One serious form of decay among young children is baby bottle tooth decay. This condition is caused by frequent and long exposures of an infant's teeth to liquids that contain sugar. Among these liquids are milk (including breast milk), formula, fruit juice and other sweetened drinks.
Putting a baby to bed for a nap or at night with a bottle other than water can cause serious and rapid tooth decay. Sweet liquid pools around the child's teeth giving plaque bacteria an opportunity to produce acids that attack tooth enamel. If you must give the baby a bottle as a comforter at bedtime, it should contain only water.
After each feeding, wipe the baby's gums and teeth with a damp
washcloth or gauze pad to remove plaque. The easiest way to do
this is to sit down, place the child's head in your lap or lay
the child on a dressing table or the floor. Whatever position
you use, be sure you can see into the child's mouth easily. Back to the Top
CARE OF YOUR CHILD'S TEETH
Begin daily brushing as soon as the child's first tooth erupts. A pea-size amount of fluoride toothpaste can be used after the child is old enough not to swallow it. By age 4 or 5, children should be able to brush their own teeth twice a day with supervision until about age seven to make sure they are doing a thorough job. However, each child is different. Your dentist can help you determine whether the child has the skill level to brush properly.
Proper brushing removes plaque from the inner, outer and chewing surfaces. When teaching children to brush, place toothbrush at a 45 degree angle; start along gum line with a soft bristle brush in a gentle circular motion. Brush the outer surfaces of each tooth, upper and lower. Repeat the same method on the inside surfaces and chewing surfaces of all the teeth. Finish by brushing the tongue to help freshen breath and remove bacteria.
Flossing removes plaque between the teeth where a toothbrush can't reach. Flossing should begin when any two teeth touch. You may wish to floss the child's teeth until he or she can do it alone. Use about 18 inches of floss, winding most of it around the middle fingers of both hands. Hold the floss lightly 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 slide it into the space between the gum and tooth until you feel resistance. Gently scrape the floss against the side of the tooth. Repeat this procedure on each tooth. Don't forget the backs of the last four teeth. Back to the Top
DENTAL X-RAYS
Radiographs (X-Rays) are a vital and necessary part of your child's dental diagnostic process. Without them, certain dental conditions can and will be missed.
X-Ray's detect much more than cavities. For example, X-Rays may be needed to survey erupting teeth, diagnose bone diseases, evaluate the results of an injury, or plan orthodontic treatment. X-Rays allow dentists to diagnose and treat health conditions that cannot be detected during a clinical examination. If dental problems are found and treated early, dental care is more comfortable for your child and more affordable for you.
The American Academy of Pediatric Dentistry recommends X-rays and examinations every six months for children with a high risk of tooth decay. On average, most pediatric dentists request radiographs approximately once a year. Approximately every 3 years it is a good idea to obtain a complete set of radiographs, either a panoramic and bitewings or periapicals and bitewings.
Pediatric dentists are particularly careful to minimize the exposure of their patients to radiation. With contemporary safeguards, the amount of radiation received in a dental X-ray is extremely small. The risk is negligible. In fact, the dental X-rays represent a far smaller risk than an undetected and untreated dental problem. Lead body aprons and shields will protect your child. Today's equipment filters out unnecessary X-rays and restricts the X-ray beam to the area of interest. High-speed sensors and proper shielding assure that your child receives a minimal amount of radiation exposure. Back to the Top
DOES YOUR CHILD GRIND HIS TEETH AT NIGHT? (BRUXISM)
Parents are often concerned about the nocturnal grinding of teeth (Bruxism). Often, the first indication is the noise created by the child grinding on their teeth during sleep. Or, the parent may notice wear (teeth getting shorter) to the dentition. One theory as to the cause involves a psychological component. Stress due to a new environment, divorce, changes at school; etc. can influence a child to grind their teeth. Another theory relates to pressure in the inner ear at night. If there are pressure changes (like in an airplane during take-off and landing when people are chewing gum, etc. to equalize pressure) the child will grind by moving his jaw to relieve this pressure.
