by Richard Baxter DMD, MS | Jul 2, 2016 | Infant oral health, Pediatric Dentistry, Uncategorized
Why did we get a new laser? We had been using the iLase dental laser from Biolase. It’s a pen-like device that belongs to a subset
of lasers called “diode” lasers. How it works is the tip is “initiated” by something like cork or blue paper before each use, which then focuses the laser energy at the tip of the laser during use and makes it very hot. The laser is then used to remove the tissue by essentially searing it off or cauterizing it. The laser has beneficial properties for tissues like “photobiomodulation” and other fancy terms, but for the most part, it’s a very hot tip. This style of laser (diode) is the most commonly used laser in dentistry, and it works well for many soft tissue procedures, but it takes a long time.
However, in the quest for the best all-around laser for our patients, I came across CO2, Er:YAG, and Er,Cr:YSGG. We went with CO2 because it acts differently than the other lasers. A diode laser is a white-hot tip that sears the tissue, whereas the Erbium and CO2 lasers work by vaporizing the water in the cells (which means much less of the “burning” smell that was present with the diode laser). Weighing all the options, I felt that the laser with the least intraoperative and postoperative pain, quickest procedure time, minimal to no bleeding, and fastest healing was the CO2 laser. Ours is sold by LightScalpel.
The procedure with the LightScalpel is about 10-20 seconds for the upper lip and about 10-20 seconds for the tongue. With the diode, sometimes it would take 60-120 seconds for the upper lip and 60 seconds for the tongue. When performing these procedures, we allow the parents back (or they can choose to remain in the consult room), and many times that is the longest 5 minutes of a parent’s life! If we can decrease the time it takes for the procedure, the better it is for the clinical team, the parent, and of course, the child.
So what does this mean in English? This means less discomfort for the baby or child with a lip or tongue tie during and after the procedure and a quicker procedure in the office.
For these reasons and more, although the CO2 laser is significantly more expensive, I believe it’s a great investment for our practice and especially for our littlest patients. We are one of the only offices in Alabama with a CO2 laser and the only office in Alabama using a CO2 laser for infants, children, and teens with tongue and lip ties. Please call our office if you have any questions about this post or would like to schedule an appointment. 205-419-7444.
by Richard Baxter DMD, MS | Jul 24, 2015 | Parent Questions, Pediatric Dentistry, Uncategorized
anxious child
A parent asked this question on our Facebook page. If anyone has any questions or suggestions for future blog posts, please post them on our page or in the comments section, and I will be happy to answer them!
Typically a child who is fearful of the dentist will have had a difficult situation at another dentist’s office or at a pediatrician’s office and is scared of anyone dressed in scrubs or medical clothing. Sometimes the fear is transmitted from a parent or relative who had a bad experience at the dentist. These relatives (often siblings) will say things to the child like “they’re going to pull out a huge needle and jab it into your gums!” Clearly this is the wrong message to send to a child who has never been before or one who is about to get some fillings done. Parents can instead try to prepare their child in a positive way while avoiding the scary things. Say things like “we like the dentist because he / she keeps your teeth healthy” or “you’re going to have a great time because you can watch Frozen while they sing songs to you and fix your teeth!” (Which is true at our office!) You can also show your child our virtual tour on our website so they can see the office before arriving. It’s generally helpful to be vague and allow us to prepare your child for the specific procedure at our office. We allow them to touch the instruments, feel the water and the air, and hear the noises in a non-threatening way while explaining what we are going to do at an age-appropriate level.
Please do not mention anything about “shots”, “drills”, “pulling or yanking teeth” or anything “hurting.” Most of the time (probably 90%), the kids don’t even know they get a teeny tiny injection because we have lots of techniques to help them through the appointment. Many times we take out their sick tooth, and they don’t even know! So prepare them in a way that portrays dentists and dentistry in a positive light, and let us work through the appointment. Although a lot of parents have had difficult experiences at the dentist themselves, and it can be hard to not tell your child about it, avoid discussing your anxiety or past bad experiences. Children can sense a parent’s anxiety. Parents are welcome to accompany children for any visit, but if the parent feels more comfortable waiting in the lobby, that is totally fine too. Also avoid discussing details of a prior difficult experience the child has had at another office. We would be happy to discuss any prior difficulties that you think we need to know about in an area away from the child.
If you have any questions about this post or any others, please call our office at 205-419-7444.
