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We love our patients, so we’d be more than happy to see you every day! Alas, we realize that’s not really possible, so here are some more realistic guidelines for making appointments.

In general, it all depends on your oral health status and your health history.

For most patients, the optimal frequency to visit the dentist is twice a year. In six months, enough tartar and plaque can build up to require a dental check-up and cleaning, especially if your dental hygiene isn’t as rigorous as it should be.

For others with gum disease, a genetic predisposition for plaque build-up or cavities, in braces, or have a weakened immune system, you’ll need to visit more frequently for optimal care.

Depending on where you fall in those categories, we will prescribe the necessary frequency to keep your optimal health.

It’s important to keep your routine visits with us so that:

• We can check for problems that you might not see or feel. Want more information? Check out our Teeth for Life section on our website.
• We can find early signs of decay (decay doesn’t become visible or cause pain until it reaches more advanced stages).  An ounce of prevention goes a long way.  See our previous blog, Understanding the 5 Stages of Tooth Decay.
• We can treat most oral health problems found affecting children (generally, the earlier a problem is found, the more manageable it is).  If your child requires treatment outside the scope of Dr. Job's expertise, we will refer your child to another outstanding specialist.
• Routine visits become routine when your child feels comfortable in the dental setting.  Having a dental home for your child is important for them to feel safe and comfortable. Read about why so many patients continue to come to our practice at All Smiles Pediatric Dentistry.  Check out our section on, What Sets Us Apart. 

There you have it! Those are the brass tacks for how often you should schedule an appointment.

But don’t let this keep you from stopping in and saying hi whenever you’re in the neighborhood!

Scheduling an appointment for your child is easy.

Start here to schedule an appointment. All of our forms are online.  Fill them out securely from your smartphone or tablet and hit send.  On appointment day, your child will be seen at their scheduled time.  For example, if you have a 9:00 AM appointment, your child will be seen at 9:00 AM.

Dr. Allen Job and his team would love seeing your smile!

Dr. Allen Job, DDS, MS, MPH, MS is a board certified pediatric dentist who practices in San Diego, California, where he specializes in prevention.  He is also an assistant professor at Loma Linda University Department of Pediatric Dentistry.

Did you know there are five distinct stages of tooth decay? And, that in the first stage of decay, you can actually take steps to reverse the progression of the disease?

Indeed, it’s true. In the first stage of decay, whether you’re a child or an adult, the application of fluoride via fluoride treatments, your toothpaste and even the local water supply can stop a cavity from penetrating through the enamel and reaching its second stage.

Even the saliva in your mouth and the foods you eat help to re-mineralize a tooth in jeopardy. But that’s just the first stage!

What about the rest? Understanding how a cavity progresses can assist you in preventing each successive stage from occurring in your children. There’s always a lot going on in that little mouth!

Stage One: White Spots

In stage one, the tooth begins to show signs of strain from the attack of sugars and acids, and white spots will begin to materialize just below the surface of the enamel. These white spots are representative of the demineralization of the tooth and can be easy to miss because they’re likely to occur on your child’s molars. A dental exam, of course, is designed to catch such cavities! Can you see why regular visits to the dentist are recommended? As mentioned previously, at this stage, the cavity can be repaired without the need to excavate the tooth. During his examination, Dr. Allen Job checks for these early signs of cavities; which often appear as white spots.

Stage Two: Enamel Decay

Stage two marks the beginning of the end for the surface enamel that is being attacked. Initially, the tooth erodes from the underside outward, so the outer enamel will still be intact for the first half of this second stage. Once the cavity breaks through the surface of the enamel, there is no turning back, and your child will need to have the cavity corrected with a filling. Dr. Job says, "Stage 2 enamel decay can be prevented by treating Stage 1 White spots with a preventive home fluoride regimen."

Stage Three: Dentin Decay

If a cavity in your child’s mouth were to progress beyond stage two without you knowing, you’d tend become aware of it when it started to hit stage three because it would probably start to cause some pain. At this level, the cavity begins to eat away at the second level of tooth material that lies beneath the enamel: the dentin. A filling can still be used to stop the onslaught of bacteria assaulting the tooth in order to prevent the cavity from reaching the tooth’s most critical component: the pulp.

Stage Four: Involvement of The Pulp

Once the cavity reaches the pulp, pain ensues. So if you’ve unfortunately missed all the signs to this point, a screaming child or moaning teenager will certainly let you know there is a big problem. Stage four is serious.  A root canal treatment, called a pulpomy, at this stage may save for a complete extraction.

Stage Five: Abscess Formation

In the fifth and final stage of a cavity, the infection has reached the tip of the root and exited the tip of the tooth’s structure. This in turn infects the surrounding tissues and possibly the bone structure. Swelling would be commonplace and pain severe. In children (as well as adults) an abscess can be fatal if not dealt with immediately. An extraction would be the order of the day should decay reach this stage. Often, completing a round of prescription antibiotics will need to be completed prior to the treatment.

