Picture of Nasolabial Cyst (Nasoalveolar Cyst, Klestadt Cyst)

These developmental cysts are rare lesions of the nasal alar region. They grow submucosally in the anterior nasal floor, often elevating and medially displacing the inferior turbinate. They expand downward into the gingivolabial sulcus, and laterally into the soft tissue of the face.

Nasolabial cysts are usually unilateral, more common in women, usually present during the fourth and fifth decades of life, and have a predilection for the black population. They are usually painless and asymptomatic, and they are recognized only when they are acutely inflamed or large enough to cause nasal obstruction. Sometimes their size will cause flattening of the nasolabial fold. They are generally thought to be of embryonic origin, arising where nasal epithelium became trapped in the cleft formed by the fusion of the maxillary, lateral, and medial nasal processes.

What type of NAM is done at Children's?

We use the negative sculpturing passive molding technique described by Drs. Grayson and Cutting. Our surgical technique takes advantage of nasoalveolar molding by decreasing the size of the incisions and scars and the amount of surgery.

In select cases, a gingivoperiosteoplasty can be performed to completely close the cleft in the gum at the time of the surgery.

Doing a GPP at the time of the lip surgery can prevent the need for a future alveolar bone graft (gum surgery) in approximately half of the children. Not all children undergoing NAM are good candidates for a GPP.

We will provide more information on NAM and discuss if it is appropriate for your child.

An orthodontist, a plastic surgeon and a nurse practitioner specially trained in NAM are available for questions between visits.

Although your child will come to the orthodontist for adjustments to the molding plate about once a week, they will still be followed as closely as necessary by the rest of the multidisciplinary team at the Craniofacial Center during regular clinic visits.

What is your experience with nasoalveolar molding?

Dr. Barry Grayson and Dr. Court Cutting at New York University Medical Center developed nasoalveolar molding and have established it as a safe and effective technique.

Although NAM is a more recent advance in cleft care, it is an improvement of techniques that have been used in the U.S. and in Europe for decades. It is therefore not a "new fad," but is here to stay.

One of our plastic surgeons and orthodontists trained with Drs. Grayson and Cutting in New York, and we have been performing nasoalveolar molding at Children's in Seattle since 2001. Our plastic surgeons use the specific surgical techniques designed for patients after molding.

An average of six children are undergoing NAM at Children's at any time.

How does nasoalveolar molding or NAM work?

To start NAM, parents work with an orthodontist. Within the first couple of weeks after birth, babies are fitted with a custom-made molding plate that looks like an orthodontic retainer. The device is attached with a small orthodontic rubberband that is taped to the baby's face.

The molding plate causes no pain and after the first few days the plate usually doesn't bother babies at all; it's an accepted part of their face.

Unlike some older techniques, the molding plate does not push or stretch the delicate tissues; it only helps gently direct the growth of the gums.

The baby wears the molding plate 24 hours day, seven days a week, including when they are feeding. The parents change the tape and clean the molding plate daily as needed.

After the baby has worn the molding plate for a week, the orthodontist slowly adjusts the shape by sculpturing the plastic. Each adjustment is very small, but it starts to guide the baby's gums as they are growing.

Adjustment of the molding plate is done by the orthodontist weekly or every other week depending on progress. Each appointment takes 40-60 minutes.

Once the cleft gap in the gums is small enough (around one quarter-inch), a post is attached to the molding plate and is inserted in the nostril. This post is then slowly adjusted to lift up the nose and open the nostril.

By the time of the surgery, the nose has been lifted and narrowed, the gap in the gums is smaller and the lips are closer together.

A smaller gap means less tension when the surgeon closes the cleft. In our experience this results in a better final result than if NAM had not been done.

What is nasoalveolar molding or NAM?

Nasoalveolar molding is a nonsurgical method of reshaping the gums, lip and nostrils before cleft lip and palate surgery, lessening the severity of the cleft. Surgery is performed after the molding is complete, approximately three to six months after birth.

NAM is used mainly for children with large clefts and has revolutionized cleft repair.

In the past, fixing a large cleft required multiple surgeries between birth and age 18, putting the child at risk for psychological and social adjustment problems.

The first procedure pulled the lip together, a second improved the position of the lip, another two would be for the nose, then another — often including a bone graft — would close the palate, and so on.

With nasoalveolar molding, the orthodontist and surgeon can improve a large cleft in the months before surgery. This helps the surgeon get a better shape of the nose and a thinner scar in only one surgery.

A better result in the first surgery means fewer surgeries later in childhood.

Cavity Fillings

Cavity fillings are biocompatible material used for filling up the cavities, which are intentionally cut on the infected part of the tooth surface. These cavities are prepared in a scientific and a principled manner in order to achieve a strong and a long lasting filling.

The main idea of preparing a cavity is to remove the infected position of the tooth so as to prevent the further spread of decay and hence the ultimate loss of the tooth.

The cavities are prepared using high speed drilling equipment, which is controlled by the dentist. Patient may not have any discomfort initially but as the drill bit move closer to the center of the tooth (where the nerves are located), the patient begins to experience sensitivity. This can be avoided if tooth is anesthetized, which of course means having to take an injection

If the cavity prepared is very deep, a layer of medicated cement is used to line the floor of the cavity to help in healing of the tissue.

In case of metal based filling material a base is given. This base is nothing but a thick coat of cement lining the floor of the cavity. The base not only adds to the strength of the over lying filling but also insulates the tooth from sharp variation in temperature, caused by the increased thermal conductivity of the metal filling.

