My biggest piece of advice is this: Do not allow or at least minimize the amount of soda, diet soda, sports-energy drinks and fruit juices you allow your children to have. This is particularly so with teenagers. With all of soda “hype” and advertising geared toward kids these days, there’s been a significant increase in the number and frequency of cavities in kids of all ages. Advertisers have been successful in their marketing and the results have been devastating. Kids are getting so many more cavities, and much, much earlier. This has had a huge ripple-effect in many areas of health, not just teeth, including obesity, diabetes, high blood pressure and more.

Dental work is not an exact science, Things wear out, break down, stop working and need to be replaced eventually. At some point, teeth can no longer be filled and fixed. After multiple fillings or other procedures, there sometimes just isn’t enough tooth left to work with. With so much soda exposure (diet and regular), teeth are being filled much earlier in our children.

This increases the rate at which this “dental fatigue” occurs, leading to earlier and more abundant tooth loss. Because of the way in which sodas and all of these new sugary drinks work, they almost always cause cavities in multiples. Rather than a single cavity in few years, kids now come in with 10 or more at one time before they are even 18 years old. This can be very traumatic to the child, very expensive for the parents and result in continual dental problems throughout the child’s life.

So I hope that my message was loud and clear and that you will take it very seriously. Even if your child is not a soda-drinker or a sweets-lover, they may still be prone to getting cavities for other reasons such as poor hygiene or even a family history. There are other things you can do to help prevent tooth decay which are discussed in the “General Information” category.

If I had a quarter for each time I was asked this question, I would be retired on a beach, relaxing with an umbrella drink in my hand! This question, as well as the one after it, has many different answers, depending on who you talk to. The reason being is this: Removal of wisdom teeth is predominantly a practice philosophy rather than an exact science. What I mean is, there is much leeway, discussion and debate among all types of dentists as to what is the best treatment of wisdom teeth is. So, what I will give you is my personal philosophy, but the decision is ultimately yours!

Wisdom teeth are the last teeth to erupt and are the teeth furthest toward the back of the mouth. They are also referred to as “third molars,” and will frequently never appear in mouth. This can be due to lack of space in the mouth or simply because many people are born without them. Often times, there is no room for the wisdom teeth to erupt, leaving them trapped in the jaw or only partially erupted. So let’s discuss a few of the problems which arise from extracting them vs. leaving them and you will quickly see why there is so much debate.

If the wisdom teeth do have space to come in completely, then a few scenarios can occur. If your child is able to reach all the way back there and keep them immaculate, then typically there are not any problems with keeping them. However, it has been my experience that few adults are able to keep them clean enough to avoid cavities or gum disease around the teeth. It is extremely rare that I actually get to witness the miracle of cavity-free wisdom teeth. Generally, it takes awhile to get a cavity back there (it usually shows up in your mid-twenties to mid-thirties.)

Once a cavity is present, the tooth either needs to be filled or extracted. Attempts to fill wisdom teeth are mediocre at best, unless you have the ability to open very wide. Because the teeth are so close the jaw-joint, it is very difficult for the dentist to see if all the decay has been removed, or keep the tooth dry enough to retain the filling.

In most cases, the filling eventually fails and the tooth has to be extracted anyway. The same holds true for gum disease. Because they are hard to clean, they very often are afflicted with moderate to severe gum disease. If left, the gum disease can cause bone loss around the tooth, bad breath and possibly increase the risk for spreading the disease to the rest of the mouth.

As adults, we heal much slower, experience more pain and have the added trouble of having to take time off of work. I personally tend to be more pro-active with recommending extraction of wisdom teeth, especially those that will likely fully erupt into the mouth. This is because I know the child will be thankful I did once they are an adult!

The other advantage is, that when you remove the wisdom teeth before they are completely developed, they are actually much easier to remove. This results in less pain after surgery, faster healing time and less of a risk of complications from the procedure. So, the possibility of reducing these risks by extracting them as an adolescent is very appealing to me as a mom and a dentist!

