Posts for tag: pediatric dentistry

ConsciousSedationEasesTreatmentAnxietyforYoungDentalPatients

While pediatric dentistry has made great strides in making young patients’ dental visit experiences more relaxing, some children and teenagers still have difficulty with anxiety. Their anxiety in turn can make necessary care much harder to provide.

For difficult cases, many dental providers for children now incorporate a technique known as conscious sedation to help ease anxiety. With this technique, they’re able to perform procedures like cavity-filling or tooth-extraction that are more difficult with an anxiety-prone patient.

While general anesthesia creates a total loss of consciousness, conscious sedation uses precise medications to suppress consciousness at different levels ranging from light to deep suppression, and create a relaxed state for the patient. A child under sedation can still breathe normally and respond to certain stimuli, including touch and verbal commands. For only a light or minimal effect, a dentist normally administers the sedation drug as a pill the child takes orally. For deeper sedation, the medication is most likely delivered through a vein (intravenously).

Sedation reduces fear and anxiety but not necessarily pain, so it’s often accompanied by some type of anesthesia, either a local anesthetic delivered by injection to the procedure site or with a nitrous oxide/oxygen gas combination that’s inhaled through a mask worn by the patient.

Even though the child isn’t completely unconscious, one of the dentist’s staff will monitor vital signs (heart and respiration rates, blood pressure and blood oxygen level) throughout the procedure. This continues even after the treatment is over until the child’s vital signs return to pre-sedation levels. Once released, they will need a ride home and should rest for the remainder of the day. They can then return to school and resume other normal activities the next day.

With the advent of newer and safer drugs, conscious sedation is becoming a more widespread technique in both medicine and dentistry. Using it to ease a child’s anxiety increases the chances they’ll receive all the dental care they need without unpleasant memories of their visit that could follow them into later life.

If you would like more information on the role of conscious sedation for children, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Sedation Dentistry for Kids.”

By Edward Joseph, D.D.S.
November 28, 2018
Category: Oral Health
ModerateYourChildsJuiceDrinkingtoLowerToothDecayRisk

Along with daily brushing and flossing, limiting your child’s sugar consumption is an important way to prevent tooth decay. We all know the usual suspects: candy, sugar-added snacks and sodas. But there’s one category you may not at first think fits the profile—juices. But even natural juices with no added sugar can raise your child’s risk of tooth decay if they’re drinking too much.

Tooth decay is caused by certain strains of bacteria in the mouth, which produce acid. Sugar in any form (sucrose, fructose, maltose, etc.) is a primary food source for these bacteria. When there’s a ready food source, bacteria consume it and produce abnormally high levels of acid. This can cause the mineral content of tooth enamel to dissolve faster than saliva, which neutralizes acid, can reverse the tide.

Juices without added sugar still contain the natural sugar of the fruit from which they originate. The American Academy of Pediatrics conducted a study of the effect of these natural juice sugars on dental health. Their conclusion: it can have an effect, so the amount of juice consumed daily by a child should be restricted according to age.

They’ve since published guidelines to that effect:

  • Under age 1 (or any child with abnormal weight gain): no juice at all;
  • Ages 1-3: no more than 4 ounces a day;
  • Ages 4-6: no more than 6 ounces a day;
  • Ages 7-18: no more than 8 ounces (1 cup) a day.

Again, these are guidelines—you should also discuss the right limits for your individual child with your dentist or pediatrician. And if you’re wondering what kind of beverages pose less risk of tooth decay, you can look to low or non-fat milk. And, of course, don’t forget water—besides containing no sugar, nature’s hydrator has a neutral pH, so it won’t increase acidity in the mouth.

Tooth decay is one of the biggest health problems many kids face. But with good teeth-friendly habits, including restricting sugar intake in any of its many forms (including juices) you can go a long way in reducing their risk of this destructive disease.

If you would like more information on best dental care practices for children, please contact us or schedule an appointment for a consultation.

By Edward Joseph, D.D.S.
October 24, 2018
Category: Oral Health
EncourageYourChildtoStopThumbSuckingbyAge4

There's something universal about thumb sucking: nearly all babies do it, and nearly all parents worry about it. While most such worries are unfounded, you should be concerned if your child sucks their thumb past age of 4 — late thumb sucking could skew bite development.

Young children suck their thumb because of the way they swallow. Babies move their tongues forward into the space between the two jaws, allowing them to form a seal around a nipple as they breast or bottle feed. Around age 4, this “infantile swallowing pattern” changes to an adult pattern where the tip of the tongue contacts the front roof of the mouth just behind the front teeth. At the same time their future bite is beginning to take shape.

In a normal bite the front teeth slightly overlap the bottom and leave no gap between the jaws when closed.  But if thumb sucking continues well into school age, the constant pushing of the tongue through the opening in the jaws could alter the front teeth's position as they erupt. As a result they may not fully erupt or erupt too far forward. This could create an open bite, with a gap between the upper and lower teeth when the jaws are closed.

