Breastfeeding is nature's way of providing complete nourishment to a newborn in their first years of life. It can also have a positive impact on their emerging immune system, as well as provide emotional support and stability. But although nursing comes naturally to an infant, there are circumstances that can make it more difficult.
One example is an abnormality that occurs in one in ten babies known as a tongue tie. A tongue tie involves a small band of tissue called a frenum, which connects the underside of the tongue with the floor of the mouth. The frenum, as well as another connecting the inside of the upper lip with the gums, is a normal part of oral anatomy that helps control movement.
But if the frenum is too short, thick or taut, it could restrict the movement of the tongue or lip. This can interfere with the baby acquiring a good seal on the breast nipple that allows them to draw out milk. Instead, the baby may try to chew on the nipple rather than suck on it, leading to an unpleasant experience for both baby and mother.
But this problem can be solved with a minor surgical procedure called a frenotomy (also frenectomy or frenuplasty). It can be a performed in a dentist's office with just a mild numbing agent applied topically to the mouth area (or injected, in rare cases of a thicker frenum) to deaden it. After a few minutes, the baby's tongue is extended to expose the frenum, which is then snipped with scissors or by laser.
There's very little post-op care required (and virtually none if performed with a laser). But there may be a need for a child to “re-learn” how to breastfeed since the abnormal frenum may have caused them to use their oral muscles in a different way to compensate. A lactation expert may be helpful in rehabilitating the baby's muscles to nurse properly.
A restrictive frenum isn't necessarily a dire situation for an infant—they can continue to feed with a bottle filled with formula or pumped breastmilk. But employing this minor procedure can enable them to gain the other benefits associated with breastfeeding.
If you would like more information on tongue ties and other oral abnormalities in children, 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.”
Buffalo Bills wide receiver Stefon Diggs wrapped up the NFL regular season in January, setting single-season records in both catches and receiving yards. The Bills handily beat the Miami Dolphins, earning themselves the second seed in the AFC playoffs, and Diggs certainly did his part, making 7 catches for 76 yards. But what set the internet ablaze was not Diggs' accomplishments on the field but rather what the camera caught him doing on the sidelines—flossing his teeth!
The Twitterverse erupted with Bills fans poking fun at Diggs. But Diggs is not ashamed of his good oral hygiene habits, and CBS play-by-play announcer Kevin Harlan expressed his support with “Dental hygiene is something to take note of, kids! There's never a bad place to floss” and “When you lead the NFL in catches and yards, you can floss anytime you want.”
We like to think so. There's an old joke among dentists:
Q. Which teeth do you need to floss?
A. Only the ones you want to keep.
Although this sounds humorous, it is borne out in research. Of note, a 2017 study showed that people who floss have a lower risk of tooth loss over periods of 5 years and 10 years, and a 2020 study found that older adults who flossed lost an average of 1 tooth in 5 years, while those who don't lost around 4 teeth in the same time period.
We in the dental profession stress the importance of flossing as a daily habit—and Stefon Diggs would likely agree—yet fewer than 1 in 3 Americans floss every day. The 2016 National Health and Nutrition Examination Survey (NHANES), conducted by the CDC's National Center for Health Statistics, revealed that only 30% of Americans floss every day, while 37% floss less than every day and 32% never floss.
The biggest enemy on the football field may be the opposing team, but the biggest enemy to your oral health is plaque, a sticky film of bacteria and food debris that builds up on tooth surfaces. Plaque can cause tooth decay and gum disease, the number one cause of tooth loss among adults. Flossing is necessary to remove plaque from between teeth and around the gums where a toothbrush can't reach. If not removed, plaque hardens into tartar, which can only be removed by the specialized tools used in the dental office. Regular professional dental cleanings are also needed to get at those hard-to-reach spots you may have missed.
If Diggs can find time to floss during a major NFL game, the rest of us can certainly find a couple minutes a day to do it. While we might not recommend Diggs' technique of flossing from one side of the mouth to the other, we commend his enthusiasm and commitment to keeping his teeth and gums healthy. Along with good dental hygiene at home—or on the sidelines if you are Stefon Diggs—regular professional dental cleanings and checkups play a key role in maintaining a healthy smile for life.
How a preventive care visit with your family dentist in Bethesda, MD, can save your smile
It’s important to protect your smile. If your smile is unhealthy, it can increase your risk of serious diseases like diabetes, heart disease, or having a stroke, according to the Mayo Clinic. An unhealthy smile also diminishes your appearance, and your ability to chew your food. Preventive care visits are an important part of protecting your smile.
Dr. John Kelly of Bethesda Row Dental in Bethesda, MD, offers a wide variety of family dentistry services, including preventive care visits, to save your smile.
Ideally, you should have a preventive care visit once every 6 to 12 months, and you should have x-rays at least once each year. You also should have your teeth professionally cleaned every 6 to 12 months.
During your preventive care visit, you will have:
- A complete dental examination, during which your dentist will look for signs of tooth decay, tooth wear, and damaged teeth.
- Any necessary x-rays, which will determine if you have tooth decay, a dental abscess, or bone loss due to periodontal disease.