Well, let’s suppose that the wisdom tooth is not in at all, partially in (but stuck that way), or has no space whatsoever to come in. An x-ray (a panorex or panoramic film) will have to be evaluated by the dentist or oral surgeon before a decision can be made. Most times the teeth can still be removed with relative ease and without complication. However, there are situations which may predispose your child to temporary or permanent complications.

Close proximity of the lower wisdom teeth to the main nerve supplying all the teeth can be a concern. Injury to this or any other nerves in the areas can cause partial or complete, permanent or temporary numbness to the lip, chin, teeth, gums, tongue or skin in the area. In addition, the top teeth may be so high up in the jaw that risk of damage to the sinuses and other structures can occur. Your oral surgeon will be aware of these complications and any others as they apply to your child.

So, if the wisdom teeth seem risky to extract and the likelihood of the teeth ever erupting is low, then I typically recommend leaving them. The benefits of extraction must be carefully measured against the risks involved and be sure to discuss them in detail with your surgeon.

I also want to bring up the importance of the oral surgeon here. As we discussed earlier, specialists exist in dentistry because they are necessary! While there are general dentists who can take out wisdom teeth with great proficiency, I still strongly encourage having an oral surgeon perform the procedure.

An oral surgeon does this procedure every day, many times a day and they are simply better, faster at it and are more familiar with the complications which can occur from their removal. They are also more familiar with the internal jaw anatomy which is rarely seen by a general dentist. This is not to say that a general dentist is not capable, as there are plenty out there that would do just as good as any oral surgeon. However, my experience has been that this is the exception and not the rule.

The answer is absolutely! In fact, many sugar-free gums today contain an amazing substance called Xylitol. Xylitol has been shown in studies to actually help decrease tooth decay and acts as a mild antibacterial agent. Some of the brands which contain xylitol are, Orbitz, Koolerz and Trident’s sugar free gum. There are more brands now on the market, so just read the package to see if it is in the gum. Generally, the closer the desired ingredient is to the beginning of the list on the package (in this case xylitol), the more it contains.

In addition, chewing gum stimulates saliva flow which helps to fight further against cavities. Saliva contains many natural anti-cavity substances in it and is just one more hopeful way to protect teeth. So let them chew like crazy!

There are various aids to help fend off cavities caused by dry mouth, including anti-cavity rinses, prescription toothpastes and more (discussed in the general questions section). There are also several over-the-counter items that can be used to help stimulate saliva flow and moisten a dry mouth, such as Biotene brand products (sold in pharmacy area of most grocery stores). Chewing sugar-free gum is also a great way to increase saliva flow and helps with the effects of dry mouth syndrome.

If your child suffers from a dry mouth, have them drink water throughout the day. Do not allow them to sip on soda, diet soda or fruit juice, or you will likely see cavities very quickly. A dry mouth alone can increase the rate of getting cavities significantly, as saliva contains many anti-cavity substances. So, once you add sugars to the mix, it is a recipe for disaster!

The only other significant effect that steroid inhalers can have on the mouth is increasing the risk of getting oral yeast infections. You may have also heard it called “thrush” or “candidiasis.” “Thrush” is a condition caused by the overgrowth of a normal bodily fungus called, “Candida Albicans.” This fungus is normally present, but occasionally (especially while taking antibiotics or steroid-containing medicines) can grow in more abundance than usual. Thrush is very frequently seen in babies during the bottle or nursing stage, but less often with inhaler use It can range in severity but looks like “curdled milk” in the mouth that won’t wipe off. If it caused by an inhaler, it is usually seen on the roof of the mouth and throat.

It doesn’t usually hurt anything but can cause irritation or burning to the oral cavity and look unsightly. However, you don’t want to leave it untreated, as it is possible for the fungus to infect the blood or other areas of the body. This is rare but should be mentioned, as to avoid a potentially life threatening situation.

Both children and adults can get candidiasis, but adults typically get it in others areas of the body and is experienced much more by women. The best way to avoid both “thrush” and dry mouth from inhaler use is to rinse the mouth out with water out after each use. This is true for both children and adults who use steroid inhalers. There are medications to treat oral yeast overgrowth and they are usually very simple and work very well. Again, if you see any white areas in your child’s mouth anywhere, always consult your dentist or pediatrician, as it could be caused by other more serious things.

