Options for kids now include sealants and
early removal of wisdom teeth.
If you've been to the dentist with your
children recently, you may have noticed that things have changed since you were
a kid.
Many
dental offices are more kid-friendly these days, offering books and toys to
pass the time in the waiting room and maybe even TV or videos to watch while
they're getting dental work.
But,
there have also been changes in the actual practice of children's dentistry.
You probably never got dental sealants as
a child, or had topical fluoride treatments. If you had your wisdom teeth
removed, more than likely it was because they were causing a problem, but today
those teeth may come out sooner to reduce the risk for complications.
Here's
a sampling of what's new in pediatric dentistry:
Dental
Sealants
Many
teeth have rough surfaces that are hard to clean. When applied to these
surfaces, a dental sealant makes the pitted and grooved area of a tooth smooth
and easy to clean.
"Back
teeth have a biting surface and crevices that are hard to clean," said Dr.
Larry Kronenberg, a pediatric dentist affiliated
with Northern Westchester Hospital in Mount Kisco, N.Y. "Depending on the
depth of the crevice, bacteria and food can get lodged in the tooth and cause
cavities."
"If
your child has shallow crevices, sealants probably aren't indicated," he
said. "But if you've ever given your child a pretzel and later saw that
the food was still stuck on the teeth, your child could benefit from
sealants."
Sealants
are easy to apply. The dentist brushes them onto the teeth, and the sealant
bonds with the tooth's enamel, according to the American Dental
Association (ADA). Sometimes a curing light is used to help the
sealants dry faster.
Fluoride
Treatments
"Ingested
fluoride works on teeth that haven't yet come into the mouth, those that
haven't erupted yet, but it has no effect on the teeth already in the
mouth," Kronenberg said. "A fluoride treatment using a gel or varnish
incorporates the fluoride into the surface outer layer of the tooth. It has to
be repeated because it gets worn off."
Fluoride
is applied using a cotton swab or brush, or it's placed in a tray that the
child bites down on and then holds in the mouth for several minutes. Once a
fluoride treatment is done, there should be no eating or drinking for 30
minutes to allow the fluoride to soak into the teeth, according to the ADA.
Kronenberg
explained that the difference between the fluoride contained in toothpaste and
fluoride treatments is the concentration. The fluoride in toothpaste
is much less concentrated, he noted.
Wisdom
Teeth
Should
they stay or should they go? That's the question kids and parents face.
Kronenberg
said that most dentists start to look at a kid's wisdom teeth at about age 16
or 17 to see if there's room for the teeth to come in properly, without causing
problems. If a tooth looks like it won't come in properly, some dentists now
suggest removing these teeth sooner rather than later to make the removal
easier. The less chance the tooth has to develop, the shallower the roots will
be, explained Kronenberg.
But not
everyone is practicing early removal.
"There's
no cut-and-dried protocol saying that all wisdom teeth have to be
extracted," said Dr. Joshua Verona from the division of dental medicine at
Beth Israel Medical Center in New York City. "If they don't affect
function or appearance, we just leave them in. We only extract wisdom teeth
when they're symptomatic."
Parents
should discuss with their family dentist the risks and benefits associated with
leaving wisdom teeth in
or taking them out.
Reducing
Anxiety
Kronenberg
said that pediatric dentists are seeing patients at a younger and younger age.
Some recommend that well-dental visits, much like well-child visits at the
pediatrician, start at age 1 so that dentists can discuss the importance of
diet and oral hygiene with the parents. But more importantly, he said, early
visits "help start a relationship between the child and the dentist at an
early age, and generally if you've built a positive relationship, children are
more willing to accept necessary treatments in the future."
More
information: The
Nemours Foundation KidsHealth website has more on good oral hygiene.
A
companion article recounts changes in pediatric
dentistry from one generation to the next.
Copyright
© 2012 HealthDay. All rights reserved.
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