Pleasanton Dentist Dr. Richard Howes dds - Can I pull my Child's Loose Tooth Out

Whether to pulls a child’s loose tooth out or not is really up to the discretion of both parent and child. Some children are reluctant to have a parent get anywhere near a loose tooth, while others are eager to have the tooth pulled and out of their mouth. This is especially true in cases where the tooth has been hanging there by a thread for a week or more. However, before deciding on whether to pull a loose tooth out or not, there are some things to consider.

To Pull or Not to Pull
Losing one’s teeth is a rather big deal for a child. Many children love to compare tooth loss stories and show off their gummy smiles. For a child, this indicates the first real change from childhood into a more grown up stage of life. While parents may be sad for the loss of their little baby (in terms of age, of course, they’ll always be your baby!) the child often feels exceedingly excited about the change. Because of this, dental professionals encourage parents to allow their child to pull any loose teeth. Not only does this give the child control over when the teeth come out, but it allows for pain control (which is extremely important).

This leads us to our second point. Sometimes a tooth, even if hanging by a thread, isn’t quite ready to come out. This occurs when the tooth is still attached by a root. If you were to pull this tooth out, it may hurt very bad, and it may also cause damage to the mouth. If the child pulls the tooth, or at least attempts to, they are in charge of the pain, and able to stop if the pain is too much. As we all know, pain is a built in protection system, and this built in off system can help the child to know when the tooth is truly ready to come out. Failure to heed this system can lead to infection. While not all teeth that are yanked out with a root still attached have problems, this act does leave the root exposed, and this increases the risk for infection. So, before pulling the tooth yourself, suggest that your child try to pull the tooth. This is not only empowering, but will also help in the health and safety aspect of it.

If the child insists that the parent pull the tooth, there is a right way to do it. Don’t tie a string to it and slam the door shut, don’t even simply grab the tooth and yank it. Instead, use a tissue and grab hold of the tooth. Once you have a nice hold on it, slowly twist the tooth. This will ease the child into it, and give them a chance to protest if the pain is too great. It will also ease the tooth into working its way out. Twist until the tooth falls out. If it doesn’t come fairly easily, you may want to give it another day or two.

source: http://www.teethcenter.com/can-i-pull-my-childs-lose-tooth-out/
by Teeth Center Staff

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Tracy Dentist - What Causes Teeth Grinding? - Smiles by Design in Livermore

Have you been woken up in the middle of the night because of loud grinding noise? Sometimes this grinding noise can be coming from a person who is asleep in the same room with you but sometimes the noise can be coming from you.

Bruxism or night grinding is a parafunctional activity that can be experienced in the day and at night, during short naps or long night-time sleep. It is a sleep disorder that involves the hard clenching of the jaw and the grinding of the teeth, so patients that suffer from bruxism often have teeth surfaces that are significanly worn down.

The degree of destruction caused by the poor habit vary greatly per patient. While it cannot really be determined what really causes the condition, the following are some theories and speculations:

1. While there really is no definite cause, many believe that teeth grinding is hereditary. Therefore, a child who is reported to be grinding his teeth at night, will have one or both of his parents enjoying the same nocturnal activity.

2. The brain and the nervous system have a very advanced method of relaying messages to each other. Once a stimulus is perceived, the nerves send the message to the brain, to bring forth a response. This response that is orchestrated by the brain can either be carried out by the conscious or the subconscious state of the brain. Chewing and clenching can either be conscious or subconscious. When food is brought into the mouth, the jaws will begin to work and the action is observed. When a person is asleep and during waking hours when a person is distracted, some unconscious habits may come forth, such as bruxism.

3. In some cases it has been found that bruxism developed as a result of taking certain medications. People who are being treated for anxiety, hypermyptonia and various digestive problems present varying levels of bruxism signs and symptoms due to stimulants and amphetamine in the drug composition.

As with most conditions, finding the cause is going to be pertinent to finding the cure. When you know the what is causing the symptom, your dentist has a better opportunity to help you find relief.

source: http://www.teethcenter.com/what-causes-teeth-grinding/
by Teeth Center Staff

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Livermore Dentist - Signs you may have a cavity - Smiles by Design in Livermore

One of the most important keys to a healthy mouth is treating issues with cavities immediately after they occur. Failure to promptly and properly treat a cavity puts the individual at a higher risk for developing further cavities since cavities can be spread to other teeth through the saliva. Because of this, it is important to know the signs of a cavity, thus allowing for prompt treatment to occur.

