Steven A. Castro, D.D.S.
2930 West Hundred Road Chester, Virginia 23831
Office - 804.751.0146   Fax - 804.768.4283
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Dental Care in Infants

Why is oral health important for my infant?

Oral health is important for a child's growth and development, overall health and well being, and self-esteem. Tooth decay can lead to pain, infection, malnutrition, poor weight gain, and premature loss of teeth – which can affect the development of permanent teeth. Oral health problems in an infant's mouth, such as bleeding gums and cavities, increase the chance for these problems in permanent teeth. Good oral health habits – started at an early age at home – increase the chance for a healthy mouth during your child's young life and carry on through adulthood.

My baby does not have teeth; do I need to clean my baby's mouth?

Yes, it's a good idea to get in the habit of cleaning your baby's gums.

To clean your baby’s mouth:
  • Lay your baby in your lap with his or her head close to your chest.
  • Gently, but firmly, rub a clean and damp piece of gauze or washcloth along both the upper and lower gums.
  • Clean the gums at least two times a day – after breakfast and after the last feeding of the day. Even better clean your baby's gums after every feeding.

What is teething?

Teething refers to the time when baby teeth (also called deciduous teeth or primary teeth) appear. Generally, teething first occurs between 6 months and 24 months of age. While this process is uneventful in some children; for others, it causes quite a bit of discomfort and irritability.

Why are baby teeth important?

Baby teeth are important because they allow an infant to eat a good diet, allow for proper jaw growth, give the face its form and appearance, assist in the formation of proper speech, and most important, act as "space savers" for adult teeth.

What are some symptoms that my child might be teething?

Symptoms include:
  • Increased irritability
  • Placing objects or fingers in the mouth and biting down on them
  • Increased saliva or drooling
  • Loss of appetite or becoming choosy about foods
  • Tender and swollen gums
  • Rash on cheeks or redness in the area of the cheeks near the affected gums
  • Restlessness
  • Ear pulling, which may be a sign of teething or possibly an ear infection (make an appointment to have your child seen by your doctor or pediatrician)

Teething does not result in fever, vomiting, or diarrhea. If your child experiences these problems, contact your physician.

What can be done to ease a child's teething pain?

Some suggestions include:
  • Massaging your child's gums with a clean finger or the back of a small cold spoon
  • Allowing your child to bite down on a chilled (but never frozen) teething ring. A frozen teething ring can damage the gums.
  • Using an over-the-counter teething ointment to numb the gums. Ask your dentist or doctor for some product recommendations.
  • Allowing your child to suck on a cold, wet cloth

Teething biscuits or cookies and frozen bananas are not recommended. These objects promote tooth decay and may cause your child to choke.

My child was actually born with teeth. Should I be concerned?

Some infants are born with one or more teeth (called natal teeth) or may have teeth emerge within the first 30 days of life (called neonatal teeth). These usually are either extra teeth or remnants from neonatal development that mimic teeth that do not need treatment. If they are, in fact, teeth, attempts should be made to maintain these teeth if they are firmly in place. However, if they are too loose and pose a danger of falling out and being inhaled by your baby, or if they interfere with feeding or irritate your baby's tongue, they may need to be removed.
Some infants are born with one or more teeth (called natal teeth) or may have teeth emerge within the first 30 days of life (called neonatal teeth). These usually are either extra teeth or remnants from neonatal development that mimic teeth that do not need treatment. If they are, in fact, teeth, attempts should be made to maintain these teeth if they are firmly in place. However, if they are too loose and pose a danger of falling out and being inhaled by your baby, or if they interfere with feeding or irritate your baby's tongue, they may need to be removed.


Canker Sores
(Also Called 'Aphthae', 'Aphthous Ulcers')

What are canker sores?

Canker sores are a common condition that affects the lining of the soft tissue of the mouth. The medical term for canker sores is "recurrent aphthous ulcerations" or simply "aphthae." Canker sores start as white to yellowish ulcers that are surrounded by redness. They are usually very small (less than 1 mm) but may enlarge to ½ to 1 inch in diameter. They tend to be painful and can interfere with eating and speaking. Healing usually takes place in seven to 10 days.

