Fargo ND Pediatric Dentist - Dr. William Hunter

Pediatric Dentistry is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants, and children through adolescence, including those with special health care needs.

A specialist in pediatric dentistry is one who has obtained a general college education, earned a doctoral degree in dentistry from one of the country’s colleges of dentistry, and has completed two or more years in a residency or graduate program in an accredited university or hospital. This educational experience qualifies the specialist as being uniquely trained to care for infants, children and teenagers, including whose with special needs.

Upon completion of specialty training, pediatric dentists voluntarily seek the personal quest for professional excellence through an evaluation and critique if their abilities by their colleagues. Pediatric dentists are eligible to be examined by the American Board of Pediatric Dentistry, a board of five peers elected by membership of American Academy of pediatric Dentists. This rigorous examination is voluntary and is for the purpose of validation and improvement of the pediatric dentist’s clinical and diagnostic abilities. Successful completion of the examination permits on to designated a Diplomate of the American Board of Pediatric Dentistry and to become a member of The College of Diplomates.
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How do I find a pediatric dentist in my hometown? Click on the following link: Dentists4Kids.com. Enter your zip or city and state for a list of pediatric dentists nearest you. If your entries result in "no matching pediatric dentist records were found," broaden your search by entering the state only or nearest city and state.

How Often Does my Child Need to See the Pediatric Dentist?

A check-up every six months is recommended in order prevent cavities and other dental problems. However, your pediatric dentist can tell you when and how often your child should visit based on their personal oral health.

Why Are The Primary Teeth So Important?

It is very important to maintain the health of the primary teeth. Neglected cavities can and frequently do lead to problems which affect developing permanent teeth. Primary teeth, or baby teeth are important for (1) proper chewing and eating, (2) providing space for the permanent teeth and guiding them into the correct position, and (3) permitting normal development of the jaw bones and muscles. Primary teeth also affect the development of speech and add to an attractive appearance. While the front 4 teeth last until 6-7 years of age, the back teeth (cuspids and molars) aren’t replaced until age 10-13.
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Eruption Of Your Child’s Teeth

Children’s teeth begin forming before birth. As early as 4 months, the first primary (or baby) teeth to erupt through the gums are the lower central incisors, followed closely by the upper central incisors. Although all 20 primary teeth usually appear by age 3, the pace and order of their eruption varies.

Permanent teeth begin appearing around age 6, starting with the first molars and lower central incisors. This process continues until approximately age 21.

Adults have 28 permanent teeth, or up to 32 including the third molars (or wisdom teeth).

TOOTH DEVELOPMENT

Look! My Tooth is Loose!
(with 16"x22" poster and stickers)

By Patricia Brennan Demuth
Illustrated by Mike Cressy

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Dental Emergencies

Toothache: Clean the area of the affected tooth.First, rinse the irritated area with warm salt water and place a cold compress on the face if it is swollen. Give the child acetaminophen for any pain, rather than placing aspirin on the teeth or gums. Finally, see a dentist as soon as possible.

Cut or Bitten Tongue, Lip or Cheek: Apply ice to injured areas to help control swelling. If there is bleeding, apply firm but gentle pressure with a gauze or cloth. If bleeding cannot be controlled by simple pressure, call a doctor or visit the hospital emergency room.

Knocked Out Permanent Tooth: What should I do if my child falls and knocks out a permanent tooth? The most important thing to do is to remain calm. Then find the tooth. Hold it by the crown rather than the root. Inspect the tooth for fractures. If it is sound, try to reinsert it in the socket. Have the patient hold the tooth in place by biting on a gauze. If you cannot reinsert the tooth, transport the tooth in a cup containing the patient’s saliva or milk and take your child and the glass immediately to the pediatric dentist. You may rinse the tooth with water only. DO NOT clean with soap, scrub or handle the tooth unnecessarily. If the patient is old enough, the tooth may also be carried in the patient’s mouth (beside the cheek). The patient must see a dentist IMMEDIATELY! Time is a critical factor in saving the tooth.

