What is a mouthguard?

A mouthguard is a device worn over your teeth that protects them from potential trauma during sport. Mouthguards are important for anyone participating in a sport that involves falls, body contact or flying equipment.

This can include football, basketball, baseball, soccer, hockey, skateboarding, gymnastics, mountain biking — or any such activity that might result in an injury to the mouth.

Mouthguards typically cover the upper teeth and are designed to protect the teeth and the soft tissues that support the teeth.

No matter what type of mouthguard you choose, it should be comfortable and able to protect the teeth and surrounding structures. When mouthguards fit well, they shouldn’t fall out when talking or impede breathing and speech.

• Custom-made mouth guards —  Individually designed and made by your dentist or a professional dental laboratory. Often, they are likely to provide the most comfortable fit and best protection. Your dentist makes an impression of your teeth and then constructs the mouth guard over a model of them. Because they fit and feel better, most children prefer customized mouth guards. However, they can be the most expensive of the range of mouthguards available.
• Boil and bite mouth guards — These come in a pre-formed shape that can be altered by boiling the mouth guard in water, then biting into the warm plastic for a customized fit. Although commonly available and used, they are not necessarily the most protective as they can at times be ill-fitting. But they are certainly better than stock mouth guards. They are available at many pharmacists and sporting equipment stores.
• Stock mouth guards — These are inexpensive and come pre-formed, ready to wear. Unfortunately, they often don’t fit very well. They can be bulky and may make breathing and talking difficult.

Mouthguards should ideally be replaced after each season because they can wear down over time, making them less effective. Replacement is especially important in children and adolescents as their mouths continue to grow and teeth continue to develop into adulthood.

Ensure you talk to us about mouthguard for your child during your appointments.

Fruit and potential impacts on children’s teeth

Most children love eating fruit: in fact, they are a great choice as a snack. They are a valuable source of vitamins and nutrients for your child’s overall health and wellbeing.

Some fruits, however, can be high in acid. This high acid content in many fruits and juices can cause enamel to lose its high mineral content rendering it weak and prone to sensitivity (to temperature changes and sweet foods) and decay. This erosion of enamel due to food acid is a slow process, however, can cause significant issues to the developing dentition in a child.

The pH value is a measure of how acidic the food is. Food that has a pH value of less than 7.0 is considered acidic; lower the pH, higher the level of acidity.

Here are some pH values of common fruits:

Lemon Juice (2.00 – 2.60); Limes (2.00 – 2.80); Cranberry Juice (2.30 – 2.52); Grapes (2.90 – 3.82); Pomegranates (2.93 – 3.20); Grapefruits (3.00 – 3.75); Blueberries (3.12 – 3.33); Pineapples (3.20 – 4.00); Apples (3.33 – 4.00); Peaches (3.30 – 4.05); Mangos (3.40 – 4.80); Oranges (3.69 – 4.34)

But keep in mind there are plenty of fruits that have higher pH values and have. For example, rockmelons which are a great natural source of vitamin C, have a much less acidic pH of 6.13-6.58. Honeydew melons and bananas are other fruits that have high pH values.

It is important to be aware that fruit juices, preserves, jams, jellies and wines can also be quite acidic. (Interestingly other plant sources, including tomatoes, peppers, broccoli and kiwi, are also equally good sources of nutrients such as vitamin C)

Here are a simple few tips to help protect your child’s teeth particularly when they have a high fruit intake

• Be wary of sucking on lemons, limes or acidic fruits as these can soften your enamel.
• Using straws may decrease the amount of time your teeth are in contact with fruit juices.
• Rinse with water after eating fruit to dilute the acids in your mouth, and wait at least 30 mins to brush your teeth.
• Use fluoridated toothpaste.
• Ensure adequate breaks between meals and intake of snacks/fruits – the frequency of food intake is equally as important as the type of food a child eats

Ensure you have a good discussion with your child dentist regarding their diet to help establish good oral health practices, early in life.

This article is intended to promote understanding of and knowledge about general oral health topics and to help begin the conversation with your children’s dentist. It should not be used as a substitute for professional advice, diagnosis or treatment. Always seek the advice of your health care professional prior to incorporating this as part of your child’s diet or health regimen.