Of course, the best way to avoid this outcome is to encourage your child to stop thumb sucking before they turn four. If, however, they're already developing a poor bite (malocclusion), all is not lost — it can be treated.

It's important, though, not to wait: if you suspect a problem you should see an orthodontist for a full evaluation and accurate diagnosis. There are even some measures that could discourage thumb sucking and lessen the need for braces later. These include a tongue crib, a metal appliance placed behind the upper and lower incisors, or exercises to train the tongue and facial muscles to adopt an adult swallowing pattern. Often, a reward system for not sucking their thumbs helps achieve success as well.

Thumb-sucking shouldn't be a concern if you help your child stop before age 4 and keep an eye on their bite development. Doing those things will help ensure they'll have both healthy and straight teeth.

If you would like more information on thumb sucking, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “How Thumb Sucking Affects the Bite.”

By Edward Joseph, D.D.S.
October 04, 2018
Category: Oral Health
HowtoHelpYourKidsFormGoodOralHygieneHabits

October is National Dental Hygiene Month. It comes as no surprise that good dental hygiene habits are best acquired early in life—and with good reason, as tooth decay is the most common disease among children. In fact, a full 43 percent of U.S. children have cavities, according to a 2018 report from the U.S. Centers for Disease Control. So how do you start young children on the path to a lifetime of good oral health? Here are five tips for instilling good dental hygiene habits in your kids:

Set a good example. Good—and bad—habits often start at home. Research shows that when young children notice other family members brushing their teeth, they want to brush, too. So let your child see you brushing and flossing your teeth, and while you’re at it model good nutritional choices for optimal oral health and use positive language when talking about your own dental visits. The example you set is a powerful force in your child’s attitude toward oral care!

Start early. You can start teaching children brushing techniques around age two or three, using a toothbrush just their size with only a pea-sized amount of fluoride toothpaste. If they want to brush by themselves, make sure you brush their teeth again after they have finished. Around age six, children should have the dexterity to brush on their own, but continue to keep an eye on their brushing skill.

Go shopping together. Kids who handpick their own oral hygiene supplies may be more likely to embrace the toothbrushing task. So shop together, and let them choose a toothbrush they can get excited about—one in their favorite color or with their favorite character. Characters also appear on toothpaste tubes, and toothpaste comes in many kid-friendly flavors.

Make dental self-care rewarding. Why should little ones care about good dental hygiene?  Young children may not be super motivated by the thought of a long-term payoff like being able to chew steak in their old age. A more tangible reward like a sticker or a star on a chart each time they brush may be more in line with what makes them tick.

Establish a dental home early on. Your child should start getting regular checkups around age one. Early positive experiences will reinforce the idea that the dental office is a friendly, non-threatening place. Children who get in the habit of taking care of their oral health from an early age have a much better chance of having healthy teeth into adulthood.

If you have questions about your child’s dental hygiene routine, call the office or schedule a consultation. You can learn more in the Dear Doctor magazine articles “Do Babies Get Tooth Decay?” and “How to Help Your Child Develop the Best Habits for Oral Health.”

By Edward Joseph, D.D.S.
August 20, 2018
Category: Dental Procedures
WhattodoifYourChildhasaToothache

When your child says they have a toothache, should you see your dentist? In most cases, the answer is yes.

And for good reason: their “toothache” could be a sign of a serious condition like tooth decay or a localized area of infection called an abscess, which could adversely affect their long-term dental health. The best way to know for sure –and to know what treatment will be necessary—is through a dental exam.

So, how quickly should you make the appointment? You can usually wait until morning if the pain has persisted for a day or through the night—most toothaches don’t constitute an emergency. One exception, though, is if the child has accompanying fever or facial swelling: in those cases you should call your dentist immediately or, if unavailable, visit an emergency room.

In the meantime, you can do a little detective work to share with the dentist at the appointment. Ask your child exactly where in their mouth they feel the pain and if they remember when it started. Look at that part of the mouth—you may be able to see brown spots on the teeth or obvious cavities indicative of decay, or reddened, swollen gums caused by an abscess. Also ask them if they remember getting hit in the mouth, which may mean their pain is the result of trauma and not disease.

You can also look for one other possible cause: a piece of candy, popcorn or other hard object wedged between the teeth putting painful pressure on the gums. Try gently flossing the teeth to see if anything dislodges. If so, the pain may alleviate quickly if the wedged object was the cause.

Speaking of pain, you can try to ease it before the dental appointment with ibuprofen or acetaminophen in appropriate doses for the child’s age. A chilled cloth or ice pack (no direct ice on skin) applied to the outside of the jaw may also help.

Seeing the dentist for any tooth pain is always a good idea. By paying prompt attention to this particular “call for help” from the body could stop a painful situation from getting worse.

If you would like more information on dental care for children, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “A Child’s Toothache: Have a Dental Exam to Figure out the Real Cause.”



Burbank, CA Dentist
Edward C. Joseph, D.D.S.
2701 West Alameda Ave, Suite #503
Burbank, CA 91505
(818) 842-7628

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