Signs of a Cavity
Like many other health conditions, the signs of a cavity vary based on the conditions surrounding it. For example, the location of the cavity may change the signs and symptoms experienced, as may the time period the cavity has gone without treatment. However, despite the location and duration of time the cavity has existed, there are some signs that can signal the existence of a cavity. These signs and symptoms include:
1) A toothache in the affected tooth, or along one particular area of the mouth
2) Sensitivity in the affected tooth
3) Holes in the teeth that can be seen or felt with the tongue or dental instrument
4) Pain with pressure (such as biting down into something)
5) Pain with consuming food or beverages that are hot or cold
6) Pus coming from the gums when pressure is applied

An individual with a cavity may present with one of these symptoms, or a variety of them. Additionally, symptoms may start out very mild and hardly noticeable, and turn more severe as time passes. It is for this reason that regular dental check-ups are highly recommended. A dentist is able to spot areas that are at risk for a cavity, as well as early cavities, and can deal with them before they become a larger problem. In some cases, this may be the only way to tell that a cavity is present or developing as many cavities show no signs until they are very well developed in the mouth. At this point, they generally cause a great deal of pain, and are much more intrusive and costly to repair.

When to Seek Dental Attention
The best time to get dental treatment for a cavity is before any signs and symptoms appear. However, since this isn’t always an option, seeking dental attention as soon as symptoms appear is extremely important. Aside from saving yourself some pain and money, treating sooner rather than later may allow for more of the actual tooth to be saved. It also means that transmission of bacteria from the cavity site to nearby teeth is minimized, and thus other teeth may be saved from also having to undergo cavity treatment.

In short, any pain in the mouth is generally the best sign that there is a problem with the teeth. So, if aching or sharp pain is experienced in the mouth, see your dentist immediately. In some cases sensitivity may be a sign of another problem, but seeking dental advise sooner will allow for the best and most minimally invasive treatment.

source: http://www.teethcenter.com/signs-you-may-have-a-cavity/
by teeth center staff

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Pleasanton Dentist - Research strengthens link between obesity and dental health in homeless children - Smiles by Design in Livermore

Obesity and dental cavities increase and become epidemic as children living below the poverty level age, according to nurse researchers from the Case Western Reserve University and the University of Akron.

“It’s the leading cause of chronic infections in children,” said Marguerite DiMarco, associate professor at the Frances Payne Bolton School of Nursing at Case Western Reserve University.

Researchers Sheau-Huey Chiu, assistant professor, and graduate assistant Jessica L. Prokp, from the University of Akron’s College of Nursing, contributed to the study.
Researchers found that as body mass index (BMI) increased with age, so do the number of cavities. These findings were published in the online Journal of Pediatric Health Care article, “Childhood obesity and dental caries in homeless children.”

The study examined the physicals of 157 children, from 2 to 17 years old, at an urban homeless shelter. Most were from single-parent families headed by women with one or two children.

Obesity was calculated based on height and weight or BMI. Cavity counts included missing, filled or injured teeth. The data was originally collected for DiMarco’s doctoral dissertation at Case Western Reserve nursing school.

While studies in Brazil, New Zealand, Sweden and Mexico have shown a relationship between obesity, dental health and poverty, few U.S. studies have examined how the three factors are linked.

A pediatric nurse practitioner, DiMarco said dental caries (tooth decay) and obesity outpaced such health issues as asthma among the children studied.

The findings support reports from the Centers for Disease Control and Prevention that obesity and poor oral health have doubled since 1980, raising the risk of diabetes and other health problems, as well as issues with self-esteem.

Poverty contributes to poor dental health by limiting access to nutritious food, refrigerators to preserve food and even running water in some homes, said DiMarco, who has seen dental caries as the predominant infectious disease in rural and urban children.

“Many people do not realize ,” she said, “that dental caries is an infectious disease that can be transmitted from the primary caregiver and siblings to other children.”

To help reduce the spread of dental infection, DiMarco reminds parents that gum disease and other oral infections can be spread by licking a child’s spoon or baby bottle, or by sharing toothbrushes.

Another problem for children of poverty is access to dental care, where families lack the financial means and transportation to make and keep an appointment. And some working poor may not qualify for Ohio’s Childhood Health Insurance Program, which subsidizes health and dental care reimbursements to providers.

“There are no easy solutions,” DiMarco said, “especially with the homeless population.”
Pediatric nurse practitioners are in a pivotal position to provide health information from birth through the teen years to prevent such health issues, DiMarco said.

http://blog.case.edu/think/2012/11/13/research_strengthens_link_between_obesity_and_dental_health_in_homeless_children

Posted by: Susan Griffith

 

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Tracy Dentist - What is oral leukoplakia? - Smiles by Design in Livermore

What is oral leukoplakia?