Knocked Out Baby Tooth: Contact your pediatric dentist during business hours. This is not usually an emergency, and in most cases, no treatment is necessary.

Chipped or Fractured Permanent Tooth: Contact your pediatric dentist immediately. Quick action can save the tooth, prevent infection and reduce the need for extensive dental treatment. Rinse the mouth with water and apply cold compresses to reduce swelling. If possible, locate and save any broken tooth fragments and bring them with you to the dentist.

Chipped or Fractured Baby Tooth: Contact your pediatric dentist.

Severe Blow to the Head: Take your child to the nearest hospital emergency room immediately.

Possible Broken or Fractured Jaw: Keep the jaw from moving and take your child to the nearest hospital emergency room.
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Dental Radiographs (X-Rays)

How safe are dental X-rays? There is very little risk in dental X-rays. Pediatric dentists are especially careful to limit the amount of radiation to which children are exposed. Lead aprons and high-speed film are used to ensure safety and minimize the amount of radiation.

Radiographs (X-Rays) are a vital and necessary part of your child’s dental diagnostic process. Without them, certain dental conditions can and will be missed.

Radiographs detect much more than cavities. For example, radiographs may be needed to survey erupting teeth, diagnose bone diseases, evaluate the results of an injury, or plan orthodontic treatment. Radiographs allow dentists to diagnose and treat health conditions that cannot be detected during a clinical examination. If dental problems are found and treated early, dental care is more comfortable for your child and more affordable for you.

The American Academy of Pediatric Dentistry recommends radiographs and examinations every six months for children with a high risk of tooth decay. On average, most pediatric dentists request radiographs approximately once a year. Approximately every 3 years, it is a good idea to obtain a complete set of radiographs, either a panoramic and bitewings or periapicals and bitewings.

Pediatric dentists are particularly careful to minimize the exposure of their patients to radiation. With contemporary safeguards, the amount of radiation received in a dental X-ray examination is extremely small. The risk is negligible. In fact, the dental radiographs represent a far smaller risk than an undetected and untreated dental problem. Lead body aprons and shields will protect your child. Today’s equipment filters out unnecessary x-rays and restricts the x-ray beam to the area of interest. High-speed film and proper shielding assure that your child receives a minimal amount of radiation exposure.
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Toothpaste: when should we begin using it and how much should we use?

Fluoridated toothpaste should be introduced when a child is 2-3 years of age. Prior to that, parents should clean the child's teeth with water and a soft-bristled toothbrush. When toothpaste is used after age 2-3, parents should supervise brushing and make sure the child uses no more than a pea-sized amount on the brush. Children should spit out and not swallow excess toothpaste after brushing.

What’s the Best Toothpaste for my Child?

Tooth brushing is one of the most important tasks for good oral health. Many toothpastes, and/or tooth polishes, however, can damage young smiles. They contain harsh abrasives, which can wear away young tooth enamel. When looking for a toothpaste for your child, make sure to pick one that is recommended by the American Dental Association as shown on the box and tube. These toothpastes have undergone testing to insure they are safe to use.

Remember, children should spit out toothpaste after brushing to avoid getting too much fluoride. If too much fluoride is ingested, a condition known as fluorosis can occur. If your child is too young or unable to spit out toothpaste, consider providing them with a fluoride free toothpaste, using no toothpaste, or using only a "pea size" amount of toothpaste.
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Does Your Child Grind His Teeth At Night? (Bruxism)

Parents are often concerned about the nocturnal grinding of teeth (bruxism). Often, the first indication is the noise created by the child grinding on their teeth during sleep. Or, the parent may notice wear (teeth getting shorter) to the dentition. One theory as to the cause involves a psychological component. Stress due to a new environment, divorce, changes at school; etc. can influence a child to grind their teeth. Another theory relates to pressure in the inner ear at night. If there are pressure changes (like in an airplane during take-off and landing, when people are chewing gum, etc. to equalize pressure) the child will grind by moving his jaw to relieve this pressure.