Information for parents and referrers: COVID-19

Information for parents and referrers re COVID-19 and changes at the practice 

As most of you would be aware due to the ongoing issues with the COVID-19 we have postponed all routine dental care.

If you are a new or routine patient of the practice we would have already been in touch to reschedule your appointment. We will endeavour to keep you updated of any changes via our website, social media channels and the telephone.

However, should you feel that your child needs urgent dental care, please contact one of our staff via telephone on 9188-0202. We have made provisions to triage and consult via telephone in urgent cases.

Given the restrictions placed on all practices by the Australian Dental Association, we may only be able to complete limited procedures on certain days.

Should your child be in pain please ensure we are aware so that we can discuss options to help manage this should treatment not be possible immediately.

If your child has a facial swelling or dental trauma, please contact:

• Westmead Centre for Oral Health (Normal business hours) – 8890 7839
• The Children’s Hospital at Westmead (After hours) – 9845 0000

We thank you for your understanding and look forward to seeing you all very soon

Stay home, stay safe

From all of us @macpdentistry

COVID-19 Related Changes at our Practice

Given the current issues with the COVID-19, we are changing things at the practice so we can continue to provide the best care possible to all our young patients. Alongside this, we are equally committed to ensuring a safe environment by reducing risks for patients, their families and staff members alike. We will be in touch with all of you via phone and SMS in the coming days and weeks to keep you up to date with the changes. Some of these may include:

1. Being an accredited practice requires us to maintain a high standard of infection control. However, due to the current modes of transmission of COVID-19, requires extra time to ensure we meet the same standards of infection control you would already be used to at our practices.
2. Prioritising our children with pain, abscesses and dental infections so they get seen quicker;
3. Increased phone contact with all parents to ensure we identify any at-risk patients prior to their arrival at the practice;
4. Altered appointment times to ensure we only have a limited number of patients in our waiting rooms at any given time keeping in mind the recommended guidelines on social distancing.

Although we will be in touch with all of you soon enough via phone, should you have any queries please do not hesitate to contact us.

We understand that this is a testing time for every single one of us and appreciate your understanding and assistance in ensuring that we all stay safe.

The use of laughing gas in children

Nitrous oxide also known as “laughing gas” is a safe, mild sedating agent that helps children remain relaxed during dental procedures.

It is administered with the use of a “mask on the nose” that are often scented to make the otherwise odourless gas more acceptable.

The gas is a mixture of oxygen and nitrous oxide that can easily be changed to achieve an appropriate and safe level of sedation for your child. The mask remains in place until the end of the procedure.

Your child is awake during the entire procedure and may feel like they are floating. While some children laugh, others either tend to become chatty or quite relaxed. When the procedure is complete, the child breathes pure oxygen to ensure the complete elimination of the nitrous oxide from the system.

We often ask that your child eats something light one hour before the procedure.

Although a very safe and effective technique, the use of nitrous oxide is dependent on a number of factors including the child’s age, temperament and ability to communicate; often acceptance of the mask is the greatest challenge.

The ability to accept treatment in the chair with happy gas is assessed and discussed extensively with parents and carers during the initial consultation visit.

Dental X-Rays and Why We Take Them

Dental X-Rays (Radiographs) are images that we use to evaluate the health of individual teeth.

These radiographs are used with low levels of radiation to capture images of the interior of your teeth and gums. This can help us detect abnormalities such as tooth decay, developmental issues or any infection associated with your child’s teeth. Often these abnormalities are not visible to the naked eye.

Fig 1: The teeth in the red circle appear healthy and unaffected to the naked eye

Fig 2: Radiographic image of the same teeth clearly shows the decay in between the two teeth

Are they safe and does my child need radiographs?

Regardless of whether you’re a child or an adult, you can have radiographs safely taken of the inside and outside of your mouth. The amount of radiation involved is extremely low.

If there is little benefit in taking a radiograph, or it does not affect immediate treatment, we may often choose not to take one.

However, cavities between teeth are best caught early. If you wait until you can see it without an X-ray, it could cause more serious damage to the teeth.

