John Riehs
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Schedule your appointment during the month of May to take advantage of these great deals!!! (214)838-3210

In office whitening $99 (regularly $125)

At home whitening $200 (regularly $400)

John Riehs
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Happy Easter!!! #prestoncenterpediatricdentistry #pcpd #DrRiehs #Easter #weloveourpatients

John Riehs
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February is dental health month and Jayden is taking Mr Teddy’s blood pressure for his first dental visit.

#prestoncenterpediatricdentistry #pcpd #DrJohnRiehs #DrRiehs  #February #firstdentalvisit #Dentalhealthmonth #bloodpressure

John Riehs
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Preston Center Pediatric Dentistry bought back over 35 pounds of candy!! Thank you to everyone who joined us in the fight against cavities.

#prestoncenterpediatricdentistry #drjohnjriehs #drjohnriehs #drriehs #candybuyback

John Riehs
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The public has become more aware of advances in cosmetic dentistry, including both the availability and variety of whitening agents on the market. As a result, parents and media request more information on dental whitening for children/adolescents. A negative self-image due to tooth discoloration could have serious consequences on adolescents and can be a consideration for whitening.

Dental whitening can be accom...plished by professional or at-home bleaching modalities. Benefits of an in-office whitening or whitening products dispensed by the dental professional include:
• A professional examination of tooth discoloration
• Control and monitoring of the teeth and gums
• Patient compliance
• Rapid results

The pretreatment examination by a dentist can help identify the pathology that may be causing tooth discoloration as well as establishing the baseline shade where progress can be evaluated and monitored. The two most common types of whitening offered by dental professionals are 1.) in-office whitening which is applied by a dental professional 2.) fabricating custom made trays where dispensed bleaching agents can be placed. Custom trays ensure great fit and fewer adverse gingival effects. Over the counter products include gels, whitening strips, toothpastes, mints, chewing gum and mouth rinses. While not as effective, these agents offer patient convenience and lower costs.

Agents used by dental professionals to whiten teeth:
1. Carbamide peroxide (10 percent to 38 percent) **most common
2. Hydrogen peroxide (3 percent to 13 percent)
These agents work by an oxidative process to remove intrinsic stain, whereas most toothpastes, rinses, and chewing gums work against extrinsic stain.

The two most common side effects with bleaching: gingival irritation and tooth sensitivity, both of which cease after discontinuance of treatment. The American Academy of Pediatric Dentistry encourages judicious use of bleaching with constant monitoring in the adolescent population.

John Riehs
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Recently, the New York Times highlighted use of silver diamine fluoride (SDF) as an alternative approach to treatment of cavities in children. The article mentioned that SDF was faster and cheaper than removing a cavity and restoring the tooth with a filling.    It also mentioned the downside that when applied, SDF blackens the tooth.

Silver diamine fluoride (SDF) is a colorless liquid that at pH 10 is 24.4% to 28.8% (weight/volume) silver and 5.0% to 5.9% fluoride.  A number of products are currently available in other countries, but at this time, Advantage Arrest™ (Elevate Oral Care, L.L.C.) is the only commercially available SDF product for dental treatment in the U.S. Silver diamine fluoride has FDA approval for tooth hypersensitivity only, not for its treatment in treating cavities. 

SDF received coverage in the Times for its use in treating cavities in children, although this might be more accurately described as caries control and management.   While the Times article focused on the use of SDF in young children, it has also been shown to be effective in management of root caries in the elderly.  It likely has additional applicability as an interim approach for managing problematic caries in individuals currently unable to tolerate more involved dental treatment.

SDF is not a complete solution to caries risk.  A single application has been reported to be insufficient for sustained benefit.  Its downsides include an unpleasant metallic taste, potential to irritate and stain gingival and mucosal surfaces, and the characteristic black staining of the tooth surfaces to which it is applied.  The tooth will still remain unrestored and susceptible to future carious insults.  The oral cavity is not static and can be affected by medications, hormonal changes, diet, bacterial counts, home care, etc.  

Currently, there are more studies underway with SDF. With more scientific insight, more information will become available about potential usages.  