The majority of cases of pediatric bruxism do not require any treatment. If excessive wear of the teeth (attrition) is present, then a mouth guard (night guard) may be indicated. The negatives to a mouth guard are the possibility of choking if the appliance becomes dislodged during sleep and it may interfere with growth of the jaws. The positive is obvious by preventing wear to the primary dentition.

The good news is most children outgrow bruxism. The grinding decreases between the ages 6-9 and children tend to stop grinding between ages 9-12. If you suspect bruxism, discuss this with your pediatrician or pediatric dentist.
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Thumb Sucking

Are thumbsucking and pacifier habits harmful for a child's teeth? Thumb and pacifier sucking habits will generally only become a problem if they go on for a very long period of time. Most children stop these habits on their own, but if they are still sucking their thumbs or fingers when the permanent teeth arrive, a mouth appliance may be recommended by your pediatric dentist.

Sucking is a natural reflex and infants and young children may use thumbs, fingers, pacifiers and other objects on which to suck. It may make them feel secure and happy, or provide a sense of security at difficult periods. Since thumb sucking is relaxing, it may induce sleep.

Thumb sucking that persists beyond the eruption of the permanent teeth can cause problems with the proper growth of the mouth and tooth alignment. How intensely a child sucks on fingers or thumbs will determine whether or not dental problems may result. Children who rest their thumbs passively in their mouths are less likely to have difficulty than those who vigorously suck their thumbs.

Children should cease thumb sucking by the time their permanent front teeth are ready to erupt. Usually, children stop between the ages of two and four. Peer pressure causes many school-aged children to stop.

Pacifiers are no substitute for thumb sucking. They can affect the teeth essentially the same way as sucking fingers and thumbs. However, use of the pacifier can be controlled and modified more easily than the thumb or finger habit. If you have concerns about thumb sucking or use of a pacifier, consult your pediatric dentist.

A few suggestions to help your child get through thumb sucking:

Instead of scolding children for thumb sucking, praise them when they are not.

Children often suck their thumbs when feeling insecure. Focus on correcting the cause of anxiety, instead of the thumb sucking.

Children who are sucking for comfort will feel less of a need when their parents provide comfort.

Reward children when they refrain from sucking during difficult periods, such as when being separated from their parents.

Your pediatric dentist can encourage children to stop sucking and explain what could happen if they continue.

If these approaches don’t work, remind the children of their habit by bandaging the thumb or putting a sock on the hand at night. Your pediatric dentist may recommend the use of a mouth appliance.
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David Decides About Thumbsucking - A Story for Children, a Guide for Parents
by Susan Heitler PHD
Paula Singer (Photographer)

What is Pulp Therapy?

The pulp of a tooth is the inner, central core of the tooth. The pulp contains nerves, blood vessels, connective tissue and reparative cells. The purpose of pulp therapy in Pediatric Dentistry is to maintain the vitality of the affected tooth (so the tooth is not lost).

Dental caries (cavities) and traumatic injury are the main reasons for a tooth to require pulp therapy. Pulp therapy is often referred to as a "nerve treatment", "children's root canal", "pulpectomy" or "pulpotomy". The two common forms of pulp therapy in children's teeth are the pulpotomy and pulpectomy.

A pulpotomy removes the diseased pulp tissue within the crown portion of the tooth. Next, an agent is placed to prevent bacterial growth and to calm the remaining nerve tissue. This is followed by a final restoration (usually a stainless steel crown).

A pulpectomy is required when the entire pulp is involved (into the root canal(s) of the tooth). During this treatment, the diseased pulp tissue is completely removed from both the crown and root. The canals are cleansed, disinfected and, in the case of primary teeth, filled with a resorbable material. Then, a final restoration is placed. A permanent tooth would be filled with a non-resorbing material.
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What is the Best Time for Orthodontic Treatment?

Developing malocclusions, or bad bites, can be recognized as early as 2-3 years of age. Often, early steps can be taken to reduce the need for major orthodontic treatment at a later age.