If your child is at this stage or any of the stages, contact us to schedule an appointment.

As you can see, cavities don’t happen overnight. In the early stages, regular visits can stall and reverse the progression of these dastardly little devils, so it really does pay to visit the dentist at pre-selected intervals. You can keep your children far from stage five their whole lives, and if a little bit of prodding to get them to the dentist accomplishes that, you can rest easy despite the griping.

Dr. Allen Job, DDS, MS, MPH, MS is a board certified pediatric dentist who practices in San Diego, California, where he specializes in prevention.  He is also an assistant professor at Loma Linda University Department of Pediatric Dentistry.

Imagine it’s winter (here in sunny San Diego, CA) … you’re standing at the door, ready to brave the cold. You’re layered-up with three shirts and a sweatshirt, your heavy winter coat, and two layers of socks underneath your waterproof winter boots. Then you’ve got those awesome jeans with the flannel on the inside, your comfy hat, scarf, and gloves. You’re set! But wait. As you step toward the door, you suddenly realize you have an itch … and it’s deep down … buried beneath all those layers. And, try as you may, every attempt to reach that bugger-of-an-itch fails. Defeated, you realize the only relief you’re ever gonna’ get is to remove each one of those layers. Where are we going with this?!

The Tongue

We’re going inside your mouth, of course, to your tongue – this is a dental article, after all! Because whether you know it or not, like you in the wintertime, your tongue is also “all covered up” – buried beneath layers of bacteria, fungi, and food residue that can inhibit your ability to taste, let alone cause your tongue to appear various shades of yellow, white, or green! Remove the bacteria, though, and your food will once again directly interact with those taste buds, and return to its natural hue. So how does one do that? With a tongue scraper, of course!

WHAT is a tongue scraper?

A tongue scraper is a U-shaped device designed to “scrape” the top layer of scum from your tongue. They have been in use since ancient times, and have been made of everything from wood to whalebone. Nowadays, they are made of more hygienic material, and come in a variety of shapes, sizes, designs and colors.

WHY use a tongue scraper?

The residue on your tongue includes things like the cavity-inducing Streptococcus mutans bacterium, fungi, rotting food (that’s not good), and what’s referred to as “volatile sulfur compounds.” In other words, sulfur – that “rotting egg smell.” Talk about ew! So, as you can see, there are several reasons why you’d want to get rid of this gunk in your mouth.

Let’s tackle them one by one:

• Reduce bad breath: ‘nuff said! We've all had morning breath, if we are honest enough to admit it.  Let the tongue scraper help you get rid of it.
• Reduce your risk of periodontal disease and cavities: Bad bacteria contribute to plaque and tartar on teeth, making them more susceptible to cavities. Bacteria build-up can also lead to inflammation of gum tissue (gingivitis). If left untreated, gingivitis can lead to periodontal disease, which means a more expensive dental visit (plus other unwanted consequences!). Speaking of avoiding an expensive dental visit, when was the last time you came in to see us?  Come see us now if it’s been awhile, by contacting us for an appointment.
• Make room for good bacteria: see our article here on probiotics for your mouth.
• Prevent heart disease? While the debate is still up in the air, some studies suggest there could be a correlation between gum disease and heart disease.

HOW does one use a tongue scraper?

In general, make sure to rinse your tongue scraper before and after use. Apply the tongue scraper to the back of your tongue and drag it forward. Then, rinse and repeat. Make sure to get the sides of your tongue as well, not just the center!

Make sure not to press too hard or you can cause yourself to bleed. And, if you’re wondering if you should scrape your tongue while recovering from a dental procedure, that’s a good question … ask Dr. Allen Job for the best advice particular to your situation.

Still not sure how this thing really works? The next time you’re in ask one of our registered dental assistants for a quick tutorial!

WHERE do I buy one?

Tongue scrapers are relatively inexpensive, and can also be found at
any local drugstore. It doesn’t matter the material, color, or brand – just find the one you like and get scraping!

At All Smiles Pediatric Dentistry, we incorporate proven techniques to share with you and your child at each dental checkup visit.  Dr. Allen Job and his team are committed to providing the latest in oral health care prevention.  For more information about brushing and flossing check out our preventive care page.  Still want more information? Check out our blog posts on prevention!  Our practice is centrally located in San Diego, CA.

Scheduling an appointment for your child is easy!  Start here to schedule an appointment. All of our forms are online.  Fill them out securely from your smartphone or tablet and hit send.  On appointment day, your child will be seen at their scheduled time.  For example, if you have a 9:00 AM appointment, your child will be seen at 9:00 AM.

Dr. Allen Job, DDS, MS, MPH, MS is a board certified pediatric dentist who practices in San Diego, California, where he specializes in prevention.  He is also an assistant professor at Loma Linda University Department of Pediatric Dentistry.

What is a tongue tie?

A tongue tie or ankyloglossia occurs when there is an abnormal band of thick tissue, also known as the frenum, which is located below the tongue.

