Question:
My 19-month-old son has seemingly ground little concavities into the biting
surfaces of his lateral upper incisors. He sporadically grinds his teeth
during the day, though has gone long streaks without doing so. His dentist
had a look and thought little of the chips 6 months ago. I'm wondering if
they don't mean big trouble someday.
My son also may have some chalky-looking incipient cavities between his
upper middle incisors, too. Not sure yet. If they were the start of
cavities, how would most general dentists handle it?
I never had caries in my baby teeth, but my son does have a half-brother who
had bad caries and wound up with crowns and all, according to his mother.
My son does not take a bottle; he breastfeeds and drinks water.
And if my son should need any restorative work--does anyone have advice for
a phobic mother? I have suffered for years with an irrational fear of
having some dental work done. I need Valium for a cleaning, fer cryeye. So
how can I avoid conveying my fears to him when he is at the dentist office?
Answer:
I am a general dentist who sees a lot of children. I'd like to answer
the last question first. Have your son's father take him to the
dentist if at all possible. Your child will sense your discomfiture
and may react likewise.
If you are the only person who can bring him, do not prepare him for
the visit. Do not comfort him by saying, "The dentist will not hurt
you." or " I won't let anything bad happen." That usually has the
opposite effect. How would a 19 month old know that the dentist may
hurt him unless you tell him so?
No preparation is needed. The day of the appointment list the things
you will do that day including the dentist appointment as if it is any
other activity like going to the museum or to visit someone.
Dentists call teeth grinding bruxism as you say in the subject.
Bruxing is very common in young children. It usually stops when the
six year molars come in all the way and contact eachother upper to
lower. I would not worry about it no matter how worn the front teeth
become.
The chalkyness could be from a few sources. Tell me if any of them
sound familiar to you.
Your child may be breathing through his mouth all night long. Peek in
on him at night to check. Does he snore? Is he a child whose nose is
always stuffy? This could be a sign of allergies or sleep apnea
(trouble breathing while asleep). If this is the case please discuss
it with your pediatrician or family practitioner.
Your child may have something in his diet that is very acidic.
Carbonated beverages and strong citrus or vit c containing chewable
vitamins come to mind. Sticky, sugary foods like fruit rollups and
raisins could be a culpret, too.
Are you brushing his teeth 2 - 3 times per day? Baby teeth require
brushing no matter the diet beginning with the eruption of the first
tooth. Ask his dentist to show you how if you are not sure that you
are brushing his teeth correctly.
If your child is developing decay at this early age it is important to
treat it right away and work to prevent more decay. Speak with your
dentist about diet, proper use of fluoride and oral hygiene.
since it seems like you are doing everything right and still your
child has such serious appearing dental problems, you should take him
right to a pedodontist. You are presenting our board with a difficult
puzzle. Your child should be examined and a thorough history taken.
BTW - If you are giving your child fluoride drops, be very certain
that he gets no other fluoride. Many bottled waters have fluoride
like Poland Spring water. Fluoride occurs naturally, so plenty of
well water has fluoride. Too much fluoride will permanantly stain
your child's adult teeth before they erupt. You won't notice a
problem until the central incisors come in. By then it will be too
late to do anything except porcelain veneers when he is older.