Stage I – Early Treatment: This period of treatment encompasses ages 2 to 6 years. At this young age, we are concerned with underdeveloped dental arches, the premature loss of primary teeth, and harmful habits such as finger or thumb sucking. Treatment initiated in this stage of development is often very successful and many times, though not always, can eliminate the need for future orthodontic/orthopedic treatment.

Stage II – Mixed Dentition: This period covers the ages of 6 to 12 years, with the eruption of the permanent incisor (front) teeth and 6 year molars. Treatment concerns deal with jaw malrelationships and dental realignment problems. This is an excellent stage to start treatment, when indicated, as your child’s hard and soft tissues are usually very responsive to orthodontic or orthopedic forces.

Stage III – Adolescent Dentition: This stage deals with the permanent teeth and the development of the final bite relationship.
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EARLY INFANT ORAL CARE

Your Child’s First Dental Visit

According to the American Academy of Pediatric Dentistry (AAPD), your child should visit the dentist by his/her 1^st birthday. You can make the first visit to the dentist enjoyable and positive. Your child should be informed of the visit and told that the dentist and their staff will explain all procedures and answer any questions. The less to-do concerning the visit, the better.

It is best if you refrain from using words around your child that might cause unnecessary fear, such as needle, pull, drill or hurt. Pediatric dental offices make a practice of using words that convey the same message, but are pleasant and non-frightening to the child.
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When Will My Baby Start Getting Teeth?

Teething, the process of baby (primary) teeth coming through the gums into the mouth, is variable among individual babies. Some babies get their teeth early and some get them late. In general, the first baby teeth to appear are usually the lower front (anterior) teeth and they usually begin erupting between the age of 6-8 months. See "Eruption of Your Child’s Teeth" for more details.
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Baby Bottle Tooth Decay / Nursing Decay / Sippy Cup Decay

One serious form of decay among young children is baby bottle tooth decay, nursing decay, or sippy cup decay. This condition is caused by frequent and long exposures of an infant’s teeth to liquids that contain sugar. Among these liquids are milk (including breast milk), formula, fruit juice and other sweetened drinks.

Putting a baby to bed for a nap or at night with a bottle, frequent use of a sippy cup (other than water), and at will breast feeding can cause serious and rapid tooth decay. Sweet liquid pools around the child’s teeth giving plaque bacteria an opportunity to produce acids that attack tooth enamel. If you must give the baby a bottle as a comforter at bedtime, it should contain only water. If your child won't fall asleep without the bottle and its usual beverage, gradually dilute the bottle's contents with water over a period of two to three weeks.

After each feeding, wipe the baby’s gums and teeth with a damp washcloth or gauze pad to remove plaque. The easiest way to do this is to sit down, place the child’s head in your lap or lay the child on a dressing table or the floor. Whatever position you use, be sure you can see into the child’s mouth easily.
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Early Childhood Caries (ECC)

The American Academy of Pediatric Dentistry (AAPD) recognizes "early childhood caries" (ECC; formerly termed baby bottle tooth decay) as a significant public health problem. The AAPD encourages oral health care providers and caregivers to implement simple preventive practices that can decrease a child’s risks of developing this devastating disease.

Caries (dental decay) is biofilm (bacterial plaque) mediated acid demineralization of enamel or dentin.

Carious lesions are produced from the interaction of 3 variables: cariogenic microorganisms (mutans streptococci), fermentable carbohydrates (sucrose), and teeth (nonshedding tooth surfaces). Given the proper time, these variables induce incipient carious lesions that continue to progress. Frequent consumption of liquids containing fermentable carbohydrates (eg, juice, milk, formula, soda) increases the risk of caries due to prolonged contact between sugars in the consumed liquid and cariogenic bacteria on the susceptible teeth. Frequent bottle feeding at night, breast-feeding on demand, and extended and repetitive use of a no-spill training cup are associated with "early childhood caries".
Mother’s saliva.

