Q. My seven-year-old daughter has recently begun to grow her front teeth to replace her milk teeth, which she recently lost. Unfortunately the teeth have grown in very crooked. My daughter sucks on her middle fingers to get herself off to sleep. Has this affected her new teeth, and what can be done to correct the teeth? I have tried very hard to persuade my daughter not to suck on her fingers, but she can't seem to relax and nod off to sleep until she sucks on them. I have tried to put unpleasant tasting things on her fingers, I have explained that she may be seriously damaging her mouth, but she won't stop. Can my dentist help, do you have any suggestions?
A. Digit sucking habits can affect the growth pattern of the jaws and can cause teeth to be crooked. Your daughter must see an orthodontist who will examine her and advise on the necessary treatment. A brace may be required to straighten the teeth or it could also be used to break the finger sucking habit.

Q. My family has teeth that are I suppose "Goofy". As a child I suffered a lot of teasing because of my teeth. My son seems to have inherited this problem, I know that in America it is common place for children to have braces and they seem to have beautiful shaped mouths and teeth over there. When can my son be fitted with a brace, and is the treatment available on the NHS. If better treatment is available privately I am prepared to pay, however I am not sure how I would go about finding a suitably qualified dentist, and how do I know his/ her charges are reasonable.
A. Orthodontic treatment is available on the NHS but not all NHS dentists carry out orthodontic treatment. If your dentist does not carry out orthodontic treatment then he should be able to refer you to a dentist who can, whether on the NHS or privately. Private orthodontic treatment is not necessarily better than NHS treatment but you may find the waiting time for the treatment is much less. The local health authority should have a list of all NHS dentists in their area who carry out orthodontic treatment and there should also be a list of private orthodontists, however the cost will vary from case to case.

Q. My daughter is aged 9 years and has last week lost her first molar tooth, isn't this a bit early?
A. Deciduous molars are usually lost between 10-12years of age; however, there is a great variation in eruption times. Therefore to loose a deciduous molar at 9 years of age is about normal. However if you are concerned about this then your dentist will be able to examine your daughter and take any necessary x-rays and see if the underlying tooth is erupting.

Q. My son aged 10 years plays a lot of sport and has recently taken up rugby. Unfortunately he's always coming in with grazed knees and bumps and bruises. I am a little concerned about his teeth, I bet one day he'll get them hurt. Please tell me what I should do in an emergency if he loses a tooth?
A. Approximately 16% of injury results in a tooth being avulsed (Knocked out completely). Should this happen the success of treatment depends on how quickly treatment is carried out. An avulsed tooth should be stored in the side of the patient's mouth or milk or water and taken to the dental surgery immediately. The dentist will then reimplant the tooth back into the socket if possible and fix it in place.
These injuries can be minimised by wearing a gum shield when playing contact sports. Your dentist will be able to take an impression and make a gum shield.

Q. There has been a lot of press coverage recently about the danger of sedation in a dental practice when treating children. My daughter, is aged 11 years and she needs to have a tooth extracted. She is really frightened and I know that unless she is sedated she won't let the dentist near her.
A. If your daughter has a fear of treatment then by staging the treatment and doing a little at a time may help her gain confidence and slowly the treatment can be carried out. If this does not work and she requires sedation then at that age this is done with nitrous oxide (laughing gas) and oxygen, which, is very safe as the child is not asleep during the procedure. You may be able to find out which dentists carry out sedation for children in your area by contacting the local health authority.

Q.I remember I once had a tooth extracted when I was about 9 years old, and I was given gas. I didn't feel a thing and I don't remember any after effects. Do dentists still give gas? How can I be reassured that my daughter is safe, would she be better off having her treatment done in hospital?
A. What you are referring to is General Anaesthesia, which was commonly used in Dental surgeries. This is only carried out in selected centres and hospitals and G.A. is not available in General Practice. In this day and age it should not be necessary to put anyone to sleep for dental treatment, as there are many safer and more suitable alternatives available for nervous patients such as sedation.

