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It is common to experience dentine hypersensitivity, with symptoms ranging from moderate to severe. Why does it happen and how do you know if this sensitivity is something to be concerned about? The first step is to determine the cause.

The most common cause of the sensitivity is exposure of the dentin. Dentin is the layer immediately surrounding the nerve of the tooth. It is alive and usually covered by the gum tissue. When gum recession is present hypersensitivity is common. Other contributors to temporary tooth hypersensitivity include teeth whitening and dental procedures such as fillings, periodontal treatment, and braces placement or adjustment. These are temporary and should be of no concern.

Permanent hypersensitivity, however, may require treatment. To understand the cause of sustained hypersensitivity, let us explain the structure of dentin and why it serves as a ‘hot spot’.

The dentin contains a large numbers of pores or tubes that run from the outside of the tooth to the nerve in the center. When dentin tubes are exposed, there is a direct connection between the mouth and dental pulp, which houses the nerve and blood supply of the tooth. External stimuli, such as mechanical pressure (tooth grinding or clenching - bruising the ligaments holding the teeth in place), temperature changes, as well as chemical stimuli (sweet–sour) are transmitted to the pain-sensitive dental pulp and activate nerve endings. A short and sharp pain is the result. These external stimuli cause fluid movement in the open tube that is transmitted as pain sensations. Something needs to be placed into the dentin tube to plug it and stop this fluid movement.

The first step in doing something about dental hypersensitivity is to determine the cause; our professional team at Issaquah Valley Dental Care can help you with this. Whether the sensitivity is due to exposed dentin or an underlying cause such as abscess or decay, corrective measures are needed. Contact us sooner rather than later so Drs. Arti and Ashi can reduce the sensitivity, and provide you with some relief!

As adults, we often wish our teeth could be as white as they were when we were small children. Baby teeth have thinner and whiter enamel than adult teeth, and those brilliant smiles are a result! But occasionally, you may be surprised to discover some staining or discoloration on those lovely first teeth. You might be tempted to apply a whitening product to your child’s teeth, but, please—read on!

Causes of Staining

• Improper Brushing—Often, a loss of tooth whiteness means that plaque has built up on the tooth surface. Careful brushing is needed to remove bacteria and plaque, and if your child isn’t brushing at least twice a day for two minutes, discoloration can be the result.
• Medications—When given in liquid form, or when added to formula or food, iron supplements can cause dark grey staining on the teeth. Medications taken by a mother while pregnant or breast feeding, such as tetracycline, can also lead to discoloration.
• Injury—If a tooth suffers a serious injury, the tooth can darken because of changes inside the enamel.
• Health conditions—Certain health problems can cause tooth discoloration, or sometimes children are born with weaker enamel that is more likely to stain.

If you have noticed any staining on your child’s primary teeth, call our Issaquah office. Simple stains can often be removed with better brushing techniques, and we can clean other surface stains in the office. Staining caused by an injury or a health condition is something we can discuss in detail with you. We can even use some professional whitening methods if those are indicated.

Why not just buy a home whitening kit for your child? There are several important reasons to leave these products on the shelf while your child is young.

• Whitening kits are designed for adults. They have been tested for adult teeth in adult trials. Check the box for age appropriate use. Most products are not recommended for pre-teen children.
• Remember that thinner enamel we mentioned earlier? Add to that the delicate skin of young children, and it’s sensible to be cautious about using a bleaching agent that can cause mouth and tooth sensitivity even in adults.
• There is no body of evidence available as to the short and long term effects of using these products on children.

If you are concerned about the brightness of your child’s smile, please talk to Drs. Arti and Ashi. We can recommend better ways to brush at home, clean your child’s teeth in the office, or suggest professional methods of whitening if there are physical or psychological reasons that it would be valuable. But while your child is young, those off-the-shelf whitening products can wait a few more years.

August 22 is National Tooth Fairy Day! If the Tooth Fairy is a treasured part of your child’s life, you’re just in time to celebrate! But what to do when the Tooth Fairy doesn’t arrive on schedule—when baby teeth stay longer than expected or are lost too soon? 

A baby’s 20 baby teeth tend to come in within a fairly predictable time frame. The bottom central incisors in the very front of your baby’s mouth typically make their appearance first, when your baby is around six to ten months old. Over the next few years, the remaining incisors, canines, and first molars arrive. Last on the scene are the second molars, which usually show up between the ages of 23-33 months. 

Just as baby teeth follow a pattern coming in, they tend to follow the same pattern falling out. The front teeth begin to wiggle and loosen around age six or seven, while the last of the baby teeth, the canines and second molars, are often lost between the ages of ten and 12. 

Baby teeth fall out as the adult teeth below them push up as they erupt. The top of the new tooth puts pressure on the root of the baby tooth, gradually dissolving it. As the root grows smaller and can’t anchor the tooth, the tooth begins to wiggle and eventually becomes loose enough to fall out. This leaves the adult tooth perfectly placed to grow into its proper position.

Sometimes, though, teeth linger far past their fall-out date. Sometimes, because of decay or trauma, they are lost much too early. In either case, Drs. Arti and Ashi can provide treatment to protect little smiles now and to ensure that there’s space for the permanent teeth to erupt and align correctly.

Teeth Which Overstay Their Welcome

If that baby tooth never gets wiggly, the team at Issaquah Valley Dental Care can help! When baby teeth stubbornly hang on, adult teeth can erupt behind them, creating a double row of teeth commonly known as “shark teeth.” These permanent teeth can become crowded or misaligned as they try to fit in any space available. Or a baby tooth can block an adult tooth from erupting at all. When that baby tooth just isn’t budging, an extraction will create space for the permanent tooth to erupt.