The success of the transmission and resultant colonization of maternal MS depends largely on the magnitude of the innoculum. Infants and toddlers whose mothers have high levels of MS, a result of untreated caries, are at greater risk of acquiring the organism than children whose mothers have low levels. Consequently, it has been shown that suppressing maternal reservoirs of MS via dental rehabilitation and antimicrobial treatments can prevent or delay infant inoculation.

Consequences of ECC include a higher risk of new carious lesions in both the primary and permanent dentitions, hospitalizations and emergency room visits, increased treatment costs and time, insufficient physical development (especially in height/weight), loss of school days and increased days with restricted activity, diminished ability to learn, and diminished oral health-related quality of life.

The AAPD recognizes a distinctive pattern of caries, known as ECC, associated with frequent or prolonged consumption of liquids containing fermentable carbohydrates. To decrease the risks of this potentially devastating pattern of caries, the AAPD discourages inappropriate feeding practices of infants and toddlers and encourages appropriate preventive measures. These include:

Infants should not be put to sleep with a bottle containing fermentable carbohydrates. At will nocturnal breast-feeding should be avoided after the first primary tooth begins to erupt. If the infant falls asleep while feeding, the teeth should be cleaned before placing the child in bed.
Parents should be encouraged to have infants drink from a cup as they approach their first birthday. Infants should be weaned from the bottle at 12 to 14 months of age.
Repetitive consumption of any liquid containing fermentable carbohydrates from a bottle or no-spill training cup should be avoided.
Oral hygiene measures should be implemented by the time of eruption of the first primary tooth.
A dental home should be established within 6 months of eruption of the first tooth and no later than 12 months of age to conduct a caries risk assessment, educate parents, and provide anticipatory guidance for prevention of dental disease.
An attempt should be made to assess and decrease the mother’s/primary caregiver’s MS levels to decrease the transmission of cariogenic bacteria and lessen the infant's or child's risk of developing ECC.

What should I use to clean my baby's teeth?

A toothbrush will remove plaque bacteria that can lead to decay. Any soft-bristled toothbrush with a small head, preferably one designed specifically for infants, should be used at least once a day at bedtime.

When should I take my child to the dentist for the first check-up?

In order to prevent dental problems, your child should see a pediatric dentist when the first tooth appears, or no later than his/her first birthday.

PREVENTION

Care of Your Child’s Teeth

Begin daily brushing as soon as the child’s first tooth erupts. A pea size amount of fluoride toothpaste can be used after the child is old enough not to swallow it. By age 4 or 5, children should be able to brush their own teeth twice a day with supervision until about age seven to make sure they are doing a thorough job. However, each child is different. Your dentist can help you determine whether the child has the skill level to brush properly.

Proper brushing removes plaque from the inner, outer and chewing surfaces. When teaching children to brush, place toothbrush at a 45 degree angle; start along gum line with a soft bristle brush in a gentle circular motion. Brush the outer surfaces of each tooth, upper and lower. Repeat the same method on the inside surfaces and chewing surfaces of all the teeth. Finish by brushing the tongue to help freshen breath and remove bacteria.

Flossing removes plaque between the teeth, where a toothbrush can’t reach. Flossing should begin when any two teeth touch. You should floss the child’s teeth until he or she can do it alone. Use about 18 inches of floss, winding most of it around the middle fingers of both hands. Hold the floss lightly between the thumbs and forefingers. Use a gentle, back-and-forth motion to guide the floss between the teeth. Curve the floss into a C-shape and slide it into the space between the gum and tooth until you feel resistance. Gently scrape the floss against the side of the tooth. Repeat this procedure on each tooth. Don’t forget the backs of the last four teeth.
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Good Diet = Healthy Teeth

How do I make my child's diet safe for his teeth? Healthy eating habits lead to healthy teeth. Like the rest of the body, the teeth, bones and the soft tissues of the mouth need a well-balanced diet. Make sure your child has a balanced diet, including one serving each of: fruits and vegetables, breads and cereals, milk and dairy products, and meat fish and eggs. Limiting the servings of sugars and starches will also aid in protecting your child's teeth from decay. You can also ask your pediatric dentist to help you select foods that protect your children's teeth.

