Sierra Centre - Sealants

Dental Sealants are becoming more and more popular and for good reason, they actually work!

In North America, the most prominent child hood disease is decay, and most often begins at an early age. Tooth decay affects one out of every five children between the ages of 2–4. This is why it is so important to develop habits around good home care such as brushing and flossing. Furthermore, 50 % of children that are 8-years old have cavities and more than 75% of 17-year-olds have more than one cavity in their mouth!

How does a sealant help prevent tooth decay?

A sealant is a white or transparent plastic coating that is professionally applied to the chewing surfaces of the chewing teeth. Most typically, sealants are put on the 1st and 2nd molars and premolars as they erupt from the gums. This safe plastic resin bonds and adheres over the depressions and grooves of the chewing surfaces to act as a barrier, protecting enamel from plaque and acids that break it down and cause cavities.

Although brushing and flossing regularly helps to remove food particles and plaque from smooth surfaces of teeth, your brush bristles cannot consistently reach all the way into each depression and groove to remove food and plaque. The purpose of the sealant is to cover the deep grooves in the middle of the tooth so food particles and bacteria will not accumulate and start tooth decay.

Is applying the sealant a complicated procedure?

Applying sealants is an easy and painless process and only takes your dental team member a few minutes to protect each tooth. The teeth being sealed are thoroughly cleaned and dried first to be sure that no bacteria becomes trapped beneath the barrier. The chewing surfaces are roughened slightly with an air abrasion technique and then prepped with a special solution to help the sealant adhere. The sealant is then applied to the tooth enamel, where it bonds directly to the tooth and hardens with a painless curing light.

As long as the sealant remains intact the tooth will be protected from decay.  Sealants are very strong and have no problem holding up well with normal chewing. Most last several years before you need to reapply.   During dental visits, your giver will check the condition of the sealant to make sure they are intact and have no cracks.

When should my child get dental sealants?

First permanent molars erupt into the mouth at about age 6 years. Placing sealants on these teeth shortly after they erupt protects them from developing cavities in areas of the teeth where food and bacteria collect. If sealants are applied routinely to susceptible tooth surfaces in conjunction with the appropriate use of fluoride, tooth decay in children can be prevented.

Bicuspids and second permanent molars erupt into the mouth between the ages of 10- 12 years. Pit and fissure surfaces of these teeth are as susceptible to dental cavities as the first permanent molars of younger children. Therefore, young teens need to receive dental sealants shortly after the eruption of their second permanent molars.

Dental sealants are very affordable, especially in view of avoiding unnecessary cavities and dental visits.  Often, insurance companies cover these types of services so bring in your booklet and let us help you discover how much they will cost. This painless and cost effective way to keep your child's teeth cavity free is available for their next visit. Ask us how!

Do dental sealants replace fluoride?

No. Fluorides, such as those used toothpaste, gels, varnish, and mouth rinse also help to prevent decay. Fluoride works best on the smooth surfaces of teeth. The chewing surfaces on the back teeth however have tiny grooves where the decay often begins. Sealants keep cavity-causing bacteria out of the grooves by covering them with a safe plastic coating. We recommend using sealants and fluorides together to prevent tooth decay.

Sierra Centre - Pit & Fissure Care

The chewing surfaces of teeth are never flat. They have functional depressions called Pit and Fissures which help chew food but also tend to trap for food and bacteria making the teeth susceptible to decay.

Factors such as dietary habits, oral hygiene and amount of sugar intake play an important role in your oral health but the pits and fissures have been suggested as "the single most important anatomic feature leading to the development of tooth decay". As a preventive measure we can place pit and fissure sealants over the susceptible areas to protect them from cavity causing bacteria.

The decay inhibiting properties of sealants are attributed to the physical obstruction of bacteria into the pits and grooves. This prevents penetration of fermentable sugars and the bacteria cannot produce acid that causes tooth decay. The safety and effectiveness of pit and fissure sealants as a decay preventive measure has been confirmed by the Canadian and American Dental Associations and is totally painless! Call and book your appointment today!

Which teeth should be sealed?

Sealants are only applied to the bicuspids, molars and premolars. These are the teeth that have pits and fissures on their biting surfaces. Your dentist will tell you which teeth should be sealed after your exam. Some teeth naturally form with deep grooves which will really benefit from a sealant, others with shallow ones which may not need it.

How long do pit and fissure sealants last?

Sealants usually last for many years, but your dentist will want to check them regularly to make sure that the seal is still intact and serving its function. They can wear over time, and sometimes your dental team member may need to add or replace some sealant to be sure that no decay can permeate them.

