Waterbury, CT Family Dentist
John R. Gagné, D.D.S.
808 Highland Ave
Waterbury, CT 06708
(203) 755-9444

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808 Highland Ave
Waterbury, CT 06708

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ChildrenwithChronicHealthConditionsmayNeedExtraDentalCare

Proactive dental care is an essential part of childhood growth. But that care can be much harder for children with chronic health issues than for healthier children.

“Chronic condition” is an umbrella term for any permanent and ongoing health issue. Asthma, Down’s syndrome, cystic fibrosis, congenital heart defects and many others fall under this umbrella, with varying symptoms and degrees of intensity. But they all have one common characteristic — a long-term effect on all aspects of a child’s health.

That includes the health of a child’s teeth and gums. Here, then, are a few areas where a chronic health condition could impact dental care and treatment.

Ineffective oral hygiene. Some chronic conditions like autism or hyperactivity disorder (ADHD) that affect behavior or cognitive skills can decrease a child’s ability or willingness to brush or floss; some conditions may also limit their physical ability to perform these tasks. Parents and caregivers may need to seek out tailored training for their child’s needs, or assist them on a regular basis.

Developmental defects. Children with chronic conditions are also more likely to have other developmental problems. For example, a child with Down, Treacher-Collins or Turner syndromes may be more likely to develop a birth defect called enamel hypoplasia in which not enough tooth enamel develops. Children with this defect must be monitored more closely and frequently for tooth decay.

Special diets and medications. A child with a chronic condition may need to eat different foods at different times as part of their treatment. But different dietary patterns like nutritional shakes or more frequent feedings to boost caloric intake can increase risk for tooth decay. Likewise, children on certain medications may develop lower saliva flow, leading to higher chance of disease. You’ll need to be more alert to the signs of tooth decay if your child is on such a diet or on certain medications, and they may need to see the dentist more often.

While many chronic conditions raise the risk of dental disease, that outcome isn’t inevitable. Working with your dentist and remaining vigilant with good hygiene practices, your special needs child can develop and maintain healthy teeth and gums.

If you would like more information on dental care for children with chronic health conditions, 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 “Managing Tooth Decay in Children with Chronic Diseases.”

By John R. Gagne, D.D.S
June 21, 2018
Category: Oral Health
Tags: oral health   fluoride  
KeepYourBabysFluorideIntakewithinModerateLimits

Like many other families, you may use formula instead of breast milk as a safe and healthy alternative to feed your infant. But, if you use a powdered form that you mix with water your child may be taking in more fluoride than they require.

Fluoride is a natural chemical that can strengthen tooth enamel and help prevent decay. After decades of study it's also been shown to pose no serious health risks. Because of fluoride's benefits and safety, many water utilities add tiny amounts to their drinking water supply.

But it can have one side effect called enamel fluorosis. If a child ingests too much fluoride during early development it can cause discoloring mottled spots or streaking in permanent teeth. Although it doesn't affect their health, the teeth can be unattractive and require cosmetic attention.

That's why it's best to keep fluoride consumption to a healthy minimum for children. That, however, is often easier said than done, since we can encounter hidden fluoride in a variety of places. Besides hygiene products and fluoridated drinking water, you may find fluoride in prepared juices and other beverages, bottled water or in foods processed with fluoridated water. There are no labeling requirements for fluoride, so you'll have to research to find out if a product contains fluoride.

There are, however, some things you can do to control your child's fluoride intake. First, know as much as you can about known sources your child may encounter like your water supply. You can find out if your utility adds fluoride and by how much by contacting them or visiting My Water's Fluoride online at https://nccd.cdc.gov/DOH_MWF/.

If you use fluoride toothpaste apply only a “smear” on the end of the brush for children under two and a pea-sized amount for older children. If you have fluoridated drinking water, consider breastfeeding your infant, use ready-to-feed formula or mix powdered formula with bottled water labeled “de-ionized,” “purified,” “demineralized” or “distilled.”

And, do feel free to discuss your concerns with us during your child's regular checkup. We'll help you adjust their diet, water intake and hygiene habits to be sure they're receiving the right amount they need for developing strong teeth — and no more.

If you would like more information on appropriate fluoride levels for 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 “Tooth Development and Infant Formula.”

DentalInjuryIsJustaTemporarySetbackforBasketballStarKevinLove

The March 27th game started off pretty well for NBA star Kevin Love. His team, the Cleveland Cavaliers, were coming off a 5-game winning streak as they faced the Miami Heat that night. Less than two minutes into the contest, Love charged in for a shot on Heat center Jordan Mickey—but instead of a basket, he got an elbow in the face that sent him to the floor (and out of the game) with an injury to his mouth.

In pictures from the aftermath, Love’s front tooth seemed clearly out of position. According to the Cavs’ official statement, “Love suffered a front tooth subluxation.” But what exactly does that mean, and how serious is his injury?

The dental term “subluxation” refers to one specific type of luxation injury—a situation where a tooth has become loosened or displaced from its proper location. A subluxation is an injury to tooth-supporting structures such as the periodontal ligament: a stretchy network of fibrous tissue that keeps the tooth in its socket. The affected tooth becomes abnormally loose, but as long as the nerves inside the tooth and the underlying bone have not been damaged, it generally has a favorable prognosis.

Treatment of a subluxation injury may involve correcting the tooth’s position immediately and/or stabilizing the tooth—often by temporarily splinting (joining) it to adjacent teeth—and maintaining a soft diet for a few weeks. This gives the injured tissues a chance to heal and helps the ligament regain proper attachment to the tooth. The condition of tooth’s pulp (soft inner tissue) must also be closely monitored; if it becomes infected, root canal treatment may be needed to preserve the tooth.

