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Is this a trick question? After all, you and your family probably already know quite a lot about cavities:

• It all begins when bacteria-filled plaque sticks to teeth and starts to attack enamel. How?
• Because the bacteria in plaque use the sugars and other foods we eat to produce acids.
• These acids gradually weaken teeth by dissolving minerals that help make up our enamel (a process called demineralization).
• Over time, a hole, or cavity, develops in the tooth surface.
• Left untreated, bacterial decay can spread to the inside of the tooth, creating a more serious cavity.

Drs. Paul Pasternack, Chara Pasternack, and Christine Biondi might discover an unexpected cavity at a regularly scheduled dental exam at our Vorhees office, but there are also some symptoms that should have you calling for an appointment. A cavity can cause sensitivity when eating something hot or cold, or it can be painful, or you might even notice visible discoloration or damage to the tooth surface.

So, if your child has any of these symptoms, it’s a cavity, right? It might be—but it might not. Sometimes, because the symptoms are similar, what we suspect is a cavity is really enamel erosion.

The bacteria-created acids weaken enamel. But it’s not just bacteria that subject our teeth to acids. Acidic foods are one of the leading causes of tooth erosion.

And while we expect damage from a lifetime of acidic foods and beverages to catch up with us as we age, the fact is that erosion is becoming a problem even for young children. How is this possible? Let’s look at some food chemistry.

Our normal saliva pH level is around a 7, which is neutral. Any number lower is acidic; any number higher is alkaline. Acidic foods have a low pH (the pH of lemon juice, for example, measures between 2 and 3), and can reduce our normal, neutral pH level. When saliva pH levels drop to 5.5 or lower, tooth enamel starts to demineralize, just as it does when exposed to the acids from oral bacteria.

Regularly snacking on citrus and other acidic fruits, fruit juices, flavored drinks, sour candies, and other acidic foods can cause enamel erosion. Especially erosive are sports drinks, energy drinks, and colas, because they contain some combination of citric acid, phosphoric acid and/or carbonation.

So, when might you suspect enamel erosion? Your child might be sensitive to hot or cold foods, or feel pain, or even have noticeable enamel loss or pitting. Even though these symptoms may not have been caused by plaque and bacteria, acidic erosion from our diets leaves weakened enamel just as vulnerable to cavities and decay.

How to avoid erosion?

• Serve acidic foods sparingly, or as part of a meal. This helps our saliva pH stay in the neutral zone.
• Balance acidic foods with low-acid choices to neutralize acids and restore a normal pH balance. For example, mix those acidic berries with a banana.
• Use a straw! These are not only fun, but this simple solution keeps erosive drinks from bathing young teeth in acids.
• Encourage your child to drink water instead of an acidic beverage, or drink it afterward to rinse acids away. The pH of pure water? A perfect, neutral 7. And by using tap water instead of bottled water, you’ll be providing fluoride, which helps strengthen enamel.
• What about brushing right after eating or drinking something acidic? Ask Drs. Paul Pasternack, Chara Pasternack, and Christine Biondi if your child should rush for the brush. We may recommend waiting 30 minutes or so after an acidic treat to give the teeth time to remineralize. Otherwise, brushing might cause more wear and tear on enamel.
• Finally, while foods are often the source of acid erosion, medical conditions can cause erosion as well. Talk to us about ways to minimize erosion while addressing these medical needs.

Be proactive. Ask your Drs. Paul Pasternack, Chara Pasternack, and Christine Biondi about healthy drinks and snacks for healthy teeth. Make sure to keep on top of brushing and flossing, and stick with fluoride toothpastes. And visit our Vorhees office regularly for exams and cleanings.

There’s really no trick to it—preventing enamel erosion helps keep your child’s teeth structurally strong and cavity-free for a lifetime of beautiful and healthy adult smiles.

All Hallows' Eve, more commonly known as Halloween, is a yearly event celebrated on October 31, and one that is anticipated by the young and young at heart all over the world. Some scholars claim that Halloween originated from Celtic festivals that honored the dead or that celebrated the harvest, while others doubt that there's any connection at all to Samhain (a Gaelic harvest festival.) Regardless of its origin, our team at the Pediatric Dentistry office of Drs. Paul Pasternack, Chara Pasternack, and Christine Biondi hopes that Halloween is fun and enjoyed by all of our awesome patients!

Trick or treat?

In North America, Halloween is predominantly celebrated by children who dress up in costumes, which range from scary to cute, who then go around the neighborhood knocking on doors asking "trick or treat", and they are given candy in return. Trick-or-treating is a time honored tradition, and though many parents groan at the pounds and pounds of candy collected by youngsters and fear for the health of their teeth, there are a few things you can do to help their teeth stay in great shape until the candy is gone:

• Limit the amount of candy they can consume each day
• Have them brush their teeth after eating candy
• Avoid hard, chewy candies as they can stick in hard to brush places
• Keep candy out of sight to reduce temptation
• Don't buy candy too far in advance to limit pre-Halloween consumption
• Help or encourage your children to floss

Halloween Fun

Halloween isn't just about gorging on candy; there are other events associated with this festive day including carving jack-o'-lanterns, painting pumpkins, decorating sugar cookies, bobbing for apples, going to haunted houses, or just curling up on the couch with a bowl full of popcorn and watching some classic, scary movies.

Halloween Around the World

Some countries, like Australia, frown upon Halloween, claiming it is an American event and not based in Australian culture, while others like Italy have embraced the fun and celebrate much as Canadians and Americans do. Mexicans have been celebrating this fun day since around 1960, and it marks the beginning of the Day of the Dead festival. Some countries in Europe have come late to the party, but since the 1990s, countries like Sweden, Norway, and Germany have started celebrating Halloween as well, and finding children in costumes or having ghosts hanging in windows has become commonplace.