How do pit and fissures work?

The sealant forms a smooth, protective barrier, by covering all the little grooves and dips in the surface of the tooth. Dental decay easily starts in these grooves and by eliminating them we can eliminate most cavities.

When should this be done?

Sealants are often applied as soon as the permanent teeth start to come through. This is usually between 6 and 7 years of age. The rest are usually sealed as soon as they appear which can be any time between 11 and 14 years of age.

Will my child feel it?

No, application of the sealant is virtually pain free, and the teeth do not feel very different afterwards. The process is similar to painting your nail with nail polish. Some kids notice that their teeth surface feels smoother as the sealant fills in the deep groves in the teeth.

Sierra Centre - Childrens Education (Fun Stuff!)

Some educational dental childrens sites are listed below.

• Colgates World of Care - Dr. Rabbit and the Legend of Tooth Kingdom
• National Museum of Dentistry
• Colgate Kids World

Here are some fun and addictive games for kids! Simply click on the image to launch the game in a window.

Monoliths Super Mario World

Pac Man Advanced

Snowman Skiing

Halloween Pumpkins

 

Sierra Centre - Grinding-Chipping

When you look in on your sleeping child, you want to hear the sounds of sweet dreams: easy breathing and perhaps an occasional sigh. Some parents may hear the harsher sounds of scraping and grinding teeth, called bruxism, which is common in kids, and cause for concern.

What Is Bruxism?

Bruxism is the medical term for grinding your teeth and or the clenching of the jaw, especially during deep sleep or while under stress. Three out of every 10 kids will grind or clench, with the highest incidence in children under 5 years old.

Causes of Bruxism

Though studies have been done, we do not know for certain why bruxism happens. In some cases, kids may grind because their top and bottom teeth are not aligned properly. Others do it as a response to pain, such as an earache or teething. Kids might grind their teeth as an unconscious way to ease the pain, just as we might rub a sore muscle. Sometimes children outgrow these fairly common causes for grinding but if you suspect this may be a problem, ask your dentist to take a look at the wear patterns on your child’s teeth.

Stress — usually nervous tension or anger — is another cause for bruxism. Your child may be worrying about a test at school or experiencing a change in routine (attending school or a new teacher) or even experiencing stress with friends or siblings. Even arguing with parents can cause enough stress to prompt teeth grinding or jaw clenching.

Often children who display hyperactive symptoms also experience bruxism.

Effects of Bruxism

There are a few affects of bruxism in children that that you should be aware of.

1. When there is constant pressure from grinding in the mouth, it tends to impede full vertical growth of the six year molars and can eventually affect proper tooth and jaw alignment of your child.
2. An incorrect bite triggers pressure points in the mouth and jaw and can cause chronic headaches, facial and dental pain. Stiff or aching  jaw joints, neck pain and the popular temporomandibular (TMJ) tension and sensitivity can all be a symptom of bruxism.
3. Often times our children have a hard time adjusting and “popping” or relieving pressure in their ears. Grinding is a natural and unconscious was of relieving this pressure.
4. In some extreme circumstances, nighttime grinding and clenching can wear down tooth enamel, chip teeth, increase temperature sensitivity, and cause severe facial pain and jaw problems, such as temporomandibular joint disease (TMJ).
5. Some of the more mild affects include morning headaches or earaches.

Diagnosing Bruxism

Lots of kids who grind their teeth aren't even aware of it. Often, it is siblings or parents who identify the problem.

Some signs to watch for include:

• grinding noises when your child is sleeping
• complaints of a sore jaw or face in the morning
• thumb sucking
• fingernail biting
• gnawing on pencils and toys
• chewing the inside of the cheek
• tender ears and temples

If you think your child is grinding his or her teeth, express your concerns to your dental team. Upon the next visit, we will examine the teeth for chipped enamel and unusual wear and tear. We will also spray air and water on the teeth to check for unusual sensitivity.

If damage is detected, the dentist will ask your child a few questions, such as:

• How do you feel before bed?
• Are you worried about anything at home or school?
• Are you angry with someone?
• What do you do before bed?
• Are you scared or nervous about something?

The exam will help the dentist determine whether the grinding is caused by anatomical (misaligned teeth) or psychological (stress) factors and come up with an effective treatment plan.

Treating Bruxism

In cases where the grinding and clenching make a child's face and jaw sore or damage the teeth, dentists may prescribe a special night guard. These custom made guards are molded to your child's teeth and is similar to the protective mouthpieces worn by athletes. Though a mouthpiece may take a few nights to get used to, it is not painful and pain relief happens so quickly that most patients have no trouble adjusting.

