Patient Information

Child's First Visit to the Dentist

Unless a problem is suspected, we would like to see your child within 6 months of the eruption of the first tooth or by one year of age. The most important goals of this first visit are to introduce your child to the office surroundings and to develop a trust in the dentist and our staff. We view this visit as an icebreaker. If your child is too frightened, uncomfortable or uncooperative, we may have to re-schedule several short visits. You will be charged a reasonable fee for the time. Please do not try to explain the first visit yourself. Do not use phrases like "Be brave!" or "Don’t be afraid". Do not offer them a bribe with special treats to get them to the office. Rather be positive and reassuring that the visit will be fun and one in which to look forward.

The appointment should be 15-30 minutes and may include necessary x-rays, a gentle, comprehensive examination of the teeth, gums, jaws, bite, and oral tissues. This is both to observe any problems and to establish a baseline so we can monitor your child’s growth and development. Depending on your child’s age and cooperation, we may also clean and polish their teeth and apply a topical fluoride. We will try to discuss and answer any questions you may have at that time. Our objective is to be gentle and patient so your child develops a positive attitude towards the dental office and their own oral health. Our long-term goal is prevention and minimizing and dental problems for him/her as they mature.


Carbonated Beverages Are Bubble Trouble

The single biggest source of calories [7%] in the American diet is from carbonated soft drinks. A carbonated beverage is one that releases carbon dioxide in normal atmospheric pressure. Artificial carbonation was first introduced in 1767 and after 1830, the sweetened and flavored lemon-lime, grape and orange carbonated drinks became very popular. Today, heavily sweetened, carbonated drinks or sodas are among the most popular beverages in the world. Consumption of carbonated soft drinks peaked in 1998 when consumption was 56.1 gallons per person per year. Soft drinks provide large amounts of sugar [mostly high-fructose corn syrup] to many individual's diets. The empty calories of soft drinks contribute to health problems, particularly obesity and tooth decay [caries]. A study from Harvard shows that soft drinks may be responsible for the doubling of obesity in children over the last 15 years.

Carbonated soft drinks not only have a high sugar content that contributes to tooth decay but also have a very acidic pH that can erode tooth enamel. Some of these drinks, especially the colas have as much caffeine as a cup of coffee and can disrupt children's or adult's sleep and leave them feeling tired during the day.

These carbonated soft drinks are also related to gastric distension, which can trigger reflux. Studies show the consumption of one can of soda a day corresponds to 53.5 minutes of elevated acid levels in the stomach.

The best approach is to cut down or avoid carbonated drinks. Many schools have removed the soft drink vending machines in their halls and cafeterias. If not, it's best to drink through a straw so the soda is swallowed from the back of the mouth and does not come in contact with the teeth causing decay. Substitute other beverages such as water and more nutritious beverages like milk.


Aphthous Stomatitis (Ulcers)- Canker sores, recurrent aphthous stomatitis, RAS

This is one of the most common oral diseases. It is estimated that it affects from 20% to 60% of the population. Lesions appear as painful ulcers ranging in size from less than 1 mm to 2 centimeters. They may be single or multiple.

Each lesion begins as a red flat spot. It soon ulcerates and the ulcer becomes covered by a membrane producing the characteristic yellow-white center with surrounding red area. The shape is usually round to oval but may be elongated in natural folds of the lip.

Aphthous stomatitis occurs on lips, cheeks, soft palate, floor of mouth, top and side of the tongue are often involved.

Aphthous lesions affect all age groups from young to old, but young adults and females are more often affected. Elapsed time between recurrences is extremely variable; some unfortunate patients have almost continuous disease whereas others go from months to years between episodes.

ETIOLOGY: The cause is unknown. The most current thought is that canker sores are caused by an immune reaction of the body. To further cloud the issue, a variety of other factors have been implicated. Withdrawal of certain foods such as cheese, tomato products, and gluten, as well as sodium lauryl sulfate-containing toothpastes, has been claimed to help some patients whereas in others, correction of iron, B12, and folate deficiencies have brought about a cure. Improvement of aphthous lesions during the last stages of pregnancy with exacerbation after delivery suggests that gonadal hormones may play a role. The occurrence of canker sores during menstruation also suggests a hormonal basis. To add a final element of mystery, aphthous stomatitis has been reported to worsen when cigarette smoking is discontinued. There are too many theories for them all to be correct. Aphthous stomatitis may not be a single disease with a single cause but, instead, a variety of diseases all manifested by painful mouth sores.