Richard Baxter, DMD, MS
by Richard Baxter DMD, MS | Jul 9, 2015 | Pediatric Dentistry
“Dentistry with a Mission” 
An article written about us when we first opened used the phrase “Dentistry with a Mission,” and it stuck. Our full mission statement is to “provide exceptional, individualized oral healthcare for infants, children, adolescents, and patients with special needs in a fun and compassionate environment. We partner with parents and focus on prevention and early detection of dental diseases in order to help our patients establish a lifetime of healthy habits. We believe every child is a blessing, and it is our privilege to serve them.”
We desire to bless those around us and also those around the world through dentistry. After visiting third world countries, and through the teaching at our church, The Church at Brook Hills, our eyes have been opened to the needs around the world and in our own community. For example, in a certain area of Ghana, there are 3 million people and 1 dentist. That’s like having two dentists for the whole state of Alabama! It is difficult for us to understand the kind of need that exists in other parts of the world. Through mPower Approach, my wife and I went to Myanmar and trained pastors to extract teeth so that the impact from our 10 day trip would continue long after we left. It’s like teaching a man to fish instead of giving him a fish. These pastors then go and share God’s love with those hurting around them and also provide a much needed service. By God’s grace, we hope to go on many more trips in the future, and I went to Ghana in January of 2016.
In addition to going on trips, we hope to use the resources that God has entrusted to us in the practice to bless others. One way we have done this is by partnering with NeverThirst who provides clean water to those without access to drinking water and brings Living Water by partnering with churches in these areas. Locally, we have supported the North Shelby Library, local schools, and students in inner-city Birmingham.
We thank you for your support of our mission. It truly is our privilege to serve you!
by Richard Baxter DMD, MS | May 4, 2015 | Parent Questions, Pediatric Dentistry
FAQ: What should I do if my child knocks out his permanent tooth?
The best thing to do with a baby tooth that is knocked out is to put it under the child’s pillow for the tooth fairy. However, when a permanent tooth is knocked out, it is critical that action be taken immediately because whether the tooth survives is based on the time it takes to get the tooth back in the socket. A tooth that is knocked out from a sports injury, a fall, or any number of other ways needs to first be briefly rinsed with water for a few seconds to get any dirt off the tooth. The next step depends on your desire and ability to replace the tooth in the socket. The absolute best thing to do with a knocked out permanent tooth is to replace it in the socket right after quickly rinsing it with water. If this isn’t a possibility (the child lost consciousness) or you are not willing or able to do this, the next best thing to do is place the tooth in cold milk. Milk is the liquid that is most like the tooth’s natural environment and the cells on the root will be able to live for several hours in cold milk. Do NOT place the tooth in water, juice, Gatorade, or coke, because if the cells on the tooth root die, the tooth will not be able to heal once it is replaced in the socket.
The lifetime cost to replace a front tooth that is knocked out and does not survive is around $10,000 (for bridges, crowns, a dental implant, etc.). So if we can keep that tooth healthy, and it survives, not only will the child have a better smile, less dental procedures, and issues, but the parent will save a significant amount of money! This is why even if it seems gross to stick the tooth back in the socket, it really is the best treatment and gives the tooth the best chance of healing. Once the tooth is replaced in the socket (or if it is in cold milk) find a pediatric dentist or general dentist as soon as possible who can help you stabilize the tooth in the mouth. The tooth will usually require a root canal within 7-10 days after being knocked out, unless the tooth just recently erupted. The child will have to wear a splint on the teeth, which is typically made from fishing line and a white filling material. The splint will stay in place for around two weeks to allow the tooth to re-attach to the bone in the jaw.
If you have any questions about a permanent tooth getting knocked out, or would like to schedule an appointment, please call us at 205-419-7444.
by Richard Baxter DMD, MS | Feb 27, 2015 | Cavities, Dental Health, Infant oral health, Parent Questions, Pediatric Dentistry
FAQ: How Does My Child Get Cavities?
Cavities
The two ways that your child can get cavities are by not brushing (or flossing) his or her teeth, and by consuming too much sugar. Sugar can be in many forms, either liquid (milk, juice, or other sugary drinks) or solid (sweets and candy). Typically the liquid form of sugar can cause cavities quicker in children. Often when we see decay in a young child, they have had access to a bottle or sippy cup whenever they want it, or they drink from a bottle at nighttime with milk in it. Milk contains a natural sugar, lactose, which can be changed into an acid by the bacteria in the mouth and cause cavities when it sits on the child’s teeth. Juice, chocolate milk, sweet tea, or even Coca Cola are often given to children to drink. These all contain similar amounts of sugar and can cause tooth decay extremely rapidly. (Side note: Juice contains more sugar than Coca Cola!) If this process of changing sugars from the diet into lactic acid by the bacteria in the mouth happens often over time, the enamel will begin to weaken. The rate of cavity formation is based on the frequency of sugar intake. If the tooth is exposed to sugar (and therefore acid) more frequently, the enamel will dissolve faster, and cavities will form rapidly. So the best time for a child to drink a beverage containing sugar (even milk) is just with meals, rather than throughout the day. At night, if a child has milk or juice, it stays on the teeth for a very long time, and there is not much saliva produced at night to wash it off the teeth. Therefore, children should only drink water at night and should drink water throughout the day as much as possible.