Q. My daughter was born with a small hole in her heart; she is monitored about once a year now at our local heart hospital. Fortunately my daughter did not require surgery and she has thrived. My husband and I have been advised that the problem will not affect her life at all other than that she has an increased risk of infection if she underwent surgery or dental treatment. My daughter is due to have a tooth extracted and to have a brace fitted. I am really worried about her treatment.
A. Any patient with a hole in the heart or any other congenital heart defect can be treated at the dental surgery quite safely. Prevention of tooth decay and gum disease by good oral hygiene is very important for your daughter. If any treatment is required and the procedure involves any kind of surgery or deep cleaning of the teeth then the dentist will give antibiotics an hour before treatment begins. This is because bacteria will be introduced into the bloodstream and the antibiotics are used to prevent any infection to the heart.

Q. We've had body piercing, tattooing, and now there's tooth jewellery, my 14-year-old daughter really wants to have a small gold star placed on her front tooth. She says that her dentist is happy to fix it for her. I am really worried about it damaging her tooth.
A. Tooth jewellery is becoming more fashionable these days and different shapes and symbols are available which can be fixed to the tooth. This is a relatively simple procedure and does not in any way damage your tooth. The jewellery is fixed to the tooth with a clear resin and can be removed if you wanted to do so. A dentist should only carry this out.

Kids Ask

Q. Dear Dentist, I am 10 years old, my first teeth looked great, but I have now got my permanent teeth and the front teeth are goofy. Can anything be done?
A. If your teeth stick out a lot and look goofy then you may need a brace to pull your teeth back into line. It would be best to wait until more permanent teeth were through before having the braces fitted, but it is best to see an orthodontist and have an examination and a treatment plan made for you.

Q. Dear Dentist, I am 14 years old and I do a lot of gym. I had a really nasty accident about a month ago when I misjudged the box and fell off hurting my face. My front tooth has turned black. Is it dead? Will it get better or will the tooth have to come out?
A. If your tooth has gone black then it is probably dead. DON’T PANIC it does not mean that your tooth will have to come out. You will need to have a root filling on your front tooth and then the colour can be improved. This can be done in a number of ways. If the discolouration is very mild then it may be possible to bleach the tooth to improve its colour, the other alternatives are to have a veneer or a crown. Your dentist will be able to advise you which option is best for you.

Q. Dear Dentist, When I was a baby and a toddler I liked drinking fruit juice in my bottle. Unfortunately this went on till I was 4 years old and started school. My baby teeth became quite rotten and had to be taken out. I am 7 now, will my permanent teeth be decayed as well?
A. Your permanent teeth that replace your baby teeth should come through as normal teeth and not decayed. If you had infections on your baby teeth before they were taken out then this may have caused some damage to the enamel of your permanent teeth developing below. We will only be able to tell if this has happened when your permanent teeth come through. You must go to the dentist regularly so that he or she can keep a check on how your teeth are developing. Now that you know what damage sugar can do to teeth you must take care of your permanent teeth by avoiding sugary foods and keeping your teeth clean by brushing with fluoride toothpaste.

Q. I am 8 years old and am getting new permanent teeth at the moment. My teeth are crowded says my dentist. What does that mean? What can be done to straighten them?
A. If you have crowding that means your teeth are too big in relation to your jaw and they do not fit in without being squashed and overlapped. You will need to be examined by an orthodontist who will take x-rays of your teeth and make models to see how to straighten your teeth.

Q. I am a 15 year old girl, I really want to have some tooth jewellery. My mum is not happy, please tell me if you think it might damage my teeth, so I can reassure my mum.
A. Tooth jewellery is becoming more fashionable these days and different shapes and symbols are available which can be fixed to the tooth. This is a relatively simple procedure and does not in any way damage your tooth. The jewellery is fixed to the tooth with a clear resin and can be removed if you wanted to do so. This should only be carried out by a dentist.

Should you require any further dental information or advice on Childcare, please contact The Dentist@Dentecom.