Often, yes. Occasionally, no.  Sensitivity to sweets in children (and adults) can mean that there is a cavity lurking.  The presence of sugar in the sweets will cause a chemical reaction within a decaying tooth. This reaction causes that “twinging nerve pain” or sensitivity, which may or may not linger for a little while after the sweet treat.   It is best to take your child to the dentist and let them examine the tooth and take an x-ray if needed to see if a cavity is causing the sensation.

Sensitivity to hot or cold in a child’s tooth (baby teeth or permanent teeth) can be of concern.  A cavity can also cause sensitivity to hot and cold, however if it is, this is usually a sign that the cavity is already large. This can also be a sign of the nerve dying and/or and abscess of a tooth.  Again, the appropriate treatment would be to see your dentist immediately and let them take an x-ray if needed.  If an x-ray is taken and other tests done confirm that the nerve is dying or that an abscess is present, your dentist will discuss options with you.

Options for treatment of cavities or abscesses (dead/dying nerve) may include procedures such as extraction (with or without a space maintainer to hold the space open for the future permanent tooth), baby tooth root canal, filling or stainless steel crown.  The decision for treatment options is made based on the amount of damage/decay in the baby tooth, the length of time until it would normally fall out and position of the underlying permanent tooth.   Of course, we want to do our best to try to save baby teeth, particularly if it will help the child avoid braces in the future.  But all of these things must be taken into consideration in order to make the best decision for the child.

Occasionally in children, but most often in adults, this sensitivity can be caused by an area where the gum has receded away from the tooth.  You don’t see this too often with children, simply because the baby teeth are actively changing form each day, and they don’t have the sensitive roots that adult teeth have.  It is quite uncommon for gums to recede in children or even in teenagers (unless they have braces).  So, the bad news is that it is likely a cavity causing the pain.

These sensations can also be normal and transient.  Your dentist will likely use a combination of diagnostic procedures to evaluate the offending tooth.  If nothing obvious can be found that explains the source of the pain, they  may opt to “watch” the tooth.  What this means is, they will ask for your help in monitoring your child’s symptoms at home and call if things change (for better or for worse).  Either way, your dentist may decide to take a new x-ray in a few weeks to see if there are any changes.

Teeth are strange in that sometimes they give symptoms disproportionate to their experienced “trauma.”  For example, when eating a chip or popcorn or some crunchy food item, occasionally a piece may break off and get lodged beneath the gum without you or your child even noticing.  The area may then become tender and feel like a toothache, hot and cold sensitive or become painful on chewing.  A trip to the dentist may show nothing and then the sensitivity goes away in a few weeks.

A tooth can also be traumatized by biting into something hard which can cause the ligament which holds the tooth in to be “bruised.”  This may cause biting sensitivity for a week or two which may also go away on its own.  There are many examples of these situations but most commonly, symptoms are actually due to the presence of a cavity or an abscess.  So, always have your dentist check the area rather than assuming there is nothing really wrong.

Unfortunately,  black spots on teeth are usually the sign of a problem.  The most common cause of black spots on both baby and permanent teeth are cavities. In the early stage of cavity development, they appear white or yellowish and are “chalky” looking.  This description is given so because the consistency of the cavity is such that it feels like chalk if you were to touch it.  It literally will “flake” away if touched with a dental instrument.  If the cavity continues to progress, it will go through several other color and consistency changes which typically yield an end-result of the black color.  Sometimes they may only appear dark brown, as color can vary between individuals.

There may or may not be any pain at all associated with the cavity.  Frequently when I find cavities the first thing that people will say to me is, “But Doc, it doesn’t hurt.”  My next response is almost always, “Cancer doesn’t usually hurt either-until it has progressed too far.”  Tough analogy, I know but very true.  If a cavity gets to the point where it hurts or starts that “twinging” feeling, it usually means that it is pretty large already.  This may or may not mean that the tooth needs a root canal.  But first, let’s describe the cavity process and how it effects teeth.