What can radiographs help to detect?

What types of radiographs are required?

Dental Trauma: Handling a dental emergency

Accidents can happen at any age but knowing what to do when a dental emergency occurs is crucial. If your child’s tooth or mouth get knocked contact your dentist immediately to get some advice or be seen.

Children that are learning to crawl or walk are prone to falling over. In fact, many injuries in young children occur during these first few years of life. Although part of normal development, significant damage can occur to teeth if injured and left untreated. During the first years of life, the primary teeth are very closely related to the permanent teeth, which are forming inside the bone. When an injury occurs to the primary teeth in this period, it can affect the aesthetics of the permanent teeth, which will present at approximately eight years of age with whitish marks or a deformation in the crown depending on the extent of the injury.

The most serious lesions on the primary teeth can cause complications to the permanent successors; ie. intrusion (when the tooth is buried in the gum) and avulsion (when the tooth is knocked out). Both situations are more serious the younger the child is. The primary tooth should not be replaced once it has been knocked out.

If your child knocks their baby (primary) tooth out:

1. Do not attempt to put it back in
2. Seek an immediate opinion from a dentist and take the tooth along with you
3. If you are unsure whether it is an adult or baby tooth store the tooth in milk and visit your dentist

If your child knocks their adult (permanent) tooth:

1. Find the tooth. Hold the tooth by the crown (the white part), not by the root (the yellow part).
2. Replant immediately, if possible
3. If contaminated, rinse shortly with cold tap water and put the tooth back in its place. This can be done by the child or an adult.
4. Hold the tooth in place. Bite on a handkerchief to hold it in position and go to the dentist immediately.
5. If you can not put the tooth back in, place it in a cup of milk or saline. When milk or saline are not available, place the tooth in the child’s mouth (between the cheeks and gums)
6. Seek immediate dental treatment

Children between 7 and 10 years of age are more exposed to suffer avulsion due to the elasticity of the bone at this age. Good oral hygiene is crucial to allow good healing.

Toothpaste: Which one to use for your child

Although children get their teeth at different times, first teeth usually appear between six and ten months. Generally, by the time children are three years old, they will have all their baby teeth.

Brushing from when the first tooth appears twice a day is recommended by most oral health professionals. This not only ensures the surfaces of the teeth are cleaned of bacteria that have the potential to cause tooth decay but also helps to establish good habits at an early age for your child.

Although most guidelines recommend not using any toothpaste until 18 months of age, your dentist may recommend using toothpaste from as early as 12 months of age. By the age of 18 months, molar teeth are in the mouth and establishing good brushing habits with toothpaste early reduces the risk of these molars being affected by tooth decay.

A general guide to choosing the best toothpaste for your child

• For children 18 months to 5 years, guidelines recommend low fluoride toothpaste for children in this age group. Low fluoride toothpaste is defined as toothpaste containing 500ppm of fluoride (usually indicated on the box). Listed below are examples of a number of products that are available at most supermarkets or chemists (please note this is not an exhaustive list). Quite often your dentist will recommend these products for children until the age of 5 or 6 with low risk of decay.

• For children within this age range that have a higher risk of decay, we recommend using toothpaste containing 1000ppm of fluoride (again this tends to be indicated on the back of the box). Discussing what type of toothpaste to use for your child is an important conversation that you should have with your dentist during your consultation.

• Once your child is over 6 years of age, we recommend using toothpaste with 1450ppm fluoride. While several adult toothpaste can be used from the ages of 6 and up, some children prefer the milder flavours of the products shown below.

• For children who don’t like the usual toothpaste flavours e.g. mint, Priceline pharmacy and Soul Pattinson chemists stock non-flavoured plain toothpaste. Alternative flavoured toothpaste (strawberry) are also available online

• Natural toothpaste –  there are a number of brands of toothpaste that promote themselves as “cruelty-free” and “natural”. You should have a discussion with your dentist regarding the use of these products to ensure appropriate use for your child, as many of these may not contain fluoride.

Finally, remember that discussing what toothpaste your child uses at different ages is an important conversation that should be had at each consultation with your dentist.