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Archives for October 2020

Can a Pediatric Dentist Really Help with Bed-Wetting?!?

Posted on October 24, 2020 by Athena Smiles.

boy in pajamas for pediatric dentist blog

My sister-in-law says her pediatric dentist helped her nine-year-old son stop wetting the bed at night and told me that I should take my seven-year-old in for the same kind of treatment. I’ve never heard of such a thing and no matter how much I search online, I can’t find anything that relates to what she’s talking about either. I’m starting to think she somehow got her wires crossed, but she’s very adamant about it. Is there a connection here? If so, what did they have done?

Thanks,

Laura

 

Dear Laura,

This is a great question on a topic that’s rarely discussed in pediatric dentistry. Your sister-in-law is not off her rocker, but her son may be experiencing a somewhat rare condition.

First, Some Quick Stats on Bedwetting by Age

According to research published by Harvard, somewhere around 80-85% of kids are dry throughout the night by age five. The number of kids still wetting the bed decreases about 15% per year after that even when no action is taken. By the time kids reach 15, only about 1% still wet the bed. At your son’s age, he probably “should have” outgrown bed-wetting, but it’s not necessarily a huge cause for concern yet.

There are Many Potential Causes

Developmental: Sometimes kids physically develop slower—it takes a bit longer for them to control over urinary sphincter or to recognize their bladder is full.

Genetic: Harvard researchers point to two genes associated with bedwetting—one on chromosome 12 and another on chromosome 13. Vincent Iannelli, MD of Very Well Family says that if both parents wet the bed, there’s a 77% chance their child will too. If only one did, there’s a 44% chance.

Hormonal: Under ordinary circumstances, hormonal shifts that happen during sleep tell our bodies to make less urine. Some children don’t have the same hormonal shifts, so their bodies keep producing urine just as they would during the day.

Other: Additional factors, such as a “small” bladder can cause the issue too.

Health Issues: It’s worth noting that conditions like urinary tract infections and diabetes can be related to bedwetting too. For this reason, it’s always a good idea to bring the pediatrician into the discussion as well.

Sleep Apnea is an Often-Overlooked Cause

Obstructive sleep apnea (OSA) is the type of sleep apnea where the airway becomes blocked. It’s often caused by obesity, but sometimes people with a small airway or other risk factors can experience it too. Additionally, about half of all people who snore loudly have OSA too, according to the Sleep Foundation. The organization notes that children with “sleep-disordered breathing” often produce more urine and that “OSA may also have an effect on a child’s arousal response, bladder pressure, or urinary hormone secretion, all of which could contribute to nighttime bedwetting.”

OSA comes with a host of other issues well beyond bedwetting. If your son is experiencing it, he needs treatment regardless. However, one thing that can help with lots of cases is an oral sleep apnea device—a pediatric dentist or family dentist can have it made for you. This is likely what your sister-in-law was referencing.

Get it Checked Out

There’s no need to panic at this point, but be diligent with this and get it checked out in case there is a medical condition contributing—an infection, diabetes, or sleep apnea should all be treated. Your pediatrician can walk you through other options to help your son sleep better and feel better too. Best of luck to you and yours.

 

This blog is sponsored by Dr. Raymond Bolt, a provider of pediatric dentistry services in Auburn, Alabama.

Filed Under: Pediatric Dentistry Tagged With: Auburn AL pediatric dentist, bedwetting, Harvard, obstructive sleep apnea, OSA, sleep apnea, Sleep Foundation, snoring, Very Well Family

A Crown Done by My Local Dentist Falls Off Once Per Month!

Posted on October 12, 2020 by Athena Smiles.

angry man auburn AL dental blog

I saw a local dentist about three months ago because one of my molars broke. It was one of those watch-and-see deals. My former dentist said the amalgam filling I had there was old and would probably cause problems for me at some point, so I wasn’t overly surprised when it went. However, I had fallen out of routine with him and I was honestly a little embarrassed, so I booked the exam for that tooth with someone new.

In any case, it’s been a mess since the very beginning. The temporary crown they fitted me with came off just about every day until they gave up on it and told me to leave it off and “baby it” until my permanent one was ready. When I got this one, it was wrong from the beginning too. It NEVER felt right. I told them that and they said I just needed time to get used to it. It also didn’t match my other teeth. It’s a very bright white. I pointed that out as well and the dentist told me he could have the lab remake it but that it would be at cost. Well, since it’s a back tooth nobody but me is going to see, I decided to let that part be.

But, about three weeks after it was “permanently” cemented, it came off. I wasn’t even doing anything. It literally fell off while I was sitting at my desk at work. I went back and they put it on. AGAIN, it didn’t feel right and AGAIN, they told me I’d get used to it. Well, just yesterday it came off again. The dentist put it back on but he also told me that if it comes off again, the lab will have to make a whole new crown and he wants something like $600 to cover the cost. Needless to say, the crown STILL does not feel right and I think I’m on borrowed time.

This doesn’t make any sense to me. I feel like he’s in the wrong here and should fix it at his expense, but at the same time, I don’t feel good going back to him. What are my options?

Thanks,

Eric

 

Dear Eric,

Yikes! That’s terrible. He is in the wrong and you deserve better.

The Color Should Have Matched

If the coloring was that far off, it’s pure laziness. It shouldn’t have been that far off to begin with, but even if it was a slight variance, he should have offered to send it back right away. A responsible dentist would have made ensured it was a good match and would have covered the expense if his office was at fault or expected his lab to cover it if they were at fault.

They Should Have Worked with You on the Temporary

It can be difficult to keep temporary crowns on some people, especially if they have a hard bite or do things they shouldn’t with it, like chewing gum. All the same, they shouldn’t have given up on it. Unless there’s more to the story, it’s worrisome that they did. Actually, if they’d paid attention to this, they might have caught the underlying issue with your permanent crown.

There’s No Excuse for Your Permanent Crown to Fall Off

While there are “reasons” crowns fall off, none of them are good excuses, especially at this stage. It sounds more like the tooth wasn’t prepared correctly. Basically, the dentist needs to make the tooth peg-shaped—more cylindrical, like a can of soda—in order to get the best retention. Any angle—where the tooth becomes more of a cone shape—is referred to as “taper.”

graph indicating how crown taper reduces retention

If the taper angles upward, like an inverted pyramid where the top of the tooth is wider and the base is narrower, a crown literally cannot go on the tooth.

If the taper angles downward, where the biting surface of the tooth is narrower than the base, the degree of that taper influences how likely it is to fall off.

Chances are, your dentist failed to prepare the tooth properly. That’s why neither the temporary nor the permanent crown will stay in place.

Go to Another Dentist

The dentist who did this crown for you has had ample time to catch his error and correct it and he hasn’t. Moreover, he’s trying to charge you for it. Either return to your regular dentist or visit another dentist to confirm this, but chances are, you’re going to need the tooth re-prepped and a new crown made. If this is correct, the first dentist should refund you or pay the new dentist to do the work properly. Best of luck to you.

 

This blog is sponsored by Auburn, Alabama dentist Raymond Bolt, DMD.

Filed Under: Auburn AL Dentist Tagged With: Auburn dentist, crown, crown color, crown falling off, crown mismatch, crown taper, dental crown, temporary crown

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