Cavities or caries are holes in teeth that are caused by a group of germs. The most serious bacteria in this group is called Streptococcus Mutans. These groups of bacteria feed on sugar that is introduced to the mouth by dietary intake. Higher sugar intake means more bacteria. What makes these types of germs damaging is that they produce acid that eats away at the structure of teeth by depleting the calcium in the tooth. They also create plaque, which is a glue-like layer that allows more bacteria to stick to the tooth surfaces. It appears as a yellowish film that builds up on teeth and contains enamel-eroding acids. The first stage to a cavity is having this sticky film on a tooth surface cause topical damage to the underlying enamel. If plaque is not removed and calcium levels are not restored in the tooth surface, a chalky white spot will appear. This is the first sign of a cavity. Once the area without calcium becomes big enough, the surface of the tooth collapses creating a hole. The hole is the cavity. It can first appear as a honey colored defect. At this point, the bacteria is highly active and will continue to breakdown the tooth if the area is not treated.

Many parents don’t even notice these stages of the disease and are only able to visualize the cavity when the damage is severe or if it eventually turns dark in color. Treating the first sign of cavities means we are able to manage the DISEASE before we have to deal with what the disease is causing, which is the actual cavities. This approach is called the medical approach to dental disease.

Although bacteria is a key factor is dental disease, it is not the only factor in causing cavities. Genetics plays a roll as well. Teeth that are poorly formed during pregnancy and early childhood are more prone to problems. Saliva is another important factor. The type, consistency and flow rate of saliva interferes with the caries process as well.

We believe that everyone deserves a healthy mouth. So our dental care is not only thorough, but also affordable and accessible to all. Your dentist will give you a comprehensive exam and recommend treatment to get your mouth on the road to healthy. The office manager will discuss costs and work with you to find payment options that fit your budget. Prime Care Dental make’s flexible payment plans available to help you make your treatment affordable, and we pledge never to surprise you with hidden fees—we’ll provide a clear, detailed estimate on the cost of your treatment plan in writing so you know what to expect.

Establishing a dental home when your baby is born is very important. Prevention requires early examination to assess your baby’s actual risk of developing dental caries. The American Academy of Pediatric Dentistry (AAPD) has stressed the importance of a dental exam by the time the first tooth erupts and no later than one year of age. The AAPD has developed a special list called the “Caries-risk Assessment Tool” (CAT) for infants, children and adolescents. By using this assessment, we can categorize your infant, according to our findings, in a low, moderate or high caries risk category. By doing so, we are able to formalize an individualized prevention or treatment plan to minimize the risk of future dental disease. This plan is altered as your child grows.  Parents are counseled about their child’s future dental development to know what to expect. Prevention plans include a comprehensive oral hygiene regimen, a diet evaluation, specific dental procedures such as sealants (which are a protective coating placed in the deep grooves of molars to seal them), and an individual recall schedule based on the needs of each patient. Studies have shown that the earlier a child gets a cavity, the stronger and more resistant the bacteria that cause it are. Controlling these stronger strains of bacteria is not easy. If they are not controlled, dental disease continues to affect your child’s mouth as they start to get their permanent teeth.  It is important to understand that first permanent molars can erupt as early as five years old in some children.

Babies are not born with bacteria in their mouths. However, they can easily acquire it. The source is simply someone who already has high levels of this bacteria and can easily transmit the germs. This is usually the baby’s mother but could be the father or caregiver. It could also be a sibling who has a high cavity rate. It can happen by eating from the same spoon as the baby or letting your toddler use your toothbrush. The higher the cavity rate for parents, the more chance they will pass the germs along to their child.

The easiest way to prevent this is to make sure that parents maintain optimum oral health levels. Once a child’s mouth has become colonized with mutans streptococcus, he or she will become prone to cavities in both baby and permanent teeth. If you have trouble with your teeth, you will need to monitor your child’s oral health closely.

