Pediatric Dentistry - Dental Care for Teens

Oral hygiene may be the last thing on the mind of an adolescent or teen. During these years, decay in between the teeth may occur for the first time and hormonal changes may create more inflammation of the gums. Here are some helpful hints from pediatric dentists to avoid some of the problems that may occur in the adolescent or teen.

• If brushing is a problem, try an electric toothbrush. This will clean the teeth more efficiently. When the twelve-year molars or wisdom teeth are erupting (coming in), use a toothbrush with a longer tuft of bristles at the end. This longer tuft of bristles will reach the newly erupting teeth that are at a lower level than the other teeth. Twelve-year molars should be sealed with a dental sealant by your family dentist as soon as they are fully erupted.
• Tartar or calculus usually occurs on the tongue side of the bottom incisors (front teeth). This is the result of food not being adequately brushed away. Some people have a tendency to form calculus and others do not. The end tuft is good for cleaning this area too.
• Use a fluoride mouth rinse (usually found in stores by the mouthwash) if one is having a problem with decay. The teeth should be brushed thoroughly before rinsing with the fluoride. It will not penetrate plaque. Use this at night just before going to bed. Do not rinse with water after using the fluoride rinse.
• Do not use a mouthwash with a high alcohol content on a daily basis. This practice could predispose one to oral cancer.
• The best cure for halitosis (bad breath) is to keep the mouth clean. Brush the roof of the mouth and the tongue. Tongue scrapers, which can be purchased in the toothbrush and toothpaste section of a store, are very helpful. A certain kind of bacteria may grow on the back of the tongue near the throat. These bacteria produce sulfide, a gas that causes halitosis. Large indentations in tonsils can catch food. If the food is not rinsed away, an odor may occur. Gargling with water may help to dislodge these food particles. A sinus infection with postnasal drip, dieting, or stomach problems could also be the cause of halitosis.
• If gums bleed with flossing, or the corners of the mouth are sore and cracking, a vitamin supplement may help. Try a multi-vitamin with meals.
• Bleeding with flossing may also mean one needs to floss more! Hormonal changes may cause gums to be red and swollen at certain times. Constant effort at keeping teeth clean is the best way to avoid bleeding and discomfort.
• Ulcers in the mouth (apthous ulcers) can be very painful. These may occur more often during orthodontic treatment, stress, or with trauma. There is no quick cure. One way to decrease the pain and shorten the duration of the ulcer is to use vitamin E. Pierce the end of a capsule of vitamin E and squeeze the vitamin over the ulcer. Do this often through the day and at bedtime.
• Soft drinks contain phosphoric acid and sugar. Try to drink through a straw and do not swish soft drinks through the teeth. Lemons are very acidic. Frequent sucking on lemons will erode (wear away) the enamel layer of teeth. Enamel will not grow back.
• Chewing tobacco should be completely avoided. There is a very high incidence of oral cancer with the use of any chewing tobacco.
• Chewing gum does stimulate the flow of saliva, and that is good for the teeth. But problems may occur with excessive gum chewing. The cusp tips of the molars are being worn away and decay is occurring in the teens. Once the enamel layer is worn down, the second layer is exposed. This layer, the dentin, decays easily. Chewing gum for more than three hours each day may result in discomfort or tenderness of the muscles in the jaws or popping or clicking in the joints of the jaws (temporomandibular joints or TMJ).
• Xylitol and sorbitol sweeteners in chewing gum have been shown to reduce the incidence of dental decay.
• Leaning the head on the palm of the hand continuously and crushing ice with the teeth has also been shown to result in TMJ symptoms and jaw muscle tenderness.
• Do not share water bottles. The herpes virus causes a cold sore and it is very contagious.
• The bacteria that cause tooth decay can also be spread from one person to another in the saliva.
• Change toothbrushes as soon as the bristles are frayed or bent. Bacteria and viruses grow on toothbrushes. Toothbrushes should be rinsed thoroughly before and after brushing. Change to a new toothbrush after an illness, especially strep. Reinfection can occur with a toothbrush that is covered with strep.
• Strep can also grow on acrylic orthodontic appliances. Clean them thoroughly during a strep infection.
• Mouth guards work. They should be worn for most sports. After orthodontic treatment is completed, or all of the permanent teeth (except the wisdom teeth) are erupted, a custom made mouth guard will provide the best protection. Have a dentist check the fit of the "boil-and-bite" mouth guard. A proper fit is very important. During orthodontic treatment, the orthodontist will recommend an appropriate mouth guard.
• The presence and position of wisdom teeth should be evaluated around fifteen years of age.
• And, finally … what teeth do you have to brush and floss? Only the ones you want to keep!

by Jane A. Soxman, DDS

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