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Oral Health Issues in Children

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Dr.Saket Gaurav
B.D.S.(India), PGD.Ortho, PGDAD(Cosmetic)
International Dental Practitioner
DENTAL MAKEOVER, Delhi NCR.

Most of us think that baby teeth are not as important as the adult teeth because baby teeth will be eventually replaced by the adult teeth, but it is still very important to care and monitor the oral health in children also. It is something very important to their general well being. A number of issues can affect the oral health of children and if not taken care at the right time may lead to serious oral health problems.

The most common oral health issues in children:

Tooth Decay: Also known as childhood tooth decay is the number one and most common dental issues. Tooth decay can cause pain, infection and even affect your child’s growth. Fortunately, it is a preventable disease. Limiting the consumption of certain foods that can leave sugars on the surface of the teeth such as candy, soft drinks and cookies or brushing the child’s teeth after consumption can prevent tooth decay.

Thumb Sucking: Many children suck their thumbs as a habit. In most cases this isn’t cause for concern, as children usually stop sucking their thumbs naturally once they grow up but if children continue this habit after their first teeth begin to appear, this can affect the alignment of the teeth and jaw.

Nursing bottle caries: This is a form of tooth decay that occurs in very young children. This mostly affects the group of teeth mostly front teeth. This develops due to prolonged exposure to milk or sugary liquids in babies or toddlers especially at bedtime. Make sure that after feeding babies you rinse their mouth at least with water.

Over-retained primary (baby) teeth: If a child’s permanent tooth begins erupting in the same space as their primary tooth that has not fallen out yet, it is important to address this issue as soon as possible.

Grinding (Bruxism): The grinding of teeth is a common developmental condition occurring in childhood that is often involuntary. Most children tend to stop grinding their teeth as they age, but if they don’t, they can cause wear on their teeth or even crack them.

Teaching your child proper oral care at a young age is very important that will pay lifelong. You can start by setting an example by taking good care of your own teeth sends a message that oral health is something to be valued. And anything that makes taking care of teeth fun, like brushing along with your child or letting them choose their own toothbrush, encourages proper oral care. To help your children protect their teeth and gums and greatly reduce their risk of getting cavities, teach them to follow these simple steps:

Brush twice a day with fluoride toothpaste to remove plaque-the sticky film on teeth that’s the main cause of tooth decay.
Floss daily to remove plaque from between your teeth.
Eat a well-balanced diet that limits starchy or sugary foods, which produce plaque acids that cause tooth decay. When you do eat these foods, try to eat them with your meal instead of as a snack-the extra saliva produced during a meal helps rinse food from the mouth.
Fruit juice and fruit drinks are not recommended for infants under 12 months.
Give fresh fruit instead of fruit juice. Chewing stimulates saliva which protects teeth against decay.
Water and milk are the best drinks.
Limit sugary drinks including: soft drinks, fruit juice, sports drinks, vitamin waters, fruit drinks and energy drinks between meals.
Make sure that your children’s drinking water is fluoridated.
Take your child to the dentist every six months for regular checkup

Make sure you keep a check on your child’s oral health. As soon as your child’s first tooth appears, it’s time to schedule a dental visit. If you notice any above mentioned issues visit your dentist for a check and take his opinion on the issue and get it treated.

Dental Emergency- What to do…

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Dr.Saket Gaurav
B.D.S.(India), PGD.Ortho, PGDAD(Cosmetic)
International Dental Practitioner
DENTAL MAKEOVER, Delhi NCR

Accidents do happen and when it happen it’s important to act quickly. Head and neck region is one of the most sensitive and also the most affected area. It’s important to know what to do in a dental emergency because knowing what to do when one occurs can mean the difference between saving and losing a tooth. No matter what kind of emergency it is, it is important to see your dentist as soon as possible after the incident has occurred. Here are some do’s and don’ts; which you should do in the most common dental emergencies:

Chipped or cracked tooth: If you crack a tooth, immediately rinse your mouth with warm water to clean the area. If you chip a tooth, try and save any broken pieces. There is a strong possibility that swelling will occur, so cold compression in the affected area can be used to minimize this. Make an appointment with your dentist as soon as possible so that all the risks can be ruled out and proper steps can be taken in order to save the tooth.