The term cement, which is frequently used, is a mix of a chemical powder and liquid. This mix, which is initially soft, turns hard over a period of time resembling the common cement used for construction

For cavity preparation, which is not very deep, a cement base may not be required.

Myths : Thumb sucking by children leads to forward placement of upper teeth .

Thumb sucking is a normal infant habit, which makes the child feel secure and happy. It usually decreases after the age of 3 years. However, if the habit persists beyond the age of 4-5 years it can cause problems of the teeth including forward placement of the teeth. In these children, depending upon the frequency and severity of the habit an intervention of the habit by a dental surgeon may be required.

Milk teeth need not be cared for because they last only for a few years, and these teeth will anyway be replaced by permanent teeth.

Early loss of milk teeth will interfere with chewing and affect the child's nutrition. Early loss of milk teeth leads to drifting of the adjacent teeth and closure of some of the space that is required for the succeeding permanent teeth to erupt into. Such a loss of space will cause the permanent teeth to erupt in irregular position and result in crowding. Therefore milk teeth need to be cared for as much as permanent teeth.

Myths : When the gums bleed, it is better not to brush the teeth.

Facts : Bleeding of gums is a sign that they are inflammed and are not healthy. This usually is a result of plaque and food particles accumulating around the teeth. Until this collection is removed, the gums continue to bleed. This is an indication that the individual needs to visit a dentist for opinion and treatment. Brushing the teeth with a soft toothbrush by the proper technique removes the plaque and helps the gums recover. Initial bleeding seen during brushing gradually reduces over a period of time.

When a Kid Damages a Tooth

It can happen to anyone, anywhere, and at almost any time. Kids can damage teeth through sports, falling, riding bikes, playing in general, or who knows doing what? But how you respond to dental trauma can determine whether the tooth can be salvaged. Here are some quick tips for parents, coaches and child care providers in the event a child damages a tooth:

* A tooth gets chipped. If you can find the chip, save it. It makes color matching easier. If the chip exposed what's called the dentin or pulp, then chances are great that bacteria in the mouth will infect it. The trauma itself could also have caused damage, and may not always be immediately apparent. Typically, the dentists waits for a short period of time to determine the extent of any damage. If the tooth hurts, changes color or is sensitive to cold or heat, chances are a root canal will be required. But, in the meantime, the dentist will patch the chipped tooth.


* A tooth gets knocked out of position. If the tooth isn't too badly moved, try gently moving it back into the proper position. Doing so may help preserve the ligament tissue. A root canal may still be needed, but moving it back into place (when possible) can help improve the chance that the tooth will reattach to the jawbone properly. If the tooth has been knocked out of position and is essentially "dangling," dentists may have to splint it. The most important thing to do is to get to a dentist as soon as possible.


* A tooth gets knocked out completely. Locate the tooth (if possible) and put it back into the socket as soon as possible. If it's dirty, rinse it off very gently with milk or water. Be sure not to scrub the tooth; the any tissue on the tooth helps reduce the chance of it becoming re-attached. If you can't place the tooth back in the socket, then put it in cold milk or a salt water mix. If that is not available, then good ol' spit still works better than plain water. NEVER wrap the tooth in a towel or napkin; doing so dries out any tissue that is still attached to the tooth. Get to the dentist as soon as possible!


* Consider whether it is a baby tooth or adult tooth. For obvious reasons, having a baby tooth knocked out or damaged is typically much less traumatic than having the same occurrence with an adult tooth. However, be sure to follow up with a dentist after a baby tooth is damaged/knocked-out. An examination can determine whether any stop-gap measure is needed and whether there is any underlying damage to the permanent teeth or jawline.

What is an Abscessed Tooth?

An abscess of the tooth is an infection. An abscess can include pus and swelling of the soft gum tissues surrounding the tooth. An abscess can develop from tooth decay or tooth trauma, such as a broken tooth. If there is an opening in the enamel of a tooth, such as a cavity, bacteria can get in and infect the pulp (center) of the tooth and cause an abscess.

Once an abscess happens, the infection could spread throughout the mouth and body. A root canal is usually the only option to save a tooth once it has become abscessed. If you suspect that you have an abscessed tooth, you should see your dentist right away.

How Often Should I See the Dentist for a Check Up and Cleaning?

Most children and adults should see their dentist for a regular cleaning and check up every six months. People at a greater risk for oral diseases should have dental check ups more than twice a year. Tobacco and alcohol use, diabetes, pregnancy, periodontal and gum disease, poor oral hygiene and certain medical conditions are some of the many factors that your dentist takes into consideration when deciding how often you need your dental cleaning and check up.

Going to your regular check ups will help to keep your gums and teeth healthy as well as detect any early problems such as gum disease, oral cancer and cavities. The best way to maintain good oral health is to visit your dentist on a regular basis.

How Bad Is Your Breath? 14 Simple Tips For Reducing Mouth Odor

Bad breath, morning breath, breath odor or halitosis are all terms used to describe a noticeably unpleasant odor exhaled on the breath. Halitosis is not a problem by itself, but it can cause concerns in our interpersonal relationships.

We are all familiar with how the consumption of certain foods such as garlic and onions can affect our breath. This occurs because these foods are absorbed into our bloodstream, where they are transferred to our lungs and exhaled. Fortunately, bad breath caused by the foods we eat is only temporary.

Common Causes of Bad Breath
The truth is, most breath odor comes from food particles trapped in our mouths. When food remains in the mouth, it becomes a breeding ground for the bacteria that can cause bad breath. Other causes can include poor oral health, improper cleaning of dentures, periodontal disease as well as smoking & tobacco products. Bad breath can also be sign of an underlying medical condition of the stomach, lungs and bloodstream.