Most snacks that children eat can lead to cavity formation. The more frequently a child snacks, the greater the chance for tooth decay. How long food remains in the mouth also plays a role. For example, hard candy and breath mints stay in the mouth a long time, which cause longer acid attacks on tooth enamel. If your child must snack, choose nutritious foods such as vegetables, low-fat yogurt, and low-fat cheese, which are healthier and better for children’s teeth.
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How Do I Prevent Cavities?

How can parents help prevent tooth decay? Parents should take their children to the dentist regularly, beginning with the eruption of the first tooth. Then, the dentist can recommend a specific program of brushing, flossing, and other treatments for parents to supervise and teach to their children. These home treatments, when added to regular dental visits and a balanced diet, will help give your child a lifetime of healthy habits.

Good oral hygiene removes bacteria and the left over food particles that combine to create cavities. For infants, use a wet gauze or clean washcloth to wipe the plaque from teeth and gums. Avoid putting your child to bed with a bottle filled with anything other than water. See "Baby Bottle Tooth Decay" for more information.

How can I prevent decay caused by nursing? Avoid nursing children to sleep or putting anything other than water in their bed-time bottle. Also, learn the proper way to brush and floss your child's teeth. Take your child to a pediatric dentist regularly to have his/her teeth and gums checked. The first dental visit should be scheduled by your child's first birthday.

For older children, brush their teeth at least twice a day. Also, watch the number of snacks containing sugar that you give your children.

The American Academy of Pediatric Dentistry recommends visits every six months to the pediatric dentist, beginning at your child’s first birthday. Routine visits will start your child on a lifetime of good dental health.

Your pediatric dentist may also recommend protective sealants or home fluoride treatments for your child. Sealants can be applied to your child’s molars to prevent decay on hard to clean surfaces.
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Seal Out Decay

How do dental sealants work? Sealants work by filling in the crevasses on the chewing surfaces of the teeth. This shuts out food particles that could get caught in the teeth, causing cavities. The application is fast and comfortable and can effectively protect teeth for many years.

A sealant is a clear or shaded plastic material that is applied to the chewing surfaces (grooves) of the back teeth (premolars and molars), where four out of five cavities in children are found. This sealant acts as a barrier to food, plaque and acid, thus protecting the decay-prone areas of the teeth.

Before Sealant Applied

After Sealant Applied

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Fluoride

Fluoride is an element, which has been shown to be beneficial to teeth. However, too little or too much fluoride can be detrimental to the teeth. Little or no fluoride will not strengthen the teeth to help them resist cavities. Excessive fluoride ingestion by preschool-aged children can lead to dental fluorosis, which is a chalky white to even brown discoloration of the permanent teeth. Many children often get more fluoride than their parents realize. Being aware of a child’s potential sources of fluoride can help parents prevent the possibility of dental fluorosis.

Some of these sources are:

Too much fluoridated toothpaste at an early age.
The inappropriate use of fluoride supplements.
Hidden sources of fluoride in the child’s diet.

How do I know if my child is getting enough fluoride? Have your pediatric dentist evaluate the fluoride level of your child's primary source of drinking water. If your child is not getting enough fluoride internally through water (especially if the fluoride level is deficient or if your child drinks bottled water without fluoride), then your pediatric dentist may prescribe fluoride supplements.

Two and three year olds may not be able to expectorate (spit out) fluoride-containing toothpaste when brushing. As a result, these youngsters may ingest an excessive amount of fluoride during tooth brushing. Toothpaste ingestion during this critical period of permanent tooth development is the greatest risk factor in the development of fluorosis.

Excessive and inappropriate intake of fluoride supplements may also contribute to fluorosis. Fluoride drops and tablets, as well as fluoride fortified vitamins should not be given to infants younger than six months of age. After that time, fluoride supplements should only be given to children after all of the sources of ingested fluoride have been accounted for and upon the recommendation of your pediatrician or pediatric dentist.

