Navigating Your Child's Sweet Tooth and Dental Trauma
This month is National Childhood Dentistry Awareness Month, and I had the pleasure of interviewing pediatric dentist Dr. Adam Silevitch. “Dr. Adam” is a partner at Pediatric Dentists NYC and a member of the American Board of Pediatric Dentistry. Born and raised in the Boston area, he earned his undergraduate degree at the University of Massachusetts-Amherst and his dental degree from the Boston University School of Dental Medicine, before completing specialized post-graduate training in pediatric dentistry from Columbia University, where he served as chief resident. If you missed Part 1 of our interview, make sure to check it out!
Dr. Husain: Dr. Silevitch, when we left off, you were mentioning some great tips for preventing dental caries in children...especially around the Valentine’s Day candies.
Dr. Adam Silevitch: Right, not all candy is created equal...and if you do nothing else, please avoid grazing! The idea of moderation doesn't apply to Halloween or Valentine’s Day, in my opinion. Not because I want your child to be happy-of course I do! But because one big candy blow out is better than consistent grazing over a period of hours, days or weeks.
Dr. Husain: So you’re saying we need to throw out the old candy or do that Candy Fairy trick? This is definitely not the first time I’ve heard grazing isn’t good for our teeth. I mean that’s why we say floss, brush your teeth, and turn off the kitchen lights after dinner. Grazing after dinner is bad for the waist line...and then we know when it comes to juice and children, allowing your child to sip juice throughout the day is so much worse than just letting them have it once. Basically, we’re trying to limit how long the teeth stay in “the cavity zone?”
Dr. Adam Silevitch: Exactly.
Dr. Husain: So a super common question I get, and as someone who grinds their teeth, what do parents need to know about teeth grinding or clenching in kids?
Dr. Adam Silevitch: Anecdotally, half my patients probably grind their teeth. Most parents will notice it while on vacation sleeping in the same room as their child. This grinding has to do with growth, our upper and lower jaws may be growing at slightly different rates and subconsciously your child is trying to fit their teeth together like a puzzle. Typically, patients will grow out of teeth grinding after puberty. If they continue to grind, then you can discuss having wear a night guard with your dentist.
Dr. Husain: Ugh, yes. I have one, and I’m so bad about wearing it! With sports, there’s also a similar kind of dental guard for the teeth to protect from trauma, right? Could you elaborate more on that? I feel like in a time of a dental emergency, no one is ever really thinking straight!
Dr. Adam Silevitch: It's normal for accidents to happen and rather than scare you, parents should have the knowledge so that they can act appropriately should an incident occur. So if a baby front tooth gets completely knocked out (avulsed), do not put it back into the socket. We recommend using ice to reduce any swelling and avoid using any oral topical analgesics and seeing a dentist within 24 hours. One key thing to know is always make sure your child did not lose consciousness during a traumatic incident. If they lost consciousnesses for any amount of time, take them directly to the closest ER. This is more important than any tooth trauma.
Dr. Husain: Totally, absolutely. I think that’s a really great point. And many ER’s have dentists on call as well. What about...say, a chipped tooth?
Dr. Adam Silevitch: If your child chips a front tooth, make sure they avoid biting any hard, crunchy foods until treated. Chipped teeth should be seen within 24 hours, but if there is no pain or discomfort, the timeline can be extended. For pain control, I like Ibuprofen (Advil or Motrin) rather than Acetaminophen (Tylenol). Ibuprofen is an anti-inflammatory and is more effective.
Dr. Husain: Is it also the same for adult dental trauma or the adult teeth?
Dr. Adam Silevitch: If an adult front tooth gets completely knocked out (avulsed), attempt to put it back in the socket immediately. If you're unable to place it back in the socket, put the tooth in milk or saliva -never in water! And get to a doctor within 2 hours of the incident. If the tooth remains out of the mouth for more than 2 hours, the chances of it surviving are greatly reduced.
Dr. Husain: I remember learning that tooth in milk trick in residency and always found it so fascinating! And the mouth is such a vascular area, there’s a risk for a lot of bleeding if there’s trauma there so if parents feel uncomfortable around that blood -understandably- they have a plan of what to do with the tooth in case of emergency. Lips also bleed a lot for the same reasons...any special precautions for when lips are involved in trauma?
Dr. Adam Silevitch: Your child’s lip acts as a bumper for their teeth and can protect them. Although there may be a lot of bleeding from a lacerated lip, the teeth may not have been injured as badly. I recommend managing the bleeding of a cut lip with firm pressure and examine the teeth for damage once bleeding has stopped.
Dr. Husain: So inevitably, emergencies happen when we are out of town. What should the parents do if a dental trauma happens when the family is traveling?
Dr. Adam Silevitch: If you're traveling and can't find a pediatric dentist, go directly to an ER and ideally pick a hospital with dentists and oral surgeons on staff, but regardless of what happens, don't panic! Children mirror the reactions of adults, so the more calm you remain, the more calm your child will be.
Dr. Husain: That’s a great point, and one I feel like it applies to many aspects of our fields. When parents hype up the doctor’s visits as being scary, kids feel more apprehensive in general, for sure. Thank you again for all the information! So many of our families, readers, me included have learned so much!
To learn more about Dr. Silevitch’s practice in New York, visit (https://pdnyc.com/).