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Let’s Talk About Fluoride

August 27th, 2025

So much of parenting is a balancing act. Making sure your child has enough play time and enough nap time. Crafting meals that are both healthy and appealing. Making sure every dental product you use is both effective and safe.

While Drs. Arti and Ashi and our team can’t recommend the perfect bedtime story, or tell you why your child just won’t go for that delicious steamed broccoli, we are more than happy to discuss the very best ways to promote healthy, strong teeth. Should fluoride toothpaste be part of your child’s dental routine? For many good reasons, the answer is yes.

Why Fluoride is Important

Our enamel is the strongest substance in our bodies, with the highest concentration of minerals, but it is not indestructible. The bacteria that live in our mouths create acids which attack our enamel. Weakened enamel leads to cavities. Fluoride is a mineral that makes the enamel surface more resistant to these acids, and can actually help our enamel repair itself in a process called “remineralization.” Fluoride helps prevent cavities and makes teeth stronger, and those are benefits that will last your child a lifetime.

Can There Be Too Much of a Good Thing?

Fluorosis is a condition that can sometimes develop when a child has been exposed to too much fluoride while the adult teeth are developing below the gum line. (Around the age of eight, children’s teeth have finished forming and are not at risk.) Fluorosis is not a disease, and doesn’t harm teeth, but can lead to faint streaks in the enamel. While this streaking is usually white and subtle, it can sometimes be darker and more noticeable. Teeth discolored by fluorosis can be treated cosmetically, but prevention is always the best option.

Finding the Perfect Balance

Talk to us about using fluoride toothpaste when your baby’s first teeth start arriving. If a very young child is at risk for tooth decay, we might recommend early use of fluoride toothpaste. And for these small children, younger than the age of three, a small smear of paste (about the size of a grain of rice) is sufficient if needed. Swallowing fluoride products increases the risk of fluorosis, so make sure to use a very small amount of paste.

Because young children can’t understand the concept of rinsing and spitting, you always want to make sure the amount of toothpaste you use is age-appropriate even as they get older.  From ages three to six, a pea-sized dab of toothpaste is enough. Children should not use fluoride rinses or supplements unless recommended, and should be monitored to make sure they spit out fluoride toothpaste or rinses after brushing.

Most drinking water already has natural levels of fluoride, which normally aren’t a problem. If you are concerned about high fluoride levels in your local water, talk to us. If your water has higher levels of fluoride than normal, you can minimize consumption when your baby is young by breastfeeding, using non-fluoridated water for mixing with formula powder or concentrate, or buying prepared formula. If your child is a toddler, don’t add fluoride rinses or supplements unless they are recommended by a dental or medical professional.

Talk to us during your visit to our Issaquah office about protecting your child’s teeth. We are happy to help you find just the right amount of fluoride to keep young smiles stronger and more resistant to tooth decay. Healthy teeth in a beautiful smile—that’s a perfect balance!

Hypersensitive Teeth

August 20th, 2025

It is common to experience dentine hypersensitivity, with symptoms ranging from moderate to severe. Why does it happen and how do you know if this sensitivity is something to be concerned about? The first step is to determine the cause.

The most common cause of the sensitivity is exposure of the dentin. Dentin is the layer immediately surrounding the nerve of the tooth. It is alive and usually covered by the gum tissue. When gum recession is present hypersensitivity is common. Other contributors to temporary tooth hypersensitivity include teeth whitening and dental procedures such as fillings, periodontal treatment, and braces placement or adjustment. These are temporary and should be of no concern.

Permanent hypersensitivity, however, may require treatment. To understand the cause of sustained hypersensitivity, let us explain the structure of dentin and why it serves as a ‘hot spot’.

The dentin contains a large numbers of pores or tubes that run from the outside of the tooth to the nerve in the center. When dentin tubes are exposed, there is a direct connection between the mouth and dental pulp, which houses the nerve and blood supply of the tooth. External stimuli, such as mechanical pressure (tooth grinding or clenching - bruising the ligaments holding the teeth in place), temperature changes, as well as chemical stimuli (sweet–sour) are transmitted to the pain-sensitive dental pulp and activate nerve endings. A short and sharp pain is the result. These external stimuli cause fluid movement in the open tube that is transmitted as pain sensations. Something needs to be placed into the dentin tube to plug it and stop this fluid movement.

The first step in doing something about dental hypersensitivity is to determine the cause; our professional team at Issaquah Valley Dental Care can help you with this. Whether the sensitivity is due to exposed dentin or an underlying cause such as abscess or decay, corrective measures are needed. Contact us sooner rather than later so Drs. Arti and Ashi can reduce the sensitivity, and provide you with some relief!

Should Children Use Whitening Products?

August 13th, 2025

As adults, we often wish our teeth could be as white as they were when we were small children. Baby teeth have thinner and whiter enamel than adult teeth, and those brilliant smiles are a result! But occasionally, you may be surprised to discover some staining or discoloration on those lovely first teeth. You might be tempted to apply a whitening product to your child’s teeth, but, please—read on!

