08/18/2022
CariFree | A different approach to dental care
Dr. Lynn's Suggestions for Happy and Healthy Teeth:
SECTION 1. Expectant mother(we start to see patients at 6 months old)
1. An expectant mother should abstain, if at all possible, from taking any drug or other substance into her body which may cause a deleterious effect on the child’s teeth. Sometimes, antibiotics administered to an expectant mother or to a baby may have a marked effect on the baby’s developing teeth. For example, tetracycline has been shown to cause irreversible staining in teeth. Minocycline also has been shown to cause a blue color to bones and staining in teeth. Sometimes, the bone will be blue and show through in areas under the gums.
2. In the third trimester of pregnancy, some expectant mothers may benefit from chewing a gum which contains Xylitol, such as, Trident Extra Care, Ice Breakers Ice Cubes, Carefree Koolers, or Theragum, to lower Streptococcus Mutans bacterial levels. This may prevent transmission of the bacteria to the child. Dr. Lynn prefers products with a higher concentration of Xylitol (Xylitol should be the first listed ingredient)
3. Adequate nutrition of the mother during pregnancy is very important to the child’s development of strong, healthy teeth that are more resistant to decay.
4. Mothers with known high Streptococcus Mutans bacterial counts may use mouth trays like football player mouth guards, which contain some stannous fluoride gels, such as, Gel-Kam, Omni-Gel or Just for Kids, leaving these in place in the mouth for five minutes per day for two weeks. This has been shown to reduce the levels of the decay-causing bacteria for up to three to four months, and thus aids in preventing bacterial transmission from parent (or other primary caregiver) to the child. ************************************************************************************************************
SECTION 2. Infant
5. Nursing (breast feeding) a baby, when possible, is usually always best for the teeth. This will aid in providing optimal nutrition, and may help prevent Respiratory Syncitial Virus (RSV) and other diseases. When nursing, it is best to ensure that the baby does not remain attached to the breast while sleeping. After the teeth erupt, this may lead to the disease called Early Childhood Caries, commonly known as Baby Bottle Tooth Decay or Nursing Caries.
6. Never allow an infant/child to fall asleep with a bottle of anything but water. Always brush after drinking milk, juice or other beverages before bedtime. After brushing, only give the infant/child water.
7. Avoid the use of distilled water, water purified by reverse osmosis, and, ready to feed formulas. Avoid boiling the infant’s water for an extended time; this will help ensure the water and/or formula contains an optimal amount of fluoride and minerals or that is is still available to the child.
8. A parent should never allow anyone to blow on the child’s food to cool it, or, use the child’s silverware without washing it, or, sip from each other’s drinks. This passes the bacteria which is mainly responsible for tooth decay, from one person to another. This can also transmit other viral or bacterial infections. A person should not blow directly into the baby’s face as this can spread droplets of bacteria-containing saliva into the child’s mouth.
9. After birth, for optimal dental health, the child’s diet should contain proper amounts of vitamins, minerals and fluoride. But, not an excessive amount!
10. The baby’s first dental exam should be performed by six months of age. This allows for discussion of ways to help prevent many of the problems associated with oral disease. Also, this allows for a timely prescription of a fluoride dietary supplement, if and when necessary. Check-ups every six months can be very important. This way, a dental problem may be addressed before serious damage may occur.
11. When the baby drinks only breast milk, bottled waters with no fluoride, well water, or spring water, or ready-to-feed formulas, a fluoride prescription may be necessary.
12. The parent should brush and floss the baby’s teeth as soon as the teeth erupt in the mouth. Care should be taken to help prevent transmission of the decay-causing bacterial organisms from the parent to child. This includes proper hand washing prior to flossing or brushing the child’s teeth. Care should be taken to prevent transmission of bacteria from one child to another, also. No sharing of food or drink from the same containers, etc.