Radiographs (x-rays) are a vital and necessary part of your child’s dental examination. Without them, certain dental conditions can and will be missed. Radiographs allow to diagnose and treat conditions that cannot be detected during a visual examination. They are needed to survey cavities and erupting teeth, to diagnose bone diseases, to evaluate the results of an injury, and to plan orthodontic treatment. The American Academy of Pediatric Dentistry (AAPD) recommends radiographs for initial examinations and at 6-12 month intervals for children at high risk of decay when proximal tooth surfaces cannot be visualized. (reference 18) Although the amount of radiation received in a dental radiographs is extremely small, we have taken extra precautions to protect our families from radiation exposure. Our facility is completely computerized utilizing the latest dental technologies. We offer digital radiography for both intra-oral and extra-oral views.

Find a dental home when your child is born. Visiting a pediatric dentist for guidance at this time is very important. This is when we discuss oral hygiene, how to care for your baby’s mouth, what to expect when teething occurs, how to avoid trauma as your child learns to crawl and take those first steps, bottles, pacifiers and proper diet counseling among other topics.

Proper feeding habits should be established for young infants. The goal is get your baby used to separating eating and sleeping. This pattern is very important once the teeth erupt. Cleaning your baby’s mouth after feeding with a soft cloth will make tooth brushing seem more familiar later.

Begin brushing your child’s teeth at least twice a day as soon as they erupt and continue to help with brushing through the toddler years. Most children will learn how to brush their teeth by age 4-5. However, parental supervision is necessary to make sure brushing is done properly.

Begin flossing your child’s teeth as soon as you see a contact point or tight spot between any two teeth. Toothbrush bristles are not able to clean contact points where two teeth touch but harmful bacteria can lodge there. A very common contact point in babies is between the upper front teeth.

Healthy eating habits lead to healthy teeth. Reducing and controlling sugar intake, snacking, and continued juice drinking is important to stop the growth of cavity-causing bacteria.

For your child’s snack, choose nutritious foods such as vegetables, low-fat yogurt, and low-fat cheese, which are healthier and better for children’s teeth.

Continue with recommended recalls at your dental home as your child grows.

A great way to motivate your child to prevent cavities by brushing their teeth is to use our “I Brush My Teeth” charts.

If your child is diagnosed with cavities, a comprehensive treatment plan needs to be presented. Because the cause of the disease is bacterial, restoring the cavities is not enough. The treatment plan must address controlling the germs and identifying the steps for prevention of future decay. If this is not done, your child will continue to develop new cavities in untreated areas. The age of your child is also very important. The younger your child is, the more challenging it is to control the caries process. Children who develop cavities younger than 71 months of age are suffering from what the American Academy of Pediatric Dentistry (AAPD) defines as “Early Childhood Caries” (ECC). The condition was previously called “baby bottle caries” because it was so often seen in children who nursed at-will through the day or at night time. Young children require special techniques to complete their dental treatment. These techniques may include behavior guidance or various forms of sedation. It is important to keep the dental experience as pleasant as possible to maintain your child’s comfort and trust during future visits.

Teeth are comprised of two hard layers surrounding a soft core. The first hard layer is the visible white layer called enamel. The underlying hard layer is called dentin and is yellow. The soft core is known as the dental pulp and is made up of blood vessels and nerve bundles. The holes caused by the caries process can be limited to the outer enamel layer. They may also include the underlying dentin layer or extend into the dental pulp. The treatment of the cavity depends on its depth. Unlike permanent teeth, primary or baby teeth have thin outer hard layers making it easier for the cavity to extend into the tooth’s pulp. Cavities that are limited to the hard layers are cleaned and filled with special dental materials. When a cavity extends into the dental pulp, removal of the diseased pulp will be necessary to preserve the tooth. This procedure is called a “pulpotomy” or a “baby root canal” in primary teeth. A special medicament is placed in the pulp area and the tooth is then ideally restored with a little cap. Our office offers cosmetic pediatric dentistry utilizing tooth-colored fillings and restorations.

Gingivitis is an inflammation of the gums. It can lead to periodontitis which is a more severe condition that includes inflammation of the tooth’s supporting tissues of bone and ligament. Periodontitis is a major cause of tooth loss and can be associated with several systemic diseases. The cause of gingivitis and periodontitis is bacterial but the groups of germs creating these problems are different than those that cause dental decay. However, good oral hygiene and an individualized dental plan are also important in stopping this type of oral disease. Careful assessment of your child and your family history are needed to create an individualized treatment plan.