Causes of Staining

  • Improper Brushing—Often, a loss of tooth whiteness means that plaque has built up on the tooth surface. Careful brushing is needed to remove bacteria and plaque, and if your child isn’t brushing at least twice a day for two minutes, discoloration can be the result.
  • Medications—When given in liquid form, or when added to formula or food, iron supplements can cause dark grey staining on the teeth. Medications taken by a mother while pregnant or breast feeding, such as tetracycline, can also lead to discoloration.
  • Injury—If a tooth suffers a serious injury, the tooth can darken because of changes inside the enamel.
  • Health conditions—Certain health problems can cause tooth discoloration, or sometimes children are born with weaker enamel that is more likely to stain.

If you have noticed any staining on your child’s primary teeth, call our Issaquah office. Simple stains can often be removed with better brushing techniques, and we can clean other surface stains in the office. Staining caused by an injury or a health condition is something we can discuss in detail with you. We can even use some professional whitening methods if those are indicated.

Why not just buy a home whitening kit for your child? There are several important reasons to leave these products on the shelf while your child is young.

  • Whitening kits are designed for adults. They have been tested for adult teeth in adult trials. Check the box for age appropriate use. Most products are not recommended for pre-teen children.
  • Remember that thinner enamel we mentioned earlier? Add to that the delicate skin of young children, and it’s sensible to be cautious about using a bleaching agent that can cause mouth and tooth sensitivity even in adults.
  • There is no body of evidence available as to the short and long term effects of using these products on children.

If you are concerned about the brightness of your child’s smile, please talk to Drs. Arti and Ashi. We can recommend better ways to brush at home, clean your child’s teeth in the office, or suggest professional methods of whitening if there are physical or psychological reasons that it would be valuable. But while your child is young, those off-the-shelf whitening products can wait a few more years.

What to Do When the Tooth Fairy Isn’t on Schedule

August 6th, 2025

August 22 is National Tooth Fairy Day! If the Tooth Fairy is a treasured part of your child’s life, you’re just in time to celebrate! But what to do when the Tooth Fairy doesn’t arrive on schedule—when baby teeth stay longer than expected or are lost too soon? 

A baby’s 20 baby teeth tend to come in within a fairly predictable time frame. The bottom central incisors in the very front of your baby’s mouth typically make their appearance first, when your baby is around six to ten months old. Over the next few years, the remaining incisors, canines, and first molars arrive. Last on the scene are the second molars, which usually show up between the ages of 23-33 months. 

Just as baby teeth follow a pattern coming in, they tend to follow the same pattern falling out. The front teeth begin to wiggle and loosen around age six or seven, while the last of the baby teeth, the canines and second molars, are often lost between the ages of ten and 12. 

Baby teeth fall out as the adult teeth below them push up as they erupt. The top of the new tooth puts pressure on the root of the baby tooth, gradually dissolving it. As the root grows smaller and can’t anchor the tooth, the tooth begins to wiggle and eventually becomes loose enough to fall out. This leaves the adult tooth perfectly placed to grow into its proper position.

Sometimes, though, teeth linger far past their fall-out date. Sometimes, because of decay or trauma, they are lost much too early. In either case, Drs. Arti and Ashi can provide treatment to protect little smiles now and to ensure that there’s space for the permanent teeth to erupt and align correctly.

Teeth Which Overstay Their Welcome

If that baby tooth never gets wiggly, the team at Issaquah Valley Dental Care can help! When baby teeth stubbornly hang on, adult teeth can erupt behind them, creating a double row of teeth commonly known as “shark teeth.” These permanent teeth can become crowded or misaligned as they try to fit in any space available. Or a baby tooth can block an adult tooth from erupting at all. When that baby tooth just isn’t budging, an extraction will create space for the permanent tooth to erupt.

Extracting a baby tooth is generally a straightforward procedure because primary teeth have very small roots. Your child’s dental team at Issaquah Valley Dental Care are experts in helping you prepare your child for the procedure in a gentle, reassuring, and age-appropriate way. 

Often, a local anesthetic is all that’s necessary for a simple extraction, but if you feel sedation would better fit your child’s needs, discuss sedation options with your dentist. After the extraction, you’ll be given clear information on how to deal with pain and swelling, which foods and drinks are best while the extraction site heals, and how to protect the area.

Teeth Which Exit Too Early

In the case of decay or trauma, Drs. Arti and Ashi will do everything possible to save the tooth. When decay is so extensive that there’s not enough structure left to hold a filling or crown, or when there’s an infection in or around the tooth, or when an accident or injury has caused serious damage, extraction might be the healthiest option. Depending on your child’s age, further treatment might be needed afterward to protect future smiles. 

Besides their roles in eating and speaking, baby teeth save space for permanent teeth. Whenever a child loses a primary tooth too soon, the family dentist will be on the lookout for potential future orthodontic problems. If remaining baby teeth shift, taking up part of the empty space left behind by the lost tooth, the adult teeth below won’t have the space they need to erupt properly. Permanent teeth might come in at an awkward angle or in the wrong place. 

In this case, Drs. Arti and Ashi might recommend a space maintainer. Space maintainers are small, custom-designed appliances which prevent the remaining baby teeth from shifting position while holding space open for the permanent tooth to arrive right on schedule and right where it belongs. 

It’s comforting to have charts which let us know when little teeth will typically come in and when they will typically fall out. But unexpected events might mean teeth overstay their welcome or depart too soon. When the Tooth Fairy can’t keep to her schedule, schedule an appointment at Issaquah Valley Dental Care in Issaquah as soon as possible to make sure your child is on track for a future of healthy smiles.

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