John Riehs
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After brushing your teeth for two minutes, parents and children (above age 5) alike should spit the toothpaste out of their mouth and NOT rinse with water. The primary benefit of toothpaste is the fluoride it contains. Therefore, it is NOT recommended to rinse with water directly following tooth brushing. Rinsing immediately removes the fluoride from your saliva and thus the beneficial properties fluoride offers: strengthening the enamel thus minimizing cavity risk and decreasing tooth sensitivity. Starting at birth, clean your infant’s gums with a soft infant toothbrush or cloth. As the teeth begin to erupt (at about 6-8 months), begin using a “smear” amount of fluoride toothpaste on the toothbrush and brush twice daily. For the 2-5 years old, dispense a “pea-sized” amount of fluoride toothpaste and continue to assist with your child’s brushing. (Most children do not have the ability to brush their teeth effectively.) It is expected most children under the age of 5 will swallow the toothpaste. As long as the guidelines for toothpaste usage are followed, the developing permanent teeth will benefit from the fluoride ingestion.

John Riehs
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Athletes in contact sports are at significant risk for traumatic injury to their teeth and mouth. It’s estimated 600,000 emergency room visits each year involve a sports-related dental injury.

Athletic mouth guards have become standard of care for safeguarding against sports-related oral injuries. The American Dental Association recommends mouth guards for 29 sports or exercise activities.

But do mouth guards actually prevent injury? Studies/research has shown the risk of an oral-facial injury in sports related activities was nearly two times greater without the wearing of a mouth guard.

All mouth guards are not alike. The stock, “off the shelf” mouth guard found in many retail stores with limited size offerings is the least expensive, but also least protective, of mouth guard types. Mouth-formed or “boil-and-bite” protectors, which are softened in boiling water and then molded to the patient’s bite/teeth, are better than the stock version.  However, the “boil and bite” often don’t cover all of the player’s back teeth.

The best option is a custom-designed guard made by a dentist for the individual patient. Although relatively expensive (costs range in the hundreds, compared with $25 or less for a stock guard), this type of guard provides the highest recognized level of mouth protection.

The bottom line: a mouth guard is a must for any sport that involves contact or high velocity objects of play. If you or a family member is a contact sport athlete, it’s essential you protect your teeth and mouth with a custom-fit, high quality mouth guard.

John Riehs
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Do you ever hear sounds like a wild animal gnashing its teeth from the bedroom of your sleeping child?

No worries. Sometimes those sounds, like wild animals, are normal in a child’s tooth development. And while teeth grinding may not sound like the healthiest of noises to come out of your child's mouth, there's generally little to worry about, according to the American Academy of Pediatric Dentistry.

1. Why do kids grind their teeth? Does the answer change depending on the age of the child?

Children exhibiting teeth grinding is very common, especially children under age 6. A lot of children will stop grinding once their six-year permanent molars erupt. The eruption of permanent teeth begins to establish the permanent bite.

Prior to this, children's bites are very flexible and subject to changes as they grow. Occasionally, children will exhibit an abnormal bite causing them to grind because of the placement of their teeth.

2. Could it be stress-related? Do children grind their teeth for some of the same reasons adults might grind their teeth?

Stress related grinding in students of middle school/high school is more common, especially during exam periods. Grinding in children below age 6 is etiologic (no know reason), but could be correlated with sleep disorders.

3. What should parents do if their child is grinding his or her teeth?

If baby teeth are still present, no intervention is necessary. If significant grinding occurs after age 6, a plan may need to be devised to prevent wear on the permanent teeth.

4. What should parents look out for?

Parents may notice wear patterns on the teeth, but your dentist will notice these as well and recommend treatment when appropriate.

5. How common is teeth-grinding?

It is very common in children less than 6 years of age. Adults can grind as well, but this may be more stress related and traditional night guards can be fabricated to prevent wear. According to some studies, there could be a correlation between children grinding their teeth and sleeping disorders.

John Riehs
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Preston Center Pediatric Dentistry will be giving HALF OFF ALL SEALANTS when appointment is scheduled in September. Call 214-838-3210 to schedule your appointment.

Sealants are protective coatings placed on the biting surfaces of the teeth to protect against cavities. The chewing surfaces of the teeth naturally have deeper grooves and pits which allow bacteria and food to be trapped in these areas. Even with effective tooth brushing, these areas can be diff...icult to keep clean. Sealants “seal out” food and plaque, thus decreasing the risk of cavity formation, by up to 67%.

Sealants are traditionally recommended on the molars of both baby and permanent teeth. The procedure is very quick and easily tolerated by most children, taking less than 10-15 minutes in most cases. Ask Dr. John J Riehs about the need for sealants on your child.

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