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Adolescent Dentistry


Adolescents have special needs. Appearance and self-image can be very important to them. Decayed or poorly-positioned teeth can make them more self-conscious. Teens also tend to eat more frequently, with unhealthy snacks and sugary drinks becoming a major factor. The pediatric dentist can provide caring and sensitive education that can help your teen prevent cavities. Other oral health care items that can be relevant to your teen includes sealants, wisdom teeth, oral piercings, missing teeth and tobacco use.

Adolescent Dentistry

Intraoral/Perioral Piercing and Oral Jewelry

The use of intraoral jewelry and piercings of oral and perioral tissues have been gaining popularity among adolescents and young adults. Intraoral jewelry or other oral accessories can lead to increased plaque levels, gingival inflammation and/or recession, caries, diminished articulation, and metal allergy. Oral piercings of the tongue, cheek, lips, and uvula have been associated with pathological conditions such as pain, infection, scar formation, tooth fractures, metal hyper-sensitivity reactions, localized periodontal disease, speech problems, and nerve damage.

Oral Habits
  • Oral habit behaviors include, among others, digit sucking, pacifier sucking, lip sucking and biting, nail-biting, bruxism, self-injurious habits, mouth breathing, and tongue thrust.
  • Bruxism, a.k.a. tooth grinding, is characterized by the regular forceful contact between the chewing surfaces of teeth, and can occur while awake or asleep. The cause is multifactorial. Reported complications include dental attrition, headaches, temporomandibular joint (TMJ) problems, and soreness of the muscles used for chewing. Research suggests that grinding of the teeth at a younger age is self-limiting and does not progress to adult bruxism.
  • Tongue thrusting (an abnormal tongue position and deviation from the normal swallowing pattern) and mouth breathing may be associated with anterior open bite, abnormal speech, and flaring out of the maxillary incisors. Treatment may consist of simple habit control, habit appliances, or orthodontics.
  • Self-injurious or self-mutilating behavior, repetitive acts that result in physical damage to the individual, is extremely rare in the normal child. However, such behavior has been associated with mental retardation, psychiatric disorders, developmental disabilities, and some syndromes. The spectrum of treatment options for developmentally disabled individuals includes pharmacologic management, behavior modification, and physical restraint. Reported dental treatment modalities include, among others, lip-bumper and occlusal bite appliances, protective padding, and possible extractions.
Tobacco Use
  • Tobacco is a risk factor for 6 of the 8 leading causes of deaths in the world and kills up to half of its users. In the US, the Surgeon General’s report states that smoking is the single greatest avoidable cause of death. This report concludes that even in nonsmokers, secondhand smoke exposure causes disease and death.
  • Tobacco use can also result in oral disease. Oral cancer, periodontitis, compromised wound healing, a reduction in the ability to smell and taste, coated tongue, staining of teeth and restorations, and leukoplakia (potentially precancerous white patches of the oral mucosa) are all seen in tobacco users. Smokeless tobacco is also a risk factor for periodontal conditions and oral cancer.
  • Initiation of tobacco use begins before age 19 for 90% of adult smokers. In fact, most studies show that people who do not use tobacco as a teen never use it. For this reason it is very important to provide education at a younger age regarding tobacco use.
  • A new term, “thirdhand” smoke, has been proposed to describe the particulate residual toxins that are deposited all over the home after a cigarette has been extinguished. Since children inhabit these low-lying contaminated areas and because the dust ingestion rate in infants is more than twice that of an adult, they are even more susceptible to thirdhand smoke. Studies have shown that these children have associated cognitive deficits in addition to the other associated risks of secondhand smoke exposure.
Dental Bleaching
  • A negative self-image due to a discolored tooth or teeth can have serious consequences on adolescents and could be considered an appropriate indication for bleaching.
  • Due to the difference in the thickness of enamel of baby and permanent teeth, tooth coloration within a dental arch may vary during the mixed dentition. Full arch cosmetic bleaching during this developmental stage, however, would result in mismatched dental appearance once the child is in the permanent dentition and is not recommended.
  • In addition to providing in-office bleaching procedures, a dentist may fabricate custom trays for at-home use of a bleaching product. Custom trays ensure intimate fit and greater efficiency of bleaching agents. Over-the-counter products for at-home use include bleaching gels, whitening strips, and brush-on agents. Their main advantages include patient convenience and lower associated costs.
  • Discuss any concerns your teen child may have about the appearance of his/her teeth with your pediatric dentist so that you can determine the appropriate timing for bleaching as well as different options and associated side effects.
Vending Machines in Schools
  • Many beverage and snack food products are targeted specifically and aggressively at the child and adolescent market. Vending machines containing these products are readily accessible to children and adolescents in schools.
  • Frequent consumption of refined carbohydrates can be a significant factor in the child and adolescent diet that contributes to the initiation and progression of cavities. Vending machines provide ready access to highly-refined carbohydrates, such as sodas, fruit juices, and sports drinks. Many of these popular drinks also contain caffeine which, if consumed regularly, may lead to habitual usage and can affect growth on the young child.
  • There is growing concern that vending machine items with limited nutritional value are “competitive foods,” resulting in snack options that are considered to be of poor nutritional quality. An effort is underway to increase the healthy choices available in vending machines by replacing sugar-sweetened drinks with bottled water, candy bars with nutrition bars, and potato chips with dried fruits and nuts.
  • As teenage girls have increased their consumption of soft drinks, their consumption of milk has decreased by 40%, which may contribute to a decrease in bone density, subsequent increase in fractures, and future risk of osteoporosis.
  • Despite maintaining a healthy diet at home it is important to be aware of poor dietary choices available to your child at school. You and the pediatric dentist can be a great source of education to help your child make healthy choices at home and school.
Copyright © 2002-<script type="text/JavaScript"><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->document.write(new Date().getFullYear());<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --></script> American Academy of Pediatric Dentistry. All rights reserved.

Although we encourage parents to read through the material presented on our website, please keep in mind that it is presented for educational purposes only and does not imply diagnoses for your child. Treatment options and diagnoses can only be given after a visit to the dentist and a thorough medical history and clinical/radiographic examination.