Knocked out tooth: It is important to keep the tooth that has been knocked out moist at all times to keep it healthy. If you can, place it back in the tooth’s socket or inside your mouth between your check and gums. This is the best environment for the tooth to be in. If you are unable to do this, place it in a jar of milk and get to your dentist as soon as possible. There is the highest possibility of your tooth being able to be saved if you see your dentist within one hour of the incident occurring.

Jaw Fracture: If you suspect that your jaw might be broken, immediately apply a cold compress to reduce inflammation. Immediately go to your dentist or the emergency department at the hospital to get an x-ray.
Dislodged Tooth: Try to relieve pain by applying a cold compress to the outside of the mouth or by taking an over-the-counter pain medication. See your dentist as soon as possible.

Soft tissue injuries: These are injuries to the soft tissue inside your mouth such as your tongue, cheeks, lips and gums, which cause bleeding. Your first priority is to control the bleeding by rinsing out your mouth with water, applying pressure to the affected area with a moistened piece of gauze and reducing swelling by applying a cold compress. If the bleeding does not stop, go directly to your dentist or doctor and continue to apply pressure on the area until you can be treated.

For toothaches: Rinse the mouth with warm water to clean it out. Gently use dental floss to remove any food caught between the teeth. Clove oil dampen cotton pellet on the affected area also helps. If pain persists take some analgesic and see your dentist.

Investigations like x-rays may be taken to evaluate the extent of damage; also it helps in treatment planning. Few precautions can be taken like using sports guard while playing outdoor games, avoid consuming too hot or too cold food items and not using teeth to cut things or open bottles to be on safer side. Always remember, when you have a dental emergency, it’s important to visit your dentist as soon as possible.

How to use- MOUTHWASH

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Dr.Saket Gaurav
B.D.S.(India), PGD.Ortho, PGDAD(Cosmetic)
International Dental Practitioner
DENTAL MAKEOVER, Delhi NCR

When we talk about good oral hygiene, three things come on our mind brushing, flossing and using mouthwash. These are often told by the dentists as well. Today we are going to talk about mouthwash. Mouthwash is a part of a good daily oral hygiene practice. Mouthwashes are beneficial, in removing food particles left in between and on the teeth even after brushing and flossing. Since, it’s a liquid; it can be reach where a tooth brush and floss cannot.

While mouthwash is not a substitute for proper brushing, it can help with a number of oral health issues like cavity protection, bad breath management and in therauptic uses. There are various types of mouthwash available. Broadly, mouthwashes containing fluoride can help in preventing the formation of tooth decay. Alternatively, antiseptic mouthwashes can help reduce the bacteria that cause gum disease and decay. Other mouthwashes may help reduce teeth sensitivity.

There are few myths regarding the use and effects of mouthwash. Let’s discuss it.

Firstly it’s a very common one, mouthwashes cures bad breath. Yes, mouthwash may temporarily cure stinky breath, but it’s not a permanent solution. There can be multiple reasons for bad breath like the food you consume, or if you have any respiratory infection or some systemic disease like diabetes etc or you have lot of plaque and tartar build up all over your mouth. So, freshening your mouth with mouthwash won’t help for long. Better see your dentist to know the exact cause of bad breath and then target the real problem.

Secondly, all mouthwashes are the same. Not really, as discussed before, there are different mouthwashes for different needs. In general, mouthwash can be classified as, regular or therapeutic uses. Rinsing with a regular mouthwash will loosen bits of food from your teeth, lessen bacteria in your mouth, temporarily reduce bad breath and leave a refreshing taste in your mouth. On the other hand, therapeutic rinses contain additional active ingredients such as essential oils, chlorhexidine, fluoride, betadine etc which has been proven to reduce plaque, fight cavities, reduce teeth sensitivity or help in gingival healing by keeping the bacterial count minimum.

