Although preventive care has improved the oral health of many American children, tooth decay is still a serious public health problem. In fact, it is five times more common than asthma. Since children learn healthy habits from their parents, there are simple steps you can take to help your child have a lifetime of healthy smiles. The following information answers some of the more common questions we hear about caring for children’s teeth.
As teeth begin to emerge, some babies may have sore or tender gums. Contrary to common belief, fever is not normal for a teething baby. If your baby has an unusually high or persistent fever while teething, call your physician. Rubbing your child’s gums with a clean wet gauze or finger may relieve some of the soreness. A clean, chilled teething ring — don’t dip it in sugar, syrup, honey or other foods — may also ease tender gums. If the child is still cranky and uncomfortable while teething, consult your dentist or physician.
Your child’s baby teeth are important in helping your child chew and speak normally. They also hold space in the jaws for the adult teeth that come in later. We usually think of a newborn baby as having no teeth, but actually the teeth are already developing in the baby’s jawbones and will erupt during the first three years of childhood. Starting infants off with good oral care can help protect their teeth for decades to come.
A baby’s front four teeth usually come in first, typically when the baby is about six months old. Don’t worry if the teeth don’t appear exactly by six months. Some children may not have a first tooth until they reach 12 or 14 months of age. By the time they are age three, most children have a full set of 20 primary teeth. As the child grows, the jaws also grow, making room for the adult teeth that begin to appear at around age six. By age 12 to 14, children typically have 28 of their 32 adult teeth. The remaining four molars, often called wisdom teeth, erupt between the ages of 17 and 25.
When your child’s first tooth appears, talk to your dentist about scheduling the first dental visit. Treat the first dental visit as you would a well-baby checkup with the child’s physician. It’s beneficial for the first dental visit to occur within six months after the first tooth appears, but no later than your child’s first birthday. Although this may seem early, starting early is the key to a lifetime of good dental health.
During the first visit, the dentist can do several things, such as:
- review the medical and dental histories of your child
- give a complete oral exam to check growth and development, oral hygiene, injuries, cavities or other problems
- determine your child’s risk of developing tooth decay
- clean the teeth and provide suggestions for daily care
- evaluate your child’s fluoride needs to optimize the preventive benefits
- review feeding practices that may lead to tooth decay
- discuss teething, pacifier use, or finger/thumb sucking habits
- talk with you about common dental injuries and what to do if one happens
- discuss treatment if needed and schedule the next check-up
I’ve heard that I shouldn’t let my baby fall asleep with a bottle in his mouth. Why is that a problem?
As soon as teeth erupt through the gums, decay can occur. One risk factor for decay, also called early childhood caries or baby bottle tooth decay, is the frequent, prolonged exposure of the baby’s teeth to liquids that contain sugar. Sweetened water, fruit juice and even store-bought milk, breast milk and formula contain sugar. Tooth decay can occur when the baby is put to bed with a bottle, or when a bottle is used as a pacifier for a fussy baby. The sugary liquids pool around the teeth while the child sleeps.
The same thing can happen as your child grows and uses a training (sippy) cup. Some toddlers will walk around with their cups, taking a little sip here and there. Again, the sugar will continually pool around their teeth. Encourage children to drink from a cup by their first birthday and discourage frequent or prolonged use of a training (sippy) cup.
Your child’s diet can also impact his teeth. To maintain good oral hygiene and healthy teeth, serve plenty of vegetables, fruits and whole grains. Provide nutritious snacks and limit sweets to mealtimes.
Sucking is a natural reflex, and infants and young children may suck on thumbs, fingers, pacifiers and other objects. It may make them feel safe, calm and happy or provide a sense of security. Since thumb sucking is relaxing, it may induce sleep.
Problems with tooth alignment and the proper growth of the mouth may result from a child’s sucking habits. The frequency, duration, and intensity of sucking can influence whether or not dental problems will result. Children who rest their thumbs passively in their mouths are less likely to have difficulty than those who vigorously suck their thumbs.
Sucking habits usually stop between the ages of two and four. If your child uses a pacifier or sucks his or her fingers past this age, talk to your dentist about what impact this habit may be having on their oral development.