Another little known situation that can contribute to halitosis is xerostomia (dry mouth). When our mouth is dry, saliva production decreases, leaving the mouth’s natural ability to clean itself impaired. Saliva is the mouth’s natural mouthwash, which contains properties that reduces bacteria in the mouth. Alcohol consumption, certain medications, breathing through the mouth instead of the nose or a salivary gland disorder can contribute to having a dry mouth.

Ways to Fight Against Bad Breath
Recommendations For Wellness

* Brush your teeth and rinse your mouth thoroughly after every meal to remove food particle from the mouth.

* When you are brushing your teeth, also brush your tongue. The tongue is covered with thousands of tiny hairs that can trap bacteria.

* Have regular check-ups with your dentist to rule out gum disease and to correct any faulty restorations, overhanging fillings or leaking crowns, all of which can trap food in the mouth.

* Chew sugarless gum or suck on sugarless lozenges to increase the flow of saliva.

* If your mouth is dry, drink plenty of water. Try swooshing it around in your mouth for at least twenty seconds to loosen any food particles the bacteria can feed upon.

* Avoid breath mints and mouthwashes that contain alcohol. Instead of helping, they can make things worse. They only temporarily cover the smell and tend to dry the mouth, creating a more favorable environment for bacteria.

* Snacking on vegetables such as raw celery or carrots can keep plaque from forming.

* If you are going to an important meeting or on a big date, avoid foods that can cause bad breath, such as onions and garlic.

* Avoid alcohol and caffeine consumption, which can dry the mouth.

* Quit smoking. Tar and nicotine can build up on the surface of the teeth, tongue and cheeks. It can also dry the mouth and inhibit saliva flow.

* Chlorophyll is a natural breath freshener and is found in leafy green vegetables like parsley.

* A few drops of peppermint or tea tree oil can be applied to the tongue or toothbrush to help freshen the breath. In addition to its refreshing nature, their antibacterial properties will kill the bacteria found in the mouth.

* Baking soda has a long history of being used to maintain good oral health and for fighting bad breath.

* A mixture of 50% hydrogen peroxide and 50% water can be swooshed around in the mouth and used as a mouthwash. Hydrogen peroxide can kill many of the bacteria that can cause bad breath.

Source:Body, Mind & SoulHealer 2005

Home Remedies for Bad Breath

Brushing at least twice a day and flossing daily can help to remove odor-causing bacteria. Before trying any natural remedies for bad breath, it's important to visit your dentist to have your teeth examined and cleaned. If a cause isn't identified, consult your doctor for further investigation. Here are some home remedies to consider:

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Drink tea. Preliminary research suggests that compounds in both green and black tea called polyphenols may stop the growth of bacteria responsible for bad breath. Polyphenols may also prevent existing bacteria from producing malodorous compounds such as hydrogen sulfide. Both green and black tea have polyphenols. Get some tips on how to brew green tea.
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Try a mouthwash containing zinc ions. Zinc appears to directly neutralize malodorous sulfur compounds and improve breath. It's found in several health food store mouthwashes as well as some drug store brands.
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Use a tongue scraper, which helps to remove dead cells, food particles and bacteria from the tongue. A tongue scaper is a special plastic instrument found in drug stores and some health food stores, that costs several dollars. In Ayurveda, a thick coating on the tongue is called "ama" and is thought to be caused by improper or incomplete digestion. Tongue cleaning with a scaper is recommended as a daily regimen to remove ama. The key is to do it gently and to rinse your mouth thoroughly afterward. If you can't find a tongue scraper, use a toothbrush to clean your tongue.
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Drink plenty of fluids. Drinking water and other fluids will help keep your mouth moist. Another reason drinking fluids might help: In traditional Chinese medicine, bad breath is often the result of excess heat in the stomach. Water, soup and watery fruits and vegetables, such as cucumber, are thought to help to rebalance the body.
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According to traditional Chinese medicine, bitter foods, such as Belgian endive and many dark green leafy vegetables are also believed to help stomach heat. Certain foods, such as coffee, alcohol, sugar, milk and fried or spicy foods are thought to worsen the problem.
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Snack on crunchy fruits and vegetables such as apples, celery, carrots or jicama. Crunchy foods can help remove food, bacteria and plaque from teeth.
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Try a mouthwash that contains essential oils. Preliminary studies suggest that essential oils, which are plant oils, may help to reduce bad breath. One study compared an essential oil mouthwash containing tea tree oil, peppermint oil and lemon oil to a standard mouthwash and found that the level of volatile sulfur compounds was significantly less after the essential oil mouthwash compared to the conventional mouthwash. It's best to use a commercially-prepared product (check the health food store) rather than buying essential oils and making your own mouthwash. If in doubt, consult your dentist.
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Use herbs to freshen your breath. Chew on a small sprig of fresh rosemary, parsley, spearmint, or tarragon for up to a minute.
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Avoid mouthwashes with alcohol. Alcohol can dry out the mouth, which contributes to bad breath.
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Get help managing stress. Many people have bad breath that doesn't have a clearly identifiable cause. One small preliminary study found that in healthy young men with good oral hygiene and general health, stress increased the production of volatile sulfur compounds in the mouth. To learn specific relaxation techniques, go to my section on mind/body techniques. Also, find out about natural remedies for anxiety.

Preventing Bad Breath - How Do I Prevent Bad Breath?

Preventing bad breath is easier that you think. We know some of the causes of bad breath, but have you ever asked yourself "How do I prevent bad breath for good?"