So while Kevin Love’s dental dilemma might have looked scary in the pictures, with proper care he has a good chance of keeping the tooth. Significantly, Love acknowledged on Twitter that the damage “…could have been so much worse if I wasn’t protected with [a] mouthguard.”

Love’s injury reminds us that whether they’re played at a big arena, a high school gym or an outdoor court, sports like basketball (as well as baseball, football and many others) have a high potential for facial injuries. That’s why all players should wear a mouthguard whenever they’re in the game. Custom-made mouthguards, available for a reasonable cost at the dental office, are the most comfortable to wear, and offer protection that’s superior to the kind available at big-box retailers.

If you have questions about dental injuries or custom-made mouthguards, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Field-Side Guide to Dental Injuries” and “Athletic Mouthguards.”

TakeStepstoTreatChronicMouthBreathingasEarlyasPossible

Many things can affect your child’s future dental health: oral hygiene, diet, or habits like thumb sucking or teeth grinding. But there’s one you might not have considered: how they breathe.

Specifically, we mean whether they breathe primarily through their mouth rather than through their nose. The latter could have an adverse impact on both oral and general health. If you’ve noticed your child snoring, their mouth falling open while awake and at rest, fatigue or irritability you should seek definite diagnosis and treatment.

Chronic mouth breathing can cause dry mouth, which in turn increases the risk of dental disease. It deprives the body of air filtration (which occurs with nose breathing) that reduces possible allergens. There’s also a reduction in nitric oxide production, stimulated by nose breathing, which benefits overall health.

Mouth breathing could also hurt your child’s jaw structure development. When breathing through the nose, a child’s tongue rests on the palate (roof of the mouth). This allows it to become a mold for the palate and upper jaw to form around. Conversely with mouth breathers the tongue rests behind the bottom teeth, which deprives the developing upper jaw of its tongue mold.

The general reason why a person breathes through the mouth is because breathing through the nose is uncomfortable or difficult. This difficulty, though, could arise for a number of reasons: allergy problems, for example, or enlarged tonsils or adenoids pressing against the nasal cavity and interfering with breathing. Abnormal tissue growth could also obstruct the tongue or lip during breathing.

Treatment for mouth breathing will depend on its particular cause. For example, problems with tonsils and adenoids and sinuses are often treated by an Ear, Nose and Throat (ENT) specialist. Cases where the mandible (upper jaw and palate) has developed too narrowly due to mouth breathing may require an orthodontist to apply a palatal expander, which gradually widens the jaw. The latter treatment could also influence the airway size, further making it easier to breathe through the nose.

The best time for many of these treatments is early in a child’s growth development. So to avoid long-term issues with facial structure and overall dental health, you should see your dentist as soon as possible if you suspect mouth breathing.

If you would like more information on issues related to your child’s dental development, please contact us or schedule an appointment for a consultation.

By John R. Gagne, D.D.S
May 22, 2018
Category: Dental Procedures
FAQInterceptiveOrthodonticsforChildren

Have you heard about interceptive orthodontics? This type of early intervention could benefit perhaps 10â??20% of children who need orthodontic treatment, making a positive impact on tooth and jaw development, facial symmetry, and overall self esteem. In case you’re not familiar with it, here are the answers to some common questions about interceptive orthodontic treatment.

Q: What’s the difference between interceptive orthodontics and regular orthodontics?
A: Standard orthodontic treatment typically involves moving teeth into better positions (usually with braces or aligners), and can be done at any age. Interceptive orthodontics uses a variety of techniques to influence the growth and development of teeth and jaws, with the aim of improving their function and appearance. Because it works with the body’s natural growth processes, interceptive treatment is most effective before the onset of puberty (around age 10-14), when growth begins to stop. It is generally not appropriate for adults.

Q: What are the advantages of early treatment with interceptive orthodontics?
A: When it’s done at the right time, interceptive treatment offers results that would be difficult or impossible to achieve at an older age without using more complex or invasive methods — for example, tooth extraction or jaw surgery. That’s why the American Association of Orthodontists, among other professional organizations, recommends that all kids have their first orthodontic screening at age 7.

Q: What are some common issues that can be treated with interceptive orthodontics?
A: One is crowding, where there is not enough room in the jaw to accommodate all the permanent teeth with proper spacing in between. A palatal expander can be used to create more room in the jaw and avoid the need for tooth extraction. Another is a situation where the top and bottom jaws don’t develop at the same rate, resulting in a serious malocclusion (bad bite). A number of special appliances may be used to promote or restrict jaw growth, which can help resolve these problems.

Q: How long does interceptive orthodontic treatment take?
A: Depending on what’s needed, a child might wear a device like a palatal expander or another type of appliance for 6-12 months, followed by a retainer for a period of time. Or, a space maintainer may be left in place for a period of months to hold a place for a permanent tooth to erupt (emerge from the gums). Interceptive treatment ends when a child’s jaw stops growing.

Q: Will braces still be needed after interceptive treatment?
A: Often, but not always, the answer is yes. However, interceptive treatment may shorten the period of time where braces need to be worn, and can help prevent many problems later on.

If you have additional questions about interceptive orthodontics, please contact our office or schedule a consultation. You can learn more in the Dear Doctor magazine article “Early Orthodontic Evaluation.”





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John R. Gagné, D.D.S.

John R. Gagné

Dr. Gagné, a member of the American Dental Association and the Academy of Laser Dentistry, is committed to providing his patients with comprehensive dental care.

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