You must have heard people saying, anyone can use the mouthwash and mouthwash is harmless. Well that’s not true. Many mouthwashes contain a high amount of alcohol. This can cause dry mouth, which is a cause of bad breath, and irritate oral tissues. In some people, the alcohol can cause sensitivity to the root surfaces of the teeth. There have also been studies suggesting a link between alcohol-containing mouthwash and oral cancer on long term use. Also, Long-term use of alcohol containing mouthwashes can kill ‘good’ bacteria and should never be given to children. Alcohol-free mouthwashes are also available. But other ingredients can cause side effects, too. Many can stain your teeth or cause a burning sensation, and therefore it isn’t recommended for long-term use. Mouthwash is not meant to be ingested, so it may cause problems if accidentally swallowed. It’s not usually recommended for young children before the age of six. This is because most children would swallow the mouthwash instead of spitting it out. Most mouthwashes contain fluoride and few contain alcohol both of these are not advisable to swallow even in trace amounts. Yet there are few mouthwashes available that are specifically made for children because they contain no alcohol and are fluoridated in right amounts. This results in protection against cavities with safety.

Mouthwash cannot replace brushing and flossing. Yes, it cuts back the level of bacteria in your mouth. But not for the whole day if brushing and flossing is not done. Plaque must be removed by a physical action and that’s exactly the role of flossing and brushing. Regular flossing and brushing with a soft-bristled toothbrush will do a much more effective job of removing plaque and debris than mouthwash alone. Research shows that adding a rinse with mouthwash to your oral care routine can in fact improve the overall cleanliness of your mouth and help keep gum inflammation at bay. But mouthwash is usually considered an add-on, not a replacement for brushing and flossing.

The best way to use mouthwash is to gargle or rinse just for a few quick seconds and then spit. Most mouthwashes are at their most effective when in contact with your mouth tissues for 30 seconds per use. Keeping the mouthwash for too long in mouth can cause loss of taste sensation for few days and may irritate the gums and soft tissues all over. If you are using the mouthwash on regular basis you may dilute the mouthwash with water in 1:1 ratio if recommended or needed.

Ask your dentist for advice about the best mouthwash for you. Read and follow the instructions on the label, looking for how much to use and for how long to rinse with the mouthwash. Always remember mouthwash isn’t a short-cut.

Tooth Sensitivity- Causes and remedies

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Dr. Saket Gaurav
B.D.S.(India), PGD.Ortho, PGDAD(Cosmetic)
International Dental Practitioner
DENTAL MAKEOVER, Delhi NCR

If drinking a glass of cold water, eating ice cream or drinking hot coffee gives you a painful shock like unpleasant sensation or experience, then for sure its sensitivity. Tooth sensitivity is one of the most common issue troubling mostly youngsters and adults. In certain cases the teeth sensitivity is also aggravated by consuming sweet, acidic food items or even with air on few occasions.

A healthy teeth, is made up of three different layers-
Enamel: The outer most layers, very hard and highly mineralized layer protect the crown portion of the teeth. No nerve innervations present in this layer.
Dentine: It’s the second layer beneath enamel and is less dense than enamel and contains microscopic tubules (small hollow tubes or canals).
Pulp: The innermost layer mainly comprised of blood vessels and nerve innervations.

Reason for sensitivity: When outer protective layer of enamel is lost these tubules allow hot, cold, acidic or sticky foods to reach the nerves or pulp inside the tooth. Dentin may also be exposed due to gum recession. This results in hypersensitivity.
The good news is that if precaution, care and dentist consult is taken at the right time it can help you get away with tooth sensitivity. Here is a list of the most common causes of tooth sensitivity with tips on what you can do to minimize the pain.

Decayed tooth or Cavities: The virulent bacteria those are present in tooth decay produce acid, which accelerates the enamel breakdown resulting in cavity formation. Once the cavity starts getting deeper and deeper and reached close to the pulp (nerves), tooth sensitivity or pain may be experienced. It is very important that you see your dentist if you suspect you have decay in your teeth. You will be advised for tooth fillings, tooth crown or root canal treatment.

Gum disease: Using a very hard bristled brush, applying extra force during brushing and smoking may cause recession of gums, which is one of the most common causes of tooth sensitivity. There are dental procedures that can treat gum disease, the already receded gums as well as changes in oral health habits such as careful brushing and quitting the habit of smoking can help.