Extracting a baby tooth is generally a straightforward procedure because primary teeth have very small roots. Your child’s dental team at Issaquah Valley Dental Care are experts in helping you prepare your child for the procedure in a gentle, reassuring, and age-appropriate way. 

Often, a local anesthetic is all that’s necessary for a simple extraction, but if you feel sedation would better fit your child’s needs, discuss sedation options with your dentist. After the extraction, you’ll be given clear information on how to deal with pain and swelling, which foods and drinks are best while the extraction site heals, and how to protect the area.

Teeth Which Exit Too Early

In the case of decay or trauma, Drs. Arti and Ashi will do everything possible to save the tooth. When decay is so extensive that there’s not enough structure left to hold a filling or crown, or when there’s an infection in or around the tooth, or when an accident or injury has caused serious damage, extraction might be the healthiest option. Depending on your child’s age, further treatment might be needed afterward to protect future smiles. 

Besides their roles in eating and speaking, baby teeth save space for permanent teeth. Whenever a child loses a primary tooth too soon, the family dentist will be on the lookout for potential future orthodontic problems. If remaining baby teeth shift, taking up part of the empty space left behind by the lost tooth, the adult teeth below won’t have the space they need to erupt properly. Permanent teeth might come in at an awkward angle or in the wrong place. 

In this case, Drs. Arti and Ashi might recommend a space maintainer. Space maintainers are small, custom-designed appliances which prevent the remaining baby teeth from shifting position while holding space open for the permanent tooth to arrive right on schedule and right where it belongs. 

It’s comforting to have charts which let us know when little teeth will typically come in and when they will typically fall out. But unexpected events might mean teeth overstay their welcome or depart too soon. When the Tooth Fairy can’t keep to her schedule, schedule an appointment at Issaquah Valley Dental Care in Issaquah as soon as possible to make sure your child is on track for a future of healthy smiles.

Whether it’s your first child or you’re an experienced mom, pregnancy is an exciting time—which you’ll be able to enjoy much more once the days of morning sickness are over.

Morning sickness affects most pregnant women, and can present in any number of ways. It might take the form of mild nausea, or cause frequent vomiting. It often occurs in the morning hours, but can take place at any time of day. It’s usually over with by the second trimester, or it can last weeks longer. Because of this wide variety of symptoms, morning sickness is more accurately referred to as NVP, the nausea and vomiting of pregnancy.

Your doctor can recommend safe and effective ways to deal with NVP, especially when symptoms are more severe. We have some recommendations to minimize the effect of morning sickness on your dental health.

Wait, dental health? That’s right. Besides its more obvious unpleasant consequences, NVP can cause problems for your teeth and gums. We have a few suggestions for getting you through the weeks of morning sickness with easy and effective strategies to protect your oral health.

Prevent Acid Damage

Vomiting and heartburn with reflux expose the teeth to stomach acids. Tooth enamel is the strongest substance in the body, but it’s not safe from acid attacks.

Normally, the pH balance in our mouths is neutral, around a 7 on a scale of 0 to 14. When acidic conditions lower the oral pH to 5.5 or below, the minerals in enamel begin to dissolve, leading to sensitivity and, eventually, cavities. The pH of our stomach acid ranges from 1.5 to 2.5. This is great for digesting food, but not great at all for enamel and sensitive gum tissue.

Whenever we vomit, the immediate (and understandable!) impulse is to reach for our toothbrushes. But this is an impulse we should resist. Because acids weaken tooth enamel, scouring the teeth with a toothbrush right away can cause more erosive damage. Instead,

• Wait half an hour or more before brushing to give your enamel time to recover its strength.
• In the meantime, rinse with water and perhaps a bit of toothpaste or diluted, doctor-approved mouthwash.

Keep Hydrated

Another consequence of frequent vomiting is dehydration. It’s always important to keep our bodies properly hydrated, and this is particularly true during pregnancy.

Hydration is also essential for oral health. Saliva helps wash away the bacteria and food particles which cause cavities and irritate the gums—especially important now, since pregnancy hormones can leave you more vulnerable to gingivitis and other forms of gum disease.

• Drink water as recommended by your doctor. It’s healthy, it hydrates, and it helps prevent cavities and gum disease. Win/win/win.
• Whichever fluids are your favorites, drinking them in measured amounts through the day will be more effective and more appetizing than drinking large amounts once or twice a day to catch up.
• You have a busy life, so make things easy on yourself. If you need to hydrate more, keep track of your hydration goals with an app or a phone notification. There are even “smart bottles” to track your intake. Or go old school, and fill a bottle marked with timed measurements to remind you to hydrate through your day.

When The Very Idea of Brushing Is Nauseating . . .

When just the thought of brushing is unappetizing, we have suggestions which might help.

• Postpone brushing until later in the day when you feel better. Rinse with water first thing in the morning instead.
• Trade in your regular toothbrush for one with a smaller brush head. This can help prevent the gag reflex.
• Brush slowly, using small strokes.
• If brushing the back teeth is particularly triggering, try deep breathing or sitting down to brush.

We want to help you enjoy a healthy pregnancy. Let us know when you first learn you’re pregnant. We have some valuable tips for the coming months, including suggestions for reducing the dental effects of NVP. Fortunately, morning sickness is temporary, and we’re here with ideas to help your beautiful smile last a lifetime!