The following guidelines will help you eliminate or significantly reduce your halitosis. If you experience chronic bad breath, see your dentist or doctor as there may be a more serious cause for the embarrassing condition.

Here is How:

* Prevent bad breath by brushing your teeth and flossing twice a day, especially after meals that contain food and spices known to cause bad breath. Remember to brush your tongue, or try using a tongue scraper, to remove any trapped food and plaque caught in the tiny hair-like fibers on the tongue. Finish off your brushing by rinsing thoroughly with water or mouthwash.

* Prevent bad breath by visit your dentist on a regular basis (every six months or as indicated by your dentist) for a complete examination of your teeth and gums and thorough cleaning by the dental hygienist.

* Preventing bad breath is achievable when you have dental problems treated as they occur, such as tooth decay, gum abscesses, and abscessed teeth.

* An easy way to prevent bad breath is to chew parsley after a meal. Parsley contains chlorophyll, a known breath freshener.

* Place a few drops of tee tree oil or peppermint oil on your tongue or use the oil on your toothbrush along with your toothpaste. Alternatively, select a toothpaste or mouth rinse that contains these natural oils known for their antibacterial properties to assist in the fight against halitosis causing bacteria.

* Preventing bad breath from smoking is easy when you take the necessary steps to quit smoking, as this is the only way to eliminate bad breath from the use of cigarettes, which is also responsible for periodontal disease.

* Avoid foods known to cause bad breath such as garlic, onions, cabbage, certain spices, and coffee.

* A dry mouth, also known as xerostomia, is a major factor when it comes to bad breath. Sip water throughout the day and during meals. Chew sugar-free gum or dissolve a sugar-free candy slowly in your mouth to keep help produce more saliva.

* The use of sugarless gum, mints, breath strips, or breath spray may increase the flow of saliva in your mouth necessary to keep it cleansed throughout the day, plus add a crisp, minty aroma in place of your bad breath. Keep in mind that even though these products do freshen your breath, the effects are usually temporary and do not necessarily prevent bad breath. If you are using breath fresheners on a regular basis, consider choosing one that contains xylitol, a sweetener that some studies have shown to reduce cavities. Avoid products that contain sugar to prevent the accumulation of plaque.

* Occasionally use a mixture of 50% hydrogen peroxide and 50% water, as a mouth rinse. Hydrogen peroxide will help kill the bacteria that cause bad breath.

* The use of commercially marketed breath freshening kits and bad breath remedies may help prevent bad breath, although there is generally insufficient research that had narrowed down a cure for bad breath. Ask your dentist or pharmacist before you invest in these products.

Dental Care for Dogs and Cats Preventative Care for Gingivitis and Periodontal Disease

According to the American Veterinary Dental Society (AVDS), eighty percent of dogs and seventy percent of cats have periodontal disease by the age of three! Alarming statistics? Yes, and it is known that proper dental care could increase their life by two to five years.

Dental care in dogs and cats has become quite common over the last six years. The AVDS has even selected February as National Pet Dental Health Month. Like humans, dog teeth and gums are also susceptible to the same oral health problems – Gingivitis and Periodontal disease.

Unlike humans, animals rarely get cavities. This is because cavities are primarily caused by the high sugar content of the human diet. Periodontal disease affects both human and mammals alike. Periodontal disease is caused by bacteria and plaque which attach the soft gum tissue of the mouth. The first stage of periodontal disease is gingivitis. This is very common. In this stage, the bacteria have mixed with saliva and formed plaque. The plaque adheres to the teeth and hardens, forming tartar and calculus. These tartar deposits irritate the gum tissue and cause inflammation, swelling and infection. It is this stage that gingivitis is most notable.

Early warning signs of gingivitis are sensitive gum tissue, redness or bleeding gums, trouble eating/chewing and bad breath. Yes, the dreaded "doggy breath"! The breath may take on a sulfur (rotting eggs) odor from the by-products of the bacteria in the mouth. This is often the first sign of gingivitis and serious dental problems.

If caught at this stage, gingivitis is treatable. A thorough dental exam and cleaning most likely will be needed. Many dogs will also most likely need to be put under anesthesia. (This presents its own series of side-effects and dangers as well.) If gingivitis is not treated, it will progress to periodontal disease. Periodontal disease is not treatable. At this stage, there is irreversible bone loss and tooth damage. Roots are also weakened and the animal may experience loose teeth and teeth that simply fall out. Animals may also begin to lose weight. This can lead to other problems associated with improper nutritional intake. Dental treatment will be needed and may result in the extraction of teeth. Again, this will need to be done under anesthesia.

Additionally, the bacteria and infection in the mouth may spread through the bloodstream to cause heart, kidney or liver disease. These diseases can cause serious damage to the organs and lead to premature death.

Periodontal disease is preventable. Like with humans, dogs need regular dental care. The first step is to have your pet examined for existing problems. If needed, your veterinarian can do a dental cleaning. Next, develop an at-home dental care program including a proper diet and mix of dry and wet foods. Diet alone can not prevent dental problems.

Most sources recommend brushing the teeth with pet toothpaste on a gauze or small pet toothbrush. This is the optimal program. If you choose to do this, be sure to select a toothpaste made for pets, avoid fluoridated products and pastes with sugars as one of the top ingredients. Brushing or even wiping the teeth with gauze will be a learning and training experience. With dogs, the process is estimated to take between 8 to 16 weeks before the animal is comfortable with the experience. Start slowly and build each day.