Oral leukoplakia is the most common premalignant or potentially malignant disorder of the oral mucosa.
It is defined as a white patch or plaque of the oral mucosa that cannot be characterized clinically or pathologically as any other disease.

Oral leukoplakia is a clinical diagnosis of exclusion. Diseases to be excluded include nicotine stomatitis, candidiasis, lichen planus, frictional keratoses, habitual cheek or lip biting, lupus erythematosus, etc.

Who does it affect?

Oral leukoplakia may affect about 0.5% of the world population, although it is likely to vary with gender, geography and ethnicity.
There is a strong association with tobacco smoking (six times more common in smokers than non-smokers) and alcohol intake (independent of drinking pattern or beverage type). It is also associated with betel quid chewing and oral submucous fibrosis.
It usually appears in adult life with prevalence increasing with increasing age:

• found in less than 1% of men under 30 years of age
• 8% of men over 70 years of age
• 2% of women over 70 years of age
• rare before age 30, peaks after 50 years
• mainly affects middle aged to elderly men
• non-smokers are likely to present at an older age.

Clinical features of oral leukoplakia

An early lesion is a slightly elevated grey-white plaque either well defined or which blends in gradually with surrounding mucosa. It can be a localised solitary lesion or multifocal and diffuse.
Two clinical forms are recognised.
1. Homogeneous – refers to homogeneous uniform colour AND texture

• uniform white colour
• uniform flat, thin appearance

The surface may become leathery – smooth, wrinkled, corrugated or with shallow cracks. This form is usually asymptomatic.
2. Non-homogeneous – refers to irregularity of either the colour OR the texture

• predominantly white or white-red (erythroleukoplakia)
• irregular texture which can be flat, nodular, exophytic, warty

Variants of the non-homogeneous form have been described including nodular, verrucous (including proliferative verrucous) and speckled. This form may be associated with mild discomfort or localized pain.
The most common site affected is the inside cheeks (buccal mucosa) and then in decreasing order of frequency:

• gums (alveolar mucosa)
• lower lip
• floor of mouth (under tongue)
• sides or undersurface of tongue (lateral or ventral tongue)
• soft palate

How is the diagnosis made?

• Biopsy of clinically suspected oral leukoplakia is mandatory to: exclude recognised diseases, and to assess for the absence or presence and grade of dysplasia.
• It is appropriate to wait 2 weeks after first presentation to assess clinical response to initial treatment, e.g. for candida, change in tooth brushing habit, cessation of smoking, etc
• The biopsy may be incisional or excisional, single or multiple and may be done under local or general anaesthetic depending on site, number of biopsies required and type of biopsy.
• Biopsies should be taken from either a symptomatic area, or if asymptomatic then from red or indurated areas.
• The presence of dysplasia, carcinoma-in-situ and invasive carcinoma cannot always be predicted clinically.

The histopathology of oral leukoplakia is not diagnostic. Epithelial changes range from atrophy (thinned) to hyperplasia (thickened) and it may show hyperkeratosis. Dysplasia (atypical changes) may be mild, moderate, severe, carcinoma in situ or invasive carcinoma. The pathology report must comment on the absence or presence of dysplasia, and the severity.

 

Treatment of oral leukoplakia

It is not known if early active treatment prevents the possible development of squamous cell carcinoma and there is a high recurrence rate after treatment.

1. Avoid aggravating habits eg quit smoking, and
2. Surgical excision, or
3. CO2 laser – excision or vaporisation.
4. Possible other options – retinoids (acitretin or isotretinoin), photodynamic therapy.

Lifelong follow-up is recommended whether or not the disorder has been treated:

• 3-12 monthly clinical checks
• Biopsy of suspicious changes

Oral mucosal examination must include the floor of mouth and sides of tongue using gauze to hold tip of the tongue and pull upwards and side to side. Most oral SCC develop in the sides & undersurface of the tongue, floor of mouth and back to the soft palate and tonsillar area. 

source: http://dermnetnz.org/site-age-specific/oral-leukoplakia.html

References:

• Dermatology. Ed. Bolognia, J et al. 2nd edition 2007. Mosby.
• van der Waal, Isaäc . Potentially malignant disorders of the oral and oropharyngeal mucosa; terminology, classification and present concepts of management. Oral Oncology 45 (2009) 317–323. Medline.