Certain foods contain high levels of fluoride, especially powdered concentrate infant formula, soy-based infant formula, infant dry cereals, creamed spinach, and infant chicken products. Please read the label or contact the manufacturer. Some beverages also contain high levels of fluoride, especially decaffeinated teas, white grape juices, and juice drinks manufactured in fluoridated cities.

Parents can take the following steps to decrease the risk of fluorosis in their children’s teeth:

Use baby tooth cleanser on the toothbrush of the very young child.
Place only a pea sized drop of children’s toothpaste on the brush when brushing.
Account for all of the sources of ingested fluoride before requesting fluoride supplements from your child’s physician or pediatric dentist.
Avoid giving any fluoride-containing supplements to infants until they are at least 6 months old.
Obtain fluoride level test results for your drinking water before giving fluoride supplements to your child (check with local water utilities).

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Mouth Guards

What can I do to protect my child's teeth during sporting events? Soft plastic mouthguards can be used to protect a child's teeth, lips, cheeks and gums from sport related injuries. A custom-fitted mouthguard developed by a pediatric dentist will protect your child from injuries to the teeth, face and even provide protection from severe injuries to the head.

When a child begins to participate in recreational activities and organized sports, injuries can occur. A properly fitted mouth guard, or mouth protector, is an important piece of athletic gear that can help protect your child’s smile, and should be used during any activity that could result in a blow to the face or mouth.

Mouth guards help prevent broken teeth, and injuries to the lips, tongue, face or jaw. A properly fitted mouth guard will stay in place while your child is wearing it, making it easy for them to talk and breathe.

Ask your pediatric dentist about custom and store-bought mouth protectors.
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Xylitol - Reducing Cavities

The American Academy of Pediatric Dentistry (AAPD) recognizes the benefits of xylitol on the oral health of infants, children, adolescents, and persons with special health care needs.

The use of XYLITOL GUM by mothers (2-3 times per day) starting 3 months after delivery and until the child was 2 years old, has proven to reduce cavities up to 70% by the time the child was 5 years old.

Studies using xylitol as either a sugar substitute or a small dietary addition have demonstrated a dramatic reduction in new tooth decay, along with some reversal of existing dental caries. Xylitol provides additional protection that enhances all existing prevention methods. This xylitol effect is long-lasting and possibly permanent. Low decay rates persist even years after the trials have been completed.

Xylitol is widely distributed throughout nature in small amounts. Some of the best sources are fruits, berries, mushrooms, lettuce, hardwoods, and corn cobs. One cup of raspberries contains less than one gram of xylitol.

Studies suggest xylitol intake that consistently produces positive results ranged from 4-20 grams per day, divided into 3-7 consumption periods. Higher results did not result in greater reduction and may lead to diminishing results. Similarly, consumption frequency of less than 3 times per day showed no effect.

To find gum or other products containing xylitol, try visiting your local health food store or search the Internet to find products containing 100% xylitol.
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ADOLESCENT DENTISTRY

To My Teenage Patients

A bright smile fresh breath – that’s what a healthy mouth means.
It also means you can talk and laugh with confidence.

Here are facts, ideas and tips on keeping a healthy smile in your teenage years.

What You Need To Know about Your Dental Health

FACT 1: You have not outgrown tooth decay. In fact, dental decay may be more of a problem for you during the teen years than it ever has been before.

FACT 2: Gum disease (gingivitis) is a risk to your dental health. It is also a threat to your appearance. Gum disease causes red and swollen gums, bleeding gums and bad breath.

FACT 3: You will have all your permanent teeth with the possible exception of your wisdom teeth (third molars. During these growing years, your face and jaws will undergo many changes. You can be healthy and attractive through these changes by taking good care of your teeth and visiting your pediatric dentist.