The majority of cases of pediatric Bruxism do not require any treatment. If excessive wear of the teeth (attrition) is present, then a mouth guard (night guard) may be indicated. The negatives to a mouth guard are the possibility of choking if the appliance becomes dislodged during sleep and it may interfere with growth of the jaws. The positive is obvious by preventing wear to the primary dentition.
The good news is most children outgrow Bruxism. The grinding gets less between the ages 6-9 and children tend to stop grinding between ages 9-12. If you suspect Bruxism, discuss this with your pediatrician or pediatric dentist. Back to the Top
ERUPTION OF YOUR CHILD'S TEETH
Children's teeth begin forming before birth. As early as 4 months, the first primary (or baby) teeth to erupt through the gums are the lower central incisors, followed closely by the upper central incisors. Although all 20 primary teeth usually appear by age 3, the pace and order of their eruption varies.
Permanent teeth begin appearing around age 6, starting with the first molars and lower central incisors. This process continues until approximately age 21.
Adults have 28 permanent teeth, or up to 32 including the third molars (or wisdom teeth).
Fluoride is an element, which has
been shown to be beneficial to teeth. However, too little or too
much fluoride can be detrimental to the teeth. Little or no fluoride
will not strengthen the teeth to help them resist cavities. Excessive
fluoride ingestion by preschool-aged children can lead to dental
fluorosis, which is a chalky white to even brown discoloration
of the permanent teeth. Many children often get more fluoride
than their parents realize. Being aware of a child's potential
sources of fluoride can help parents prevent the possibility of
dental fluorosis.
Some of these sources are:
Too much fluoridated toothpaste at an
early age.
The inappropriate use of fluoride supplements.
Hidden sources of fluoride in the child's
diet.
Two and three-year olds may not be able
to expectorate (spit out) fluoride-containing toothpaste when
brushing. As a result, these youngsters may ingest an excessive
amount of fluoride during tooth brushing. Toothpaste ingestion
during this critical period of permanent tooth development is
the greatest risk factor in the development of fluorosis.
Excessive and inappropriate intake of fluoride supplements may
also contribute to fluorosis. Fluoride drops and tablets, as well
as fluoride fortified vitamins should not be given to infants
younger than six months of age. After that time, fluoride supplements
should only be given to children after all of the sources of ingested
fluoride have been accounted for and upon the recommendation of
your pediatrician or pediatric dentist.
Certain foods contain high levels of fluoride, especially: powdered
concentrate infant formula, soy-based infant formula, infant dry
cereals, creamed spinach, and infant chicken products. Please
read the label or contact the manufacturer. Some beverages also
contain high levels of fluoride, especially: decaffeinated teas,
white grape juices, and juice drinks manufactured in fluoridated
cities. Blending the syrup, carbonation with the city water supply
often makes soft drinks at fast food restaurants - so if fluoride
is in the water - this is another source.
Parents can take the following steps to decrease the risk of fluorosis
in their children's teeth:
Use baby tooth cleanser on the toothbrush
in the very young child.
Place only a pea-sized drop of children's
toothpaste on the brush when brushing.
Account for all of the sources of ingested
fluoride before requesting fluoride supplements from your
child's physician or pediatric dentist.
Avoid giving any fluoride-containing supplements
to infants until they are 6 months old.
Obtain fluoride level test results for
your drinking water before giving fluoride supplements to
your child (check with local water utilities).
Healthy eating habits lead to healthy teeth. Like the rest of the body, the teeth, bones and the soft tissues of the mouth need a well-balanced diet. Children should eat a variety of foods from the five major food groups. Most snacks that children eat can lead to cavity formation. The more frequently a child snacks, the greater the chance for tooth decay. How long food remains in the mouth also plays a role. For example, hard candy and breath mints stay in the mouth a long time, which cause longer acid attacks on tooth enamel. If your child must snack, choose nutritious foods such as vegetables, low-fat yogurt, and low-fat cheese which are healthier and better for children's teeth. Back to the Top
How Do I Prevent Cavities
Good oral hygiene removes bacteria and
the left over food particles that combine to create cavities.