Helping Kids With Bruxism

Whether the cause is physical or psychological, kids might be able to control bruxism by creating a relaxing routine before bedtime — for example, by taking a warm bath or shower, listening to a few minutes of soothing music, or reading a book.

For bruxism that's caused by stress, we encourage you to ask questions to uncover what could be upsetting your child and then work towards a solution with them. For example, a child’s first day of school or worry about being away from home for a first camping trip might need reassurance that mom or dad will be nearby if anything happens.

If the issue is more complicated, such as moving to a new town or a divorce or death in the family, discuss your child's concerns and try to ease any fears. If you're concerned about your child's emotional state, talk to your doctor. At Sierra, we are concerned with the entire well being of our guests and we work with a number of other health care practitioners to ensure your best health. If you would like a referral to one of our wonderful partners in health please let us know.

How Long Does Bruxism Last?

Childhood bruxism can be outgrown by adolescence. Some children stop grinding when they lose their baby teeth because permanent teeth are much more sensitive to pain. This pain makes them more aware of the habit and helps them to stop. However, a few children do continue to grind into adolescence. If your childs bruxism is caused by the stress of an improper bite, it will continue until the bite is corrected and should be looked at by your dentist.

Preventing Bruxism

Because some bruxism is a child's natural reaction to growth and development, most cases can't be prevented. Stress-induced bruxism can be avoided, however, by talking with kids regularly about their feelings and helping them deal with stress with exercises such as breathing, prayer or children’s yoga. Your dentist can also create a custom oral appliance to align the jaw and prevent damage caused by bruxism. Find out if your child is a candidate at their next appointment.

Sierra Centre - Sleep Deprivation (Behavioural Issues)

How much sleep does my child need?

The amount of sleep that a child needs is completely dependent on that individual child. Factors such as age and other personal characteristics such as activity and sensitivity levels can affect the amount of sleep needed for adequate rest and rehabilitation of the body.  According to the Nemours Foundation, which specializes in children's health issues, a 3-month old will sleep an average of 15 hours a day. This will gradually decrease as a child grows older, eventually giving up daily naps altogether. Here are a few rough guidelines from the Nemours Foundation. Please remember, these are not hard and fast rules. Some children need more or less sleep than others their age.

• From 6 to 12 months, an infant may nap about 3 hours during the day and sleep up to 11 hours at night.
• From ages 1 to 3, toddlers average about 10 to 13 hours of sleep per day.
• Preschoolers sleep about 10 to 12 hours per night.
• Children aged 6 to 9 need about 10 hours of sleep a night.
• Teens need about 8 to 9.5 hours of sleep per night.

How can I tell if my child is sleep deprived?

Some of the key indicators of a sleep deprived child include an especially sensitive or cranky disposition, a low frustration point, tendency to throw tantrums, act out, and even  display hyperactivity characteristics.  With some kids, the behavioral signs are more subtle. If your child seems even-tempered but has trouble waking every morning, sleeps in whenever they have the chance, or falls asleep in the afternoon, in the vehicle or in front of the TV they probably need more z's. In a survey conducted by the National Sleep Foundation, 15 percent of kids reported falling asleep at school.

My child seems to get enough sleep but has trouble getting up in the morning. Why?

If your 9-year-old sleeps 10 hours at night but still hates to rise and lacks their shine, they may need closer to 11 hours. Possibly, your child is getting the right quantity of sleep but is lacking quality of sleep and this is where we can help.  One of the most frequent causes of deprivation in children and adults alike is sleep apnea. Sleep Apnea is a serious sleep disorder that can cause your child's upper airway passages to become blocked repeatedly during the night. The condition affects sleep and regeneration of the body as oxygen intake is compromised. You may hear snoring or brief periods of quiet interspersed with snoring. Each time the airway is blocked, the child wakes enough to shift position and open the airway therefore constantly interrupting their sleep.  A dentist trained in airways analysis can also help determine if tonsils, adenoids or an overbite (set back lower jaw) may be contributing to insufficient sleep and creating unnecessary problems.

If you suspect your child might suffer from sleep apnea, or traditional medications for hyperactivity and short fuse are not sufficient talk to your Sierra team member. We have a number of options available to screen for and treat inadequate sleep.

How does sleep deprivation affect my child?

