Billy giving advice on teething on TV3 Tuesday 19/8/2015.
Teething is a complex issue for a number of reasons. Firstly it is difficult to get an accurate description of what is happening from an 8 month old! Parents have to guess why Junior is off form, red cheeked, not eating, dribbling and putting their fingers in their mouth! These 4 signs can be attributed to teething. In a Finnish study of 126 infants who had primary teeth erupting reported by Tasanen in 1968, teething was found not to cause increased incidence of infection, skin rashes, increase in temperature, diarrhoea, cough, sleep disturbance.
So if a child has significant temperature increase, diarrhoea, cough, skin rash he /she should be assessed promptly. It is not caused by teething. We should look for another cause.
The second reason that makes teething experience very variable is the pain signalling mechanism in young children is still developing. In very young children they have not developed the supressing pathway that older children or adults possess. That is one reason why the discomfort may be more marked with the first tooth compared with later teeth. How this signalling mechanism works is also related to our genetic makeup and our environment. This may account for the large variation in symptoms.
Teething is a local issue so most treatments are local:
1. Wipe the area with a soft flannel regularly
2. A teething ring can help. Keep it cool in the fridge.
3. If the temperature is raised paracetamol will help control this and reduce discomfort.
4. Ice cream is soothing and helps maintain fluids.
5. If the child is on solids cold apple sauce is good.
A recent review by a satisfied parent (and child) when visiting Billy for an assessment visit.
Billy Fenlon receiving a Fellowship from the Faculty of Dentistry at the Royal College of Surgeons in Ireland.7/7/2014
Poster created for Creches in as part of our Best Chance Programme
Eva, Billy, Claire and Ann Marie with the Best Child Dental Health Initiative Award at the Irish Dentistry Awards Dinner 2014.
We were shortlisted for the Best Child Dental Health Initiative at the Irish Dentistry Awards 2014 for our Best Chance Programme.
We were delighted to win!
Laminated custom fit mouthguards offer the best protection against dental trauma. Master Fit Mouthguards provide custom fit mouthguards to clubs, schools and colleges on a group basis. For more information visit:
I have posted a video that discusses the various types of mouthguard available, it also shows the steps involved in fabrication and fitting a custom fit mouthguard. you can view it at:
The Quicksleeper 4
When children require dental treatment such as fillings or extractions it is important that their teeth are completely numb. Local anaesthetic has been used to make dental treatment comfortable for over 100 years. A new technique for anaesthetising children’s teeth is now available in Ireland. Normally the local anaesthetic is placed by injection on the surface of the bone close to the tooth, or close to the nerve trunk that supplies the tooth. The new technique involves placing the local anaesthetic within the bone beside the root of the tooth. This is achieved by the mechanical rotation of the needle leading to penetration of the outer plate of the bone. The needle then advances to deliver the local anaesthetic near the root tip.
There are several advantages to this technique;
There is less discomfort while the anaesthetic is being administered.
Less anaesthetic is needed for the same result
Only the area next to the injection is numb.
The numbness only lasts 45mins – to 1 hour 30 minutes so children are less likely to injure their lip or cheek.
Only one injection site is needed.
More likely to be successful where conventional techniques have failed.
More likely to be successful on inflamed teeth.
The Quicksleeper 4 is made in France by Dental Hi-tech. It is composed of a micro-computer connected to a syringe system that delivers the local anaesthetic at a slow (comfortable) rate. It also rotates the needle for 5 second intervals that allows the penetration of the bone and delivery of the local anaesthetic at the root tip where the nerve enters the tooth. This results in rapid onset of numbness that is confined to the segment beside the injection site. Smaller volumes of local anaesthetic are required and this reduces the extent and duration numbness. In children this leads to a reduction in the risk of inadvertently biting the lip or cheek. If a child bites their cheek it is painful and swollen when the numbness wears off. These symptoms can take 7-10 days to resolve.
Dr William Fenlon, a Paediatric Dentist working at the Northbrook Clinic Ranelagh has been using the Quicksleeper 4 since June 2012. He has found it successful for all ages from 3 years up to 14 years of age. The incidence of soft tissue injury following local anaesthetic has been eliminated when this method is utilised. While the purchase cost of the Unit is high, its effectiveness and its advantages justify the investment. It is important to have a range of techniques available; this technique works well in most situations for most children.
Price List 1.7.2010
This is a condition affecting the enamel of the permanent front teeth and permanent six year molar teeth. Normal enamel is white and very hard, hypomineralized enamel is creamy, yellow or brown in colour and is chalky in texture. As a result these teeth look different in appearance, they also undergo wear and are at higher risk of developing decay.
The cause is not undestood but it results from some outside interference during the enamel formation i.e. from birth to four years of age. Respiratory problems, high temperatures and exposure to antibiotics have been put forward as possible causes.
These hypomineralized teeth are often sensitive to cold or brushing.
Management starts with desensitising tooth pastes, application of remineralizing mooses soon after eruption, followed by fissure sealing when fully erupted. If surface breakdown occurs restoration with a filling or crown is indicated. In severe cases, where all the molars are involved extensively, it may be necessary to remove the molars. The best result from a space point of view occurs if the molars are removed at nine to ten years of age. This allows the next molars to slot into the position of the extracted molars. The front teeth may require cosmetic fillings but treatment is often delayed until the teeth are fully erupted. Long term porcelain veneers or crowns may be needed for the front teeth.
Traumatic Dental Injuries
Outside falls and fights contact sports pose the greatest risk of sustaining injuries to the teeth. While playing rugby, hockey, Gaelic football, basketball and soccer, injuries can occur from collisions with elbows, heads, sticks and ball. By wearing a gum shield or mouth guard 90% of dental injuries can be prevented.
Which type of gum shield should I use?
There are two types of gum shield - Boil and Bite and Customised.
The boil and bite gum shield are suitable for children aged 6 to12 years of age. Their dentition is changing as the primary teeth are replaced by permanent teeth. These gum shields are fitted by heating them in boiling water and biting while they are soft. They can be remoulded as the teeth change. Most sports shops stock this type of gum shield. Shock Doctor market a line of gum shields called Gel Max, the youth size is suitable from 6-12 years of age.
When all the primary teeth have been lost at 12-13 years of age a Customised gum shield can be made. These offer the best protection and will fit exactly to your teeth. A print is taken of the teeth; a laminated PVC gum shield is fabricated in a Dental Laboratory.
NB Gum shields should be worn for training as well as games. After use, the gum shield should be rinsed before being stored in a plastic box to keep it clean. If it is left in the bottom of the kit bag it will get soiled with clay/dirt and is less likely to be worn next time out. If the gum shield becomes heavily soiled it can be cleaned with a toothbrush and toothpaste.
28th January 2010.
After Hours Emergency
We are in the practice each day during the week. For Patients of the practice who have an emergency that requires immediate attention or advice, for example a knocked out permanent tooth, you can contact the office at 01.4968119 where a message will direct you to my mobile number outside office hours.