Newborns come into the world eager and ready to partake of their mother's milk. But an anatomical quirk with some infants could make breastfeeding more difficult for them.
The structure in question is a frenum, a tiny band of tissue connecting softer parts of the mouth with firmer parts, like the upper lip to the gums, and the tongue to the floor of the mouth. If they're abnormally short, thick or tight, however, the baby might find it difficult to obtain a good seal around the mother's nipple.
Without that seal, the baby has a difficult time drawing milk out of the breast and as a result, they may attempt to compensate by chewing on the nipple. The sad outcome is often continuing hunger and frustration for the baby, and pain for the mother.
To alleviate this problem, a physician can clip the frenum to loosen it. Known as a frenotomy, (or a frenectomy or frenuplasty, depending on the exact actions taken), it's a minor procedure a doctor can perform in their office.
It begins with the doctor deadening the area with a numbing gel or injected anesthesia. After a few minutes to allow the anesthesia to take effect, they clip the frenum with surgical scissors or with a laser (there's usually little to no bleeding with the latter).
Once the frenum has been clipped, the baby should be able to nurse right away. However, they may have a learning curve to using the now freed-up parts of their mouth to obtain a solid seal while nursing.
Abnormal frenums that interfere with nursing are usually treated as soon as possible. But even if it isn't impeding breastfeeding, an abnormal frenum could eventually interfere with other functions like speech development, or it could foster the development of a gap between the front teeth. It may be necessary, then, to revisit the frenum at an older age and treat it at that time.
Although technically a surgical procedure, frenotomies are minor and safe to perform on newborns. Their outcome, though, can be transformative, allowing a newborn to gain the full nourishment and emotional bonding they need while breastfeeding.
If you would like more information on tongue or lip ties, 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 “Tongue Ties, Lip Ties and Breastfeeding.”
According to the World Health Organization, more than 1 billion people around the world have a disability. That's one in eight individuals of all ages who may need assistance managing their daily lives. One area in particular that often requires caregiver attention is oral health, which isn't always easy.
Depending on the disability, addressing a disabled individual's health needs can be overwhelming—and such concerns may be even greater now due to COVID 19. In light of all these and other pressing issues, caring for a disabled person's teeth and gums could easily take a back seat.
But oral health has a far greater impact on a person's health than just their mouth. Inflammation related to gum disease, for example, could worsen other systemic diseases like diabetes or heart disease. And, unhealthy (or missing) teeth could inhibit a person in meeting their nutritional needs.
But you can effectively manage their oral health by keeping your focus on a few principal items related to dental care. In recognition of International Day of People with Disabilities this December 3rd, here are some practical guidelines for ensuring your friend or family member maintains their oral health.
Stay consistent with daily hygiene. Brushing and flossing can be very effective toward preventing dental disease, but only if it's consistently practiced every day. Someone with a disability may need help maintaining that consistency, so be sure you set a regular time and place for them to brush and floss to help reinforce the habit.
Make brushing and flossing easier. These twin hygiene tasks may also pose challenges for a disabled person who has issues with physical dexterity or cognitive function. You can help ease those challenges by making sure they have the best tools to help them perform the task at hand, like large-handled brushes, flossing picks or water flossers.
Brush and floss together. For some individuals with a disability, a caregiver may need to perform their hygiene tasks for them. But even if they're able to do it for themselves, it may still be overwhelming for them on their own. In that case, brushing and flossing with them, and injecting a little fun into the activity, can help positively reinforce the habit for them.
Accompany them to the dentist. If you're heavily involved in a disabled person's daily oral care, you may want to go with them and sit in on their regular dental visits. This is a time when you and their dentist can "exchange notes," so to speak, to better be in sync with what needs to be done to improve your loved one's oral care.
It's normal for your child to breathe through their mouth if they're winded from play, or if they have a stuffy nose from an occasional cold. But what if they're doing it all the time, even at rest? That could be a problem for their overall health—and their oral health as well.
Although we can breathe through both the nose and the mouth, our bodies naturally prefer the former. The nasal passages filter out allergens and other harmful particles, as well as warm and humidify incoming air. Nose breathing also helps generate nitric oxide, a highly beneficial molecule to physical health.
We switch to mouth breathing when we're not receiving sufficient air through the nose. For chronic mouth breathers, something has obstructed or restricted the nasal passages like allergies or enlarged tonsils or adenoids.
Mouth breathing especially can affect a child's oral health because of the relationship between the tongue and jaw development. During nose breathing, the tongue rests against the roof of the mouth (palate), where it serves as a kind of mold around which the growing upper jaw can develop.
