The American Academy of Pediatrics and other healthcare organizations recommend breastfeeding as the best means for infant feeding. While bottle feeding can supply the nutrition necessary for a baby's healthy development, breastfeeding also provides emotional benefits for both baby and mother.
But there might be an obstacle in a baby's mouth that prevents them from getting a good seal on the mother's breast nipple—a small band of tissue called a frenum. This term describes any tissue that connects a soft part of the mouth like the upper lip or tongue to a more rigid structure like the gums or the floor of the mouth, respectively.
Although a normal part of anatomy, frenums that are too short, thick or inelastic can restrict a baby's lip or tongue movement and prevent an adequate seal while nursing. The baby may adjust by chewing rather than sucking on the nipple. Besides a painful experience for the mother, the baby may still not receive an adequate flow of breast milk.
Bottle-feeding is an option since it may be easier for a baby with abnormal frenums to negotiate during nursing. But the problem might also be alleviated with a minor surgical procedure to snip the frenum tissue and allow more freedom of movement.
Often performed in the office, we would first numb the frenum and surrounding area with a topical anesthetic, sometimes accompanied by injection into the frenum if it's abnormally thick. After the numbing takes effect, we gently expose the tissue and cut it with either surgical scissors or a laser, the latter of which may involve less bleeding and discomfort. The baby should be able to nurse right away.
If you wait later to undergo the procedure, the baby may already have developed compensation habits while nursing. It may then be necessary for a lactation consultant to help you and your baby "re-learn" normal nursing behavior. It's much easier, therefore, to attempt this procedure earlier rather than later to avoid extensive re-training.
While there's little risk, frenum procedures are still minor surgery. You should, therefore, discuss your options completely with your dental provider. Treating an abnormal frenum, though, could be the best way to realize the full benefits of breastfeeding.
Watching your newborn develop into a toddler, then an elementary schooler, a teenager, and finally an adult is one of the most exciting and rewarding experiences there is. Throughout the years, you’ll note the passing of many physical milestones — including changes that involve the coming and going of primary and permanent teeth. Here are some answers to frequently asked questions about children’s dental development.
When will I see my baby’s first tooth come in?
The two lower front teeth usually erupt (emerge from the gums) together, between the ages of 6 and 10 months. But your baby’s teeth may come earlier or later. Some babies are even born with teeth! You will know the first tooth is about to come in if you see signs of teething, such as irritability and a lot of drooling. The last of the 20 baby teeth to come in are the 2-year molars, so named for the age at which they erupt.
When do kids start to lose their baby teeth?
Baby teeth are generally lost in the same order in which they appeared, starting with the lower front teeth around age 6. Children will continue to lose their primary teeth until around age 12.
What makes baby teeth fall out?
Pressure from the emerging permanent tooth below the gum will cause the roots of the baby tooth to break down or “resorb” little by little. As more of the root structure disappears, the primary tooth loses its anchorage in the jawbone and falls out.
When will I know if my child needs braces?
Bite problems (malocclusions) usually become apparent when a child has a mixture of primary and permanent teeth, around age 6-8. Certain malocclusions are easier to treat while a child’s jaw is still growing, before puberty is reached. Using appliances designed for this purpose, orthodontists can actually influence the growth and development of a child’s jaw — to make more room for crowded teeth, for example. We can discuss interceptive orthodontics more fully with you at your child’s next appointment.
When do wisdom teeth come in and why do they cause problems?
Wisdom teeth (also called third molars) usually come in between the ages of 17 and 25. By that time, there may not be enough room in the jaw to accommodate them — or they may be positioned to come in at an angle instead of vertically. Either of these situations can cause them to push against the roots of a neighboring tooth and become trapped beneath the gum, which is known as impaction. An impacted wisdom tooth may lead to an infection or damage to adjacent healthy teeth. That it is why it is important for developing wisdom teeth to be monitored regularly at the dental office.
If you have additional questions about your child’s dental development, please contact us or schedule a consultation. You can also learn more by reading the Dear Doctor magazine articles “Losing a Baby Tooth” and “The Importance of Baby Teeth.”
Parents have been dealing with their children's teething pain for as long as parents and children have been around. Along the way, the human race has developed different ways to ease the discomfort of this natural process of dental development. While most are good, common-sense measures, one in particular needs to be avoided at all costs—applying topical oral products to the gums containing Benzocaine.
Benzocaine is a topical anesthetic often found in oral products like Anbesol, Orajel or Topex to help ease tooth pain or sensitivity. The agent can be found in gel, spray, ointment or lozenge products sold over-the-counter. As an analgesic, it's considered relatively safe for adults to use.
But that's not the case with infants or younger children. Researchers have found a link between Benzocaine and methemoglobinemia, a potentially fatal blood condition. Methemoglobinemia elevates the amount of a hemoglobin-like protein called methemoglobin, which in high concentrations can lower oxygen levels being transported to the body's cells through the bloodstream.