A more practical option for many pet owners may be an oral hygiene solution. There are now pet oral hygiene solutions on the market that can be added to pets’ drinking water. These are much easier and more convenient to use and are formulated for animals. Owner compliance with these programs, unlike with daily brushing, is much higher. As the pet drinks, the solution works to repel and retard the plaque and eliminate the bacteria and bacteria by-products. They are odorless and colorless.

Another helpful "trick" is to try one of the healthy dental treats on the market. They help remove the forming tarter. Be sure to check the label for ingredients -- some treats are really "tricks" in that they contain sugars, dyes and other questionable substances.

Once an at-home program is established, be sure to follow-up with regular veterinary exams.

Diabetes and Gum Disease - What's The Connection?

Gum disease, also known as periodontal disease, is one of the leading causes of tooth loss among adults and is also frequently linked to the control of diabetes. Gum disease is an infection in the gum tissues and bone that keep your teeth in place and has also been linked to heart disease and strokes.

Factors That Link Diabetes to Gum Disease

* Studies show that people with insufficient blood sugar control seem to develop gum disease more frequently and more severely then people who have good management over their diabetes.
* Diabetes slows circulation, which can also make the gum tissues more susceptible to infections.
* Diabetes reduces the body’s resistance to infection, which increases the probability of the gums becoming infected.
* High glucose levels in saliva promotes growth of bacteria that cause gum disease.
* People with diabetes who smoke are far more likely to develop gum disease than people who smoke and do not have diabetes.
* Poor oral hygiene is a major factor in gum disease for everyone, but it is even more so for a person with diabetes.

Signs and Symptoms of Gum Disease
* Red and swollen gums
* Gums that tend to bleed easily
* Gums separating from the teeth
* Loose teeth
* Frequent bad breath
* Change in the way your teeth fit together
* Change in the way partials or dentures fit

Prevention
* Maintain good control over your blood sugar levels.
* Do not smoke.
* Good oral hygiene and regular dental check ups are essential in preventing gum disease.
* Eat a healthy and well-balanced diet.

Be sure to tell your dentist and hygienist that you have diabetes so that he can detect any signs of early gum disease.

There are two major stages of periodontal disease, gingivitis and periodontitis. People with diabetes tend to develop gum disease more frequently than others. However, if it is diagnosed in the early stage (gingivitis), it can be treated and reversed. If treatment is not received, a more serious and advanced stage (periodontitis) may follow which includes bone loss and is irreversible.

Dental Health Guide for Children Caring for Your Child's Teeth

Parents often have questions about how to take care of their children's teeth. When should you start brushing? What kind of toothpaste is best? When should you go to the dentist? Knowing the answers to these questions can help you keep your kids' teeth healthy and cavity free.

Although you don't necessarily need to brush them yet, you should start cleaning your infant's teeth as soon as he gets his first tooth. At first, you can just use a wash cloth to clean your infant's teeth. As he gets more, you can use a soft children's toothbrush.

Because there is some danger if your child gets too much fluoride, your choice of toothpaste is important. Keep in mind that most brands of kids' toothpaste are fluoridated. They just have different flavors and popular characters on them to make them more fun for children, but that doesn't make it safe for your children to swallow too much of the toothpaste.

If using a fluoride toothpaste, use a small, pea-size amount of toothpaste, so that there is little danger of your child getting too much fluoride if he swallows it. And begin to encourage your child to spit out the toothpaste at a young age.

The other alternative for younger children is to use a non-fluoridated toothpaste, such as Baby Orajel Tooth and Gum Cleanser, until they are spitting the toothpaste out.

The timing of the first visit to the dentist is a little controversial. The American Academy of Pediatric Dentistry states that children should see a dentist when they get their first tooth and not later than 1 year of age. In contrast, according to the American Academy of Pediatrics, unless your child has risk factors for having problems with his teeth, such as sleeping with a cup or bottle, teeth staining, thumb sucking, etc., the first visit to the dentist should be by around the third birthday.

However, an early visit to the dentist is a good way to learn proper oral hygiene at an early age, including avoiding nighttime bottles or cups of formula or juice, proper toothbrushing, and a diet that promotes good dental health. You may also want to see a Pediatric dentist early if your child has a medical condition that puts him at risk of having dental problems, such as Down Syndrome.

Another important topic is figuring out if your child is getting enough fluoride. Children begin to need supplemental fluoride by the age of six months. If he is drinking tap water (either alone, or mixed with formula or 100% fruit juice), and you live in an area with the water is fluoridated, then he should be getting an adequate amount of fluoride. If he doesn't drink water, or is drinking well water, unfluoridated bottled water (most brands of bottled water don't have fluoride in them unless the label specifically states that they do), or filtered water, then he may not be getting enough fluoride to keep his teeth healthy. Talk with your Pediatrician or dentist about fluoride supplements.

Water filters are a special concern, because some of them do filter out fluoride. Counter top filters and the pitcher type filters usually don't remove fluoride, but more sophisticated, point of use filters can. If in doubt, check with the manufacturer to see if the filter removes fluoride.

You should also talk with your dentist about using sealants in your school age child. A sealant is a plastic material that is applied to the teeth, hardens, and provides a barrier against plaque and other harmful substances. Sealants can be applied to the 1st and 2nd permanent molars to help protect the grooves and pits of these teeth that can be hard to clean and are prone to developing cavities, and appropriate premolars as soon as possible after they erupt (usually after 6 years of age).

What about flossing? Flossing is an important part of good dental hygiene. You can usually begin flossing once your child is about 3-4 years old, but they likely won't be able to floss on their own until they are 8-10 years old.