Healthy eating habits lead to healthy teeth. Like the rest of the body, the teeth, bones and soft tissues of the mouth need a well-balanced diet. It is important to establish a healthy feeding pattern when your baby is born. When teething starts, proper feeding habits along with good oral hygiene will stop dental cavities from forming. Infants that are breast-fed receive the best form of nutrition. Human breast milk is not a cause of cavities on its own. (reference 17) However, problems can occur when carbohydrates are introduced to your child’s diet while they are still nursing. Baby formula, carbohydrates and sugars can cause cavities when at-will feeding occurs continuously during the day or at night. Salivary flow, which helps wash away these sugars is very low during the night. This means sugars remain on the tooth surfaces for longer times allowing the bacteria to form harmful acids.

If your toddler has not yet given up the bottle, be sure that it contains only water at naps and bedtime. Avoiding repetitive drinking of sugary fruit juices and sweetened beverages is very important. Children should eat a variety of foods from the five major food groups. Please know that most packaged snack foods that children eat can lead to cavity formation. Chips, cookies and candies are loaded with sugar. The more frequently a child snacks, the greater the chance is for tooth decay. How long food remains in the mouth also plays a role. For example, hard candy and sticky caramels stay in the mouth a long time. The bacteria can use these sugars for longer time periods causing longer acid attacks on tooth enamel. If your child snacks, choose nutritious foods such as vegetables, low-fat yogurt, and low-fat cheese, which are healthier and better for children’s teeth. For more nutritional information, please visit http://www.choosemyplate.gov/

According to the American Academy of Pediatric Dentistry (AAPD), the adjustment of the fluoride level in community water supplies to optimal concentration is the most beneficial and inexpensive method of reducing the occurrence of caries. (reference 19) Fluoride is an important part of the crystalline structure of enamel and makes teeth less soluble to decay acids. The enamel can incorporate fluoride at different stages of tooth development. This means systemic and topical fluoride can be beneficial.

Fluoridated Drinking Water: Some local water companies provide tap water naturally high in fluoride. However, if you have a home filter of the reverse osmosis type, this fluoride will be removed by the filtering process. In other areas it is necessary to purchase bottled fluoridated water. All major suppliers have fluoridated water for home delivery. Bottled water with fluoride is available at most markets. The most common brands are Sparkletts with Fluoride (1.0 mg/L), Dannon Fluoride to Go (1.0 mg/L) and Gerber Baby Water (0.5 mg/L). Fluoridated water can be used for drinking and cooking. Frequency is more important than the amount of water consumed. Ideal fluoride content is 0.8-1.0mg/L of fluoride except for water used to reconstitute powdered baby formula, which should not have fluoride content greater than 0.5mg/L.

Toothpaste: Use an American Dental Association (ADA) approved toothpaste for brushing your child’s teeth. Do not start fluoridated toothpaste until two years of age because the fluoride concentration is high and young children can swallow it. A half-pea sized amount of paste is sufficient for small children.

Fluoride Rinse: Once your child has learned how to expectorate properly, a fluoride rinse may be added to the oral hygiene plan. It is important that your child is able to spit out the rinse because swallowing it would cause ingestion of high levels of fluoride.

Professional Applications: Higher concentrations of fluoride treatment are available for professional use in the dental office. The newest type of these products comes in a varnish form and is able to stick to your child’s teeth for several hours providing more benefit to the enamel. Applications are part of a comprehensive prevention program in the dental home. (reference 20,21)

Supplements: A careful evaluation of all sources of fluoride, your child’s risk for cavities and the frequency of dental visits is required before your child is placed on fluoride supplements. Fluoride works in optimal concentrations. If fluoride levels are too low, the benefits are reduced. If fluoride levels are too high, there will be a risk of fluorosis. Fluorosis is a chalky white or brown discoloration of the permanent teeth. Many children often get more fluoride than their parents realize. Being aware of a child’s potential sources of fluoride can help parents prevent the possibility of this problem.