The frequency of sugar consumed is only one piece of the puzzle. We also need to have high amounts of bacteria that can convert the sugar to acid. The main way we can reduce the bacteria in the mouth is by brushing and flossing. It’s important to start brushing a child’s teeth as soon as they enter the mouth, typically around six months. You can begin using a fluoride toothpaste (which makes the enamel stronger and harder to dissolve) as soon as you start brushing by using a smear of toothpaste. As soon as teeth begin to touch, most often where the back molars meet or where the two front teeth meet, it’s a good idea to start flossing. You can use little flossers with handles, and wipe the piece of floss off after going between each set of teeth.
The final piece of the puzzle is the part that you cannot really change. Your child will get bacteria in their mouth that can cause cavities (typically from mom, but sometimes from dad or another relative). So it’s important for everyone around the baby to have excellent oral health to minimize the bacteria transferred when you kiss your baby, they try your food, or any other activities where saliva may be transferred from parent to baby. However, you cannot change the genetics that influence the hardness of the teeth. Some people’s teeth are a little softer (and more likely to get cavities), and we don’t yet know why. BUT the important thing to realize is that if you or your spouse have “bad teeth” or if you have a history of “soft teeth” in the family, be sure to be extra careful with sugar in the child’s diet and be extra careful to brush your child’s teeth very well, twice a day. Even if the child has “softer teeth”, he or she can still be cavity free with good brushing and limiting sugar intake.
If you have any other questions about cavities in young children, we would be happy to answer them for you. Call our office at 205-419-7444.
by Richard Baxter DMD, MS | Feb 18, 2015 | Dental Health, Infant oral health, Parent Questions, Pediatric Dentistry
Frequently Asked Question: When should my child first go to the dentist?
FirstDentalVisit
The old answer was to see the dentist by age three. This recommendation was because most dentists who see kids are general dentists who did not want to see small, crying, uncooperative children, nor were their offices equipped to see small children. Most general dentists (family dentists) are doing crowns, dentures, fillings, and seeing anyone from age 3 to 100. Recently, pediatric dentists have changed the recommended first age to “First Visit by the First Birthday”. This change was in response to us seeing so many children at age three (the traditional first visit) who already had severe decay. Typically this was due to taking a bottle at night and not brushing the teeth due to a lack of education. We have seen countless children in our six months of being open who already have a mouthful of cavities by the time we first see them at age three. So we agree with the AAPD and ADA which recommend the first visit by age 1. Pediatric Dentists (like Dr. Baxter) receive special training in residency to examine and work with small children under age three.
What do we do at our age one visit? We will focus on prevention and education of the parent. This educational component is the most important part of the visit (not the actual tooth cleaning). We will discuss dietary habits, drinking with a bottle or sippy cup, any thumb sucking or pacifier habits, and review brushing habits. We will typically do a knee to knee exam (lap exam) and cleaning with children age 3 and under. This is where the child lays in the parent’s lap and leans back into the hygienist or dentist’s lap to clean and examine the teeth more easily. This is less threatening to a child than getting in a chair. Sometimes children will jump up on our benches (which don’t move) because they are used to getting on the exam table at the pediatrician’s office. If they jump up there, we will brush their teeth on our regular benches if they are comfortable. We try to make the visit as easy and comfortable for both child and parent as possible, but even still, most children do cry (some more than others!). Sometimes the children do cry and scream, but in a pediatric office we are used to this behavior and it doesn’t disrupt our office like it would a more cosmetic focused, general dentistry office. We will brush their teeth with a gentle toothbrush and examine the teeth and gums for any cavities or anything that doesn’t look normal. The last step is to paint the fluoride varnish, which is a sticky fluoride that will protect the teeth and make them stronger.
If you have any questions about oral health for infants and young children, please give us a call, or if you would like to set up an appointment, you can call us at 205-419-7444.