A cavity is simply a bacterial  infection in the tooth.  These bacteria use the sugar in our foods to “eat” and thrive.  As they “digest” these sugars, the bacteria secrete a strong acid as a waste product.  This strong acid decomposes healthy tooth structure (called enamel and dentin, which are non-living substances) and turns it soft and mushy.  If this process continues, it eventually decomposes close to or into the nerve chamber of the tooth (also called the pulp chamber or nerve).

Once these bacteria are exposed to the living tooth nerve tissue, it infects the pulp chamber and causes the nerve and blood vessels in the tooth to die.  The process is usually quite painful in its final dramatic death scene, but may eventually stop hurting.  Loss of pain sensation is because the infection likely found a way to escape the highly dense tooth compartment (the tooth root system and surrounding bone).

Here’s where it gets really gross.  This release of pressure and pain is because the pus/infection found a way to drain into the mouth.  Often you can’t see where it is draining, but sometimes you can.  It is usually in the form of a little “knot”  or bump on the gum next to the tooth which expels puss through a tiny little opening.   This secretion of puss releases pressure build up from the infection and then suddenly you feel much better.  At least for awhile.  If left long, the infection will come back much worse, usually with outward and swelling and a whole lot of pain!

Once this start of this entire process begins, it is irreversible and the dead nerve tissue has to be removed or a massive infection can occur.  This infection can stay localized within the jaw, but can also become life-threatening if the infection enters the blood stream and goes through the rest of the body.  This process to remove the infection is called a root canal and the treatment and type of root canal depends on whether the tooth is a baby tooth or a permanent tooth.  We’ll address root canals of both kinds in a later section.

Trust me when I tell you that root canals have gotten a bad reputation.  Yes they are expensive (can range from $600-$1000 each), so preventing them is better than having to pay for one.  However, the reputation they have received for being horribly painful is a myth.  Normally root canals are only painful if you wait to go to the dentist until your infection/abscess is very bad (swollen and/or painful to the point of tears).  The reason for this is that the localized infection actually counteracts the anesthetic used to put the tooth to sleep, allowing the root canal procedure to be felt.  Very painful indeed.

So what exactly is a root canal?  Well, simply put, a root canal is the removal of the dead or dying nerve tissue within the tooth, followed by a cleansing of the nerve canals to remove as much of the bacteria as possible.  Then the empty, clean nerve canals are filled with a special sterile rubber material which seals the canals to prevent more bacteria from entering the tooth.  It is generally not painful at all, and one of the dental procedures I consider to be the most boring and relaxing of all (for both the patient and the dentist).  The key here again is to NOT wait until it starts to hurt.  If you or your child feels something strange going on in a tooth, it is always better to have it looked at and be on the “safe-side.”

While the black spots are usually cavities, this whole root canal process is meant to describe what happens in a permanent tooth.  Baby teeth can also get these same types of cavities, but the treatment is slightly different for both the cavity and the root canal (if needed).  The discussion on treatment of cavities and root canals in baby teeth will be discussed further in the next few questions.

There are other causes for black spots, but they are less common and include the following: damage during tooth development, underlying systemic disorders and excessive amounts of fluoride (usually occurs when given excessive fluoride supplement).  As always, take your child to the dentist for an evaluation immediately if you see black or white spots on their teeth.

Most people are not aware that tooth decay is actually a bacterial infection, a lot like a sinus infection.  The way that they differ is that decay is a chronic infection that isn’t cured with the use of antibiotics.  If left untreated, it can have multiple affects on the body as well as the mouth such as pain, loss of teeth, inability to chew or speak and possible life threatening infections.

In order for both the initial and chronic infection (tooth decay) to occur, three things are needed.  First and most important, the bacteria itself has to be present.  Infants, when born lack this bacteria in their mouths.  Unfortunately, the way they get it is through mouth to mouth or facial contact with someone who does (the cavity causing bacteria can be transmitted through saliva).  Oh, I know, we all love to coo and cuddle and receive a plethora of slobbery smooches to our cute little babes, but there is a price to pay.  The longer we can keep dirty adult mouths away from our kids, the better chance they will have of not acquiring the decay causing little bugs.

