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Teething – Newton, Weston, Dover, MA

Teething As a parent of two and one due any day, Dr. Christine Ambrose, family dentist at Newton Wellesley Dental Partners, knows first hand that new parents welcome getting a decent 5 -6 hour stretch of sleep after the birth of their baby. All of a sudden, your child turns 6 months and he/ she has reverted back to waking up 2-3 times a night. Ugh, it has got to be that pesky teething! Or is it something else? As sleep deprived parents, we always need an explanation to help us understand our child’s behavior.  Project1According to Clay Jones, Pediatrician at Newton Wellesley Hospital, “it does not appear that the eruption of a tooth can be successfully predicted by any collection of symptoms. I have spoken to many parents who believe that their child has been teething for weeks without a tooth revealing itself. It just doesn’t work that way.” How do you differentiate between teething and something else? There are some very general symptoms, some more frequent than others; here are some guidelines. Teething generally begins at about 6 months, but can start at as young as 3 months. Sometimes it can start as late as 1 year. Generally symptoms can last about 3-5 days, but not 2 weeks or 2 months. Frequent symptoms: Mild Fever under 101F Drooling Runny nose Decreased appetite Gum swelling in area of tooth erupting Common symptoms: Increased Biting / Chewing Rosy cheeks Irritability / difficulty sleeping NOT Symptoms: Fever above 101 Body rash Cough / congestion Diarrhea or vomiting Recommended treatment for teething are the following: Chill a rubber teething ring. Make sure to read cleaning instructions carefully. If you don’t have a teething ring, freeze a wet washcloth and let your child chew on it. Liquid filled teething rings are not recommended.  Administer Baby Tylenol. Do not use aspirin because of the risk of Reye Syndrome. Do not give Tylenol regularly because this can lead to tooth decay and increase risk of liver disease. Serve your child cold foods, like chilled applesauce and yogurt. Use of topicals is not recommended. The FDA does not recommend use of benzocaine in children under the age of 2 because of the risk of methemoglobinemia, a rare condition that may interfere with oxygen transport. In summary, teething symptoms are not always consistent and may not be the culprit behind your child’s behavior. We as parents want to understand, so that we can control and help, but sometimes trying too hard to understand may make you miss other alternatives like sleep training. Keep in mind, teething does not cause systemic symptoms. If your child has a fever, diarrhea, significant changes in behavior and excess irritability, talk to your pediatrician before chalking it up to teething. If your child has minor discomfort, a few days of TLC will likely be the most effective remedy. For additional blogs, visit:  www.NewtonWellesleyDentalPartners.com or if you'd like to contact Dr. Ambrose, click here. Original information: http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm385817.htm http://www.cnn.com/2016/02/19/health/baby-teething-no-fever/index.html?eref=rss_topstories https://www.sciencebasedmedicine.org/seperating-fact-from-fiction-in-pediatric-medicine-infant-teething/ Artwork: www.parenting.com

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What’s in Your Drink this St. Patrick’s Day? – Newton, MA