TREATMENT: To reduce pain, patients with a few lesions may be treated with topical medications such as Orabase® with Benzocaine, Zilactin®, or Soothe-N-Seal®. Anti-inflammatory agents such as topical steroids or Aphthasol® have also been shown to be effective. For severe or widespread disease, systemic prednisone such as a Medrol 4 mg Dosepak® is helpful. Long-term systemic steroid therapy may be associated with numerous adverse effects, including osteoporosis, aseptic necrosis, cataracts, depression, fluid retention and exacerbation of diabetes.

PROGNOSIS: Cure is seldom achieved by alleviation of symptoms and delay of recurrence may be achieved by the above mentioned treatment. Without treatment, healing time varies from 4 days for a small lesion to a month or more for major aphthae, which may also cause scarring.

DIFFERENTIAL DIAGNOSIS: Aphthous stomatitis must be differentiated from herpetic stomatitis, the disease with which it is most often confused. Recurrent intraoral herpes occurs almost exclusively on mucosa overlying bone. The hard palate is the most common site. Lesions indistinguishable from aphthous stomatitis have been reported in Behcet’s syndrome, Reiter’s syndrome, Crohn’s disease, and celiac disease.


Self-Care Tips for Temporomandibular Disorder (TMD)

Self-care is an essential part of your treatment.  The success of our treatment will depend, in large part, on the way YOU treat injured areas.  You will find in the following list, therefore, an easy way to actively participate in your treatment as well as improve your current symptoms.

  1. Avoid activities which move your jaw out of the resting position -- avoid chewing your lips and/or cheeks; avoid biting your nails; and avoid holding objects in your mouth (pens, pencils, etc.)
  2. Avoid full opening of your mouth -- avoid foods like apples, large burgers or sandwiches (unless they are cut into smaller pieces); avoid yawning too wide (place your tongue on the roof of your mouth when yawning to avoid excessive opening).
  3. Avoid excessive pressure on the TM joint -- do not lean your chin on your hand; sleep on your back, if possible, avoiding added stress on your jaw joints; avoid cradling the phone against your ear (use light weight headsets instead); do not chew food with your front teeth.
  4. Avoid prolonged use of your joints -- avoid foods that are chewy, hard, tough, or any other food that will require prolonged chewing (steaks, hard rolls, toffee, bagels, raw carrots, ice cubes, etc.); avoid chewing gum; avoid pushing forward (protruding) your lower jaw unnecessarily.
  5. Take care of your neck -- maintain good posture; avoid a head forward posture which may increase jaw and neck muscle activity and soreness; vary your activities approximately every 10 minutes to give your neck a break from sustained positions (especially computer desk work); avoid sleeping on your stomach; use a pillow that supports your neck adequately.
  6. Heat/ice -- apply ice for severe pain and recent injuries (less than 72 hours); apply moist heat on tense muscles for 10 minutes, then lightly brush the painful area with an ice cube. Re-warm the area for 1-2 minutes. Repeat ice and heat combination 4-5 times.
  7. Medical/Dental care -- always advise your practitioner about your temporomandibular disorder when proceeding with dental or medical care.

Remembering "LIPS TOGETHER AND TEETH APART" is an important step in breaking the daytime habit of clenching and/or grinding teeth. In fact, many people are unaware they even have the habit until it has been pointed out to them. This simple step will help relax tense and taut muscles and promote healing of damaged temporomandibular joints. Times when you are most likely to clench or grind your teeth are when driving, physical exertion (sports), and when you are under emotional tension or stress. During these times you should repeat to yourself: "LIPS TOGETHER AND TEETH APART..."

By sealing your lips and gently blowing or puffing air, you will automatically separate your teeth and simultaneously relax your jaw and facial muscles. Remember that you have had this habit for a long time, and it will not vanish overnight. You must preserve and practice this exercise every time you find your teeth clenched together.


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