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Livermore Dentist - 10 Tips for Dealing with Dental Anxiety - Smiles by Design in Livermore

Do you know somebody who hates going to the dentist? The answer is probably yes. More than 80 percent of American adults have some fear of the dentist, a study by the American Association of Endodontists discovered in 1999. Nearly 25 percent of Americans are so fearful, they avoid their dental check-ups unless they’re in pain, a Wall Street Journal article reports.
Some people are afraid of the sound of the drill, while others say they’re afraid the procedure will be painful. Some people say they hate feeling like they’re not in control when they’re leaning back in the chair, and others feel like their personal space is being violated when the dentist or hygienist is working on their teeth. Some people say they don’t want to go to the dentist because they’re afraid of being lectured about not brushing or flossing their teeth properly.
Unfortunately, the longer you delay visiting the dentist, the bigger and more costly the problems are to fix. Plaque, a sticky, colorless film of bacteria on your teeth, can cause gum disease and cavities. If the decay reaches the nerve of the tooth, then you will need a root canal and a crown. If you have advanced gum disease, the bacteria destroys the bone supporting your teeth, causing your teeth to become loose and possibly need to be extracted. Plus, new studies link gum disease with an increased risk of heart attacks, strokes and diabetes.
Here are some ways to deal with dental anxiety so you can get the care that you need:

1. Tell your dentist about your anxiety and create a strategy. Some patients feel better if the dentist tells them what is happening at every step of the process. Other patients prefer to have the dentist talk about something other than the work that is being done. Listening to a calming voice talk about the ballgame that was on last night could help distract you.
2. Establish a signal for when you need a break. Let the dentist know if you raise your hand, it means you need him/her to stop for a minute.
3. Listen to music. Bring an iPod and headphones, close your eyes, and concentrate on your favorite songs instead of the sounds of the dentist’s office.
4. Bring a friend. It can help to know you have someone you trust sitting in the waiting room and keeping you calm.
5. Wear your own sunglasses. Typically, your dentist will supply protective eyewear, but the one-size-fits-all model may not be comfortable for you.
6. Have something to hold. Kids may want to cuddle a teddy bear. Adults may choose to have a worry stone, a stress relief ball or a hand grip to squeeze during treatment.
7. Picture yourself somewhere else. Visualization techniques such as imagining you’re on the beach watching the waves can help relax you.
8. Silently repeat a mantra. You know how people always say think good thoughts? It’s true. Telling yourself simple mantras like “I am okay” or “I am safe” can help keep you calm.
9. Consider medication. Before your appointment, call your dentist about your fears and discuss whether you should take a prescription. Make sure you follow your dentist’s instructions regarding any medication.
10. Consider sedation dentistry. In extreme cases, there are some patients whose anxiety has reached the point of becoming a phobia. In these cases, talk to your dentist about whether anesthesia may be the best option.

The most important thing to remember is there are ways to cope with dental anxiety so you or someone you love can have a beautiful and healthy smile. The first step is to talk to your dentist. Make an appointment today.
Written by: Beth Gaddis
http://www.coastdental.com/blog/10-Tips-for-Dealing-with-Dental-Anxiety.aspx

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Pleasanton Dentist - Surprising Ways to Keep Your Teeth Healthy - Smiles by Design in Livermore

In addition to brushing and flossing, a healthful diet (with natural or added fluoride) protects teeth from decay and keeps the gums healthy. Read on to discover how to keep your smile safe and strong.

Tooth decay (cavities and dental caries) and gum disease are caused by colonies of bacteria that constantly coat the teeth with a sticky film called plaque. If plaque is not brushed away, these bacteria break down the sugars and starches in foods to produce acids that wear away the tooth enamel. The plaque also hardens into tartar, which can lead to gum inflammation, or gingivitis.

A well-balanced diet provides the minerals, vitamins, and other nutrients essential for healthy teeth and gums. Fluoride, occurring naturally in foods and water, or added to the water supply, can be a powerful tool in fighting decay. It can reduce the rate of cavities by as much as 60 percent.

Dental Health Guidelines
Start right by eating right during pregnancy. Make sure that your children’s teeth get off to a good start by eating sensibly during pregnancy. Particularly important is calcium, which helps to form strong teeth and bones, and vitamin D, which the body needs to absorb calcium.

You need lots of calcium for healthy teeth and gums. Low-fat dairy products, fortified soy and rice beverages, canned salmon or sardines (with bones), almonds, and dark green leafy vegetables are excellent sources of calcium.
You need vitamin D to help absorb the calcium. Vitamin D is obtained from fluid milk, fortified soy and rice beverages, margarine, fatty fish such as salmon, and moderate exposure to the sun.