In addition to teaching your children the importance of regular brushing and flossing, routine visits to the dentist and a healthy diet, it is important that you set a good example by also practicing good dental hygiene. If you do not brush and floss each day or regularly see a dentist, then it is unlikely that your children will either.

How To How to Prevent Gum Disease

Gum Disease can affect more than just our oral health. The American Dental Association states, “There is evidence that bacteria in the mouth which are associated with gum disease may be linked to heart disease, artery blockages and stroke.”

The following tips can help you to prevent gum disease:

Here's How:

1. Brush your teeth properly twice a day. Brushing your teeth thoroughly removes plaque from the surface before it hardens into calculus.
2. Use a fluoride toothpaste. Using a toothpaste with fluoride helps to prevent decay.
3. Floss your teeth daily. Flossing is the only way to remove plaque from in between your teeth that a toothbrush can’t reach.
4. Use a mouth rinse. An antimicrobial mouth rinse can provide extra help in controlling plaque. Listerine is a good choice and has been approved by the American Dental Association.
5. Visit your dentist for regular check ups. Visiting your dentist on a regular basis is the best way to make sure that your teeth and gums stay healthy.

Losing the First Baby Teeth

It isn't normal for teeth to come out in pieces like that, so you likely should see a dentist. It may just be that you are seeing her permanent tooth beginning to come through already, although it is a little early for that. The first permanent teeth usually don't come in until a child is 6-7 years old.

In fact, it is even a little early for her to lose her first tooth. The average age for shedding the first baby teeth is also 6-7 years old, although some kids do start losing teeth at age 5.

Another option, if she isn't due for a visit to the dentist, is to see if you can just bring the tooth by the office and have someone look at it. If they really think that it isn't a whole tooth, then schedule an appointment for your child.

Healthy Teeth for Kids

Despite all that is known about keeping teeth healthy, the importance of good dental hygiene, and the importance of early visits to the dentist for toddlers, kids continue to get cavities at increasing rates.

In fact, the Centers for Disease Control and Prevention (CDC) reports that cavities in baby teeth have been increasing in recent years. On the positive side, cavities in permanent teeth of children and teens have been decreasing.

Most parents know the basics of how to keep their kids' teeth healthy, especially the importance of frequent brushing and avoiding junk food. Unfortunately, these basics often just aren't enough. To keep your child's teeth healthy, it's important that you follow specific steps:

* Clean your baby's gums, even before he gets his first baby tooth.
* Brush your child's teeth twice a day with a soft toothbrush and non-fluoride toothpaste, until he is two years old.
* Switch to a fluoride toothpaste once your child is two years old. Only use a pea-sized amount of toothpaste to help prevent fluorosis, or tooth staining, which can be caused by swallowing too much fluoride.
* If your child brushes his own teeth, be sure to brush them again for him -- until he gets very good at doing it himself (usually at age 6) -- to make sure they are adequately clean.
* Be sure to brush at least twice a day, but especially at bedtime -- all sides of each tooth, including the backsides, and the gumline.
* See a dentist for regular checkups six months after your child's first tooth comes in. If your child is at risk for getting cavities (has a close family member with a lot of cavities, drinks milk or juice at night, has an obvious cavity or tooth staining with white spots), that first checkup should take place when he is twelve months old. Pediatricians can monitor children's teeth, but many do not have any special education about healthy teeth or instructing you about good dental hygiene.
* Consider helping your child floss each day once he has teeth that touch each other, since this area between teeth is a common area for cavities to form.
* Consider dental sealants for permanent molars at around age six to reduce the risk of cavities in these teeth.

Hidden Dangers

Parents often believe the myth that baby teeth just aren't that important. After all, who cares if your child gets cavities in his baby teeth since they are just going to fall out and be replaced with permanent teeth later on, right? This is a dangerous misconception.

Poor dental habits that your child learns early in life can last a lifetime. The same things that led to cavities in his baby teeth will likely also cause him to get cavities in his permanent teeth. And if his baby teeth fall out early, it can lead to spacing issues when his permanent teeth do come in. Besides all of that, poor teeth in early childhood can lead to poor self esteem, nutrition and growth problems, pain, and infections.

Other hidden dangers to your child's teeth include:

* Eating or drinking something after your child brushes his teeth at bedtime.
* Drinking too much fruit juice throughout the day.
* Putting your child to sleep with a bottle or cup of milk or juice, or giving him milk or juice in the middle of the night.
* Eating sticky snacks, which includes many fruit snacks, raisins, dried fruit, candies, etc.
* Eating unhealthy snacks frequently throughout the day between meals, including sugary snacks, chewy candy, hard candy, and potato chips.
* Not getting enough fluoride, which is especially a problem for kids who don't drink water or only drink bottled water, which typically doesn't have fluoride in it.
* Getting a lot of added sugar in his diet from sugary cereals, unhealthy snacks, chocolate milk, etc.

To avoid these hidden dangers, be sure to brush your child's teeth at bedtime and avoid giving him anything else to eat or drink after that. Talk to your pediatrician or dentist about a fluoride supplement if your child is drinking fluoridated water, and encourage him to eat healthy snacks, such as fruits and vegetables.

Also, make sure he brushes after eating any sticky snacks, which may otherwise stick to his teeth.

What is Tooth Sensitivity?

Tooth sensitivity is a common problem that affects millions of people. Basically, tooth sensitivity means experiencing pain or discomfort to your teeth from sweets, cold air, hot drinks, cold drinks or ice cream. Some people with sensitive teeth even experience discomfort from brushing and flossing. The good news is that sensitive teeth can be treated.

