Sinus Surgery

Your child won't keep his or her first teeth forever, but that doesn't mean those tiny pearly whites don't need conscientious care. Maintaining your child's dental health now will provide health benefits well into adulthood, as primary (baby) teeth serve some extremely important functions.

Kids developing jaws and teeth.

For one thing, primary teeth serve as guides for the eruption of permanent (adult) teeth, holding the space into which these new teeth will erupt. The crowns (tops) of the permanent teeth actually push against the roots of the baby teeth, causing them to resorb, or melt away. In this way, the adult teeth can take their proper place.

What's more, your child's primary teeth will be there for most of childhood, helping your child to bite, chew and speak. For the first six or so years, he or she will be relying on primary teeth exclusively to perform these important functions. Until around age 12, your child will have a mix of primary and permanent teeth. You will want to make sure those teeth stay healthy and are lost naturally — when it's time.

Your Child's First Teeth

Kids mouth anatomy.

Your child's 20 baby teeth will begin to appear usually between six and nine months, though in some cases it may start as early as three months or as late as twelve months. The two lower front teeth tend to erupt first, followed by the two upper ones, these teeth are called the central incisors. Then the neighboring teeth called lateral incisors will erupt too. The first molars come in next, followed by the canines (eyeteeth). And finally, the last teeth to erupt are the two-year molars. Sometimes your baby can experience teething discomfort during this process. If so, there are courses of action to help make your child more comfortable.

Your infant's gums should be gently wiped after each feeding with a water-soaked gauze pad or damp washcloth. As soon as the first tooth erupts, establish a daily brushing routine with a small, soft-bristled toothbrush and no more than a thin smear of fluoridated toothpaste. Your child may need your help with this important task until about the age of 6.

Your Child's First Dental Appointment

Age one dental visit

The American Academy of Pediatric Dentistry recommends that your child see a dentist by his/her first birthday, or as early as the first tooth erupts. Though this may sound early, learning proper pediatric oral hygiene techniques, checking for cavities, and watching for developmental problems is extremely important.

There are a number of forms of tooth decay that can affect babies and small children. Early Childhood Caries (tooth decay) can develop rapidly, progressing from the hard, outer enamel layer of a tooth into the softer, inner dentin in six months or less.

Most of all, it's important for your child to have a positive experience at the dental office as he/she will be a regular visitor for years to come.

Pediatric Dental Treatments

There are a variety of dental treatments offered to prevent tooth decay in children, or to save or repair teeth when necessary. They include:

Topical Fluoride — Fluoride incorporates into the enamel of teeth, making it harder and more resistant to decay. Although there is a small amount of fluoride in toothpastes and in some drinking water supplies, a higher concentration can be applied professionally to your child's teeth for maximum protection.

Dental Sealants — A plastic coating can be applied at the dental office to prevent cavities by sealing the little grooves on the chewing surfaces of back teeth known as “pits and fissures.” These little crevices become the perfect environments for decay-causing bacteria. Immature tooth enamel is more permeable and therefore less resistant to tooth decay. Dental sealants are easy to apply and provide years of protection (Watch Dental Sealant Video).

Root Canal Treatment — Perhaps you have had a root canal treatment yourself, to save an injured or severely decayed tooth. Well, sometimes children need root canals, too. In children these are called pulpotomies or pulpectomies. As mentioned above, baby teeth are important guides to the permanent teeth that are already forming beneath your child's gums. Therefore, saving them from premature loss can help prevent a malocclusion (“mal” – bad; “occlusion” – bite) that requires orthodontic treatment.

Bonding — Chips and minor fractures to front teeth — common childhood occurrences — can be repaired with tooth-colored bonding materials. These lifelike resins made of plastic and glass can be used on baby teeth as well as permanent teeth and last until the youngster has completed facial growth (Watch Bonding Video).

Orthodontic Concerns

Orthodontic Problems.