Second and equally as important, is that these “bugs” need a “host” mouth to grow in.  Without that slobbery little Petri dish of a mouth, these bacteria could not grow.  Just add teeth to the mix and you’ve got a tooth decay party in there!  Without teeth to grow and in, cavities could not occur.

Third and also very important is that these bacteria need nutrition in order to grow.  I personally enjoy sweets, potato chips and other goodies, and these little buggers are no exception!  The sweeter the better!  Sugar (a carbohydrate) is the main staple for these bacteria.  They consume it for energy and in the process of doing so, create acids as byproducts, which are harmful for the teeth.  These very strong acids are what break down the tooth structure, causing what are known as cavities.  So, a cavity is really a bacterial infection resulting in the decomposition of tooth structure.  So, the more sugar containing or simple carbohydrates rich foods eaten in the presence of these bugs will lead more quickly to a cavity.   This of course can only occur if those specific bacteria are present in the mouth in high enough numbers to cause damage.  And, unfortunately, this is the case for most people.

In most adults, there are plenty of bacteria to cause cavities and  more than enough to pass along to our children.  In addition to their fine choice in dining, these little bacteria also flourish in areas which are high in acidity.  What does this mean for us?  Well, our generation has a particular liking for one of the finest-ever, cavity causing inventions. Brown, clear, orange, yellow diet or regular, soda has become one of the most delectable dietary delights for cavity-causing germs.  Soda happens to be extremely acidic and loaded with sugar.  This makes a perfect recipe for speedy, extensive tooth decay.  And, for children whose teeth decay much faster due to their tooth composition, this can mean a ton of dental work and expensive dental bills.

I already know what you are probably thinking- “But it’s diet soda, I or my kids won’t get cavities from that!”  WRONG!  Though it doesn’t contain the sugar needed for the decay process, it is very acidic and provides the perfect environment for these bacteria. As mentioned earlier, these bacteria thrive in an acidic environment.  In addition to providing a better environment for growth, the constant exposure to acid softens the enamel of the teeth, making them easier to break down.   This is true for diet and regular sodas.  Diet soda, combined with other sugary foods or carbohydrates that can be broken down into these usable sugars can cause decay almost as rapidly as regular soda.

So, when you consume other simple sugars such as juices, candy, potato chips, raisins, crackers and more, you can be doing the same thing as having a soda (without the presence of the acid) if you don’t brush soon after.  For children, raisins in particular can cause an abundance of cavities.  This fact is troubling, as I see parents trying so hard to give their children a nutritious snack, but it may be unknowingly wreaking havoc on their child’s baby teeth.  I am not saying to outlaw raisins, fruit, juice, etc., because they are definitely delicious and nutritious. Just be aware of their hidden dangers and try to incorporate brushing soon after these types of snacks.  Otherwise, a sticky film of bacteria will adhere to the teeth and attempt to begin the tooth decay process.  This is why brushing your teeth is recommended at least twice a day for two minutes.  Of course, this brushing can also help avoid gum disease, but will definitely help to reduce decay when combined with a proper diet.

I know, I know-I am taking away all the fun and enjoyment out of eating.  But, there is a solution that will allow you to have some of your cake and eat it too!  One of the other biggest factors in this decay process is the frequency of exposure to these dietary delights.  The more frequent you have them, the faster and more decay you will have.  So, if your child wants juice because they are used to having it, then there is a way to do it correctly.  The child should have no more than one glass of fruit juice a day and should drink it all at meal time or snack time.  DO NOT let your child sip on one cup of juice the entire day.  Even though it is still only one cup, it is the consistent exposure to sugar throughout the day that will cause damage.  This same principle applies to soda/diet soda as well as to adult or baby teeth.

I strongly discourage any child from having soda.  My children never got it as toddlers and they actually don’t prefer to have it now.  They are used to milk and water with a meal and water throughout the day if they are thirsty.  They never complain about it and it gives me time to worry about other important stuff like saving for college and getting their homework assignment finished.  The real struggle will be if your child is already used to having these things in their diet, so I recommend curtailing it early on to avoid major tantrums.

