Q I have a toothache. What do I do?

A A toothache or tooth pain results when the nerve inside of a tooth is irritated. This can be caused by infection, decay, trauma, or loss of a tooth. Pain sometimes originates in another area and radiates to the jaw, thus appearing to be a toothache. The most common sites or origin are the temporomandibular joints (TMJs), ear pain, and even occasional heart problems. Tooth pain is persistent and can be quite excruciating. It is important to see a dentist as soon as possible should a problem arise.

Q When should I first take my child to the dentist?

A “First visit by first birthday” sums it up. Your child should visit a dentist when the first tooth comes in, usually between six and twelve months of age. Early examination and preventive care will protect your child’s smile now and in the future. The earlier the first dental visit, the better chance of preventing dental problems. Children with healthy teeth can chew food well, speak clearly and share precious smiles. Start your child on a lifetime of good dental habits now!

Dental problems can begin early. A big concern is Baby Bottle Tooth Decay (BBTD), which is preventable. BBTD can result from long periods of exposing baby teeth to liquids that contain sugar including formula, milk, breast milk, and juice. A baby who has a habit of sleeping with a baby bottle filled with any sugary liquid or a breast in their mouth is at risk of getting BBTD. The liquid pools around the upper front teeth and creates an excellent environment to promote the growth of decay-causing bacteria. Removing the bottle before the first tooth appears and wiping the child’s gums and teeth with a soft cloth before being put to bed can help prevent decay. Frequent snacking on sweet or sticky foods can also cause decay.

Brushing is a good habit to start early! The teeth must be cleaned as they erupt. Use a damp wash cloth or a toothbrush. If your health care provider agrees, use a tiny dab of fluoride toothpaste. Tooth brushing is definitely a parent’s job in the preschool years. Children are usually able to brush their teeth well once they reach the age of 6 to 8 years old. Be sure to check your child’s teeth regularly for any chalky white or brown spots, which could be the beginning of tooth decay.

Q Which toothbrush is better – manual or electric?

A The purpose of a toothbrush is to mechanically remove plaque and food from teeth. Both manual and electric toothbrushes accomplish this task. Electric toothbrushes are great for kids who lack motivation to brush and patients who have trouble using a manual toothbrush due to physical limitations. We recommend using a toothbrush with soft bristles.

Q What are dental sealants?

A A dental sealant is a thin, plastic coating bonded to the grooves of the biting surface of back teeth (usually molars and premolars). Sealants form a protective shell over these teeth and make them less susceptible to developing cavities. Sealants are recommended for children during their cavity-prone years of ages 6 to 14.

Q How often should I see a dentist?

A The American Dental Association (ADA) recommends visiting the dentist at least twice a year for a professional examination and cleaning. We sometimes recommend more frequent cleanings for patients with gingivitis and periodontal disease. Your dentist and hygienist at Dr. Brian LaBombard, DMD will devise a regular cleaning schedule to meet your individual needs.

Q What is fluoride, and why is it important for my teeth?

A Fluoride is a mineral occurring naturally in many foods and water. Throughout the day, minerals are lost from and added to a tooth’s outside enamel layer by two processes – demineralization and remineralization. Demineralization results when acids, formed from plaque, bacteria, and sugars in the mouth, attack the enamel. The body combats this process by redepositing (remineralization) fluoride, calcium, and phosphate from food and water to the enamel. When too much demineralization occurs without remineralization, a cavity forms.

Fluoride helps to prevent decay by making the tooth surface more resistant to acid attacks, and it also reverses early decay. In children under six years of age, fluoride is incorporated into the development of permanent teeth, making it difficult for acids to demineralize the teeth. Additionally, fluoride speeds up the daily remineralization process and strengthens teeth in both children and adults.

Q Are there any risks associated with fluoride use?

A Fluoride is safe and effective when used as directed but can be hazardous at high doses. For this reason, it is important for parents to carefully oversee their children’s use of fluoride-containing products and to keep fluoride products away from children, especially those under the age of 6.
Additionally, excess fluoride can cause defects in the tooth’s enamel that range from barely noticeable white specks or streaks to an undesirable brown discoloration. These defects are known as fluorosis and occur when the teeth are forming — usually in children under 6 years. Fluorosis, when it occurs, is usually associated with naturally occurring fluoride, such as that found in tap water. If your water’s fluoride content is unknown, a water sample should be tested to make sure the fluoride level is adequate and not excessive.

Tips for parents:

Be careful when using fluoridated toothpaste in children under age 6. Children at this age are more likely to swallow toothpaste instead of spit it into the sink.
Use a pea-sized amount of fluoride toothpaste for children.
Avoiding flavored toothpaste minimizes risk, as flavored toothpaste is more likely to be “eaten” by children.

Q How do I know I have a cracked tooth?

A Tiny cracks are very common and may not cause discomfort or problems. However, if you feel a sharp pain in your tooth or you feel pain or sensitivity when eating hot or cold food, we recommend visiting the dentist. The crack may be the result of a number of factors:

– chewing on hard candy, ice, or nuts
– an accident or blow to the mouth
– clenching or grinding your teeth
– putting uneven pressure on teeth while chewing or stress on a tooth
– wear and tear on a tooth with a large filling or restoration that has a significant loss of tooth structure
– exposing teeth to extreme temperatures, for instance eating very hot food following by cold ice water
– teeth weakened by endodontic treatment (root canal)

It is helpful to communicate where the pain or sensitivity occurs in your mouth so the dentist can identify the crack. In some cases a small crack may be treated with bonding or a filling. If the crack is more significant and exposes the tooth’s pulp, causing damage or disease to the pulp, the dentist may need to perform a root canal to save the tooth and eliminate pain.

Contact us at Dr. Brian LaBombard, DMD to schedule a thorough dental exam if you are experiencing tooth pain and suspect you have a cracked tooth.

Q What should I do if my child or I have a dental injury?

A Dental emergencies occur for many reasons, including auto accidents, falls, and contact sports. If you or your child suffer trauma to the face or teeth, go to the hospital emergency room. The hospital staff will most likely include an oral surgeon who can treat jaw fractures and perform emergency tooth removal along with other reconstructive services.

If you experience a dental injury that is not associated with a head or neck trauma, go to your dentist immediately for a dental evaluation. In many cases, the dentist can treat dental injuries such as broken or fractured teeth, teeth that have been knocked out of the mouth or teeth displaced by a blow to the mouth.

Use cold packs or ice to reduce a patient’s pain and swelling. If a tooth comes out, place it in milk or contact lens solution immediately and bring it with you to the emergency room or dentist.

Q Why would I want to replace my silver fillings?

A For more than a century, dentists have used silver-mercury amalgam fillings to restore broken or decayed teeth. Although dental amalgam is a commonly used and safe material for tooth restoration, concerns have been raised due to its mercury content. Some patients choose to replace silver fillings for aesthetic reasons or other beliefs.

Silver amalgam fillings can break down over time and bacteria may grow between the filling and the tooth, causing decay or a cavity underneath the filling. Replacing silver-mercury amalgam fillings with composite fillings prevents decay or cavities from forming between a silver filling and tooth while also improving the appearance and providing a stronger and more durable restoration.

Q When would an old filling need to be replaced with a crown?

A When a tooth has a very large filling and very little natural tooth structure remaining, it is highly susceptible to fracture and breakdown. The best treatment for this type of tooth is a crown which serves to hold the tooth together and thus lengthens the life of the tooth. Often times, the dentist will replace the large, old filling with a new, stronger one and then place a crown over the entire tooth.