Local Dental Care - Pennsylvania Children's Dental Directory

Dental Health Care: Discolored Primary Teeth

Discoloration of the primary (baby) incisors (front teeth) is most often noticed by parents. This discoloration may be extrinsic or intrinsic. Tooth brushing or a professional cleaning can remove extrinsic discolorations or stains. Intrinsic discoloration occurs within the tooth structure.

Some apple juices and grape juice may cause staining. This type of stain can usually be brushed off the teeth at home. If your child has a tendency to stain, try diluting the juice with water. Once the enamel begins to break down, the staining may be more difficult to remove because it is deep down in the tiny holes created by break down of the enamel. This could progress on to decay. If the teeth appear to be a dull, white color in some spots, discontinue juices completely or dilute the juice with water. Juice is twenty times more decay-causing than milk. Juices should be limited to mealtime only.

Liquid and chewable medicines have a high sugar content and most are colored with dye. A light yellow-brown film may cover the teeth. This occurs most often on the bottom front teeth. Bedtime tooth brushing is especially important when your child is taking liquid or chewable medicine. Tetracycline is the only antibiotic that could cause damage to the developing permanent teeth if given before eight years of age.

Iron in chewable or liquid vitamins may cause staining of the grooves of the primary (baby) molars. This is difficult to remove, but overall is harmless.

You must brush your child's teeth until six years of age. Bedtime brushing is the most important time of day. Staining may occur if plaque remains on teeth for a long period of time. Plaque is made up of cells from the inside of the mouth, bacteria, and food residues. Teeth may appear to be discolored, but a thorough brushing may remove this stain. Do not use toothpaste until two years of age. Baking soda toothpaste seems to be best for stain removal.

Bacteria called chromogenic (colored) bacteria may cause a dark green or brown stain on the teeth. This stain is usually along the gum line. These bacteria are harmless and will one day just disappear. We do not know why they grow in some mouths and not others. A professional cleaning is usually necessary to remove this stain.

Intrinsic discoloration cannot be removed by cleaning the teeth. This occurs because the enamel on the primary teeth did not form in the usual manner. This may be inherited from one or both parents. It does not necessarily mean that the primary teeth will be more susceptible to decay or that the permanent teeth will have the same appearance.

Trauma to a primary incisor (front tooth) may cause discoloration. If the blood vessels deep inside the tooth break, the blood may be absorbed into the tiny tubes that travel from the inside of the tooth to the outer enamel layer. This is similar to a black and blue mark on the skin. Enamel is translucent, so you can see the evidence of the damage. This may resolve without treatment, but your pediatric dentist should be consulted. A procedure to remove the tissue from the inside of the tooth (pulpectomy) may be necessary.

by Jane A. Soxman, DDS

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.

A Kid's Dentist Explains Dental Visits

Parents often feel helpless when a son or daughter is fearful or apprehensive regarding a trip to the pediatric dentist. Talk with your dentist about your concerns. A partnership must exist between the parent and the dentist. Your own attitudes and understanding of what will occur during each visit will greatly influence the outcome of your child's visit. The following information will assist you in helping your child toward a comfortable and successful visit to the dentist.

Schedule a morning appointment. Children are more rested in the morning, and morning appointments usually have less waiting time. If your child is in school, he or she may worry all day about the appointment and will be tired after school.

Do not promise an expensive present if your child is well-behaved. Your little one may assume that he is about to do something very difficult. A surprise waiting to be given just after the visit may be more appropriate. Do not tell your child to be brave or that nothing will hurt. The idea that seeing the dentist requires being brave or that something might hurt may have never occurred to the child.

During any waiting time, sit close beside your child and read him a story. This not only provides distraction, but also places a child in a more relaxed frame of mind. Free play should be avoided.

If your child is scheduled for restorations (fillings), say as little as possible regarding the events of the visit. Your tone of voice and body language could accidentally create a sense of fear or apprehension in an unsuspecting child. The parent who is more comfortable with dental treatment should do the talking. Allow your dentist to use his or her experience to determine how much your child should be told just prior to the procedure.

If local anesthesia (a shot to numb the teeth) is to be used, do not discuss this issue with your child before the visit. The most feared part of the visit is usually the injection. In some cases, the use of local anesthesia may not be necessary. Do not attempt to predict what your dentist will do. If your child asks about the need for a shot, answer saying that you do not know. Most injections are performed painlessly with the child unaware of the occurrence. A child who comes to the office already intensely worried about the shot is much more difficult to calm.

Your expectations of your child's ability to cooperate for a dental procedure must be age-appropriate. By four years of age, an emotionally and physically healthy child should be able to separate from his parent for an examination and possibly treatment. Dentists have varying opinions as to whether or not a parent should be present for treatment. Some parents are reluctant to separate from the child, and others prefer not to accompany the child for treatment. Parents should agree with the philosophy of their kid's dentist.

Only one parent should accompany the child for the visit. The parent who is more comfortable with dental visits should be the choice. Consistency is very important. The dentist, child, and parent function as a team. The rules must stay the same. If the visit went well with Dad, he should be the parent who accompanies the child for every visit. Apprehensive or fearful children generally do better with Dad. Mom may be a little more emotional and more anxious regarding the treatment. However, this is not always the case. You are the expert for your child's emotional well-being. You should decide who would be the better choice for this particular experience.

If you are present for treatment, you should be the kid's dentist silent partner. You may pat your child or offer some words of support or praise, but remain calm and quiet. Do not repeat the dentist's requests of your child and do not raise your voice at any time. The dentist will manage the behavior. The dentist's attention should not be divided between you and your child, and your child's attention should not be divided between you and the dentist. A minor operation is being performed. The kid's dentist must concentrate not only on the procedure but also on managing your child's behavior. Try not to distract him or her.

Some children will attempt to manipulate their parents during treatment. If your child is crying, listen to the sound of the crying. Compensatory crying often occurs. The child is not in discomfort, but is just coping by crying. Parents may become the court of appeals. The child constantly attempts to delay treatment by reaching out for a hug. If both you and your dentist believe your child is capable of undergoing treatment, you must provide tough love at this time. If your child will not cooperate with you present, your dentist may ask you to leave the treatment room. Leave your car keys with your little one, so he knows you are not leaving the office. Assure him that you will be close by.

If you do not plan to be present during treatment, separate from your child in the reception room and not after she is seated in the dental chair.

Parental love must permit children to move toward independence. A parent's permitting his or her child, age four or older, to undergo treatment without the parent present sends two messages. First, "It is ok. I really do not need to be right beside you for this." Secondly, "You can do it! I have confidence in you." This child has been given a sense of empowerment.

The limitations and strengths of each child must be recognized. By sharing with your dentist in the proper preparation and guidance, both you and your child can begin to look forward to that next dental visit!

By Jane A. Soxman, DDS

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.