I am not going to lie. It is going to be absolute torture to get them to stop once they have started.  You are going to want to give up on trying because you will be so weary of watching your little angel throw tantrums and refuse to sleep or function without their comfort drinks.  You must be persistent or you will pay later down the road and I mean that literally and figuratively.  If you have older children, remember, they do not have access to sodas and sugary foods without you.  They may have access other ways such as at school or at a friend’s house, but you can definitely control what goes on at home.

If you or your child seem to be “cavity prone,” your dentist may also recommend the use of additional fluoride-containing aids to help strengthen the enamel.  Many of these can be purchased over-the-counter, such as ACT Home Fluoride Rinse, Listerine Smart Rinse and several others.  Again, those are not usually recommended until age six or until the child is able to rinse without swallowing.  This is because fluoride can be toxic if swallowed in larger amounts.  Often times children up to eighteen are given a professional strength fluoride treatment at the dentist after their cleaning and check-up.  It is usually only done once or twice a year as needed in hopes of strengthening teeth to prevent cavities.

If you have a teenager, your dentist may also prescribe a pharmacy strength, professional grade fluoride toothpaste or gel.  This kind of toothpaste has much more fluoride than regular toothpaste and is used when the teenager or adult has a history or frequent or multiple cavities.

I have to mention again that you should NEVER give a child fluoride tablets or drops without consulting your pediatrician or dentist first.  This is usually done if you have well-water rather than public water (which has fluoride added already to help prevent decay).  This is very different from the rinses discussed above, as these supplements are ingested and deposited internally.  Rinses and toothpastes are a topical, externally applied substance and aren’t distributed throughout the body.

I have to stress again that just because you have well-water does not mean that it doesn’t contain fluoride.  Fluoride is a natural mineral and so may or may not be present in many natural water sources.  If you are concerned about needing to supplement your child with fluoride tablets or drops, you need to have your well tested for the amount of fluoride already present.  If your well contains enough fluoride already, and you then  supplement your child additionally, you can cause minor to severe damage to your child’s teeth.

The amount of fluoride needed to help prevent cavities is very specific.  If given too much during the time of tooth development, it can cause discoloration, pitting and weakening of the teeth.  This condition is called “fluorosis” and is not reversible.  Treatment depends on the severity of the damage and can be both embarrassing for the child and expensive for the parent.  More concerning is the potential for bodily toxicity if the amount given is not appropriate for the weight and age of the child.

If you, your child or someone you know continues to get cavities regularly despite all efforts to avoid them, there could be something else going on.  Occasionally, adults or children may have an overabundance of the cavity causing bacteria.  This excess presence of  cavity-causing “bugs” can increase the rate and/or amount of cavities received.  If you feel that you have been successful at achieving good oral hygiene and are not consuming abnormal amounts of sugars or carbohydrates, then tell your dentist.  Usually they will recognize this anyhow and discuss nutrition with you once more to be sure there isn’t something you’re eating

Of course, we already discussed earlier in the When should I first take my child to the dentist? post that your child should start seeing the dentist early and we also learned that they should go for check-ups and cleaning every six months. At the check up appointment, the dentist may want take a few x-rays.  There are many different types of x-rays that are considered acceptable for a child, and it really depends on what the dental team is looking to evaluate.

Generally speaking, usually around three or four years old, check-up x-rays (also called bite wing x-rays) may be taken if the child does not have spaces or has limited spaces between the baby teeth or if decay is suspected in an area between the teeth. Children at this age have very small mouths, and so typically all is needed are two of these films (understand that this may vary depending on the child).  These films are done every year to eighteen months, again depending on the child.  There really isn’t a minimum age requirement for these check-up x-rays, it is really dependent on the spaces between their teeth and the visibility between them.  These x-rays are done to look for cavities in between the teeth, thus the reason they may not be necessary to take if the child has adequate spaces between their teeth.  If spaces are present, the dentist can usually see the tooth directly without the use of x-rays.

At around age 5 or older, your dentist may choose to take another x-ray called a panorex or “panoramic film.”  This film does not look for cavities but rather is a tool for evaluating possible missing teeth, disorders of the jaw including cysts, tumors (cancerous and non-cancerous) and a myriad of other things.  It may also be used to aid in orthodontic evaluation in the future.  This is a film that is typically done every three to five years or even less depending on the use for the x-ray.

