Keeping Your Child’s Teeth Healthy

When should I schedule my child’s first trip to the dentist? Should
my 3-year-old be flossing? How do I know if my child needs braces?

Many parents have a tough time judging how much dental care their
kids need. They know they want to prevent cavities, but they don’t
always know the best way to do so. Here are some tips and guidelines.

When Should Kids Start Brushing?

Good dental care begins before a baby’s first tooth appears.
Just because you can’t see the teeth doesn’t mean they aren’t there.
Teeth actually begin to form in the second trimester of pregnancy. At
birth, your baby has 20 primary teeth, some of which are fully developed
in the jaw.

Here’s when and how to care for those little choppers:

• Even before your baby starts teething, run a clean, damp washcloth over the gums to clear away harmful bacteria.
• Once your baby gets teeth, brush them with an infant toothbrush. Use water and a tiny bit of fluoride toothpaste (about the size of a grain of rice). Use fluoride toothpaste that carries the American Dental Association’s (ADA) seal of acceptance. (If you are using baby toothpaste without the fluoride, keep it to the same amount because you still want to minimize any toothpaste that is swallowed.)
• Once your baby’s teeth touch, you can begin flossing in between them.
• Around age 2, your child should learn to spit while brushing. Avoid giving your child water to swish and spit because this might make swallowing toothpaste more likely.
• Kids ages 3 and up should use only a pea-sized amount of fluoride toothpaste.
• Always supervise kids younger than 6 while brushing, as they are more likely to swallow toothpaste.

Even babies can develop tooth decay if good feeding habits aren’t
practiced. Putting a baby to sleep with a bottle might be convenient,
but can harm the baby’s teeth. When the sugars from juice or milk remain
on a baby’s teeth for hours, they can eat away at the enamel, creating a
condition known as bottle mouth. Pocked, pitted, or
discolored front teeth are signs of bottle mouth. Kids with severe cases
might develop cavities and need all of their front teeth pulled
(permanent teeth will grow in later).

Parents and childcare providers should help young kids set specific
times for drinking each day because sucking on a bottle throughout the
day can be equally damaging to young teeth. Babies as young as 6 months
are encouraged to switch from a bottle to a sippy cup(with a straw or
hard spout). By 12 months of age, they’ll have the motor skills and
coordination to use the cup on their own.

Visiting the Dentist

The ADA recommends that children see a dentist by their first
birthday. At this first visit, the dentist will explain proper brushing
and flossing techniques and do a modified exam while your baby sits on
your lap.

These visits can help find potential problems early and help kids get
used to visiting the dentist so they’ll have less fear about going as
they get older. Consider taking your child to a dentist who specializes
in treating kids. Pediatric dentists are trained to handle the wide
range of issues associated with kids’ dental health. They also know when
to refer you to a different type of specialist, such as an orthodontist
to correct an overbite or an oral surgeon for jaw realignment.

If a child seems to be at risk for cavities or other problems, the
dentist may start applying topical fluoride even before all teeth come
in (this also can be done in the pediatrician’s office). Fluoride
hardens the tooth enamel, helping to ward off the most common childhood
oral disease — dental cavities (also called dental caries).

Preventing Cavities

Cavities happen when bacteria and food left on the
teeth after eating are not brushed away. Acid collects on a tooth,
softening its enamel until a hole — or cavity — forms.

Here’s how to keep cavities away:

• Start good oral habits early. Teach kids to brush at least twice a day with fluoride toothpaste and to floss regularly.
• Get enough fluoride. Regular use of fluoride toughens the enamel, making it harder for acid to penetrate. Although many towns require tap water to be fluoridated, others don’t. If your water supply is not fluoridated or if your family uses purified water, ask your dentist for fluoride supplements. Most toothpastes contain fluoride but toothpaste alone will not fully protect a child’s teeth. Be careful, however, since too much fluoride can cause tooth discoloration. Check with your dentist before supplementing.
• Limit or avoid certain foods. Sugary foods, juices, candy (especially sticky gummy candy, gummy vitamins, or fruit leather or “roll-ups”) can erode enamel and cause cavities. If your kids eat these foods, have them rinse their mouth or brush their teeth after eating to wash away the sugar. The same goes for taking sweetened liquid medicines: always have kids rinse or brush afterward.

As your child’s permanent teeth grow in, the dentist can help prevent
decay by applying a thin wash of resin (called a sealant) to the back
teeth, where most chewing is done. This protective coating keeps
bacteria from settling in the hard-to-reach crevices of the molars. But
make sure that kids know that sealants aren’t a replacement for good
brushing and regular flossing.

If Your Child Has a Problem

If you are prone to tooth decay or gum disease, your kids might be at
higher risk as well. So sometimes even the most best brushing and
flossing habits can’t prevent a cavity. Be sure to call your dentist if
your child complains of tooth pain, which could be a sign of a cavity
that needs treatment.

New materials mean pediatric dentists have more filling and repair
options than ever. A silver-colored material called amalgam (a special
mix of metals) was once the substance of choice for most fillings in
permanent teeth. But now, other materials like composite resins
are becoming popular. Resins bond to the teeth so the filling won’t pop
out, and also can be used to rebuild teeth damaged through injury or
conditions like a cleft palate. Because resins are often tooth-colored,
they’re considered more attractive.

But in cases of fracture, extensive decay, or malformation of baby
teeth, dentists often opt for stainless steel or ceramic crowns. Crowns
maintain the tooth while preventing the decay from spreading.

Orthodontia

As kids get older, their bite and the straightness of their teeth can
become an issue. Orthodontic treatment begins earlier now than it used
to, but what once was a symbol of preteen embarrassment — a mouth filled
with metal wires and braces — is a relic of the past. Kids as young as
age 7 now sport corrective appliances, and efficient, plastic-based
(sometimes clear) materials have replaced old-fashioned metal.

Dentists know that manipulation of teeth at a younger age can be
easier and more effective in the long run. Younger children’s teeth can
be positioned with relatively minor orthodontic devices, preventing
major treatment later on.

In some rare instances, usually when a more complicated dental
procedure is to be done, a dentist will recommend using general
anesthesia. Parents should make sure that the professional who gives the
medicine is a trained anesthesiologist or oral surgeon before agreeing
to the procedure. Don’t be afraid ask your dentist questions.

Regular checkups and good dental hygiene can help prevent the need
for this kind of extensive dental work. Also, encourage your kids to use
a mouthguard during sports, which can prevent serious dental injuries.

As kids grow, plan on routine dental checkups anywhere from once
every 3 months to once a year, depending on your dentist’s
recommendations. Keeping sugary foods in check, encouraging regular
brushing and flossing, and working with your dentist will all contribute
to your child’s good dental health.

Reviewed by: Rupal Christine Gupta, MD

Date reviewed: May 2015

source: “Keeping Your Child’s Teeth Healthy.” Rupal Christine Gupta,
MD oralhealthgroup.com. Kids Health, May 2015. Web. Feb. 6th, 2017.