By Douglas M. Hope, DMD, MAGD
August 08, 2020
Category: Dental Procedures
Tags: oral health   pregnancy  
EliminatinganInfantsLiporTongueTieCanMakeBreastfeedingEasier

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.”

2KindsofOrthodonticRetainersThatCanProtectYourNewSmile

While retainers are often viewed as a nuisance, they’re crucial to protect the gains made with bite correction. Without them, all of the progress achieved through braces or clear aligners could be lost.

Here’s why: The same elastic gum tissue called the periodontal ligament that holds teeth in place also allows them to move incrementally in response to changes in the mouth. That’s why we can move teeth with braces or aligners, which put pressure on the teeth toward a desired direction of movement while the periodontal ligament does the rest.

But the mechanics can also work in reverse: With pressure relieved when the braces are removed, the teeth could revert to their original positions through a kind of “muscle memory.” The light pressure provided by a retainer is enough to keep or “retain” teeth in their new positions.

The best known retainer is a removable appliance. Initially, a patient wears it continuously and only takes it out during oral hygiene. Wear duration may later be reduced to night time only and eventually not at all, depending on a patient’s individual needs.

While effective, removable retainers do have some downsides. Like braces, they’re visible to others. And because they’re removable, they’re frequently misplaced or lost, leading to the added expense of a new one.

An alternative is a bonded retainer, a thin piece of wire attached to the back of the newly moved teeth to keep them in place. Because it’s behind the teeth it’s not visible—and there’s no misplacing it because only a dentist can take it out.

A bonded retainer is a good option, especially if a patient is immature and not as diligent about wearing or keeping up with their appliance. But it can make flossing difficult to perform, and if they’re removed or broken prematurely, the teeth could revert to their former positions.

If you decide to go with a bonded retainer, be sure you get some tips from your dental hygienist on how to floss with it. And if you decide later to have it removed early, be sure to replace it with a removable retainer. Either of these two options can help you keep your new and improved smile.

If you would like more information on bonded retainers, 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 “Bonded Retainers.”

By Douglas M. Hope, DMD, MAGD
July 19, 2020
Category: Oral Health
NBAPlayersInjuryPointsOutNeedforMouthguards

Basketball isn't a contact sport—right? Maybe once upon a time that was true… but today, not so much. Just ask New York Knicks point guard Dennis Smith Jr. While scrambling for a loose ball in a recent game, Smith's mouth took a hit from an opposing player's elbow—and he came up missing a big part of his front tooth. It's a type of injury that has become common in this fast-paced game.

Research shows that when it comes to dental damage, basketball is a leader in the field. In fact, one study published in the Journal of the American Dental Association (JADA) found that intercollegiate athletes who play basketball suffered a rate of dental injuries several times higher than those who played baseball, volleyball or track—even football!

Part of the problem is the nature of the game: With ten fast-moving players competing for space on a small court, collisions are bound to occur. Yet football requires even closer and more aggressive contact. Why don't football players suffer as many orofacial (mouth and face) injuries?

The answer is protective gear. While football players are generally required to wear helmets and mouth guards, hoopsters are not. And, with a few notable exceptions (like Golden State Warriors player Stephen Curry), most don't—which is an unfortunate choice.

Yes, modern dentistry offers many different options for a great-looking, long lasting tooth restoration or replacement. Based on each individual's situation, it's certainly possible to restore a damaged tooth via cosmetic bonding, veneers, bridgework, crowns, or dental implants. But depending on what's needed, these treatments may involve considerable time and expense. It's better to prevent dental injuries before they happen—and the best way to do that is with a custom-made mouthguard.

Here at the dental office we can provide a high-quality mouthguard that's fabricated from an exact model of your mouth, so it fits perfectly. Custom-made mouthguards offer effective protection against injury and are the most comfortable to wear; that's vital, because if you don't wear a mouthguard, it's not helping. Those "off-the-rack" or "boil-and-bite" mouthguards just can't offer the same level of comfort and protection as one that's designed and made just for you.

Do mouthguards really work? The same JADA study mentioned above found that when basketball players were required to wear mouthguards, the injury rate was cut by more than half! So if you (or your children) love to play basketball—or baseball—or any sport where there's a danger of orofacial injury—a custom-made mouthguard is a good investment in your smile's future.

