Posts for: July, 2017

By Ralph Sahakian, D.M.D., P.C.
July 24, 2017
Category: Oral Health
DentalCareisDifficultbutnotImpossibleforaSpecialNeedsChild

A child with a chronic illness or condition often requires a lot of focus on care for their special needs. Other aspects of their health can often take a back seat — too often including dental care.

Proper dental care can be a challenge for special needs children if they have diminished physical, intellectual or behavioral capacities. Children with autism or attention deficit disorders may not be able or willing to perform tasks like brushing and flossing. Other conditions could make them intolerant to toothpaste in the mouth, or create an inability to keep their mouths open or to spit.

Some chronic conditions also seem predisposed to dental defects. For example, enamel hypoplasia, a lack of sufficient tooth enamel, is common with Down, Treacher-Collins or Turner Syndromes, and can greatly increase the risk of tooth decay.

But even though difficult, effective dental care isn't impossible. It begins with your dental provider.

Pediatric dentists are often excellent in this regard: they often have the training and experience to treat children with chronic conditions. Whoever you choose must be able to partner with you in caring for your child's dental needs.

Daily hygiene is also a critical factor. Your goal should be the same as with any child — to teach them to brush and floss for themselves. Depending on their condition, however, you may need to assist them for a longer term, perhaps permanently. But it is imperative — daily hygiene is their best defense against oral diseases.

You should also consider their medication and how it may impact their dental health. Antidepressants, antihistamines or drugs that assist with breathing function can cause mouth dryness. This, as well as drugs with sugar or acid compounds, can increase risk for dental disease. If they must take these types of medications, try to give them at mealtime to reduce their effect in the mouth.

Above all, pursue the same professional dental care as you would for any other child. Keep up regular dental visits beginning around their first birthday for cleanings and preventive measures like topical fluoride or sealants. By taking these measures you'll help ensure their dental health won't suffer.

If you would like more information on dental care for special needs children, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Managing Tooth Decay in Children with Chronic Diseases.”


FifthHarmonysCamilaCabelloChipsaToothbutConcertStillWorthIt

Everyone loves a concert where there's plenty of audience participation… until it starts to get out of hand.├é┬áRecently, the platinum-selling band Fifth Harmony was playing to a packed house in Atlanta when things went awry for vocalist Camila Cabello. Fans were batting around a big plastic ball, and one unfortunate swing sent the ball hurtling toward the stage — and directly into Cabello's face. Pushing the microphone into her mouth, it left the “Worth It” singer with a chipped front tooth.

Ouch! Cabello finished the show nevertheless, and didn't seem too upset. “Atlanta… u wild… love u,” she tweeted later that night. “Gotta get it fixed now tho lol.” Fortunately, dentistry offers a number of ways to make that chipped tooth look as good as new.

A small chip at the edge of the tooth can sometimes be polished with dental instruments to remove the sharp edges. If it's a little bigger, a procedure called dental bonding may be recommended. Here, the missing part is filled in with a mixture of plastic resin and glass fillers, which are then cured (hardened) with a special light. The tooth-colored bonding material provides a tough, lifelike restoration that's hard to tell apart from your natural teeth. While bonding can be performed in just one office visit, the material can stain over time and may eventually need to be replaced.

Porcelain veneers are a more long-lasting solution. These wafer-thin coverings go over the entire front surface of the tooth, and can resolve a number of defects — including chips, discoloration, and even minor size or spacing irregularities. You can get a single veneer or have your whole smile redone, in shades ranging from a pearly luster to an ultra-bright white; that's why veneers are a favorite of Hollywood stars. Getting veneers is a procedure that takes several office visits, but the beautiful results can last for many years.

If a chip or crack extends into the inner part of a tooth, you'll probably need a crown (or cap) to restore the tooth's function and appearance. As long as the roots are healthy, the entire part of the tooth above the gum line can be replaced with a natural-looking restoration. You may also need a root canal to remove the damaged pulp material and prevent infection if the fracture went too far. While small chips or cracks aren't usually an emergency (unless accompanied by pain), damage to the tooth's pulp requires prompt attention.

If you have questions about smile restoration, please contact us and schedule an appointment. You can read more in the Dear Doctor magazine articles “Porcelain Veneers: Strength & Beauty As Never Before” and “Porcelain Crowns & Veneers.”


By Ralph Sahakian, D.M.D., P.C.
July 01, 2017
Category: Oral Health
Tags: oral appliance  
TakeCareofYourDentalAppliancetoExtenditsLongevity

What do dentures, retainers and nightguards have in common? Along with orthodontic aligners and athletic mouthguards, they’re all types of removable dental appliances. They also share another commonality: each one depends on the wearer caring for it to ensure its longevity.

The most important thing you can do for your appliance is to clean it regularly. Don’t use toothpaste, though, even with dentures: while your natural tooth enamel can handle the abrasive particles in toothpaste, your appliance’s materials may not. Toothpaste can create tiny scratches that can harbor disease-causing bacteria. Instead, use liquid dish detergent or hand soap with warm water.

Although boiling water may disinfect your appliance, it’s not advisable to use. Even hot water can distort plastic components and warp the appliance’s fit in your mouth. Likewise, don’t use bleach, which can fade the plastic color used to resemble gum tissue and break down the material’s composition. When you clean your appliance, use a brush — but not the one you use for your natural teeth. Use a soft toothbrush, a nail brush or a specialized brush for appliances like dentures.

You should also protect your appliance from damage. Some appliances like dentures have parts that can break if they’re dropped on a hard surface — like the porcelain in your sink. To prevent this, place a towel in the sink to cushion the appliance if it accidentally slips from your hand during cleaning. And when the appliance isn’t in your mouth, don’t keep it on a low table or night stand where small children or pets can easily get their hands (or paws) on it.

And one more thing: don’t wear your denture appliance around the clock — take it out, for instance, while you sleep. Leaving dentures in interferes with the acid-neutralizing and antibacterial function of your mouth’s saliva, which could increase your risk of disease (and bad breath).

Appliances can be an expensive investment in your dental health. By following these guidelines you’ll help protect that investment for years to come.

If you would like more information on caring for your dental appliance, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “10 Tips for Cleaning Your Oral Appliance.”




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Ralph Sahakian, D.M.D., P.C.

14 Lake Avenue Worcester, MA 01604