Because of their smaller anatomy and organ systems, younger children can have severe reactions to increases in methemoglobin, which can range from shortness of breath or fatigue to seizures, coma or even death. That's why you should never use products with Benzocaine or similar numbing agents to ease teething pain. Instead, follow these common sense practices:
- Give your child chilled rubber teething rings, wet washcloths or pacifiers to chew or gnaw on. The combination of cold temperatures and pressure from biting on them will help ease the pain. Just be sure the item isn't frozen, which could cause frost burns to soft tissues.
- For temporary relief from soreness, gently massage your baby's gums with a clean, bare finger or with it wrapped in a clean, wet cloth. The massaging action helps counteract the pressure of the incoming tooth.
- For intense episodes of teething discomfort, ask your healthcare provider about using an over-the-counter pain reliever like acetaminophen or ibuprofen. Be sure you use only the recommended dose size for your child's age.
Teething is in many ways like a storm—it too shall pass. Be sure you're helping your baby weather it safely.
The NBA's reigning MVP Giannis Antetokounmpo may seem unstoppable, but he proved no match for a troubled tooth. Antetokounmpo, the self-proclaimed “Greek Freak,” missed one of the final three 2020 regular season games for a dental issue that resulted in last-minute oral surgery. According to a Milwaukee Bucks spokesperson, the star underwent “a root-canal like procedure.”
Root canal therapy, often simply called “a root canal,” may be needed when there is an infection inside the tooth. When dental pulp becomes inflamed or infected, excruciating pain can result. Pulp is the soft tissue that fills the inside of the tooth. It is made up of nerves, blood vessels and connective tissue. During root canal treatment, the pulp is removed, the space inside the tooth is disinfected, it is filled with a special material, and then the hole is sealed up.
A root canal is nothing to fear. It relieves pain by getting rid of infection and is so effective that over 15 million of them are performed in the U.S. each year. This routine procedure generally requires only local anesthetic, and your mouth should be back to normal within a day or two after treatment. Antetokounmpo can attest to that, as he returned to play the next day.
However, delaying root canal treatment when you need it can have serious consequences. If left untreated, an infection inside the tooth continues to spread, and it may move into the gums and jaw and cause other problems in the body. So, how do you know if you may need a root canal? Here are some signs:
Lingering sensitivity to hot or cold temperatures. One sign of nerve damage inside your tooth is pain that is still there 30 seconds after eating or drinking something hot or cold.
Intense pain when biting down. You may feel pain deep within your tooth, or in your jaw, face or other teeth. The pain may be hard to pinpoint—and even if it improves at times, it usually comes back.
A chipped, cracked or discolored tooth. A chip or crack can allow bacteria to enter the tooth, and the tooth may darken if the tissue inside is damaged.
A pimple on the gum. A bump or pimple on the gum that doesn't go away or keeps coming back may signify that a nearby tooth is infected.
Tender, swollen gums. Swollen gums may indicate an infection inside the tooth or the need for periodontal treatment.
And sometimes there is no pain, but an infection may be discovered during a dental exam.
Tooth pain should never be ignored, so don't put off a dental visit when you have a toothache. In fact, if a bad toothache goes away, it could mean that the nerves inside the tooth have died, but the infection may still be raging. Also, be sure to keep up with your regular dental checkups. We may spot a small problem that can be addressed before it becomes a bigger problem that would require more extensive treatment.
Remember, for dental issues both large and small, we're on your team! If you would like more information about tooth pain, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Tooth Pain? Don't Wait!” and “Root Canal Treatment: What You Need to Know.”
There’s really no secret to keeping your child’s teeth healthy — good, daily hygiene habits, regular dental visits and early treatment for emerging problems. It’s a lot easier for those things to happen if your child feels comfortable with dental care and visiting the dentist. Sadly, that’s not always the case: many children develop an unhealthy fear of the dentist because the initial relationship may have been mishandled.
Here, then, are 3 tips that will help you foster a healthy relationship between your child and their dentist.
Visit the dentist before their first birthday. From a health standpoint, dental visits should begin soon after your child’s first teeth emerge (erupt) in the mouth. Visiting the dentist by their first birthday also improves the chances they’ll develop a sufficient level of comfort with the visits, more so than if you waited a year or two longer.
Choose your dentist with your child’s sense of security and comfort in mind. When you’re looking for a dentist to care for your child, think of it as looking for a “new member of the family.” It’s important to find an office environment that’s kid-friendly and staff members that work well with children. Some dentists specialize in pediatric dentistry and many general dentists have additional training in working with children. The key is a dental team that has a good, trust-building rapport with children.
Set an example, both in the home and at the dentist. Children learn quite a bit watching what their caregivers say and how they react in potentially stressful situations. If dental care is important to you personally, it’s more likely to become important to your child. And when you visit the dentist with your child, be sure to project calm and a sense that it’s routine — if you display tenseness or nervousness your child may take that as a sign that visiting the dentist is something to fear.
You want your child to learn that the dentist is their friend who’s there to help them. That lesson should begin early with the right dental team — and by making dental care a priority in your own life.
If you would like more information on dental care for your child, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Taking the Stress out of Dentistry for Kids.”
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