Archives for March 2021

Our 9-year-old is bedwetting. Is this hereditary or sleep apnea?

Posted on March 29, 2021 by AllSmiles.

I read online that bedwetting after age 7 is a reason for concern. Our son will be nine years old in September, and he wets the bed regularly. I looked at so many references about this online that I cannot remember where I read what. I’m still looking for the websites I saw that say bedwetting might be related to sleep apnea. Our family dentist does not offer the mouthpiece for snoring, so I am unsure what to do next. Is this hereditary? Thank you. Layla from GA

Layla,

According to the Mayo Clinic, family history can be a risk factor for bedwetting, but there are other causes. If either or both parents experienced bedwetting as children, their children might wet the bed at night.

Causes of Bedwetting in Children

Some causes of bedwetting in children include:

Inability to recognize when their bladder is full
Small bladder
Hormonal imbalance
Urinary tract infection
Diabetes
Chronic constipation
Urinary tract or nervous system structural malformation
Sleep apnea

Nerves that control the bladder suppress urination while we sleep. But if nerves are slow to mature or a child is a deep sleeper, suppression may not work well.

Suggestions for Bedwetting

If your child is bedwetting past age seven, three suggestions to help include using nighttime pull-ups, awakening them at night to use the bathroom, or considering if sleep apnea is a contributing factor.

Use nighttime pull-ups – If your son’s pediatrician cannot find a medical reason for his bedwetting, you can try a nighttime pull-up until your son grows out of it. Most reports indicate that bedwetting issues usually resolve by the teen years.
Awaken your child – Schedule a time to wake your child up at night to use the bathroom.
Consider sleep apnea – Children who snore at night may have sleep apnea. Sleep apnea deprives the body of oxygen and can cause them to awaken at night. And while awake, the bladder may release and cause bedwetting. If your child is diagnosed with sleep apnea, the Vivos System™ is an orthodontic system that widens the oral cavity and can treat sleep apnea in adults and children. You might be able to find a dentist in your area who provides the appliance if your child has a sleep study that confirms sleep apnea. Or the sleep specialist may prefer alternative treatment.

Your family dentist or primary care doctor will be able to refer you to a sleep apnea specialist.

David Finley, DDS, of Monroe, LA, sponsors this post.

Why is my crowned tooth sensitive to heat?

Posted on March 25, 2021 by AllSmiles.

Two of my crowns are more than 20 years old. Last week, I visited my dentist to get up my first box of Invisalign aligners and get a dental cleaning. Today, I felt sudden intense pain in an upper left crown, and the pain gets worse when I drink coffee. My dental office is closed until the beginning of April. Is Invisalign causing pain and sensitivity as my teeth shift? Do I need to see another dentist, or can it wait until April? Thank you. Asa from TN

Asa,

The symptoms you describe mean that your tooth pulp is dying. You will need root canal treatment to remove the infection and save your tooth.

Tooth pain and sensitivity – Tooth sensitivity that comes and goes does not necessarily mean the tooth is dying. But sudden intense pain that arises on its own indicates the tooth is dying. And when warm or hot temperature changes increase the pain, the indications are strong.
Infected tooth pulp – When infected pulp calls the body’s defenses to fight the infection, the pulp tissue begins to swell. But it is confined within your tooth, chokes, and dies. As the tooth dies, it can give off gasses that increase pressure and pain inside the tooth. Cold temperatures contract the gasses and can provide relief.

Photo of an upper aligner for Invisalign, which is offered by Monroe, LA dentist Dr. David Finley.

See a dentist if you have sudden intense pain. It is unlikely that Invisalign is the cause.

Although pressure on the tooth from Invisalign movement can irritate an infected tooth, Invisalign is not the cause of your tooth pain. Your tooth infection was probably already brimming, and the dental cleaning may have aggravated it further.

Root Canal for a Crowned Tooth

Although a dentist can make a small opening in the crown and perform root canal treatment through it, removing the crown gives a better view of the tooth’s condition. And your crown is more than 20 years old, so replacing it and the other old crown can prevent future issues.

Causes of Tooth Pain Beneath an Old Crown

Trapped decay beneath a crown can lead to an infection. If the margin between your gums and the crown is leaking, bacterial can seep in and promote decay. Another culprit might be exposed tooth roots that are irritated.

Can Your Tooth Pain Wait?

An infection will continue to spread until a dentist treats it. The pain and sensitivity you are experiencing are signals to see a dentist right away. Ask friends or family members for a recommendation. Or search online for an experienced dentist with positive patient reviews. You can wear a temporary crown and wait until your dentist returns to receive your new crowns.