There are other x-rays sometimes done for other reasons.  One more commonly done x-ray is called a “P.A.”, which stands for a periapical x-ray.  It is just a fancy dental word for an x-ray that shows the entire tooth, including the root and the surrounding bone and is usually done on children to evaluate a possible abscess or to determine the length of time until a permanent tooth will erupt.  This is an acceptable x-ray for children at any age if the dentist has a concern about a specific tooth.

Another film that a parent may encounter at the dentist is called an occlusal film.  This is a film that may be taken of either the upper or lower teeth and is meant to see a better three dimensional view of erupting teeth or pinpoint pathology within the jaws.  This kind of x-ray is not done that often, but is very important when trying to determine very specific details that would otherwise not show up.  It is usually only done if the dentist has a very specific reason for taking it.

One question I am frequently asked regarding x-rays and children are about the relative danger to the child.  In general, x-rays in moderation are considered to be safe when precautions are taken to minimize radiation exposure.  This is the same for adults.  In fact, we are often taught in school that we receive more radiation exposure from the sun on a single day then we do in a set of yearly x-rays.

For children, it is especially important that the areas sensitive to radiation are covered during x-rays.  These areas include the thyroid/neck area as well as the reproductive areas of the child.  This shielding is done with a lead apron.  Dental offices are also required to undergo annual testing and evaluation of the radiation equipment (this varies by state) to be sure they are in compliance with state radiation regulations.  In addition, most states require that the staff taking x-rays have completed a regulated x-ray dental safety and technique course in order to take x-rays.  These certificates will usually be posted for patients to see.

There is, what I call a dental “urban legend” which I hear from 90% of my patients who are also mothers: “I never had cavities until I had my first child-now I have a cavity for each child born! ” I know from personal experience that pregnancy can bring about many new symptoms, most not enjoyable, few which are. Some symptoms I had, were an insatiable appetite, strange cravings and peculiar repulsion of things I normally enjoyed. Unfortunately, I did not get repulsed by chocolate, desserts or picnic foods like some lucky mothers do. I have found through my experience of two pregnancies, that most other moms experience the same. And so, the junk-food and snacking festivities often begin with the onset of pregnancy.

While typically, as a woman, we may also be concerned with excess weight gain during pregnancy, there is yet a bigger danger lurking beneath the moon-pies and chocolate chip ice cream. It is called CAVITIES! An increase in frequency of snacking, even with healthy items such as fruits and whole grain breads can cause cavities to crop up without any warning. Let’s face it, the last thing on our minds as a pregnant woman is our teeth. We are typically overwhelmed with other essentials such as, what color stroller and car-seat we want or how to use the crazy looking apparatus called a breast pump.

So, how do we combat these cavity-causing snacking frenzies? Well, as a mother, I am not about to tell you to stop snacking, as that would likely induce some tears followed by more snacking. What I will tell you is that if you increase your snacking, be sure to increase your tooth-brushing. Cavities are formed by bacteria in your mouth and on your teeth which feed on the snacks you provide for them. A bacterial layer is created on the surface of your teeth and can easily be removed with your tooth brush. No need to brush hard, as this can cause damage to your teeth. The best type of toothbrush to use is a “sonicare” or “Oral-B” electric toothbrush. They do a remarkable job. However, a soft nylon bristled tooth brush is fine as well. Make sure you use a fluoride containing toothpaste and brush at least three times a day. You can use over-the-counter mouthwashes if you like, just be careful not to ingest them.

Snacking is not the only worry when it comes to cavities. Many moms experience gastro-esophageal reflux during pregnancy, and it can often be severe. This constant exposure of stomach acids to the mouth causes the teeth to be more prone to cavities for many reasons. If you are suffering from heart burn, or gastro-esophageal reflux, then be sure you are rinsing your mouth or drinking plenty of water and limiting the amount of sugary snacking you do. You may want to talk to your obstetrician about medication and diet options if you feel it is severe.

The other reason keeping cavities away in mom is important, is that the bacteria that cause cavities can be passed along to your newborn. Yikes!