If you would like more information about custom-made athletic mouthguards, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Athletic Mouthguards” and “An Introduction to Sports Injuries & Dentistry.”

EvenAll-NaturalFruitJuicesCouldRaiseYourChildsRiskforToothDecay

The amount of sugar your child consumes has a huge bearing on their tooth decay risk: The more they take in, the higher it is for this destructive disease. That's why you should moderate their intake of the usual suspects: sodas, candies and other sugar-laden foods. But you should also put the brakes on something considered wholesome and nutritious: fruit juices. And that includes all natural juice with no sugar added.

Sugar in any form is a prime food source for decay-causing bacteria. As bacteria consume leftover sugar in the mouth, they produce acid as a byproduct. With an ample source of sugar, they also multiply—and this in turn increases their acid production. Acid at these high levels can soften and erode tooth enamel, which leads to tooth decay and cavities.

Limiting or even excluding sugar-added foods and snacks can help minimize your children's risk for tooth decay. For designated snack times, substitute items like carrot sticks or even popcorn with a dash of spice rather than sweet snacks and candies. If you do allow occasional sweet foods, limit those to mealtimes when saliva, which neutralizes acid, is most active in the mouth.

As you manage sugary items your children may eat or drink, the American Academy of Pediatrics also advises you to moderate their consumption of fruit juices, including all-natural brands with no added sugar. Their recommended limits on daily juice drinking depend on a child's age and overall health:

  • Infants (less than one year) or any children with abnormal weight gain: no juice at all;
  • Toddlers (ages 1-3): 4 ounces or less per day;
  • Younger children (4-6): 6 ounces or less per day; and
  • Older children (7-18): 8 ounces (1 cup) or less per day.

As for the rest of your children's daily hydration needs, the most dental-friendly liquid for any of us is plain water. For older school-age children, low- or non-fat milk is also a sound choice.

Preventing tooth decay in your children is a continuous task that requires all of us, parents and dental providers, to do our part. Besides daily hygiene (brushing and flossing) and regular dental visits, keeping sugar at bay—including with juices—is an important part of that effort.

If you would like more information on best dental health practices for children, please contact us or schedule an appointment for a consultation.

By Douglas M. Hope, DMD, MAGD
June 29, 2020
Category: Oral Health
NewStudiesShowSealantsCouldHelpYourChildAvoidToothDecay

Your child could hit a speed bump on their road to dental maturity—tooth decay. In fact, children are susceptible to an aggressive form of decay known as Early Childhood Caries (ECC) that can lead to tooth loss and possible bite issues for other teeth.

But dentists have a few weapons in their arsenal for helping children avoid tooth decay. One of these used for many years now is the application of sealants to the biting surfaces of both primary and permanent teeth. Now, two major research studies have produced evidence that sealant applications help reduce children's tooth decay.

Applying sealant is a quick and painless procedure that doesn't require drilling or anesthesia. A dentist brushes the sealant in liquid form to the nooks and crannies of a tooth's biting surfaces, which tend to accumulate decay-causing bacterial plaque. They then use a curing light to harden the sealant.

The studies previously mentioned that involved thousands of patients over a number of years, found that pediatric patients without dental sealants were more than three times likely to get cavities compared to those who had sealants applied to their teeth. The studies also found the beneficial effect of a sealant could last four years or more after its application.

The American Dental Association and the American Academy of Pediatric Dentistry recommend sealants for children, especially those at high risk for decay. It's common practice now for children to first get sealants when their first permanent molars erupt (teeth that are highly susceptible to decay), usually between the ages of 5 and 7, and then later as additional molars come in.

There is a modest cost for sealant applications, but far less than the potential costs for decay treatment and later bite issues. Having your child undergo sealant treatment is a worthwhile investment: It could prevent decay and tooth loss in the near-term, and also help your child avoid more extensive dental problems in the future.

If you would like more information on sealants and other preventive measures for children's teeth, please contact us or schedule an appointment for a consultation.





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Douglas M. Hope, DMD, MAGD

(860) 651-4915
8 Plank Hill Rd. Simsbury, CT 06070