Consider for a moment how adults act and react to their external world when they do not have adequate sleep; this is even more evident in our children who are often more sensitive. It is estimated that over 50% of the children taking ADD medications could be treated by alternative means with no medication required. Dark circles under the eyes, restless sleep, bed wetting, and night mares are other common symptoms of sleep apnea which can be diagnosed and treated by trained dentists. Others have proven that Attention Deficit Disorder ADD and Attention Deficit Hyperactivity Disorder ADHD can be improved with a better night’s sleep. The positive effects of sleep on the body, both mentally and physically are endless. Sleep allows our body to regenerate and restore balance. Parents have reported that  with more sleep, their children are calmer, more content and more able to cope with the external world when they have adequate sleep.

Many daytime attention, and behavioral problems are a result of poor sleep patterns in children. Snoring, often combined with sleep apnea (gasping for breath or stopping breathing for a few seconds) is a common cause of a lack of adequate sleep. Snoring can cause a decrease in oxygen during the night resulting in tired restless children in the morning. A thorough assessment by a dentist trained in sleep apnea could bring new found hope. Ask us how.

Sierra Centre - Palatal Expanders/Spacers

A palatal expander is used to widen the upper jaw so that the bottom and upper teeth will fit together better. It was thought this can only be done when a patient is still growing, unless surgery is used to separate the two halves of the palate, however there is evidence to the contrary. A palatal expander is most often followed by braces to straighten out all the teeth now that room has been created.

The expansion process usually results in a large gap between the patient's top front teeth, although this does not always happen. This gap is closed naturally and the teeth may overlap which leads to braces being needed. Sometimes with expanders, the patient has to turn the expansion screw themselves to tighten up the expander. For expansion that is not managed by the patient on the and lower jaw, a bionator may be a more suitable alternative.

Although it may vary from person to person, most usually feel slight pressure on their teeth. As the patient turns the expansion screw using the key, a space may develop between the front two teeth. Some may notice a larger space while others do not notice a space at all. It usually takes several days to adjust to eating and speaking after first receiving the rapid palatal expander. Patients may experience pain and headaches while wearing palatal expanders and when the screw is turned. They may also feel a sore on their tongue from contact with the expander's metal bars. Patients who have expanders may also experience extra saliva and lisps (pronouncing the letter S as a T sound) or a slight 'hissing' S sound.

An extremely narrow upper dental arch will often lead to crowding of teeth and irregular dental alignment when a child is older. The older a person is, the more difficult it can be to correct a very narrow upper dental arch. In a case of severe bilateral maxillary constriction, a palatal expander can be used to improve the shape of the upper dental arch. The appliance changes the dental arch from a "U" shape to a more normal, wider, ovoid shape. Today, the technology in braces allows dentists to do expand the dental arch as well. Ask your dentist how at your next appointment.

Sierra Centre - Retainers

What's a Retainer?

A retainer is a piece of plastic and metal that is custom-made for each patients mouth and dental needs. It fits snugly around teeth and inner mouth. No two retainers are alike, even though many look similar. Retainers are extremely common and you may know people who have them. In fact, most people (kids and adults) who have braces are asked to wear a retainer consistently after getting their braces taken off to avoid movement. Other people wear retainers to close gaps in their teeth, to help with speech problems, or to solve other medical problems.

Why Do I Need to Wear a Retainer?

There are different reasons why you might need a retainer. The most common reason is to help your teeth stay set in their new positions after wearing braces. It's important to wear your retainer because as your body grows, your teeth shift in your mouth.

After your braces are removed, your orthodontist will fit you for a custom made retainer. He or she will tell you how long to wear it and when. For example, you might have to wear it all day for 3 months but then only at night after that. Some kids may wear their retainer only at night right from the start. The retainer keeps the teeth in line and you won't even notice it while you're sleeping!

Other kids may wear retainers to close a space between their teeth or just to move one tooth. In these cases, braces aren't needed because retainers can do the job. Often, retainers will be worn for several years to close a space, for example, and then keep the gap closed by holding the teeth in place. When you wear a retainer for any reason, certain teeth may feel pressure and might even feel sore for the first few days. If you experience this, don't worry — it's completely normal and will subside quickly.

Retainers can help many mouth problems besides shifting teeth. Sometimes they're used to help a medical problem. For example, you may have a tongue thrust (a condition where your tongue sneaks through your teeth when you talk). Some retainers, known as a crib or tongue cage retainers, are designed with small metal bars that hang down from the roof of your mouth. These retainers keep your tongue from going forward in between your teeth when you speak. Your tongue is trained to go to the roof of your mouth instead of through your teeth. The length of time kids wear a tongue cage varies depending on the individual.