How You Can Keep a Healthy Smile - It is up to you! What you do and do not do is important. Here is a checklist for a healthy smile:

Eat intelligently! Life is going to be hectic now. Choose fresh fruits and vegetables instead of junk foods when you eat on the run.
Snack smartly. Be careful of snack foods containing sugar; they can cause damage to the teeth and gums.
Practice good prevention at least twice a day. Brush effectively using a fluoridated toothpaste. Floss to prevent gum disease and tooth decay on the sides of the teeth.
Keep up with your dental checkups. Tooth cleanings, fluoride treatments and sealants are important preventive services for you.
Do not smoke or chew tobacco! The warnings you hear and read about are true. Besides lung and heart problems, tobacco can cause oral cancer. Of all cancers, 2.4 percent occur in the mouth and tobacco use has been estimated to account for over 90 percent of cancers of the oral cavity and pharynx.* If you are using tobacco and notice any changes in your mouth, contact your doctor immediately.
Wear a mouth guard for any sport or activity in which your mouth can be hit.
Buckle up in the car. A seat belt and shoulder harness can keep your face from striking the steering wheel, the dashboard or windshield during minor accidents.

Quiz on Eating Disorders - You (or a friend) may have an eating disorder if you answer YES to the following questions:

Do you weigh yourself more than once a day?
Are you obsessed with being very thin, even while you are below a normal weight?
Do you have a fear of not being able to stop eating?
Do you vomit after a meal – or have the urge to do so?
(For females only) Have you missed three consecutive menstrual periods?
All eating disorders have health risks. The worst cases can lead to death. Eating disorders associated with vomiting can damage the teeth because of stomach acid. If you suspect you have an eating disorder, please see your doctor as soon as possible.

Tips For Smart Snacking

Be careful of between-meal snacks.
Clear the snack from the teeth as soon as possible. Even a simple swish and rinse with water will help.
Do not let snacks take the place of nutritionally balanced meals.

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Tongue Piercing – Is it Really Cool?

You might not be surprised anymore to see people with pierced tongues, lips or cheeks, but you might be surprised to know just how dangerous these piercings can be.

There are many risks involved with oral piercings, including chipped or cracked teeth, blood clots, blood poisoning, heart infections, brain abscess, nerve disorders (trigeminal neuralgia), receding gums or scar tissue. Your mouth contains millions of bacteria, and infection is a common complication of oral piercing. Your tongue could swell large enough to close off your airway!

Common symptoms after piercing include pain, swelling, infection, an increased flow of saliva and injuries to gum tissue. Difficult-to-control bleeding or nerve damage can result if a blood vessel or nerve bundle is in the path of the needle.

So follow the advice of the American Dental Association and give your mouth a break – skip the mouth jewelry.
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Tobacco – Bad News in Any Form

Tobacco in any form can jeopardize your child’s health and cause incurable damage. Teach your child about the dangers of tobacco.

Smokeless tobacco, also called spit, chew or snuff, is often used by teens who believe that it is a safe alternative to smoking cigarettes. This is an unfortunate misconception. Studies show that spit tobacco may be more addictive than smoking cigarettes and may be more difficult to quit. Teens who use it may be interested to know that one can of snuff per day delivers as much nicotine as 60 cigarettes. In as little as three to four months, smokeless tobacco use can cause periodontal disease and produce pre-cancerous lesions called leukoplakias.

If your child is a tobacco user you should watch for the following that could be early signs of oral cancer:

A sore that won’t heal.
White or red leathery patches on the lips, and on or under the tongue.
Pain, tenderness or numbness anywhere in the mouth or lips.
Difficulty chewing, swallowing, speaking or moving the jaw or tongue; or a change in the way the teeth fit together.

Because the early signs of oral cancer usually are not painful, people often ignore them. If it’s not caught in the early stages, oral cancer can require extensive, sometimes disfiguring, surgery. Even worse, it can kill.

Help your child avoid tobacco in any form. By doing so, they will avoid bringing cancer-causing chemicals in direct contact with their tongue, gums and cheek.
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Fargo ND Pediatric Dentist ~ Dr. William Hunter ~ Pediatric Dentistry, Ltd. ~ Specialist in Dentistry for Infants, Children and Teenagers

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