How does a tongue tie affect feeding of newborn babies?

A tongue tie prevents the tongue from having the full range of motion.  This is considered a developmental problem since it arises before a baby is born.  Tongue tie restricts how a newborn nurses, often causing improper latch with the mother’s nipple.

What other problems can arise from having a tongue tie?

Having a tongue tie can create speech difficulties, malocclusion, and gum recession.¹

Is having a tongue tie pretty common?

Tongue tie occurs between 4% - 10.7% of the population.²

Are there different types of tongue tie?

Anterior Tongue Tie

Yes, there are two primary forms of tongue ties complete and partial.³  When the frenum has limited tongue movement it is considered a partial ankyloglossia.  This is known as an anterior tongue tie. Often, one can see an anterior tongue tie since it appears as a thin band of tissue under the tongue.

Posterior Tongue Tie

However, if  the tongue appears to be fused to the floor of the mouth it is then considered to be a total ankyloglossia.  This is known as a posterior tongue tie. Posterior tongue ties are much harder to visualize.  The tongue has to be elevated from the floor of the mouth in order to diagnose a posterior tongue tie.

What is a lip tie?

An upper lip tie is present when the upper lip is lifted and the band of connective tissue (frenum) is tight, causing the gums to blanch (turn white).  There are four classifications for lip tie, ranging from mild (Class 1) to severe (Class 4).

What are the 4 classifications of Lip Tie?

Class I: Mucosal

Class 2: Gingival

Class 3: Papillary

Class 4:  Papilla Penetrating

Upper Lip, Lower Lip, and Tongue Ties. Can someone have more than 1 lip tie?

A lip tie can occur on either, the upper lip, the lower lip, or both.  Often a lip tie accompanies a tongue tie.

How does a lip tie affect a baby?

Lip ties can be associated with breastfeeding difficulties in infants.⁴   They can be associated with facial cervical caries (tooth decay at the gumline), due to interference with proper oral hygiene.⁵  Moreover, they can also be associated with the gum recession. ⁶

How are tongue and lip ties treated?

Physicians, such as an ENT (Ear Nose Throat Specialist), usually will treat tongue and lip ties with a scalpel or surgical scissors.  They may also require treatment to be completed with some form of sedation, ranging from local anesthetic to general anesthesia.  Sutures or stitches may also need to be placed.

Today, pediatric dentists and some physicians trained in treating tongue tie and lip ties can perform this procedure in an outpatient setting, using a laser.  With using a laser, there is less pain, less bleeding, and no need for sutures.  This translates to faster healing and in most cases quicker resolution to the problem.  This form of treatment usually requires using just a topical anesthetic and occasionally, a local anesthetic.

How long does the procedure take?

The procedure usually takes less than 10 minutes from start to finish.  Mothers are able to nurse right after procedure with their infant.

What happens after the procedure?

In order to get optimal results and to ensure proper healing, it is essential that parents complete the post treatment therapy exercises with their infant and also follow-up with a daily oral hygiene routine.  Moreover, a series of follow-up care appointments will be setup to monitor the healing process.

What about older children or adults?

Older children and adults can also benefit from lip tie and tongue tie correction.  The benefits include: improved oral hygiene, decreasing orthodontic severity especially from lip tie treatment, and improved speech.

If your child is showing signs of tongue tie or lip tie, contact Dr. Allen Job at All Smiles Pediatric Dentistry, to for a comprehensive evaluation to see if your child will be a good candidate for laser treatment.

References

1. Segal L, Stephenson R, Dawes M, Feldman P. Prevalence, diagnosis, and treatment of ankyloglossia. Can Fam Physician 2007;53(6):1027-33
2. Boutsi EZ, Tatakis DN. Maxillary labial frenum attachment in children. Int J Paediatr Dent 2011;21(4):284-8.
3. McDonald RE, Avery DR, Weddell JA. Gingivitis and periodontal disease. In: Dean JA, Avery DR, McDonald RE, eds. McDonald and Avery’s Dentistry for the Child and Adolescent. 9th ed. Maryland Heights, Mo: Mosby Elsevier; 2011:389-91.
4. Coryllos E, Genna CW, Salloum A. Congenital tongue-tie and its impact on breastfeeding. Breastfeeding: Best for baby and mother. Am Acad Pedia (newsletter) 2004; Summer:1-7.
5. Kotlow L. The influence of the maxillary frenum on the development and pattern of dental caries on anterior teeth in breastfeeding infants: Prevention, diagnosis, and treatment. J Hum Lact 2010;26(3):304-8.
6. Minsk L. The frenectomy as an adjunct to periodontal Compend Contin Educ Dent 2002;23(5): 424-6, 428.

*This blog is part of the Baby Steps Series. Look for future blogs in this series.

Dr. Allen Job, DDS, MS, MPH, MS is a board certified pediatric dentist who practices in San Diego, California, where he specializes in prevention.  He is also an assistant professor at Loma Linda University Department of Pediatric Dentistry.