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SECTION 3. Child
13. A parent should always assist the child with brushing and flossing. Children are not skilled enough to do the kind of job necessary for proper brushing and flossing of teeth. I recommend daily assistance at each brushing until approximately eleven years of age, then, once-per-day assistance into early teenage years. Please make sure all surfaces are brushed. Turn the bristles of the brush toward the gums at a 45 degree angle, so that the bacteria and plaque can be removed under the gums in the cleaning process. The floss also should gently go under the gum until it reaches a natural stop, allowing the floss to wrap around the tooth like a letter “C”. Gently use up and down motions to clean each tooth, including behind the last tooth, also flossing where a single tooth is not adjacent to another. If gums bleed when brushing or flossing, it generally means it is done incorrectly and/or not frequently enough, leaving bacteria under gums to cause inflammation and gum infections, which can eventually lead to periodontal disease. Warm salt water rinses can help gums heal while adjusting to proper brushing and flossing techniques. (1 tsp salt to tall glass of water, swish and spit)
14. Do not allow the child to swallow toothpaste or fluorides, other than those which are designed to be systemic dietary fluoride supplements. And even then, only in the proper amounts based on the child’s age and sometimes their weight. The child’s total fluoride intake needs to be evaluated to help reduce the risk of over-medicating or leading to fluorosis of teeth. Too little fluoride may create the risk of tooth decay; too much fluoride may lead to enamel discoloration.
15. The two most important times to brush and floss the teeth are after breakfast and at bedtime. Brushing the tongue is important for the child’s dental health. A tongue scraper or special tongue brush may be used. Proper cleaning of these after each use is important, as in keeping the toothbrush clean.
16. After fourteen months of age, I recommend brushing a BARELY VISIBLE amount (smaller than can easily be visualized amount) of a topical fluoride, such as, Prevident 5000 Plus, or, Gel-Kam, etc., on the child’s teeth. Apply the fluoride front to back, on the top of, and, in-between the teeth...using CAUTION to prevent the child from swallowing it. Wipe out the extra, and/or, have the child lean forward while brushing, thus, allowing the saliva to drain from the child’s mouth.
17. A special fluoride varnish may be applied to all teeth periodically, as needed. This is different from the routine fluoride treatment, which we perform at the regular dental cleaning and examination. Fluoride varnish is a very sticky resin that has a higher concentration of fluoride in it. When painted on dry teeth it sets up in the presence of saliva and remains in place for 24 hours or longer, thus, allowing the fluoride to leach into the enamel of the teeth and help make it stronger. This has been shown to have up to an 81.2 percent remineralization rate, according to a study of Head Start children performed at the University of Florida.
18. MI Paste (which contains no fluoride) can sometimes be recommended for use on teeth in children who are UNDER 6 years of age, depending upon individual needs. MI Paste Plus WHICH CONTAINS FLUORIDE, is sometimes recommended for use on the teeth of children who are OVER 6.years of age. MI Paste puts calcium and phosphate back into the teeth, helping repair the weakened enamel, and, in some cases, it may help improve discolored areas. This is a at-home treatment. Two times daily, rub on and hold in mouth for up to 3 minutes, and spit, then do not rinse. Older children, and even adults, may benefit from using MI Paste after brushing with Prevident 5000 toothpaste.
19. An electric or battery operated toothbrush with a rotating head is recommended for better cleaning.
20. If you live in, or move to, a location where the water is not fluoridated, or begin drinking some well water or spring water that does not contain enough fluoride, a prescription for dietary fluoride may be necessary.
21. If you notice a change of color in the child’s teeth, have a dental evaluation performed.
22. It is advisable to help children become accustomed to drinking from a cup, by nine months of age. Discontinue the use of a bottle and/or pacifier, and/or wean the child shortly after the first birthday (maybe by eighteen months of age). This may help prevent other problems as well.