Fluoride is key. To a large extent, cavities can be prevented by giving children fluoride in the first few years of life. Fluoride is supplied through fluoridated water (not all municipalities fluoridate their water supply, however), beverages made with fluoridated water, tea, and some fish, as well as many brands of toothpaste and some mouthwash. Fluoride supplements are available for children who don’t have access to fluoridated drinking water. It is wise to check to see if the water supply in your area is fluoridated. Excess consumption of fluoride can cause mottling of the teeth.

Also needed are phosphorus, magnesium, vitamin A, and beta carotene. In addition to calcium and fluoride, minerals needed for the formation of tooth enamel include phosphorus (richly supplied in meat, fish, and eggs) and magnesium (found in whole grains, spinach, and bananas). Vitamin A also helps build strong bones and teeth. Good sources of beta carotene, which the body turns into vitamin A, include orange-colored fruits and vegetables and the dark green leafy vegetables.

Children are particularly vulnerable to tooth decay; parents should:
1. Provide a good diet throughout childhood
2. Brush children’s teeth until they’re mature enough to do a thorough job by themselves (usually by 6 or 7 years old)
3. Supervise twice-daily brushing and flossing thereafter
4. Never put babies or toddlers to bed accompanied by a bottle of milk (which contains the natural sugar lactose), juice, or other sweet drink
5. Never dip pacifiers in honey or syrup

1. The sugar factor. Sucrose, most familiar to us as granulated sugar, is the leading cause of tooth decay, but it is far from the only culprit. Although sugary foods, including cookies, candies, and sodas, are major offenders, starchy foods (such as breads and cereals) also play an important part in tooth decay. When starches mix with amylase, an enzyme in saliva, the result is an acid bath that erodes the enamel and makes teeth more susceptible to decay. If starchy foods linger in the mouth, the acid bath is prolonged, and the potential for damage is all the greater.

Be careful when eating dried fruits. Dried fruits can have an adverse effect on teeth, because they are high in sugar and cling to the teeth. Even unsweetened fruit juices can contribute to tooth decay — they are acidic and contain relatively high levels of simple sugars.

Fresh fruits, especially apples, are better choices. Fresh fruit, although both sweet and acidic, is much less likely to cause a problem, because chewing stimulates the saliva flow. Saliva decreases mouth acidity and washes away food particles. Apples, for example, have been called nature’s toothbrush because they stimulate the gums, increase saliva flow and reduce the build-up of cavity-causing bacteria. A chronically dry mouth also contributes to decay. Saliva flow slows during sleep; going to bed without brushing the teeth is especially harmful. Certain drugs, including those used for high blood pressure, also cut down saliva flow.

2. Gum disease. More teeth are lost through gum disease than through tooth decay. Gum disease is likely to strike anyone who neglects oral hygiene or eats a poor diet. Particularly at risk are people with alcoholism, malnutrition, or AIDS/HIV infection or who are being treated with steroid drugs or certain cancer chemotherapies. Regular brushing and flossing help to prevent puffy, sore, and inflamed gums.

Gingivitis, a very common condition that causes the gums to redden, swell, and bleed, is typically caused by the gradual buildup of plaque. Treatment requires good dental hygiene and removal of plaque by a dentist or dental hygienist. Left untreated, gingivitis can lead to periodontitis — an advanced infection of the gums that causes teeth to loosen and fall out. There may even be more serious consequences of gum disease. Studies have shown a link between poor oral health and heart disease. Bleeding gums apparently provide an entry port for bacteria or viruses that can cause heart problems. Women with tooth or gum problems are also more likely to give birth to premature babies.

Bleeding gums may also be a sign that your intake of vitamin C is deficient. Be sure that your diet includes plenty of fresh fruits and vegetables every day; munching on hard, fibrous foods, such as a celery stick or carrot, stimulates the gums.

3. Helpful foods. You can protect your teeth by concluding meals with foods that do not promote cavities and may even prevent them. For instance, aged cheeses help prevent cavities if consumed at the end of a meal. Chewing sugarless gum stimulates the flow of saliva, which decreases acid and flushes out food particles. Rinsing your mouth and brushing your teeth after eating are important strategies to prevent cavities. Here are some tips:
Consume Plenty Of
1. Calcium-rich foods, such as low-fat milk, yogurt, and cheese.
2. Fresh fruits and vegetables for vitamins A and C, and for chewing in order to promote healthy gums.
3. Tea, which is a good source of fluoride.

Limit
1. Dried fruits and other sticky foods that lodge between the teeth.

Avoid
1. Sweet drinks and snacks.
2. Steady sipping of acidic drinks for prolonged periods.

source: http://www.rd.com/health/wellness/3-surprising-ways-to-keep-your-teeth-healthy/

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