Health Expert Q&A | The Source Weekly - Bend, Oregon

Health Expert Q&A

With Elise Burrus: Pediatric Dental Associates

Q: My nine-year-old daughter complains of painful sores inside her mouth on her cheeks. What causes these? Is this something a dentist can address or is it a medical problem?

A: Aphthous ulcers, or "canker sores," are small, oval-shaped sores that can develop in the mouth. There are several factors that can contribute to the cause of these ulcers, such as emotional stress, cheek bite, poor toothbrushing, braces, food sensitivities or vitamin deficiencies. Canker sores do heal on their own within 7-10 days. Kids that get frequent canker sores should be evaluated by their dentist to identify possible triggers and discuss methods to relieve discomfort.

Q: My three children brush their teeth regularly every morning and evening. My oldest son, however, usually has a cavity when he visits the dentist. (My other two children have never had one). What is he doing wrong?

A: Cavities are caused by several factors, and these factors can be different even between siblings. Dietary habits and oral hygiene routine are the biggest components to evaluate; however, other factors that can contribute to a higher incidence of tooth decay are oral bacterial colonization, enamel defects, tooth anatomy, saliva flow and mouth breathing. If one child in the family is more prone to cavities, identifying individual risk factors would be essential for future cavity prevention.

Q: Is it dangerous to expose my four-year-old to radiation through X-rays at the dentist?

A: Dental X-rays for children are safe and essential for accurate diagnosis of cavities, missing teeth, extra teeth, abnormal lesions and for monitoring growth and development. Modern dental X-rays are digital, which produce 90% less radiation than traditional film. People are exposed to more radiation by simply being outside or flying in an airplane!

Q: What is the difference between a pediatric dentist and a family dentist? My family dentist offers services to all ages, so I'm unsure why my children should go to a pediatric dentist.

A: Pediatric dentists are specialists that exclusively focus on the oral health of young people. Family dentists are general practitioners that see adults and children in their office. Like pediatricians, who are the experts in the medical needs of children, pediatric dentists have the expertise to address dental issues specific to children. Two years of additional training beyond dental school is required to become a pediatric dentist. Through this extra schooling, pediatric dentists learn how to work with children and become experts in the dental procedures used for baby teeth and young adult teeth. Training also includes a big emphasis on child development and communication techniques, as kids need to be spoken to in a manner that they can understand. The environment of a pediatric dental office tends to be colorful, inviting, playful and fun so that kids can feel less anxious visiting the dentist.  

Q: What should I know about silver diamine fluoride? This treatment was recommended to my son, and I want to make sure it is safe.

A: Silver Diamine Fluoride is a liquid solution that is often applied to small or early cavities to prevent the progression of tooth decay. SDF has properties that inhibit the growth of cavity-causing bacteria and help strengthen teeth. If early cavities are diagnosed in a young child, SDF is a great option to help control the decay process and ideally prevent the child from needing more extensive dental work in the future. SDF is safe and application is easy, taking only a few minutes to apply. SDF would not be used if a patient has a silver allergy or if the cavity is too deep. One of the primary drawbacks to SDF treatment is that it results in black staining on the decayed portion of the tooth. As a result, SDF is most often used on children's back teeth where staining is less noticeable.

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