Another use for retainers is to help people with temporomandibular disorder (TMD). This disorder is usually a result of a bite problem (the teeth don't meet together properly when the jaws are closed) called malocclusion (say: mal-uh-kloo-zhun) or bruxism (say: bruk-sih-zum), which is grinding your teeth while you sleep. Grinding stretches the muscles and joints in your mouth and jaws and sometimes can cause jaw pain or headaches. Retainers can help you by preventing your mouth from closing completely at night, which keeps you from grinding your teeth.

Getting Fitted for and Wearing a Retainer

This is the easy part. Your orthodontist will fit you for the retainer using a material known as alginate (say: al-juh-nate). It's a chewy, chalky kind of thick liquid that makes a mold of your teeth when you sink them into it. The fitting process is fast, painless, and has a mild flavor.

Your finished retainer can be designed to express your style and likes. Get creative! Sparkles, pictures such as Batman, Christmas trees, or Halloween bats on the plastic part of the retainer can be created for you. Once you've been fitted for your retainer we will have it ready within a week and will call you for a retainer check and pickup of your new appliance.

You may think your retainer feels weird at first, that's normal. See your orthodontist for an adjustment if the retainer causes pain that lasts more than a few days or cuts or rubs against your gums. At first, you'll need to get used to talking with it in your mouth. Talking slowly at first is a good way to practice and eventually, you won't even notice it's there. Dentists advise reading aloud for several minutes each day. You may also notice an increased saliva flow (more spit in your mouth) in the first few days of wearing your new retainer, this is also normal.

Caring for Your Retainer

Retainers live in your mouth along with bacteria, plaque, and leftover food particles. You should clean your retainer every day, but make sure to check with your orthodontist about how your type of retainer should be cleaned (some kinds shouldn't be cleaned with toothpaste). You can also soak it in mouthwash or a denture cleaning agent to freshen it up and kill germs and bacteria.

The plastic of your retainer can crack if it gets too dry, so it is advised that you soak it when it isn't in your mouth. Plastic can warp easily, so avoid hot water and other heat sources. Finally, do not bend the wires or try to adjust your retainer. Flipping the retainer around in your mouth can cause the wires to bend and may compromise the performance of your appliance.

One important way to take care of your retainer is not to lose it. They are expensive and your mom or dad might have to pay for lost or damaged retainers. Worse yet, they might ask you to help pay for a new one! So look before you dump your lunch tray and try to keep it in the same spot at home when you're not wearing it. In other words, retain your retainer!

Sierra Centre - Spacing & Bone Growth

Spacing (the opposite of crowding), is an excess of space for your teeth which results in gaps between your teeth. This generally occurs when the teeth are smaller than the available space. Spacing can also be caused by protrusive teeth, missing teeth, impacted teeth or abnormal tissue attachments to the gums.

Spacing should be corrected because it can:

• result in gum problems due to the lack of protection by the teeth
• prevent proper functioning of the teeth
• make your smile less attractive

How can spacing of the teeth be orthodontically corrected?

The spaces can be closed by using a Damon bracket (traditional wire braces) or Invisalign treatment depending on your particular case. Both systems are able to move the teeth together and align them within the arch, talk to your dentist about which system will work best for you.

Sierra Centre - Thumb Sucking Cessation (Oral Habits)

Before breathing, before birth, children will suck their thumbs. Sucking is a natural reflex that is practiced and coordinated prenatally (before birth). We have all seen the pictures of fetuses in their mother's wombs with their thumbs in their mouths. After birth, sucking provides baby's first nutrition.

Thumb or finger sucking is a convenience for parents. Children who suck their thumbs are able to comfort themselves in a variety of situations. They may be more independent. Children find their own thumbs easier than pacifiers. Thumbs are always the right size and they never wear out. It's easy to understand why thumb sucking is so prevalent and so hard to quit.

The major dental problem caused by thumb sucking is malocclusion. Teeth, lips and jaws have a natural relationship. Consistent pressure of the thumb or fingers against the teeth alters the normal growth of the teeth and jaws. This force can cause the upper teeth to protrude and the lower teeth to retrude. In addition, the bone that supports the teeth, even the entire lower jaw may be held back in a slower growth pattern. The habit usually stops by the time the child is five years old, and the damage usually reverses itself. Children who continue finger habits past five years old may need some type of intervention.

There are several techniques recommended for the cessation of finger sucking. Most often, children just lose interest, or peer pressure ends it. Parents, who notice a habit lasting past the fourth birthday, may help their children with a system of encouragement or rewards. A day without thumb sucking can be rewarded with praise or a special treat. The final cessation of the habit might deserve a larger reward. If these tactics still are not working, talk to your dentist about a thumb sucking cessation device to assist your child with this habit.