Most babies come into the world ready and able to nourish at their mother's breast—no training required! About one in ten children, though, may have a structural abnormality with their tongue or lip that makes it difficult for them to breastfeed.
The abnormality involves a small strip of tissue called a frenum or frenulum, which is found in the mouth connecting soft tissue to more rigid structures. You'll find a frenum attaching the upper lip to the gums, while another connects the underside of the tongue to the floor of the mouth.
Frenums are a normal part of oral anatomy and usually don't pose a problem. But if the frenum tissue is too short, thick or tight, it could restrict lip or tongue movement. If so, a baby may not be able to achieve a good seal on their mother's nipple, causing them to ineffectively chew rather than suck to access the mother's milk. Such a situation guarantees an unpleasant experience for both mother and baby.
The problem can be addressed with a minor surgical procedure performed in a dentist's office. During the procedure, the dentist first numbs the area with an anesthetic gel. The frenum is then snipped with scissors or a laser.
With very little if any post-procedure care, the baby can immediately begin nursing. But although the physical impediment may be removed, the child may need to “relearn” how to nurse. It may take time for the baby to readjust, and could require help from a professional.
Nursing isn't the only reason for dealing with an abnormally shortened frenum. Abnormal frenums can interfere with speech development and may even widen gaps between the front teeth, contributing to poor bite development. It's often worthwhile to clip a frenum early before it creates other problems.
It isn't absolutely necessary to deal with a “tongue” or “lip tie” in this manner—a baby can be nourished by bottle. But to gain the physical and emotional benefits of breastfeeding, taking care of this particular problem early may be a good option.
If you would like more information on the problem of tongue or lip ties in infants, 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.”
Madeline Stuart, acclaimed fashion model; Chris Burke, successful actor; Collette Divitto, founder of Collettey's Cookies. Each of them is accomplished in their own right—and each has Down syndrome. In October, Down Syndrome Awareness Month recognizes the achievements of people with Down syndrome overcoming incredible challenges. One such challenge, keeping their dental health on track, is something they and their families face every day.
Down syndrome, also known as trisomy 21, is a genetic disorder that happens when the body's cells contain an extra copy of chromosome number 21. This can cause a wide range of physical, intellectual and developmental impairments that, among other things, can contribute to dental disease and other oral health concerns.
But oral problems can be minimized, especially during childhood. Here are four ways to better manage dental care for a child with Down syndrome.
Begin dental visits early. Down syndrome patients can have physical challenges that could result in delayed tooth eruption, undersized teeth or smaller jaws that contribute to poor bite development and greater risk of tooth decay and periodontal (gum) disease. To stay ahead of any developing issues, you should begin regular visits to the dentist no later than the child's first birthday.
Be aware of dental anxiety. Some children with Down syndrome experience significant anxiety about the clinical aspects of their care. We strive to provide a comfortable, caring environment for all patients, including those with special needs. A variety of relaxation techniques as well as sedation options may help to reduce anxiety.
Coordinate medical and dental care. Medical problems can affect dental care. Be sure, then, to keep us informed about your child's health issues. For example, heart defects are more common among those with Down syndrome, and dental patients with heart conditions may need to be treated with antibiotics before certain dental procedures to minimize the chances of infection.
Make daily hygiene easier. Daily brushing and flossing are important for everyone's dental health, but they can be difficult for someone with Down syndrome. In some cases, you may have to assist or even perform these tasks for your child. You can make oral hygiene easier by choosing toothbrushes that fit your child's level of physical ability or using special flossing devices.
The physical disabilities of those with Down syndrome fall along a wide spectrum, with some individuals needing more help than others. Tailoring their dental care to their specific needs and capabilities can help keep your child's teeth and gums healthy for the long term.
If you would like more information about providing dental care for children with disabilities, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Managing Tooth Decay in Children With Chronic Diseases” and “Dentistry & Oral Health for Children.”
The humble squirrel—darlings to some, bird feeder-robbing nuisances to others—has its own month. Since 1995, the Squirrel Lovers Club of Chicago has celebrated October as Squirrel Awareness Month to pay tribute to this diverse family of rodents with over 270 species. It's also an opportunity to indulge in our favorite “squirrelly” fact: Squirrels' teeth don't stop growing.
And we do mean grow. A squirrel's four front incisors increase about 6 inches a year—a good thing since squirrels put those teeth through their paces gnawing through hard-shelled nuts and seeds. If they didn't keep growing, you'd see plenty of squirrels with worn-to-nothing front teeth.
We humans have some cause to be envious because, unlike squirrels, our permanent teeth stop growing by the time we reach adulthood. That could be a problem since nearly all of us encounter tooth wear as we age.
And it could be even worse. Bad habits like crunching ice, biting into hard foods or using our teeth as tools can contribute to accelerated wear. Some people also involuntarily clench or grind their teeth, creating higher than normal pressure that can wear down teeth.
Suffice it to say, it's worth the effort to quit conscious bad dental practices to prevent your teeth from wearing faster than normal. A teeth-grinding habit, though, may require more than willpower: We'll need to look at other ways to reduce its effect on your teeth.
First, you may want to try to reduce chronic stress, the top contributor to adult teeth grinding. Better stress management with the help of counseling, relaxation techniques, biofeedback or group therapy can all help reduce the occurrence of this destructive habit.
Such efforts, though, can take time. In the meantime, we may be able to help you reduce the effect of a grinding habit with a custom-made mouth guard. This plastic guard worn in the mouth prevents teeth from making hard contact with each other during grinding, and so it reduces the damaging forces that can wear down teeth.
By the way, if you've already experienced excessive tooth wear, not all hope is lost. We may be able to restore your teeth to normal length with the help of bonded porcelain veneers or crowns. After a thorough evaluation, we can give you options for turning back the “age clock” on your smile.
Our teeth may not continuously grow like squirrels', but we can still protect them from the effects of excessive wear. Good dental practices and habits—and restorative measures when necessary—can keep your smile looking as young as ever.