Why Brush a Dog's Teeth?

Dental health care is very important for our pets. Having a healthy mouth will not only affect the teeth and gums, but it will also affect the heart, liver, kidneys, and the general overall health of your pet. Taking care of your pet's teeth at home is very important because it allows you to keep a check on what's happening and will extend the regular visits by your veterinarian.

So, by taking good care of your dog's teeth, you will be extending their life potentially with good overall health.
When to Brush a Dog's Teeth
Ideally, you should be brushing your dog's teeth every day. And if you get into a habit, it makes it easier. It makes it a positive experience for your dog, and they will remind you and look forward to it. At the very least, once a week is a good place to start. But basically, just like us, we need to brush their teeth as often as possible.
Starting the Tooth Brushing Habit
Every dog is different in how they will accept you working in their mouth and touching their teeth. You know your dog best, but you don't want to get hurt. So, we want to start with short, very positive sessions. And you can just be getting them familiar with the brush. Let them sniff it, and let them lick off some toothpaste.
Dog Brushing Toothpaste
The toothpaste we use, we do not want to use human toothpaste. That can upset your pet's stomach and you do not want to use that. They make pet toothpaste in various flavors: chicken, beef, malt, as well as mint. Try a few and see what your dog prefers.
How to Brush the Dog's Teeth
Once you've worked up to the stage where your dog is comfortable with the toothbrush, the toothpaste, or the finger sponge that you've decided to use, its time to start brushing. When you do this, start slow. Work from the tooth, from the gum to the lower part of the tooth, and in a circular motion. We're using gentle toothpaste - it's an enzymatic toothpaste, and it'll help break down the tartar and plaque build-up, and the bristles are soft. Use a gentle, circular motion, and work your way around the mouth.
Tips for Successful Tooth Care
Some tips for a successful brushing session would include - start slow, short sessions, and very positive. Your first sessions might only be letting your dog sniff the toothpaste, and work up from there. Keep it short and keep it positive and your dog will start to look forward to a daily brushing routine.

Gum Disease and Your Overall Health

Often taken for granted, the monotonous task of brushing and flossing our teeth daily has never been more important in order to avoid gum disease and the risks gum disease place on our overall health. It has been estimated that 75% of Americans have some form of gum disease, which has been linked to serious health complications and causes various dental problems that are often avoidable.

What is Gum Disease?
Periodontal disease, also called gum disease, is mainly caused by bacteria from plaque and tartar build up. Other factors that have the potential to cause gum disease may include:

* Tobacco use
* Clenching or grinding your teeth
* Certain medications
* Genetics

Types of Gum Disease Include:

* Gingivitis - The beginning stage of gum disease and is often undetected. This stage of the disease is reversible.

* Periodontitis - Untreated gingivitis may lead to this next stage of gum disease. With many levels of periodontitis, the common outcome is chronic inflammatory response, a condition when the body breaks down the bone and tissue in the infected area of the mouth, ultimately resulting in tooth and bone loss.

Signs of Gum Disease Include:

* Red, bleeding, and/or swollen gums
* Bad breath
* Mobility of the teeth
* Tooth sensitivity caused by receding gums
* Abscessed teeth
* Tooth loss

Recent studies suggest gum disease may contribute to or be warning signs of potentially life threatening conditions such as:

* Heart Disease and Stroke - Studies suggest gingivitis may increase the risk of heart disease and stroke because of the high levels of bacteria found in infected areas of the mouth. As the level of periodontal disease increases, the risk of cardiovascular disease may increase with it. Other studies have suggested that the inflammation in the gums may create a chronic inflammation response in other parts of the body which has also been implicated in increasing the risk of heart disease and stroke.

* Diabetes - People with diabetes often have some form of gum disease, likely caused by high blood glucose, according to the CDC. People with diabetes need to take extra care to ensure proper brushing and flossing techniques are used to prevent the advancement of the gum disease. Regular check-ups and cleanings with your dental hygienist should be followed.

* Chronic Kidney Disease - A study, conducted by Case Western Reserve University, suggests that people without any natural teeth, known as edentulous, are more likely to have chronic kidney disease (CDK), than people with natural teeth. CDK affects blood pressure potentially causing heart disease, contributed to kidney failure, and affects bone health.

* Preterm Birth - Babies that are born premature -- before 37 weeks of gestation -- may face numerous health complications. Research indicates that women with periodontal disease are three to five times more likely to have a baby born preterm compared to women without any form of gum disease. Women are more susceptible to gingivitis when pregnant and should follow their regular brushing habits, and continue with dental cleanings and examinations.

Treatments for Gum Disease
Depending on the type of gum disease, some of the available treatment options are:

* Removal of plaque and calculus by way of scaling done by your dental hygienist or dentist.

* Medications such as chlorhexidine gluconate, a mouth rinse prescribed by your dentist or hygienist to help kill the bacteria in your mouth, along with frequent cleanings.

* Surgery may be necessary in certain cases to stop, halt, or minimize the progression of periodontal disease. Surgery is also used to replace bone that was lost in advanced stages of the disease.

What Can I Do to Prevent Gum Disease?
Proper brushing and flossing is the easiest way to reduce and prevent gum disease, but regular cleanings with your dental hygienist or dentist are necessary to remove calculus and treat advanced gum disease. If you are concerned that you may have gum disease, contact your dentist.

Whiten Your Teeth for a Bridal Smile on Your Wedding Day

Nothing is more stunning than a beautiful bride in a beautiful dress with a beautiful smile. If you are getting married, what better way to prepare for your big day than having your teeth whitened? Remember…those photos will last forever.