For infants, use a wet gauze or clean washcloth to wipe the plaque
from teeth and gums. Avoid putting your child to bed with a bottle
filled with anything other than water. See "Baby
Bottle Tooth Decay" for more information. Back to the Top
When a child begins to participate in recreational activities and organized sports, injuries can occur. A properly fitted mouth guard, or mouth protector, is an important piece of athletic gear that can help protect your child's smile, and should be used during any activity that could result in a blow to the face or mouth.
Mouth guards help prevent broken teeth, and injuries to the lips, tongue, face or jaw. A properly fitted mouth guard will stay in place while your child is wearing it, making it easy for them to talk and breathe.
Ask your pediatric dentist about custom and store-bought mouth protectors. Back to the Top
SEAL OUT DECAY
A sealant is a clear or shaded plastic
material that is applied to the chewing surfaces (grooves) of
the back teeth (premolars and molars), where four out of five
cavities in children are found. This sealant acts as a barrier
to food, plaque and acid, thus protecting the decay-prone areas
of the teeth. Back to the Top
THUMB SUCKING
Sucking is a natural reflex and
infants and young children may use thumbs, fingers, pacifiers
and other objects on which to suck. It may make them feel secure
and happy or provide a sense of security at difficult periods.
Since thumb sucking is relaxing, it may induce sleep.
Thumb sucking that persists beyond the eruption of the permanent
teeth can cause problems with the proper growth of the mouth and
tooth alignment. How intensely a child sucks on fingers or thumbs
will determine whether or not dental problems may result. Children
who rest their thumbs passively in their mouths are less likely
to have difficulty than those who vigorously suck their thumbs.
Children should cease thumb sucking by the time their permanent
front teeth are ready to erupt. Usually, children stop between
the ages of two and four. Peer pressure causes many school-aged
children to stop.
Pacifiers are no substitute for thumb sucking. They can affect
the teeth essentially the same way as sucking fingers and thumbs.
However, use of the pacifier can be controlled and modified more
easily than the thumb or finger habit. If you have concerns about
thumb sucking or use of a pacifier, consult your pediatric dentist.
A few suggestions to help your child get through thumb sucking:
Instead of scolding children for thumb
sucking, praise them when they are not.
Children often suck their thumbs when
feeling insecure. Focus on correcting the cause of anxiety,
instead of the thumb sucking.
Children who are sucking for comfort will
feel less of a need when their parents provide comfort.
Reward children when they refrain from
sucking during difficult periods, such as when being separated
from their parents.
Your pediatric dentist can encourage children
to stop sucking and explain what could happen if they continue.
If these approaches don't work, remind
the children of their habit by bandaging the thumb or putting
a sock on the hand at night. Your pediatric dentist may recommend
the use of a mouth appliance.
Tobacco in any form can jeopardize
your child's health and cause incurable damage. Teach your child
about the dangers of tobacco.
Smokeless tobacco, also called spit, chew or snuff, is often used
by teens who believe that it is a safe alternative to smoking
cigarettes. This is an unfortunate misconception. Studies show
that spit tobacco may be more addictive than smoking cigarettes
and may be more difficult to quit. Teens who use it may be interested
to know that one can of snuff per day delivers as much nicotine
as 60 cigarettes. In as little as three to four months, smokeless
tobacco use can cause periodontal disease and produce pre-cancerous
lesions called leukoplakias.
If your child is a tobacco user you should watch for the following
that could be early signs of oral cancer:
A sore that won't heal
White or red leathery patches on your
lips, and on or under your tongue
Pain, tenderness or numbness anywhere
in the mouth or lips
Difficulty chewing, swallowing, speaking
or moving your jaw or tongue; or a change in the way your
teeth fit together
Because the early signs of oral cancer
usually are not painful, people often ignore them. If it's not
caught in the early stages, oral cancer can require extensive,
sometimes disfiguring, surgery. Even worse, it can kill.
Help your child avoid tobacco in any form. By doing so, they will
avoid bringing cancer-causing chemicals in direct contact with
their tongue, gums and cheek.
You might not be surprised anymore to
see people with pierced tongues, lips or cheeks, but you might
be surprised to know just how dangerous these piercings can be.
There are many risks involved with oral piercings including chipped
or cracked teeth, blood clots, or blood poisoning. Your mouth
contains millions of bacteria, and infection is a common complication
of oral piercing. Your tongue could swell large enough to close
off your airway!