One note of caution about pacifiers: If your child uses a pacifier, provide one that is clean — don’t dip it in sugar or honey, or put it in your mouth before giving it to the child. The cavity-causing bacteria in your mouth can be transferred to your baby.
Cleaning your child’s teeth is an important step to prevent cavities. After each feeding, you can wipe the baby’s gums with a clean, damp gauze pad or washcloth. This will remove plaque and bits of food that can harm erupting teeth.
When your child’s teeth begin to erupt, brush them gently with a child-size toothbrush and water. At this age, you do not need to worry about using toothpaste, particularly any with fluoride. Water will do just fine. By spending a few minutes each day to care for your baby’s teeth, you can help ensure that your child’s smile gets off to a healthy start.
When your child can be counted on to spit and not swallow toothpaste (usually not before age two), begin brushing the teeth with a pea-sized amount of toothpaste. The American Dental Association recommends fluoridated toothpaste. Ask your dentist about your child’s fluoride needs. Use a soft child-sized toothbrush and replace it when it is worn. A toothbrush with bent or frayed bristles will not remove plaque effectively. Most parents need to model and supervise their child’s brushing for the first six years or so and may need to give a final once over to be sure a thorough job has been done.
I may have fallen into bad habits with my own brushing. What is the best way to brush my child’s teeth?
It is not hard to brush your child’s teeth, but to get the most out of your brushing, follow these steps:
- Position your child so you can see into the mouth easily; some parents find it easier to have their child sit, resting his or her head in your lap.
- Place the toothbrush against the gums.
- Move the brush back and forth gently in short (tooth-wide) strokes. Brush the outer surfaces of each tooth, upper and lower. Repeat the same method for the inside surfaces and chewing surfaces of the teeth.
- Finish by brushing the tongue to help freshen breath and remove bacteria.
Flossing helps prevent cavities between the teeth. Ideally, you’ll begin using floss once the teeth begin to touch one another. Some tips to help you floss your child’s teeth are:
- Use about a foot and a half of floss. Wind most of it around the middle fingers of both hands. Hold the floss between the thumbs and forefingers. Use a gentle, back-and-forth motion to guide the floss between the teeth.
- Curve the floss into a C-shape and guide it into the space between the gum and tooth until you feel resistance. Gently scrape the floss against the side of the tooth.
- Repeat these steps on each tooth. Don’t forget the backs of the last teeth in each corner of the mouth.
Flossing can be a difficult skill to master and your child may need you’re assistance for some time. You can always check with your dentist for suggestions and tips about flossing.
The key reason why tooth decay has been greatly reduced in the past few decades is due to the use of fluoride. Fluoride is a mineral that occurs naturally in all water sources, including oceans and lakes. During childhood, when teeth are still forming, fluoride works by making tooth enamel more resistant to the acid that causes tooth decay. After teeth erupt, fluoride helps repair, or re-mineralize, areas where the acid attacks have already begun.
Topical fluorides may be found in toothpastes, mouth rinses and fluoride applied in the dental office. Systemic fluorides are those that are swallowed. They include fluoridated water and dietary fluoride supplements in the form of tablets, drops or lozenges. The maximum reduction in tooth decay is seen when fluoride is available both topically and systemically. Water fluoridation provides both topical and systemic benefits for preventing tooth decay and is an extremely effective and inexpensive means of obtaining the fluoride necessary for optimal prevention of tooth decay. If you are unsure about the fluoride level in your community’s water, ask your dentist and/or contact your local or state health department or water supplier.
Children who regularly drink bottled water or unfluoridated tap water may be missing the benefits of fluoride. While some bottled water naturally contains optimal levels of fluoride, the majority of bottled waters do not. Check the bottle water label or contact the distributor to see if fluoride has been added.
Before you give your child any vitamin or supplement that contains fluoride, check with your child’s dentist or pediatrician to see if one is needed. Based on their assessment of your family’s oral health, additional fluoride-containing products may or may not be needed.
By taking a few minutes every day and by developing good dental habits early, your child can have a beautiful smile that lasts a lifetime.
by Doc Bresler’s Cavity Busters www.cavitybusters.com Dedicated to raising a whole generation of kids who look forward to going to the dentist!
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