Dental Conditions We Treat
Some of the more common dental conditions treated at Children's Hospital Colorado include:
Dental Caries (Cavities)
Most of the activities of the dental clinic revolve around diagnosis and treatment of dental caries or “cavities.” Dental caries is the most prevalent chronic childhood disease and is five times more common than asthma and seven times more common than hay fever. Unfortunately, people who are underserved and from lower socioeconomic areas tend to have more dental caries, although a child from any family or socioeconomic group can be diagnosed with cavities.
Parents should see a dentist with their infant six months after eruption of his/her first tooth or at one year of age for an infant oral health exam. During this first visit, a patient’s individual risk factors for dental caries are evaluated and discussed.
Caries can be prevented with appropriate guidance. In the same manner parents take their children to pediatricians for regular wellness exams, they should take advantage of the opportunity for a “dental home." Our goal is to help as many children as possible to grow up free of dental caries.
What Causes Cavities?
Dental caries is caused by bacteria, usually streptococcus mutans, and the process of forming cavities is dynamic. Bacteria that are present in the mouth and in plaque on teeth convert sugars from the food that a child eats or drinks into an acid. The acids "demineralize," or dissolve, tooth enamel by removing its minerals, mostly calcium. If there is any calcium in the saliva, then the "dissolved" enamel can be replenished either with the calcium, or more likely with fluoride from drinking water. Fluoride decreases the demineralization process by making enamel much harder and resistant to acids. The fluoride and local calcium cause teeth to be "remineralized."
Recent changes in lifestyles and nutrition have caused a significant increase in “bottle caries” which are early childhood caries. Parents are often not aware that frequent consumption of milk, juices or even formula from a bottle or sippy-cup is the main reason for development of many cavities.
How Are Cavities Treated?
Dental caries initially appears as a white spot on the tooth, and at this stage the "demineralization" can be reversed with appropriate fluoride treatment and nutritional changes. Thus, it is important to see the dentist on a regular basis to increase the likelihood that the white spot can be detected and treated before the tooth develops a cavity.
The next step in the process following the white spot is formation of a cavity, which often can be recognized by its brown color. If caries forms between the teeth, it can only be recognized on dental radiographs (x-rays).
A tooth with a smaller cavity can be restored with dental materials such as fillings or crowns, but extraction is often the only treatment possible if the cavity is large and involves the nerve and the bone around the tooth.
Malocclusion
Malocclusion usually refers to crowded or misaligned teeth, a significant discrepancy in tooth-to-jaw size or in jaw-to-jaw relationship. Malocclusions are diagnosed using clinical examination and x-rays, dental arch analysis from plaster models made from impressions of all teeth, and radiographic analysis of the relationship of the facial bones to each other.
Malocclusions can be treated with removable or fixed orthodontic appliances, but difficult cases may require additional jaw surgery after orthodontic pre-treatment with braces.
Orthodontics
At Children's Hospital Colorado Dental Center, we provide early orthodontic treatment to selected conditions that impair proper growth of the teeth and jaws. Such interceptive orthodontic treatment may be indicated between 6 and 10 years of age as permanent teeth come in. Older children and adolescents requiring comprehensive orthodontic treatment are generally referred to orthodontic specialists.
Soft and Hard Tissue Disease
These diseases can be caused by a host of conditions including infections (e.g., herpes or fungal infections), blood and/or immunological problems, genetic predispositions, cancers, or local environmental factors. The conditions are diagnosed through clinical and radiographic examinations and, in some cases, through laboratory studies such as cultures.
Oro-Facial Trauma
Traumatic injuries involving the head and face are relatively common; it is estimated that about 50 percent of the population has or will have some type of traumatic injury involving teeth. Most commonly the front, upper teeth are involved. Motor vehicle accidents, falls around the home or playgrounds, and injuries associated with sports or play activities account for the majority of injuries.
Traumatic injuries can be diagnosed and treated using a variety of techniques. Probably the most important aspect of maximizing long-term prognosis for dental injuries is to visit the dentist as quickly as possible after injury and follow-up faithfully as directed. Milk is the best household product for transporting knocked-out teeth to the dentist, but commercially available kits provide the best preservation medium and are worth keeping around the house in case of a dental emergency.
Ideally, a tooth should be reimplanted immediately after an injury. The dentist usually repositions and stabilizes the injured tooth. If its nerve is injured, root canal therapy must be performed.
Learn more about trauma care
Craniofacial Anomalies
Children's Hospital Colorado provides comprehensive treatment of cleft lip and palate. Our Department of Plastic and Reconstructive Surgery offers expertise in the treatment of many other craniofacial abnormalities.
Learn more about treatment for craniofacial anomalies
