Hunterdon Pediatric Dental Associates

We are open at this time. We ask for your patience while we deal with our new normal office disinfection & patient isolation. Thank You for your anticipated cooperation- Dr. Stephen T. Tafaro DMD

Hunterdon Pediatric Dental Associates would like to let our patients and potential patients know that we are open at this time. Call the office at 908-788-6700 to make an appointment. We are taking extra precautions with sterilization and disinfection to ensure our patient's safety. We will let know if our status changes. Thank You, Stephen T. Tafaro, DMD

What is gingivitis and how do you treat it? Gingivitis is a reversible inflammation of the gum tissues due to plaque accumulation around an in between the teeth. It presents as red, swollen gum tissues where the teeth and gums meet. The body’s immune system recognizes the bacteria and responds to it by sending antibodies to the area to fight the infection. To do this, the small blood vessels become opened and fragile, thereby causing them to bleed when touched. If the gingivitis should worsen, the gum tissues can swell up, over growing the teeth and making it easier for plaque to stay on the teeth. Treatment for gingivitis starts with more attentive and regular home care. Gentle brushing at the gumline and daily flossing will remove the bacteria and stimulate healing. If bleeding still occurs, then a professional cleaning as well as detailed home care instruction may be needed. Children who have braces on their teeth are much more prone to developing gingivitis as the braces allow plaque to more easily accumulate. In this case, more attentive and frequent home care care is required. It should be noted that gingivitis is the first step in gum disease. Because children’s immune systems are normally stronger, progression to more severe forms of gum disease is very limited. However, if good oral hygiene habits are not developed early, then there is a good chance that irreversible gum disease could form. Remember, once you have irreversible gum disease, it can not be cured. The disease can only be controlled through more frequent cleanings and many times surgical procedures.

Why are X Rays needed and is the radiation my child receives harmful? Dental radiographs are a very necessary part of the examination process. Because baby teeth are developed very quickly, there tooth structure is not as well formed. Thus, they are more prone to developing decay. A small cavity that starts in between the teeth can become very large in a short period of time. This could cause the tooth to require more costly and extensive restorations or loss of a tooth from infection. Radiographs are also needed to monitor the development and eruption of teeth for orthodontic purposes. Improvements in technology has led to the development of X Ray machines and fast films that deliver very little radiation to a very specified area. When comparing digital radiographic systems to traditional film systems, there is very little difference in the amount of radiation the patient receives. Although there is no way to determine exactly how much radiation is too much for any given person, we do know that children are more susceptible to the effects of radiation and all efforts to limit radiation should be done. In following this recommendation, our office’s standard radiation policy is to take two radiograph per year beginning at the age of 4 ½ years. A Panoramic radiograph (Equivalent to three regular radiographs) is taken at the age when the first permanent teeth erupt, about six years old. If determined it is necessary, it is repeated at the age of 10 – 11 years old. Once the patient has all permanent teeth present, Radiographs are taken every 18 – 24 months. It is important to note that factors such as decay rate, ectopic positions of teeth and the frequency your child visits the dentist may alter the need for radiographs.

