want to remove any permanent teeth to
correct the crowding.
Palatal Expander
 An
appliance which is placed in the roof of the
mouth to widen the upper dental arch. The
maxilla, or upper dental arch, is joined in
the center by a joint, which allows it to be
painlessly separated and spread. Temporarily
you may see a space develop between the
upper two front teeth. This will slowly go
away in a few days. Once this has occurred,
the two halves knit back together and new
bone fills in the space.
Quad Helix
 This
appliance provides continual, gradual
pressure in as many as four directions, to
move molars, expand or contract arches or
assist in eliminating finger or thumb
habits.
Bi Helix
An appliance used to expand the lower
arch without interfering with tongue posture
or movement.
Hawley
 A
universally used retainer with many
applications; to move teeth, close spaces,
maintain alignment during or after
treatment.
Nance
This appliance maintains the position of
the maxillary molars without using any other
teeth. The plastic button on the
palate provides stability.
Retainers
At the completion of the active phase of
orthodontic treatment, braces are removed
and removable appliances called retainers
are placed. To retain means to hold. Teeth
must be retained or held in their new
positions while the tissues, meaning the
bone, elastic membranes around the roots,
the gums, tongue and lips have adapted
themselves to the new tooth positions. Teeth
can move if they are not retained. It is
extremely important to wear your retainers
as directed!
Orthodontic
Care
Braces Care
You will be shown the proper care of your
braces when your orthodontic treatment
begins. Proper cleansing of your mouth is
necessary every time you eat. Teeth with
braces are harder to clean, and trap food
very easily. If food is left lodged on the
brackets and wires, it can cause unsightly
etching of the enamel on your teeth. Your
most important job is to keep your mouth
clean. If food is allowed to collect, the
symptoms of gum disease will show in your
mouth. The gums will swell and bleed and the
pressure from the disease will slow down
tooth movement.
 BRUSHING:
You should brush your teeth 4-5 times per
day.
- Brush back and forth across……between
the wires and gums on the upper and
lower to loosen any food particles.
- Next, brush correctly as if you had
no brackets or appliances on.
- Start on the outside of the uppers
with the bristles at a 45 degree angle
toward the gum and scrub with a circular
motion two or three teeth at a time
using ten strokes, then move on.
- Next, do the same on the inner
surface of the upper teeth.
- Then, go to the lower teeth and
repeat steps 1 & 2.
Look in a mirror to see if you have
missed any places. Your teeth, brackets and
wires should be free of any food particles
and plaque.
Note: If your gums bleed when
brushing, do not avoid brushing, but rather
continue stimulating the area with the
bristles. Be sure to angle your toothbrush
so that the area under your gum line is
cleaned. After 3 or 4 days of proper
brushing, the bleeding should stop and your
gums should be healthy again.
FLOSSING: Use a special floss
threader to floss with your braces on. Be
sure to floss at least once per day.
FLUORIDE RINSE OR GEL: May be
recommended for preventive measures.
Appliance
Care
Clean the retainer by brushing with
toothpaste. If you are wearing a lower fixed
retainer be extra careful to brush the wire
and the inside of the lower teeth. Always
bring your retainer to each appointment.
Avoid flipping the retainer with your
tongue, this can cause damage to your teeth.
Place the retainer in the plastic case when
it is re-moved from your mouth. Never wrap
the retainer in a paper napkin or tissue,
someone may throw it away. Don't put it in
your pocket or you may break or lose it.
Excessive heat will warp and ruin the
retainer.
Elastics
Care
If elastics (rubber bands) are worn
intermittently, they will continually
"shock" the teeth and cause more soreness.
Sore teeth between appointments usually
indicate improper wear of headgear or
elastics or inadequate hygiene. Wear your
elastics correctly, attaching them as you
were told. Wear elastics all the time,
unless otherwise directed. Take your
elastics off while brushing. Change elastics
as directed, usually once or twice a day.
Proper Diet
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Avoid Sticky Foods such as:
Caramels
Candy bars with caramel
Fruit Roll-Ups
Gum
Candy or caramel apples
Skittles
Starbursts
Toffee
Gummy Bears
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Avoid Hard or Tough Foods Such
as:
Pizza Crust
Nuts
Hard Candy
Corn Chips
Ice Cubes
Bagels
Popcorn Kernels
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Cut the following foods into
small pieces and chew with the back
teeth:
Apples
Carrots
Corn on the Cob
Pizza
Pears
Celery
Chicken Wings
Spare Ribs
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Orthodontic
Emergencies or Problems
Please feel free to contact the office if
you are experiencing any discomfort or if
you have any questions. Below are a few
simple steps that might help if you are
unable to contact us or if you need a “quick
fix”.
Loose
Bracket
Occasionally, a glued bracket may come
loose. You can remove the loose bracket and
save it in an envelope to bring to the
office or leave it where it is, if it is not
causing any irritation. Call the office as
soon as possible in order for us to allow
time to re-glue the bracket.
Poking Wire
If a wire is poking your gums or cheek
there are several things you can try until
you can get to the office for an
appointment. First try a ball of wax on the
wire that is causing the irritation. You may
also try using a nail clipper or cuticle
cutter to cut the extra piece of wire that
is sticking out. Sometimes, a poking wire
can be safely turned down so that it no
longer causes discomfort. To do this you may
use a pencil eraser, or some other smooth
object, and tuck the offending wire back out
of the way.
Wire Out of Back
Brace
Please be careful to avoid hard or sticky
foods that may bend the wire or cause it to
come out of the back brace. If this does
happen, you may use needle nose pliers or
tweezers to put the wire back into the hole
in the back brace. If you are unable to do
this, you may clip the wire to ease the
discomfort. Please call the office as soon
as possible to schedule an appointment to
replace the wire.
Poking
Elastic (Rubber Band) Hook
Some brackets have small hooks on them
for elastic wear. These hooks can
occasionally become irritating to the lips
or cheeks. If this happens, you may either
use a pencil eraser to carefully push the
hook in, or you can place a ball of wax on
the hook to make the area feel smooth.
Sore Teeth
You may be experiencing some discomfort
after beginning treatment or at the change
of wires or adjusting of appliances. This is
normal and should diminish within 24-72
hours. A few suggestions to help with the
discomfort:
- Rinse with warm water, eat a soft
diet, take acetaminophen (Tylenol) or
ibuprofen (Advil) as directed on the
bottle.
- Chewing on the sore teeth may be
sorer in the short term but feel better
faster.
- If pain persists more than a few
days, call our office.
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