When breathing through the mouth, however, the tongue falls against the back of the bottom teeth. If this becomes chronic, the jaw may develop too narrowly, depriving the incoming teeth of enough room to erupt and leading to a poor bite.
If you notice things like your child's mouth falling open while at rest, snoring, irritability or problems with concentration (associated with poor sleep due to blocked nasal passages), then consider having a doctor examine them for a possible nasal obstruction. You should also check with your dentist to see if your child's jaw development has been affected. If caught early, there are interventional measures that could get it back on track.
Even after correction of a nasal obstruction, a child may still find it difficult to readapt to nose breathing because of a "muscle memory" for breathing through the mouth. In that case, they may need orofacial therapy to retrain their muscles for nose breathing.
It's important to stay aware of any signs of chronic mouth breathing with your child. Diagnosing and treating the condition early could help them avoid other problems later in life.
If you would like more information on the effects of mouth breathing on jaw development, 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 “The Trouble With Mouth Breathing.”
Until recently, the standard treatment for tooth decay remained essentially the same for nearly a century: Remove any decayed structure, then prepare and fill the cavity. But that singular protocol has begun to change recently.
Although "drilling and filling" saves teeth, it doesn't fully address the causes of decay. In response, dentists have broadened their approach to the disease—the focus now is on an individual patient's particular set of risk factors for decay and how to reduce those.
At the heart of this new approach is a better understanding of oral bacteria, the true cause of decay. Bacteria produce acid, which can erode tooth enamel and create a gateway into the tooth for decay to advance. We therefore want to lower those risk factors that may lead to bacterial growth and elevated acidity.
One of our major objectives in this newer approach is to reduce plaque, a thin film of food particles used by bacteria for food and habitation. Removing plaque, principally through better oral hygiene, in turn reduces decay-causing bacteria.
Plaque isn't the only mechanism for bacterial growth and acidity. Appliances like dentures or retainers accumulate bacteria if not regularly cleaned. Reduced saliva flow, often due to certain medications or smoking, limits this fluid's ability to buffer acid and acid reflux or acidic beverages like sodas, sports or energy drinks can disrupt the mouth's normal pH and increase the risk for enamel erosion.
Our aim, then, is to develop a long-term strategy based on the patient's individual set of oral disease risk factors. To determine those, we'll need to examine their medical history (including family), current health status and lifestyle habits. From there, we can create a specific plan targeting the identified risk factors for decay.
Some of the elements of such a strategy might include:
Improving the mouth environment by limiting the presence of oral bacteria and acid can reduce the occurrence of tooth decay and the extent of treatment that might be needed. It's a more nuanced approach that can improve dental health.
If you would like more information on tooth decay prevention and treatment, 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 “Tooth Decay: How to Assess Your Risk.”
In addition to daily oral hygiene and regular dental visits, a tooth-friendly diet can boost your kid's dental health and development. You can help by setting high standards for eating only nutritious foods and snacks at home.
But what happens when they're not home—when they're at school? Although public schools follow the Smarts Snacks in Schools initiative sponsored by the U.S. Department of Agriculture, those guidelines only recommend minimum nutritional standards for foods and snacks offered on campus. Many dentists, though, don't believe they go far enough to support dental health.
Besides that, your kids may have access to another snack source: their peers. Indeed, some of their classmates' snacks may be high in sugar and not conducive to good dental health. Your kids may face a strong temptation to barter their healthy snacks for their classmates' less than ideal offerings.
So, what can you as a parent do to make sure your kids are eating snacks that benefit their dental health while at school? For one thing, get involved as an advocate for snacks and other food items offered by the school that exceed the USDA's minimum nutritional standards. The better those snacks available through vending machines or the cafeteria are in nutritional value, the better for healthy teeth and gums.
On the home front, work to instill eating habits that major on great, nutritional snacks and foods. Part of that is helping your kids understand the difference in foods: some are conducive to health (including for their teeth and gums) while others aren't. Teach them that healthier foods should make up the vast majority of what they eat, while less healthier choices should be limited or avoided altogether.
Doing that is easier if you take a creative, playful approach to the snacks you send with them to school. For example, if you send them to school with their own snacks, add a little excitement like cinnamon-flavored popcorn or cheese and whole wheat bread bites in different shapes. And make it easier for them with bite-sized snacks like grapes, baby carrots or nuts.
You can't always control what snacks your kids eat, especially at school. But following these tips, you may be able to influence them in the right direction.
If you would like more information on helping your child develop tooth-friendly snacking habits, 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 “Snacking at School.”