Xylitol Toxicity in Dogs What is Xylitol? Xylitol is a naturally occurring substance that is widely used as a sugar substitute. Chemically, it is a sugar alcohol, and in nature it is found in berries, plums, corn, oats, mushrooms, lettuce, trees, and some other hardwood trees and fruits. Commercially, most xylitol is extracted from corn fiber, birch trees, hardwood trees and other vegetable material. Although it has been used as a sugar substitute for decades, its popularity has increased dramatically in the last few years. How is it used? Xylitol is manufactured into a white powder that looks and tastes similar to sugar. In many countries it has been approved for use in oral care products, pharmaceuticals and as a food additive. Products that may contain xylitol include sugar-free gum, candies, breath mints, baked goods, cough syrup, children's chewable vitamins, mouthwash, and toothpaste, to list a few. Why is xylitol increasing in popularity and use? Xylitol is about as sweet as sucrose, but contains only about two-thirds of the calories. As a sugar substitute, it is lower on the glycemic index, a scale that ranks carbohydrate-rich foods by how much they raise blood sugar levels compared to glucose. Being lower on the glycemic index makes xylitol useful for diabetics or people on low carbohydrate diets. With respect to oral health, research has shown that xylitol helps reduce the formation of plaque, inhibits dental cavities, and stimulates the production of saliva. How safe is xylitol? Xylitol is safe for use in humans. Xylitol, like most sugar alcohols, may have a mild laxative effect when eaten in large amounts, when first introduced to a diet. This occurs because, until the digestive system adapts, xylitol may not be completely digested in the intestines. This causes mild diarrhea and/or mild intestinal discomfort. Xylitol is extremely toxic to dogs. However, xylitol is extremely toxic to dogs. Even small amounts of xylitol can cause hypoglycemia (low blood sugar), seizures, liver failure or even death in dogs. If your pet is showing these symptoms do not wait for symptoms to get worse. It's better to contact your local VCA Veterinarian. We offer a free first exam* for new clients. Why is xylitol toxic to dogs? In the past 5 years, Pet Poison Helpline, an animal poison control based out of Minneapolis, MN, has had over 1500 calls for xylitol poisoning, due to the growing awareness of this common kitchen toxin. In both humans and dogs, the level of blood sugar is controlled by the release of insulin from the pancreas. Xylitol does not stimulate the release of insulin from the pancreas in humans. However, when non-primate species (e.g., a dog) eat something containing xylitol, the xylitol is quickly absorbed into the bloodstream, resulting in a potent release of insulin from the pancreas. This rapid release of insulin results in a rapid and profound decrease in the level of blood sugar (hypoglycemia), an effect that occurs within 10-60 minutes of eating the xylitol. Untreated, this hypoglycemia can be life-threatening. How much xylitol is poisonous to a dog? The dose of xylitol that can cause hypoglycemia in the dog has been reported between 50 milligrams (mg) of xylitol per pound of body weight (100 mg per kg). The higher the dose ingested, the more the risk of liver failure. The most common source of xylitol poisoning that Pet Poison Helpline gets called about comes from sugar-free gum. With certain brands of gum, only 9 pieces of gum can result in severe hypoglycemia in a 45 pound dog, while 45 pieces would need to be ingested to result in liver failure. With other common brands of gum (which contain 1 g/piece of gum), only 2 pieces would result in severe hypoglycemia, while 10 pieces can result in liver failure. As there is a large range of xylitol in each different brand and flavor of gum, it is important to identify whether a toxic amount has been ingested. Xylitol is estimated to be 100 times as toxic as chocolate to dogs. Intake of very high doses of xylitol (225mg/lb or 500 mg/kg body weight) has been implicated in liver failure in dogs. What should I do if my dog eats something containing xylitol? you suspect that your pet has eaten a xylitol-containing product, please contact your veterinarian or Pet Poison Helpline (800-213-6680) immediately. Do not induce vomiting or give anything orally to your dog unless specifically directed to do so by your veterinarian. It is important to get treatment for your dog as quickly as possible. As some dogs may already be hypoglycemic, inducing vomiting can make them worse! What are the symptoms of xylitol poisoning? Symptoms of xylitol toxicity develop rapidly, usually within 15-30 minutes of consumption. Signs of hypoglycemia may include any or all of the following: •Vomiting •Weakness •Incoordination or difficulty walking or standing (walking like drunk) •Depression or lethargy •Tremors •Seizures •Coma In severe cases, the dog may develop seizures or liver failure. Dogs that develop liver failure from xylitol poisoning often show signs of hypoglycemia. How is xylitol poisoning diagnosed? A presumptive diagnosis of xylitol poisoning is made if there is a known or possible history that the dog ate something containing xylitol, coupled with symptoms of hypoglycemia. Since toxicity develops rapidly, your veterinarian will not wait for a confirmed diagnosis before beginning treatment. Is there an antidote for xylitol toxicity? No. There is no antidote for xylitol toxicity, although treatment with sugar supplementation, IV fluids, and liver protective drugs are beneficial. How is xylitol poisoning treated? xylitol_toxicity_in_dogs2Fast and aggressive treatment by your veterinarian is essential to effectively reverse any toxic effects and prevent the development of severe problems. If your dog has just eaten xylitol but has not yet developed any clinical signs, your veterinarian may induce vomiting to prevent further absorption, depending on what your dog's blood glucose level is. If clinical signs have developed, treatment will be based on the symptoms that are being shown. Since xylitol toxicity can cause both low blood glucose and low potassium levels, your veterinarian will perform blood work to determine whether these problems need to be treated. In all cases, your dog will require hospitalization for blood sugar monitoring, dextrose administration, intravenous fluids, liver protectants, and any other supportive care that may be needed. Blood work should be monitored frequently to make sure that blood sugar and liver function remain normal. What is the prognosis for recovery from xylitol poisoning? The prognosis is good for dogs that are treated before symptoms develop, or for dogs that develop uncomplicated hypoglycemia that is reversed rapidly. If liver failure or a bleeding disorder develops, the prognosis is generally poor. If the dog lapses into a coma, the prognosis is very poor. How can I prevent this problem? If you personally use products containing xylitol, make sure they are stored safely, out of reach of your pets. Do not share any food that may contain xylitol with your pets. Only use pet toothpaste for pets, never human toothpaste. Keep in mind that there are some veterinary products that contain small amounts of xylitol (e.g., gabapentin medication, mouthwashes). At prescribed doses, these should not result in xylitol poisoning; however, if ingested in large amounts, can potentially result in poisoning. If you personally use products containing xylitol,make sure they are stored safely, out of reach of your pets. The toxicity of xylitol for cats and other species is not documented at this time, although there has been some concern that other non-primate species (e.g., cats, ferrets, etc.) may react to xylitol in a similar manner as dogs. With any poisoning, prompt decontamination and treatment is always warranted, as it's less dangerous to your pet, and less expensive for you to treat early! Rapid diagnosis and treatment is imperative Pet Poison Helpline | Animal Poison Control Center Pet Poison Helpline | Animal Poison Control Center Pet Poison Helpline | Animal Poison Control Center Pet Poison Helpline | Animal Poison Control Center Pet Poison Helpline | Animal Poison Control Center See more at petpoisonhelpline.com