Common symptoms after piercing include pain, swelling, infection,
an increased flow of saliva and injuries to gum tissue. Difficult-to-control
bleeding or nerve damage can result if a blood vessel or nerve
bundle is in the path of the needle.
So follow the advice of the American Dental Association and give
your mouth a break - skip the mouth jewelry. Back to the
Top
WHAT IS THE BEST TIME FOR ORTHODONTIC TREATMENT?
Developing malocclusions, or bad bites,
can be recognized as early as 2-3 years of age. Often, early steps
can be taken to reduce the need for major orthodontic treatment
at a later age.
Stage I - Early Treatment: This period of treatment encompasses
ages 2 to 6 years. At this young age, we are concerned with underdeveloped
dental arches, the premature loss of primary teeth, and harmful
habits such as finger or thumb sucking. Treatment initiated in
this stage of development is often very successful and many times,
though not always, can eliminate the need for future orthodontic/orthopedic
treatment.
Stage II - Mixed Dentition: This period covers the ages of 6 to
12 years, with the eruption of the permanent incisor (front) teeth
and 6 year molars. Treatment concerns deal with jaw malrelationships
and dental realignment problems. This is an excellent stage to
start treatment, when indicated, as your child's hard and soft
tissues are usually very responsive to orthodontic or orthopedic
forces.
Stage III - Adolescent Dentition: This stage deals with the permanent
teeth and the development of the final bite relationship. Back to the
Top
WHAT IS THE BEST TOOTHPASTE FOR MY CHILD?
Tooth brushing is one of the most important
tasks for good oral health. Many toothpastes, and/or tooth polishes,
however, can damage young smiles. They contain harsh abrasives
which can wear away young tooth enamel. When looking for a toothpaste
for your child make sure to pick one that is recommended by the
American Dental Association. These toothpastes have undergone
testing to insure they are safe to use.
Remember, children should spit out toothpaste after brushing to
avoid getting too much fluoride. If too much fluoride is ingested,
a condition known as fluorosis can occur. If your child is too
young or unable to spit out toothpaste, consider providing them
with a fluoride free toothpaste, using no toothpaste, or using
only a "pea size" amount of toothpaste. Back to the
Top
WHAT IS THE PEDIATRIC DENTIST?
The pediatric dentist has an extra two
years of specialized training and is dedicated to the oral health
of children from infancy through the teenage years. The very young,
pre-teens, and teenagers all need different approaches in dealing
with their behavior, guiding their dental growth and development,
and helping them avoid future dental problems. The pediatric dentist
is best qualified to meet these needs. Back to the
Top
WHY ARE THE PRIMARY TEETH SO IMPORTANT?
It is very important to maintain the health
of the primary teeth. Neglected cavities can and frequently do
lead to problems which affect developing permanent teeth. Primary
teeth, or baby-teeth are important for (1) proper chewing and
eating, (2) providing space for the permanent teeth and guiding
them into the correct position, and (3) permitting normal development
of the jaw bones and muscles. Primary teeth also affect the development
of speech and add to an attractive appearance. While the front
4 teeth last until 6-7 years of age, the back teeth (cuspids and
molars) aren't replaced until age 10-13. Back to the
Top
WHEN WILL MY BABY START GETTING TEETH?
Teething, the process of baby (primary)
teeth coming through the gums into the mouth, is variable among
individual babies. Some babies get their teeth early and some
get them late. In general the first baby teeth are usually the
lower front (anterior) teeth and usually begin erupting between
the age of 6-8 months. See "Eruption of Your Child's Teeth" for
more details. Back to the
Top
YOUR CHILD'S FIRST DENTAL VISIT
Your child should visit the dentist by
his/her 1st birthday. You can make the first visit to the dentist
enjoyable and positive. Your child should be informed of the visit
and told that the dentist and his staff will explain all procedures
and answer any questions. The less to-do concerning the visit,
the better.
It is best if you refrain from using words around your child that
might cause unnecessary fear, such as needle, pull, drill or hurt.
Pediatric dental offices make a practice of using words that convey
the same message, but are pleasant and non-frightening to the
child. Back to the
Top