Teeth grinding: People suffering from Bruxism (the grinding, of the teeth most commonly during sleep or awake) can experience a wearing down of the enamel on their teeth. This results in exposing the dentin layer, which leads to the tooth sensitivity. Using a mouth guard might help.

Citrus/Acidic foods: Consuming to much of citrus and acidic food items causes erosion of the enamel layer leading to teeth sensitivity. Try to avoid foods such as citrus fruits, pickles and tomato sauce and other acidic food items. Use of desensitizing toothpaste might help.

Plaque: a sticky deposit on teeth in which bacteria proliferate. Excessive plaque accumulation on the tooth surface may lead to tooth decay and once this occurs, your teeth may become sensitive. Maintaining good oral hygiene habits and visiting your dentist every 6 months for cleanings and check up will help in keeping a healthy oral hygiene.

Cracked/Fractured tooth: Trauma may result in the fracture or crack of the tooth, once the fracture line gets deeper involving the dentine and pulp, you may experience sensitivity or pain. It is important to consult with your dentist to discuss treatment options which will depend on the extent of damage, treatment like tooth fillings, tooth crowning or root canal treatment if the nerves are involved may be advised.

Applying force while brushing: Brushing with too much force/pressure can wear away the enamel layer, exposing the soft dentin underneath leading to sensitivity. You should try to brush more gently or with a soft bristled toothbrush. If the dentin layer is already exposed, consult your dentist for treatment options.
Excessive use of Whitening toothpaste: Some of us think that using the whitening toothpaste will whiten the teeth, that’s true it does whiten but the chemicals present in it also causes chemical erosion leading to wearing away of the enamel layer and resulting in teeth sensitivity. You may switch to fluoride or desensitizing toothpaste instead. If the discomfort persists then consult your dentist.

Mouthwashes: Few mouthwashes contain alcohol or other chemicals that can aggravate sensitive teeth. Make sure that you opt for a non-alcoholic standard mouthwash.

Recent dental procedure: it is normal to experience increased tooth sensitivity after a dental procedure like tooth fillings, cleaning etc. This is nothing to be concerned about unless the sensitivity does not disappear on its own. But if it doesn’t then consult your dentist.

Soft DRINKS and their effect on ORAL HEALTH

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Dr.Saket Gaurav
B.D.S.(India), PGD.Ortho, PGDAD(Cosmetic)
International Dental Practitioner
DENTAL MAKEOVER, Delhi NCR.

Commonly it is called “soda” or “soft drink”, different words are used to identify a carbonated/aerated, sugary cold drink or soft drink which is available in various flavors and different brand names. The advert says drinking it is fun, happiness, fact of life, winning mantra, living mantra, the way you should be etc, etc and what not. But these carbonated/aerated soft drinks can lead to not only oral but also general health issues.

Soft drinks and packed juices are very common and easily available dietary source today, which is consumed by most of us anytime in a day or many times in a day, once consumed acids & acidic sugar products and by-products in it softens the enamel (outer most layer of the tooth) which is also supposed to be hardest and most highly mineralized substance in human body contributing to the formation of cavities on the tooth surface and also erosion of the enamel layer leading to tooth sensitivity. In certain cases, this affected enamel caused by soft drinks when combines with inefficient and improper brushing and poor oral hygiene may lead to the gum disease and tooth loss. Because of the high sugar, sodium and caffeine content in soda, it dehydrates the body and over a long period of time can cause chronic dehydration. However, the sugar-free drinks are also not very safe as the acidic potential can still cause problems like dehydration and enamel loss, but they are less harmful in comparison. It appears that increased soft drink consumption is a major factor that contributes to obesity, kidney damage, osteoporosis, elevated blood pressure (on regular use). Soft drinks also have long been suspected of leading to lower calcium levels and higher phosphate levels in the blood. When phosphate levels are high and calcium levels are low, calcium is pulled out of the bones, which causes weakening of the bones.