Who gets canker sores?

Anyone can get canker sores. They seem to be more common in Caucasians, young adults, and women.

What is the cause of canker sores?

Canker sores are not due to an infection and are therefore not contagious. The actual cause is unknown, but many doctors believe that canker sores are due to a localized self-immunity that leads to destruction of lining tissues.

What can I do to prevent canker sores?

Some patients relate the onset of lesions to minor injuries to the inside of the mouth, acidic foods, stress, and menstruation. Use a soft bristle toothbrush, avoid very hot (temperature) foods, like pizza, and don't talk while eating. Patients should also avoid oral hygiene products containing sodium lauryl sulfate.
How are canker sores diagnosed?

The typical appearance of canker sores, their history of recurrence, and location are usually sufficient to make a clinical diagnosis. The main confusion for patients and physicians alike is separating canker sores from cold sores, which are caused by herpes simplex infection (HSV-1). While both conditions commonly occur in the mouth, their causes and treatments are completely different. Therefore it is important to distinguish the two.

How are canker sores treated?

Patients who are infrequently bothered by canker sores may choose not to treat or may use simple over-the-counter products such as Cankaid®, Zilactin®, or Orabase®. If you get many painful ulcers that don't heal before new ones appear, or you get very large ulcers, your doctor may prescribe corticosteroid gels--solutions or pills that temporarily suppress the overactive immune system. A paste called Aphthasol® is also effective.

Are any other diseases associated with canker sores?

Some diseases of the immune system may be associated with canker sores. They include systemic lupus erythematosus, Behcet's disease, inflammatory bowel diseases, and AIDS. It is important to remember that most canker sores occur without an associated disease.


Dental Injuries

In any sport, injuries to the teeth and mouth can occur. A fall or a blow by an object, such as a bat, body part, ball, etc. can lead to injuries. Proper and prompt management is necessary to ensure the best possible survival rate of the involved teeth.

Anatomy

The outer-most layer is called the enamel and is comprised of mineral salts, which make this protective cover the hardest substance in the body. There are two different sections that comprise a tooth. The crown extends above the gum line and is the area in which chewing occurs. The root affixes with the bone to hold the tooth in place and also allows nerves and blood vessels to pass.

Injury Classifications
There are two different classifications of dental injuries. Direct dental injuries occur when the mouth or head is struck by an object such as a bat or a forearm. Indirect injuries occur when an open mouth is closed abruptly, forcing the lower jaw’s teeth to be crushed into the upper teeth. Teeth that have had a large cavity or a previous root canal are usually affected by indirect injuries.
There are different types of injuries that may result. Proper management of these injuries is vital to saving the tooth.

Types of Injuries

  • An avulsed tooth is defined as when the tooth is completely knocked out of its socket. Once the tooth is knocked out of the mouth, never pick it up by the roots. It should only be picked up by the crown. The tooth should immediately be placed in a plastic container filled with whole milk, saliva or saline solution. If a container is not readily available and the athlete is conscious, coherent, can follow directions and is mature enough, the tooth can be placed under the athlete’s tongue. A tooth that has been out for over two hours has a poor chance of survival. The athlete with an avulsed tooth needs to be referred to a dentist as quickly as possible.
  • A luxated tooth has been loosened but not completely knocked out. The tooth can be moved forward, backward and sideways. Treatment should consist of pushing the tooth back into its original position. The athlete should then be transported to the nearest dentist for final care.
  • Fractured teeth are common as well. There are four different classifications of fractures and are differentiated by the number of layers that are involved. Treatment of fractures is the same as that of an avulsed tooth.

Prevention

Prevention of dental injuries starts with ensuring that protective equipment is in proper working condition. In certain contact sports, mouth guards are required. In these sports they should be worn in practice as well as the game. An athlete that has orthodontia should also wear a mouth guard in any sport.

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