Los dientes del niño ¿CÓMO CUIDAR LOS DIENTES DE SUS HIJOS? La buena higiene bucal comienza antes de que salga el primer diente de leche. Los bebés nacen con todos los dientes. No podemos verlos porque están escondidos en las encías. Los dientes del bebé comienzan a cortar las encías aproximadamente a los 6 meses, pero es importante comenzar a practicar la buena higiene bucal incluso antes de que salga el primer diente. De encías sanas salen dientes sanos. Para los 3 años de edad, los niños tienen todos los dientes de leche, que se llaman dientes primarios. Los dientes de leche comienzan a caerse aproximadamente a los 6 años, en ese momento comienzan a salir los dientes permanentes, o adultos. Es normal que haya espacios entre los dientes de leche porque dejan lugar para los dientes permanentes. La mayoría de los dientes permanentes ya habrán salido a los 13 años de edad. Las caries producidas por el uso del biberón son un problema grave. Pueden formarse caries si los bebés beben leche, fórmula láctea o jugo de un biberón por períodos prolongados. Para evitarlo: •Retire el biberón una vez que el bebé haya terminado. •No acueste al bebé con un biberón. Algunos consejos prácticos para mantener los dientes de los niños sanos y fuertes 0–2 años •Limpie las encías del bebé con una toallita después de darle de comer. Eso ayudará a quitar la película adherente llamada placa que puede causar caries. •Lávele los dientes dos veces al día con agua y un cepillo dental de cerdas blandas. 3-5 años •Haga que comience a usar una pasta dental con flúor a los 3 años de edad. •Sólo use una cantidad pequeña del tamaño de un guisante. Asegúrese de que su hijo escupa la pasta después del cepillado. •Trate de que ya haya dejado de chuparse el dedo y de usar chupete a los 4 años de edad. •Comience a llevarlo a visitas con sus profesionales de atención dental cada 6 meses. 6–9 años •Haga que comience a usar hilo dental en cuanto los dientes se toquen. •Explique a su hijo que es normal que los dientes de leche se caigan, y que así es como salen los dientes "adultos". •Hasta que los niños puedan practicar buenos hábitos de higiene bucal por sí mismos, los padres deberán ayudarlos a cepillarse los dientes y usar hilo dental dos veces al día. •Siempre preste especial atención a la parte posterior de los dientes, en donde puede haber más placa. 10–12 años •Exija que los niños que practiquen deportes usen un protector bucal para proteger su sonrisa. 13 años en adelante •Los padres pueden aprovechar el interés de sus hijos adolescentes en la apariencia recordándoles que tener una sonrisa saludable y el aliento fresco los ayudará a verse y sentirse de lo mejor. Algunos consejos prácticos •Aliente a los adolescentes que usen correctores dentales a que se cepillen los dientes y usen hilo dental exhaustivamente. •Cuando les quiten los correctores dentales, el aspecto de sus dientes dependerá de cómo los hayan tratado durante el tratamiento de ortodoncia. •Sugiérales que lleven un cepillo de dientes, pasta e hilo dental en su bolso o bolso de gimnasio para usarlos durante el día. Consejos prácticos para una mejor salud dental de los niños •Es importante comenzar a practicar la buena higiene bucal incluso antes de que salga el primer diente. De encías sanas salen dientes sanos. •Es importante que los niños se cepillen los dientes dos veces al día con una pasta dental con flúor, y que comiencen a usar hilo dental en cuanto tengan dos dientes que se toquen. •Los niños deben limitar el consumo de comidas y bebidas con azúcar y pegajosas para protegerse de las caries.