Soft drink consumption has increased dramatically across the world, especially among children and teenagers. Everyone in spite of their age and gender can be benefitted from reducing the number of soft drinks they consume. Beverages containing less sugar and acid such as water, milk and 100 percent pure fruit juice, fresh juice is even better. Drink them yourself and encourage everyone including kids to do the same. Never drink soft drinks empty stomach as they may harm the gastric mucosa (inner layer of the stomach). Ask your dentist about fluoride application in the form of a foam, gel or rinse, which can be done for all age groups. Make sure that after consuming a soft drink, you flush your mouth with water to remove acids and save tooth from getting exposed to acids for too long. Since, fluoride reduces cavities and strengthens tooth enamel, so brush with fluoride-containing toothpaste. Also rinsing with a fluoride mouthwash also can help. Your dentist can recommend a higher fluoride containing toothpaste depending on the severity of the problem.

Dental Health for Women

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Dr.Saket Gaurav
B.D.S.(India), PGD.Ortho, PGDAD(Cosmetic)
International Dental Practitioner
DENTAL MAKEOVER, Delhi NCR.

Everyone needs to look after their oral health, but for women, specific periods in their life can affect their oral health significantly. Changes in female hormone levels during puberty, menstruation, pregnancy and menopause exaggerate the way gums react to plaque. Since, gum disease is usually painless, many women may not even realize they have it until it reaches an advanced state. As, gum disease is a bacterial infection, it can enter the bloodstream and may be a factor in causing other health complications like:

Heart disease: People with gum disease may be more at risk for heart disease and have nearly twice the risk of having a fatal heart attack.
Stroke: Few studies found a casual relationship of oral infections as a risk factor for stroke.
Diabetes: People with diabetes are more likely to have gum disease and may make it more difficult for diabetics to control their blood sugar. Gum disease may also be a risk factor for diabetes, even in otherwise healthy individuals.
Respiratory problems: Bacteria that grow in the oral cavity can travel to the lungs causing respiratory disease such as pneumonia – especially in people with gum disease.
Pregnancy outcomes: Pregnant women who have gum disease may be more likely to have a baby born too early or too small. Gum disease may also trigger increased levels of biological fluids that induce labor.

Women can expect their dental health to change during these specific periods of their life in the following ways:

Puberty: The increase in estrogen and progesterone causes blood vessels to dilate which can affect gums and can cause bleeding, swelling and redness. The changes in hormones affect the bacteria in the mouth at this time, meaning that cavities and bad breath can develop. Ulcers are also more common in teenagers than children.
Menstruation: In the lead up to their period, some women experience swollen or sensitive gums that are prone to bleeding, while others can experience mouth ulcers or cold sores. Once menstruation begins, these symptoms commonly disappear.
Oral contraceptive: Taking an oral contraceptive is common for many women. The synthetic hormones in these tablets can cause gingivitis, an inflammation of the gums, which results from an excessive build up of plaque.
Pregnancy: The significant changes in hormones during pregnancy make oral health care a priority for women during this time. Gingivitis is, again, common in pregnant women, but also ‘pregnancy tumours’, which are non-cancerous, benign growths that develop when swollen gums become irritated. Normally, these tumors will naturally shrink and disappear after the baby’s birth, although if they interfere with brushing or are uncomfortable, the dentist may decide to remove them.
Lactation: There are many benefits of breastfeeding for both mother and baby, but the period of lactation can also negatively impact a woman’s oral health. Adapting to life with a new baby can often mean that women skip brushing and flossing their teeth, resulting in an increased likelihood of cavities and gum disease developing. The increase in stress and tiredness can also cause Bruxism to develop, which is the grinding or clenching of teeth during sleep. This can result in headaches, neck and jaw pain, or teeth cracking.
Menopause: There are many possible changes that can occur in a woman’s mouth during menopause. These include burning mouth syndrome, dry mouth, gingivitis and mucosal changes which can result in changes in the appearance of gums and can cause them to bleed easily.

It is very important to ensure that women maintain their good daily dental hygiene so that the teeth and gums are at their best to deal with these hormonal fluctuations. To reduce this plaque build-up on teeth following care should be taken:-

Brush two to three times daily and floss once a day
Choose health food and not high-sugar foods
Avoid snacking
Drink mainly water and milk. Avoid adding sugar to drinks
Chew sugar free gum after starchy and high sugar foods to help stimulate saliva
Have regular check-ups at your dentist, to check your teeth and gums to detect any early problems and remove plaque and calculus build-ups to keep your mouth healthy.

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