David Finley, DDS, an accredited cosmetic dentist in Monroe, LA, sponsors this post.

My daughter’s primary teeth won’t fall out

Posted on March 17, 2021 by AllSmiles.

My 7-year-old daughter has two permanent teeth emerging behind primary teeth. I tried to wiggle the baby teeth to see if they will move, but they are solid. Should I wait a few more weeks, or do I need a dentist to remove the baby teeth? – Thank you. India

India,

Thank you for submitting your question.

If you see permanent teeth erupting, but the primary teeth are not moving, you should ask a dentist to remove the primary teeth. Otherwise, multiple problems can result.

When Primary Teeth Do Not Fall Out

If your child’s primary teeth do not fall out, the results can be two rows of teeth, impacted teeth, or incorrectly positioned teeth.

Two rows of teeth

When primary teeth will not fall out and make room for permanent teeth, your child might have a second row of teeth. The result is overcrowding, the need for extractions, and possibly orthodontic treatment.

Impacted teeth

If baby teeth do not make room for primary teeth, your child’s teeth might become impacted—trapped beneath the gums. Permanent teeth can grow horizontally or slanted and fail to erupt. Eventually, a dentist must extract the primary teeth, and your child might need oral surgery, orthodontic treatment, or both to help the primary tooth emerge. Impacted teeth can cause pain and crowding and lead to orthodontic treatment.

Incorrectly positioned teeth

If permanent teeth manage to erupt with primary teeth intact, the permanent teeth might emerge behind the primary ones or in another position. Baby teeth will still require extraction, and your child will need braces to reposition permanent teeth.

Preventing Problems with Primary Tooth Eruption

Dental visits at an early age and knowing when to watch for tooth eruption can prevent or minimize problems with delayed permanent tooth eruption.

Early dental visits

When your child’s first tooth erupts, bring them to your family dentist for an exam. Yearly dental exams are preventive care to detect any issues with your child’s oral health.

Watch for tooth eruption

Parents can watch for proper tooth eruption using the American Dental Associations, tooth eruption charts. If your child’s teeth are erupting off schedule, visit a dentist for an examination. Early intervention can minimize your child’s discomfort and some of the expense of correcting the issue.

David Finley, DDS of Monroe, LA, sponsors this post.

Dental bonding doesn’t match, but my dentist says it’s okay

Posted on March 12, 2021 by AllSmiles.

I had sensitivity near the gumline on four of my front teeth. My dentist applied bonding on the teeth to cover the roots after I finished Invisalign treatment in early February. Although I did not get the bonding for cosmetic reasons, you can see the difference between my teeth and the bonding. The bonding is pasty looking and has a matte finish. People used to compliment my smile. I complained to my dentist, but she says it looks fine because the bonding is near the tooth roots, and you can barely see it. I’m going to see another dentist to correct it. Will a dentist need to remove the bonding, or can they apply new bonding over what my dentist did? Will removing the old bonding damage my tooth enamel? Thank you. Kendyl from Knoxville, TN

Kendyl,

We are sorry about your experience. We are sure it is disappointing, especially after completing your Invisalign treatment and looking forward to a new smile. It is not challenging to get color and texture right for fillings at the gumline. A good general dentist can match the color and polish the composite to a natural gloss. If your case were complex and affecting your teeth’s smile zone, we would recommend an expert cosmetic dentist. But another dentist with some cosmetic dentistry training should be able to help.

Must Mismatched Bonding Be Removed or Just Resurfaced?

Whether mismatched bonded must be replaced or resurfaced depends on the extent of the mismatch. Another dentist may remove some of the filling surfaces, apply the correct color, and polish the bonding. Even if the dentist must remove your existing bonding, they can use dental instruments to remove the composite without damaging your tooth.

Abfraction lesions near the gumline

Three veritical photos of a woman putting on and wearing Invisalign trays.

A cosmetic dentist can provide dental bonding that complements your straight teeth after Invisalign treatment

An abfraction lesion is a notch near the gumline. It develops from excessive teeth clenching, which causes teeth to flex and weaken. Teeth clenching can cause gum recession. And if you have abfraction lesions hear your gumline, your dentist must choose a softer, flexible composite that will absorb the stress of tooth flexing when you clench. Silux Plus and Renamel are two brands of flexible composite. Otherwise, the fillings will weaken and pop out.

If you are going to switch dentists, we recommend looking for dentists with advanced cosmetic dentistry training. An accredited cosmetic can achieve the results you want, but again, your situation is not complex, so a dentist with cosmetic dentistry training can give you good results.