Looking forward to throwing back a few Guiness' this Thursday? In the spirit of Saint Patrick’s Day Dr. Christine Ambrose, family practitioner at Newton Wellesley Dental Partners, shares some tips about alcohol consumption and your teeth. The CDC defines moderate alcohol use as one drink a day for women and no more than two a day for men. It is well documented that gum disease, cavities, and oral cancer are serious oral health complications for heavy drinkers. There is not much conclusive evidence for moderate drinking but dentists regularly see these effects on the teeth that are related alcohol use. Project1 Cavities: The sugars and acids in alcoholic drinks could promote tooth decay. When your tooth is exposed to acid, the enamel demineralizes. Minerals (mostly Calcium) are removed from the tooth’s enamel making it an easy target for bacteria to cause problems. Enamel starts to breakdown at pH’s less than 5.5. Here is a short list of drinks, common mixers, and their pH’s to give you an idea of what your teeth are up against! Beer                      4.3-4.6 Wines                    3.0-3.6 Vodka                    4.0 Orange Juice         3.7 Tomato Juice         4.29 Coca-Cola              2.5 To help abate the effects of acid, try to alternate with sips of water. If you drink, brush and floss! Staining: Red wines and dark beers all have chromogens that give them color. These can adhere to your teeth leading to stains. Some stains become almost impossible to remove even by your hygienist. Minimize the staining effect by using a straw. Also try to rinse with water between drinks. Dry Mouth: Drinks high in alcohol like spirits tend to decrease saliva production. Saliva keeps teeth moist and helps them self-cleanse plaque and bacteria away. For more info on dry mouth, see Dr. Johnson’s blog post from March 9, 2016. Try to stay hydrated by drinking water. In summary, enjoy that stout or lager but please don’t forget to drink water, use a straw, brush and floss! For more blogs or additional information visit: www.NewtonWellesleyDentalPartners.com References: http://www.healthline.com/health/dental-and-oral-health/what-does-alcohol-do-to-your-teeth http://dentistrytoday.com/todays-dental-news/4262-sugars-acids-in-alcohol-may-lead-to-tooth-decay Image: www.stpatricksday-2016.com

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Dental Issues During Pregnancy

Dental Issues During Pregnancy Dr. Christine Ambrose, family practitioner at Newton Wellesley Dental Partners, wants women to know about dental issues during pregnancy. As a mother and dentist, she is fully aware of those factors that relate to dental decisions. Pregnancy can pose a unique set of management considerations for your dentist. Dental care must be rendered to every mother and with precaution. Some tips I’d like to share include timing, xrays, medications, and complications. Timing: Elective dental care is best avoided during the first trimester, usually the second trimester is the safest time to provide routine dental care. Priorities are cleanings, treating cavities, and eliminating potential problems that could occur later in pregnancy and postpartum. Dental X-Rays: It is best to avoid dental x-rays during pregnancy, especially in the first trimester. However if dental treatment is necessary , an x-ray maybe necessary to make an accurate diagnosis. Based on studies, it has been calculated that the risk of a first generation fetal defect from a dental xray is 9 in 1 billion. X-rays should be used selectively and only in dental emergencies. Medications: Ideally, no medications should be administered during pregnancy. This is sometimes impossible, most of the medications used in dentistry including anesthesia can be given safely. Anesthetics with epinephrine are considered relatively safe with limitations on dosage. Pain medication of choice is acetaminophen. Don’t use NSAIDs (ibuprofen, naproxen) or Aspirin as these can constrict blood flow. Penicillins,, erythromycin, and cephalosporins are also considered safe. Tetracyclines should not be used as they can cause teeth staining in the baby’s developing teeth. Complications: Due to hormonal changes, sometimes women can develop pregnancy gingivitis, where the gums are inflamed and sensitive. The usual symptom is gums that bleed a little after brushing. Kelley Sullivan RDH recommends practicing good oral hygiene; brushing twice daily, flossing once daily, and mouth rinse. Don’t skip cleanings because you are pregnant! In severe cases, it may be recommended to come more frequently for cleanings. There is no established link between dental cavities and pregnancy. Decay is cause by the presence of bacteria and a diet high is carbohydrates and poor oral hygiene. If you are eating more frequently, brush more frequently! Many women are convinced that pregnancy causes tooth loss and that calcium is drawn from the teeth to supply fetal development. The calcium in teeth is not available to systemic circulation like bones. Calcium supplementation is not meant to prevent “soft teeth” but for general nutritional requirements.   Sources: Little and Falace's Dental Management of the Medically Compromised Patient, 8e (Little, Dental Management of the Medically Compromised Patient) 8th Edition by James W. Little DMD MS (Author), Craig Miller DMD MS (Author), Nelson L. Rhodus DMD MPH (Author), Donald Falace DMD (Author)   story: http://www.webmd.com/oral-health/pregnancy-gingivitis-tumors image: www.dentalsouth.net  

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