By around age 7, most malocclusions have become evident. Interceptive orthodontic treatment around this time can help direct proper tooth positioning and/or jaw growth, eliminating or simplifying the need for later treatment. There are many orthodontic problems that can be detected early and are examples of why a trained professional should evaluate your child during his/her growth and development.

Sports & Your Child's Teeth

If your child is active in sports, a custom-made mouthguard is a highly recommended safeguard. According to the American Dental Association, an athlete is 60 times more likely to suffer dental harm when not wearing one of these protective devices. A custom mouthguard is made specifically for your child using a model of his or her teeth. This will offer greater protection than an off-the-shelf model. It's an investment that pays off highly in the form of reduced pain, suffering — and dental expenses down the road!

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Location of the sinuses.

If you want to replace a missing or failing tooth with a state-of-the-art dental implant (watch dental implant video), your dentist will first need to make sure that you have sufficient bone in your jaw to anchor the implant. This is true no matter what type of tooth is being replaced. However, if it is an upper back tooth and there is not enough bone under the gum where the implant needs to go, the base of the implant could end up poking through an air space (located to the side of the nose) called a sinus cavity. Since you can't anchor a dental implant to air, this presents a problem — but it is one that can often be solved with a minor in-office surgical procedure called a “sinus membrane lift.”

Sinus surgery step by step.A sinus membrane lift, or sinus augmentation, involves adding bone to fill in the bottom of that air space, essentially raising the floor of the sinus cavity. Why wouldn't there be enough bone there already? For some people, it's simply a matter of how large their sinus cavities are, and their shape. In other cases, bone has actually been lost from the area. For example, if your tooth has been missing a long time, the bone that used to surround it may have begun to deteriorate. Bone in general needs stimulation to stay strong; in the case of the jawbone, that stimulation comes from the teeth. When teeth are lost, the bone loses stimulation and the body ceases to make new bone cells in that area. This leads to a reduction in bone volume and density. Also, if your tooth loss was due to periodontal (gum) disease, your tooth-supporting bone may have been reduced as a result of the disease. No matter what the reason is for insufficient bone, a sinus membrane lift can create more bone where it is needed.

Where does this additional bone come from? It can be bone from elsewhere in your body, such as another part of your jaw or your hip. But most often, it will be bone-grafting materials that are processed in a laboratory for these kinds of purposes. The original source may have been a human or animal donor (usually a cow). Synthetic products can also be used. All grafting materials must be approved by the Food and Drug Administration (FDA) and prepared according to their guidelines. The materials are specially treated to render them completely sterile, non-contagious, and free of rejection factors. For the most part, bone grafts act as scaffolds that the body will eventually replace with its own bone.

The Procedure

Prior to scheduling surgery, your dentist will assess the shape, location, and health of the sinus using x-ray imaging. Your options for anesthesia will also be discussed. The surgery itself is usually carried out under local anesthesia by numbing the area, just as is done for a routine filling. Some people require additional sedation or anti-anxiety medication, which can either be administered orally (by mouth) or by intravenously (through a vein) via injection.

When the area has been completely numbed, an incision will be made in your gum to expose the bone that used to contain your missing tooth or teeth. A small opening will be made in the bone to reveal the membrane that lines the sinus. This membrane will be raised and the space beneath it will be filled with bone grafting material. The gum is then stitched back up. In some cases, the implant(s) can be placed directly into the grafting material before the gum is closed, eliminating the need for a second surgical procedure later on to place the implant. Often, however, the surgical site is allowed to heal for approximately 6-7 months before an implant is placed.

What to Expect After Sinus Surgery

You may experience moderate swelling and some minor discomfort that generally lasts a few days — about the same as having an upper impacted wisdom tooth removed. Sometimes a non-steroidal anti-inflammatory medication (prescription or over-the-counter) is recommended to help minimize this. A course of antibiotics may be prescribed to prevent infection. If the sinus membrane becomes a bit inflamed, leading to a feeling of minor congestion, a decongestant can be helpful. If you suffer from seasonal allergies, make sure to schedule your surgery for a time when this will not be an issue.

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