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Tuesday, July 22, 2014

How Many Cavities Does My Child Have??

On the tail of the most recent blog post with an article about Baby Root Canals, here is another article I recently wrote for Weekly Biz newspaper. This is informative for parents.

Parents, the American Dental Association recommends that a dentist examines a child within 6 months after the first tooth comes in and no later than their first birthday.  I usually recommend even EARLIER THAN THAT.  The first dental visit is a "well baby checkup" visit more for parents. I go over things to watch out for when baby teeth start coming out, drinking from a bottle, cleaning the baby's gums, etc... I also give parents a chart so they can have an idea of when baby teeth come in, and when the baby teeth change to adult teeth. I also discuss good habits vs bad habits such as thumbsucking, etc...

Hopefully, no parent will have to hear that their child has even one cavity.


8 Cavities on a 6 Year Old?



Mr. and Mrs. N are new patients in my office. Yesterday they bought their son in to see me.  He was going to start school in September and have never been to the dental office.

Every time I see an older child in my office for their first ever dental visit, I don’t know what to expect. I don’t know if their friends have told them any scary stories; I don’t know if their parents have tried to scare them into eating less junk food; I don’t know how they will react to the different instruments and noises in my office; I don’t know if there will be any crying; I don’t know if they will even want to come in!

Turns out, I had no reason to be nervous!  He was very well behaved throughout the whole visit.  He sat still while we took x-rays and watched in the mirror while I checked his teeth during the exam. 

When the x-rays were done, I looked at them together with his parents and him. To everyone’s surprise, he had 8 cavities on his back teeth. All 8 of his back teeth had a cavity on them.  The cavities started from in between the teeth. His parents were shocked. “He doesn’t eat any candy at all! He doesn’t drink juice. It’s only water or milk that he drinks! He doesn’t eat sweets! How could this have happened? What is going on? Are you sure there are 8 cavities? How could there be so many in a 6 year old child?”

After putting on my detective hat and asking questions, I found out that there were a lot of problems.  He was only brushing his teeth once a day in the morning. Not good! The best thing is brushing at least 2 times a day. Once in the morning and then, last thing at night. After the night time brushing, nothing goes in the mouth except water.  The bacteria in the mouth will eat the sugars and produce an acid that will cause cavities.  It’s not only sugar that the bacteria eat; it’s also carbohydrates and “hidden sugar”. Breads, milk, fruit, and other foods also contain types of sugar. It’s not just candy, donuts and ice cream that are problems.

He was also not flossing. Not good!  Flossing your child’s teeth will start healthy habits for life. It will also clean out food particles between the teeth that the toothbrush cannot reach.

Another big problem was that he was not using a fluoride toothpaste.  His parents had seen on the internet that fluoride was not healthy. They were concerned that he was swallowing too much fluoride using the fluoride toothpaste.  At 6 years old, my little patient should have been taught how to properly rinse and spit out.  Fluoride really does do a good job at helping prevent cavities.  By avoiding fluoride, it only added to the how quickly the cavities were formed.

After a long appointment, all the cavities were cleaned out and filled. 3 were actually deep enough that he may need a baby root canal in the future.  This was indeed a very tough and expensive lesson that Mr and Mrs N learned.

I found out later on that Mr and Mrs N are expecting their second child early next year.  They laughed and said that what they do with their first child is always an experiment.  Now they know what to do with the second child!





Tuesday, July 15, 2014

My Child Needs A Root Canal?? No WAY!

My assistant reminded me that I need to give her a new monthly article so she can translate it.
This one is for the Bi-Daily Sun Japanese Newspaper. I get a personal happy kick out of seeing my face with the article. I can't read Japanese but it's still fun to flip the newspaper open to see myself smiling back at me! Kekeke!

This month's article is on baby root canals. Enjoy and hope parents out there learn something new! If you have any questions or comments, please let me know or you can always ask your own dentist as well.

Dear Diary….  My Child Needs a Root Canal?


Dear Diary….  I received a text message that put a frown on my face. It was from Mr S. His whole family are patients at my dental office.  He was out of town with his family and his 7 year old daughter had a toothache.  They took her to the local dentist. After an exam and an xray, the dentist said she needed a baby root canal. Mr S got worried and called me to see what was going on. A root canal on a baby tooth? Isn't this the same tooth I did a filling on a few months ago? Is a baby root canal the same as an adult root canal? Is it really necessary?

There is no age limit for a root canal treatment. A root canal may be needed when a baby tooth has been hurt from a fall or from an infection.  A few months ago, I had cleaned out a very deep cavity on his daughter but because the decay was very close to the nerve, I told Mr S that the tooth may end up dying in the future. His daughter was having a bad toothache in that tooth now.

A bad toothache is a good indication that the nerve is dying. Once the nerve dies, it becomes infected.  If a toothache is related to eating or drinking something cold or hot, eating or drinking something sweet or acidic, the tooth most likely can be repaired with a filling. Once the pain is constant or throbbing, this can mean that the decay has become worse and gotten closer to the nerve. Another indication of needing a root canal may be the change of color of a tooth. The color may vary from pink to red to brown to grey or even black. There may or may not be pain in this case.

The filling of a baby root canal is also different from that of an adult tooth. A baby tooth’s roots will be resorbed as the adult tooth grows so the baby root canal filling material will need to be absorbed at that later time.

If the infection of a baby tooth has become too advanced, the baby tooth may need to be removed. Losing a baby tooth early may lead to other problems in the future like crooked teeth. 

Root canal treatment on a baby tooth is a much better choice for a child than removing the tooth if possible. Having a baby tooth in place with a root canal will help the child keep full function of all their teeth, jaws and tongue. It will prevent speech problems, eating and chewing problems and helps guide the adult tooth underneath into its proper position.


My little 7 year old patient was very well behaved in new dentist’s chair. Not even needing laughing gas for her injection. Her tooth was saved with a baby root canal in 1 hour. I’m glad that it turned out fine. I called them later that day to see how she was doing. Her dad told me that it went well. But even though she was OK at the other dental office; she wanted to come back to seeing me because she said I always have funny stories to tell her. That put a smile on my face!