Having your teeth whitened is relatively inexpensive and can produce amazing results, but it’s not for everyone.

* Teeth whitening does not produce the same results on all types of teeth discoloration.
* Someone with yellow-tinted teeth would probably have great results with bleaching, while someone with gray-tinted teeth might be disappointed because they don't bleach as well.
* If you have tooth-coloring fillings and / or crowns and bridges, they will be darker after your teeth are bleached because they don't lighten with the whitening process.
* A person with gum disease should not get their teeth whitened.

Be sure to schedule an appointment with your dentist to see if you would be a good candidate for teeth whitening.

Different Types of Whitening

So many whitening options are available that it can be quite overwhelming, especially when you have a wedding to plan. Three popular and effective bleaching options are:

* The one hour, in-office whitening treatment by a dentist
* Bleaching trays and gels from your dentist or purchased over the counter
* Whitening strips sold over the counter
* Whitening Toothpastes

In-office teeth whitening offers excellent results. This procedure is performed in the dental office and can be done very quickly, usually in a little over an hour. In-office bleaching is usually more expensive, but the time that you save by having immediate results can make this option appealing.

Bleaching trays and gels are effective as well; however the desired results take longer to achieve. The gel-filled trays generally need to be worn for several hours a day or overnight, and it usually takes 3 or 4 days before any results are noticed if purchased from the dentist. Teeth whitening kits from the dentist produce faster and more effective results because they contain a stronger peroxide-bleaching agent than whitening kits purchased over the counter.

Teeth whitening strips sold over the counter are fairly inexpensive and easy to use. They do work, but seeing results usually takes take longer since the peroxide-bleaching agent in teeth whitening strips is not as strong as the bleaching chemicals available from a dentist.

Whitening toothpastes contain mild abrasives to remove surface stains. Some whitening toothpastes may have additional polishing agents and special chemicals that are more effective against stains than regular toothpastes, but these toothpastes are not designed to actually "bleach" your teeth.

Before you Whiten Your Teeth

If your dentist has decided that you are a candidate for teeth whitening, schedule an appointment to have your teeth cleaned first. Having your teeth professionally cleaned by a dental hygienist will remove surface stains caused from coffee, tea, nicotine, and certain foods.

A common side effect of teeth whitening is sensitive teeth, so you may want to use a toothpaste for sensitive teeth for a few weeks before starting the bleaching process.

Maintenance

After having your teeth whitened, touchups are generally needed to maintain your desired shade, depending upon habits such as smoking, eating certain foods and drinking coffee and tea which can all stain your teeth.

Using a whitening toothpaste can help keep your teeth white by removing surface stains.

Good oral hygiene is essential to maintaining your beautiful smile, so remember to brush properly at least twice a day and floss daily. Visiting your dentist for regular check ups and cleanings will also help to keep your smile white and bright.

Now…breathe and relax. Your wedding will be beautiful and so will you.

Top 10 Facts About Teeth Whitening

Teeth whitening, also known as teeth bleaching, has become extremely popular over the last several years. It’s a great way to improve your appearance, it’s reasonably priced, non-surgical and non-invasive.

As with everything else, teeth whitening isn't perfect and it isn't for everyone. Before you decide to have your teeth whitened, you should talk with your dentist. Your dentist can determine if you are a good candidate for teeth whitening. Knowing the facts can help you with your decision also:

Teeth Whitening Fact #1
Teeth whitening procedures are not covered by most dental insurance plans.

Teeth Whitening Fact #2
Tooth colored fillings, crowns, bridges and veneers will not lighten when your teeth are bleached.

Teeth Whitening Fact #3
Teeth whitening toothpastes can make your teeth appear a little lighter by removing stains, but they do not actually bleach your teeth.

Teeth Whitening Fact #4
Teeth whitening does not produce the same results on all types of teeth discoloration. Someone with yellow tinted teeth would probably have great results with bleaching, while someone with gray tinted teeth might be disappointed because gray tinted teeth don't bleach as well.

Teeth Whitening Fact #5
Tooth sensitivity and gum irritation are common side effects of teeth whitening treatments.

Teeth Whitening Fact #6
If you have any cavities, they should be filled before you have your teeth whitened.

Teeth Whitening Fact #7
Teeth whitening kits from the dentist produce faster results because they contain a stronger peroxide bleaching agent than whitening kits purchased over the counter.

Teeth Whitening Fact #8
Touch ups are usually needed to maintain your desired shade, depending upon habits such as smoking, drinking coffee and tea and eating certain foods which will stain your teeth.

Teeth Whitening Fact #9
People with gum disease shouldn't get their teeth whitened.

Teeth Whitening Fact #10
It's a good idea to have a dental cleaning prior to having your teeth whitened to remove surface stains.

Do Teeth Whitening Toothpastes Really Work?

Teeth whitening toothpastes seem to be popping up everywhere and you've got to wonder if they really work.

Whitening toothpastes, like all other toothpastes, contain mild abrasives to remove surface stains. Teeth whitening toothpastes may have additional polishing agents and special chemicals that are more effective against stains than regular toothpastes. While whitening toothpastes can make your teeth appear a little lighter, by getting rid of stains, they do not actually bleach your teeth.

Teeth whitening toothpastes are ideal for people who smoke, drink coffee and tea and eat certain foods that can stain your teeth. Teeth whitening toothpastes are also good to use after you have undergone a teeth whitening procedure to keep surface stains from building up on your teeth.

If you decide to use a teeth whitening toothpaste, be sure that it contains fluoride for extra protection against tooth decay.