Halloween is about fun; stepping outside our normal lives and donning a costume or gathering with friends to knock on doors and ask for candy is as much a part of our culture as hot dogs and barbecue on Labor Day. Have a safe and happy Halloween from the team at Pasternack Pediatric Dental!

Baby teeth are very important to your child’s present and future dental health, so we want to help you keep your child free from cavities and gum disease even before those permanent teeth erupt. That’s why we recommend professional cleanings at our Vorhees office—to keep plaque and tartar from damaging little teeth and gums.

But a dental cleaning might be a bit stressful for young children, especially when they’re not used to the steps, the sounds, and the sensations of the cleaning process.

So, just as we strive to make every examination and visit a positive experience for your child, we do our best to make their cleanings a happy, stress-free time. How do we do this? With your help!

• Preparation

A happy experience begins even before your child arrives in the office. If you are relaxed and positive before an appointment, you’ll help your child feel relaxed and positive, too.

Explaining what goes on during a cleaning even before your visit will help your child feel more comfortable when unfamiliar tools like dental mirrors, scalers, and polishing brushes are used. You can talk about your own experience, read a book together, watch a video, or find online resources to help your child understand what will happen during your visit, and why cleanings are so important for happy, healthy teeth.

Sometimes children benefit from a form of mild, conscious sedation (such as nitrous oxide) when they have special health needs or dental anxiety. If you feel this is an option we should discuss, please talk to us in advance and we’ll answer any of your questions.

• Pre-Cleaning Examination

After being made welcome in the office and settled comfortably in the dental chair, we’ll examine your child’s teeth and gums for any signs of plaque and tartar.  A small, handled mirror is used to check out hard-to-see places behind the teeth and in the back of the mouth. Gum health is also important, and your child’s gums will be examined for any signs of gingivitis, or mild gum disease.

Plaque and tartar cause cavities and gum disease, even for young children. Finding any trouble spots will let us know where to concentrate on cleaning, and where you can help your child to brush more effectively.

• Removing Plaque and Tartar

No matter how well a child (or an adult!) brushes and flosses, plaque can build up in some hard-to-reach spots, especially between the teeth and along the gumline. And if plaque isn’t removed within a few days, it starts hardening into tartar—and tartar can’t be brushed away.

That’s why removing tartar is a job for a dental professional. Using a special tool called a scaler, we gently scrape built-up plaque and tartar off tooth enamel (especially where it tends to accumulate behind and between teeth) and near the gumline. Sometimes an ultrasonic scaler can be used to dislodge tartar with sound waves.

Scalers can make a scraping noise and cause some pressure, and ultrasonic scalers use a stream of water as they clean. We’re happy to explain, in an age-appropriate way, why tools make these noises and how they work to clean little teeth.

• Polishing & Flossing

After the plaque and tartar are removed, your child’s teeth will be polished with a power brush and a special gritty toothpaste. This is usually a bit noisy as well. A careful flossing and a final rinse will wash away any leftover particles or paste.

Once the teeth are cleaned, you may choose to have a fluoride treatment or a dental sealant applied to your child’s teeth.

• After a Cleaning

Your praise and encouragement are always welcome! Giving children praise for helping keep those little teeth clean, shiny, and healthy makes them partners in the process.

How do we clean your child’s teeth? Gently. Thoroughly. Expertly. We want to make sure each cleaning is just one of the many positive dental experiences your child will have in our office. Help us make your child’s cleaning appointment stress-free with positive preparation and reinforcement, and together we’ll start your child on the path to a lifetime of shining smiles and proactive dental care!

According to the American Association of Pediatric Density, roughly one in five children suffers from canker sores. Canker sores are small sores that appear inside the cheeks, on the lips, on the surface of the gums, and under the tongue.

Even though, canker sores are not contagious, they do tend to run in families. There are several reasons your child may be suffering from canker sores including:

• Children who have Vitamin B12, iron, and folic acid deficiencies tend to get canker sores more often than children who have normal levels of these vitamins and minerals.
• Children who suffer from food allergies are also at a higher risk for developing canker sores. It’s difficult to determine what your child may be allergic to. If you feel strongly that the canker sores are related to an allergy, then a visit to an allergist is highly recommended.
• Biting their lip or cheek can also result in a canker sore.
• Any injury to mouth, where the skin breaks can cause a canker sore.
• Brushing their teeth too hard can also be a problem.
• Your child may be sensitive to an ingredient in their toothpaste. Try switching toothpastes and see if it makes a difference.
• Emotional disturbances and stress are also factors to consider.

If your child has frequent canker sores a visit to our Vorhees office will be beneficial. Canker sores are painful and usually last about 14 days. Drs. Paul Pasternack, Chara Pasternack, and Christine Biondi may recommend one or a few of the following treatment options:

• Avoid food that is acidic, salty, and spicy.
• A toothbrush with soft bristles may be helpful.
• Avoid mouthwash and toothpaste that contain SLS.
• Do not feed your child foods that they may be allergic to.

Canker Sore Remedies

• Eating yogurt that contains Acidophilus will relieve the pain and help the canker sore heal faster.
• Put one teaspoon of baking soda in an eight-ounce glass of lukewarm water. Have your child gargle and swish it around his or her mouth several times a day. Not only does this remedy relieve the pain, the canker sore could be gone in as little as 24 hours.
• Place a wet tea bag on the sore and hold it there for a few minutes several times a day. This remedy will help with the pain and quickly heal the sore.
• Camphor, Benzocaine, Lidocaine, and Orajel are over-the-counter medications that can help.

If you have questions about your child’s canker sore, contact Drs. Paul Pasternack, Chara Pasternack, and Christine Biondi to schedule an appointment.