Preventive Dentistry

Dental prophylaxis is also called a dental cleaning or simply a “cleaning.” It is one of the most effective forms of preventing dental diseases. Dental prophylaxis can help eliminate the need for dental fillings, crowns and almost every other form of dental restoration! When the patient is free from dental plaque there are much less chances of tooth decay. In addition, frequent dental cleanings and checkups enable the dental team to diagnose dental issues when things are still relatively small which typically allows them to perform the most conservative treatment possible and sometimes remedy the issue with non-invasive or therapeutic treatments. A dental cleaning involves the examination of the teeth and identifying early steps to help avoid tooth decay. Plaque and irritants are completely removed from the oral cavity during the process. Physical debridement as well as the removal of calculus/tartar by use of ultrasonic technology followed by polishing and flossing are the methods most commonly used methods.

Sealants are modified resin materials that are thin and flowable which are easily placed onto the flat chewing surfaces of the back teeth. Sealants help protect the tooth by inhibiting bacterial growth and providing a smooth surface. These smooth surfaces are much easier to clean and, in turn, decreases the chances for debris to accumulate in the pits and grooves which could then cause cavities. The best part is there are no “shots” needed to place sealants!

Indications for Sealants

Traditionally, sealants are most commonly used as a preventive measure for children and teenagers when they are in their cavity prone years. Patients who have Xerostomia, or dry mouth, are undergoing orthodontic treatment, show evidence of incipient caries, or who are highly prone to caries should be evaluated as candidates for sealant placement. Primary molars also can benefit from the placement of sealants.

Space maintainers are custom made appliances for your child's mouth which are used to maintain the space needed for the permanent tooth when it is time for it to come in. Space maintainers hold the empty space left by a prematurely lost tooth by preventing movement, or “shifting,” of the remaining teeth until the permanent tooth takes its natural position in the child's mouth. This treatment is much more affordable and much easier on your child than to move them back later with braces. This does not guarantee that braces can be totally avoided, but it significantly improves the odds for at least the area of the missing tooth in particular. Remember, the permanent or “adult” teeth are larger than the baby teeth so any loss of space can significantly impact the entire side of the mouth where the baby tooth came out too soon.

Why are they important to children's dental care?

Baby teeth usually stay in place until they are "pushed out" by a permanent tooth that takes its place. Unfortunately, some children lose baby teeth too early. A tooth may be knocked out accidentally or removed due to severe dental decay. When this occurs, a space maintainer may be required to help prevent future dental problems. Space maintainers encourage normal development of the jaw bones and muscles, save space for the larger permanent teeth, and help guide them into position.

How can losing a baby tooth too early cause problems for permanent teeth?

Teeth attempt to "fill" any space available to them. If your child loses a baby tooth to early, the remaining baby teeth may tilt, drift, shift, move up or down in order to fill the gap. Adult teeth will do the same thing. When this happens, they fill the space intended for the larger permanent tooth. The permanent tooth can come in crowded, crooked, behind or in front of the other teeth, or it can be completely blocked from coming in at all. This condition, if left untreated, may require extensive and expensive orthodontic treatment which may include braces or even surgery to correct the issue all caused by the premature loss of a baby tooth.

Do space maintainers require any special care?

Yes, they do, and you as a parent can help. Make sure your child avoids hard or sticky foods such as chewing gum, suckers, caramels, popcorn, etc. Teeth should be brushed after each meal, making sure to clean the teeth with bands especially well. Once a day, a fluoride mouthwash should be used to help prevent decalcification of the teeth around the band . Do not try to bend the wire for any reason. Notify our office immediately if the bands come loose or the space maintainer is damaged in any way. If the permanent tooth begins to erupt under the wire, this also needs to be checked because it could be time to remove the space maintainer.

What is fluoride?

The fluoride ion comes from the element fluorine. Fluoride, either applied topically to erupted teeth, or ingested orally during tooth development helps to prevent tooth decay, strengthen tooth enamel, and reduce the harmful effects of plaque. Fluoride also makes the entire tooth structure more resistant to decay and promotes remineralization which aids in repairing early decay before the damage is even visible.

Where is fluoride found?

Topical fluoride is found in products containing strong concentrations of fluoride and are usually distributed via health professionals. Fluoride may also be found over the counter in toothpastes and mouth rinses. Concentrated fluoridate varnishes and/or gels are either topically applied by a dentist or other oral health professional. Fluoride may also be prescribed as an at-home regimen particularly for persons with a high risk of dental caries or those without fluoridated water. Fluoride is present naturally in low concentration in most drinking water supplies and foods even if it has not be supplemented to higher concentration levels. Fresh water supplies generally contain between 0.01 – 0.3 ppm. In some locations, the fresh water contains dangerously high levels of fluoride, leading to serious health problems. In addition, all tea leaves contain fluoride; however, mature leaves contain as much as 10 to 20 times the fluoride levels of young leaves from the same plant.

Systemic fluoride may be ingested through public and private water supplies as a dietary supplement. Some bottled water supplies may contain fluoride as well. Make sure to check the label. Once ingested, systemic fluoride is absorbed via the gastrointestinal tract then distributed and deposited throughout the body via the blood supply.

What health risks are associated with fluoride uses?

In general, fluoride consumption is safe. Health risks associated with fluoridation are almost always due to misuse and over concentration. To avoid misuse and over concentration, avoid consuming overly fluoridated substances as this may cause teeth to become discolored, and may cause the enamel of the teeth to look spotted, pitted, or stained — a condition known as dental fluorosis. Avoid swallowing toothpaste and other dental hygiene products such as fluoride mouthwashes. Call the local water department and/or the health department to evaluate the fluoride level in your local drinking reservoir if you have concerns. Children are especially vulnerable to dental fluorosis as their developing teeth are more sensitive to higher fluoride levels. Consult a pediatric dentist or other oral health care professional if you notice changes in the condition of your child's teeth.