23. Never allow the child to drink chocolate milk, strawberry milk, or other flavored milks, orange sugary drinks, sugary or acidic beverages of any kind or any soft drink, such as, colas or cutrus based soft drinks. The following beverages may pose a dental risk to the child: Juicy Juice, Gatorade, Kool-Aid, Fruit Punch, Sunny Delight, and Ovaltine, due to added corn syrup, acids and sugars etc.
24. We recommend regular fluoridated city water, or, fluoridated natural spring water, that is not treated by reverse osmosis or distillation. White whole milk, and, only juice that is labeled 100% juice WHICH IS ALSO LABELED as not-from-concentrate AND low acid, is usually better for the teeth. Dilute juice with water to further reduce the risk, AND, drink through a straw, to get the beverage past the teeth before swallowing.
25. Avoid chewy, sticky sugar-containing candy such as Star Burst, Airheads, Gummy Bears, taffy, toffee, and caramels. Avoid sour candy, as this is extra hard on teeth due to additional acid content. Also, avoid breakfast cereals high in sugar, and chewy fruit rolls, such as Fruit Rollups, etc.
26. Children may have a hard time letting go of oral habits, like thumb or finger sucking, tongue trusting, or bruxism (grinding). These habits may be somewhat or completely corrected or improved and/or prevented by certain oral appliances.
27. Children playing hard contact sports should wear a high-quality protective mouth guard. Injuries should be addressed quickly if a tooth is loose or multiple teeth are mobile, or, if the gums are bleeding at time of injury, or, if a tooth turns dark or a color other than natural white, or, if the gum swells, etc. In the case of a broken tooth, put the broken part in a container with some of the patients own saliva, and bring it to your emergency appointment. If the tooth is knocked out, put the tooth in cold milk and bring it to the appointment. If there is no milk available, again, use the patients iwn saliva to help it temain moist. In any of these cases, make an appointment to be seen very quickly, or, if emergency conditions exist, go to the nearest emergency room as soon as possible. This would include serious facial injuries, excess bleeding, excess swelling, excessive pain, or a condition in which the eyes do not focus in unison, difficulty in breathing, etc.
28. Children exhibiting erosion of the teeth may have a condition known as gastro-intestinal esophageal reflux disease (GERD). Treatment should be received promptly to reduce a sometimes 43-times greater risk of esophageal cancer.
29. Some teeth may benefit from being treated with a protective plastic-like coating, known as Dental Sealants, to help protect against decay in the pits and fissures, or deep grooves, frequently found in molar, premolar, and, sometimes, even lateral incisors or other teeth.
30. All family members should receive regular dental cleanings, examinations, x-rays, and screenings, along with special fluoride applications. (We start seeing children at the age of 6 months and follow them through their teen years).
31. For any of the following injuries, as previously mentioned in part, contact the dentist immediately...injuries that cause teeth to break, loose teeth, gums to bleed. Likewise, if a tooth is ever knocked completely out of the mouth, place tooth in cold white milk, and contact the dentist.
** treats which Dr. Lynn approves of, in various levels, are (not an all-inclusive list and always subject to changes) either:
fruit, homemade freezer pops from diluted approved juices, cheddar cheese, yogurt, occasional ice cream, frozen yogurt, solid chocolate like a Hershy bar, pudding, etc. Xylitol gum is recommended, such as, Ice Breakers Ice Cubes, Carefree Kooler’s, Trident X-tra Care or Theragum, where xylitol is the first ingredient listed. Xylitol candy may be found at some health food stores or online sites such as www.carifree.com. Please note IceBreaker “candy” is NOT approved by Dr Lynn for caries reduction, it is not a xylitol product.
32. Smaller cavities may have their progression stopped through multiple periodic applications of a type of medication called, Silver Diamine Fluoride. It is excellent, but will turn the cavity black in appearance. An esthetic restoration can be placed over this, but sometimes the darkness still can show through. When compared to MI Paste or MI Paste Plus, MI Paste products do not act as fast as the Silver Diamine Fluoride, but, they also do not stain the area black.
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