- A check of the health of your gums and the underlying bone support of your teeth, to determine if you have gum disease or periodontal disease.
- A professional dental cleaning to remove the soft deposits (plaque) and hard deposits (tartar and stain) from your teeth.
Your dentist will develop a treatment plan based on the findings during your preventive care visit. Whether you need restorations such as fillings or crowns, or specialty care like root canal therapy, your family dentist will know what to do.
The treatment plan will also include how often you should have your teeth cleaned, depending on whether your gums are healthy, or whether you have periodontal disease. If you have periodontal disease, your dentist may recommend supportive periodontal therapy appointments every 3 to 4 months to manage the health of your smile.
In between preventive care visits, make sure you brush after eating and before bed, and floss your teeth at least once each day to keep your smile healthy.
To find out more about the importance of preventive care visits, and how they can save your smile, call Dr. John Kelly of Bethesda Row Dental in Bethesda, MD, at (301) 657-3220. Call today!
“Personalize Your Plate” is the theme for this year's National Nutrition Month in March, sponsored by the Academy of Nutrition and Dietetics. It means there isn't a single diet for all of us: We're each unique with differing body types and tastes, and our diets need to be unique as well. Still, though, you'll want to be sure to include basic nutrients that are generally good for all of us—including for our teeth.
As you “personalize” your daily diet, be sure it includes dental-friendly vitamins and minerals. Here are some of the more important ones that contribute to strong and healthy teeth, and the kinds of foods in which you'll find them.
Vitamin D. This vitamin is a key element for growing and maintaining healthy teeth and bone, mainly by helping the body absorb calcium. You'll find vitamin D in milk, eggs or fatty fish—and you'll also gain a little strolling outdoors in the sunshine!
Vitamin E. As an antioxidant, vitamin E helps the body fight free radical molecules that contribute to cancer development, including oral cancer. You'll find vitamin E naturally in seeds and nuts (and derivative cooking oils), wheat germ and whole grains.
Calcium. When included with vitamin D and phosphorus, calcium is an important “construction material” for building strong teeth and bones. You'll find calcium in dairy products like milk and cheese as well as greens, legumes and tofu.
Phosphorus. Eighty-five percent of the body's phosphorus, a companion mineral to calcium, is found in teeth and bones, where it helps to keep them strong and healthy. You'll find this important mineral in meats, milk and eggs.
Magnesium. This mineral helps mineralize teeth and bones, giving them strength and protection against disease. You can get magnesium by eating nuts, legumes, whole grains, dark leafy greens, seafood and—if you limit the added sugar content—chocolate.
Fluoride. Most people are familiar with fluoride added to drinking water or toothpaste to strengthen tooth enamel against tooth decay, but the mineral also occurs naturally in some foods. You can obtain low amounts of fluoride in seafood and black or green tea.
One last thing! While we're promoting foods that you should eat for healthier teeth, there's also one you'll want to cut back on: processed sugar. This carbohydrate is a major factor in oral bacterial growth that causes tooth decay and gum disease. So, eating foods low in sugar and high in these key vitamins and minerals will help ensure your teeth stay healthy.
If you would like more information about the importance of nutrition in dental care, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Nutrition: Its Role in General & Oral Health.”
“Orthodontic treatment” and “braces” almost seem like synonymous terms. But while braces certainly are orthodontic, it isn't the only tool in an orthodontist's toolkit.
A good example is a device is known as a Herbst appliance. It's used in situations where the upper jaw is outpacing the growth and development of the lower jaw during childhood. If not corrected, this could cause the top teeth to protrude abnormally beyond the lower teeth.
The Herbst appliance gently and gradually coaxes the lower jaw to grow in a more forward direction, thus “catching up” with the upper jaw. The top part of the device consists of two metal tubes hinged to small elastic bands, which are cemented to the cheek side of the upper back teeth (molars), one on either side of the jaw.
Two smaller tubes are attached in like fashion to the lower teeth, and then inserted into the larger tubes. As the lower jaw moves, the smaller tubes move within the larger to create pressure that gently pushes the jaw forward. Over time, this can sync the growth progress of both the upper and lower jaws, and reduce the chances of a poor bite.
For best results, a Herbst appliance is usually placed to coincide with a child's most rapid period of jaw growth, usually between 11 and 14. They could be placed as early as 8 or 9, however, in situations where the front teeth are already protruding well beyond the lips. In any event, the goal is to positively influence the growth of the lower jaw to alleviate or at least minimize the need for future orthodontic treatment.
As a fixed device, there's no need for a child or parent to tend to it as with other methods, like orthodontic headwear worn in conjunction with braces. A Herbst appliance can, however, alter the normal sensations associated with eating, swallowing and speaking, which may take a little adjustment time for the child. Wearers will also need to be extra vigilant with daily brushing and flossing because of a higher risk of tooth decay.
These, though, are minor inconveniences compared with the benefit of improved bite development. As such, a Herbst appliance could be a positive investment in your child's dental future.
If you would like more information on interceptive orthodontics, 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 “The Herbst Appliance.”
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