Saturday, 2 July 2016

Why Regular Dental Visits Are Important

Visiting the dentist regularly has many benefits, such as:

Promoting Good Oral Health

During dental visits, oral health providers ask questions to learn about the pregnant woman’s and parents’ oral health practices. For example, they may ask if the pregnant woman or child drinks fluoridated tap water or snacks frequently or if parents give the child a bottle filled with something other than water at bedtime (See Where We Stand: Fruit Juice). This information can help oral health providers deliver care and provide education to make it less likely that the woman or child will have problems later.

Teaching Children to Value Good Oral Health

Early dental visits teach a child that oral health is important. A child who is taken for dental visits early in life is more likely to have a good attitude about oral health providers and dental visits. Pregnant women who get oral health care are also more likely to take their child to get care.

Finding Oral Health Problems Early

One goal of dental visits is finding problems early. Tooth decay can be stopped or managed if it is caught early. Treating problems early keeps oral diseases from getting worse and costs less than treatment would later. Treating disease early is also important because oral disease can be transmitted from mother to baby through saliva.

How to Find a Pediatric Dentist

To find a dentist to care for your child visit the American Academy of Pediatric Dentistry web site or insurekidsnow.gov.

Additional Information:


Last Updated
2/10/2016
Source
Brush Up on Oral Health Newsletter (Copyright © 2013 The National Center on Health)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

When Children Begin to Lose their Baby Teeth

When will my child start losing his baby teeth? How can I be sure his adult teeth stay healthy?

Erupting permanent teeth cause the roots of baby teeth to be reabsorbed so that by the time they are loose there is little holding them in place besides a small amount of tissue. Most children lose their baby teeth in this order:
  • Baby teeth ordinarily are shed first at about age 6 when the incisors, the middle teeth in front, become loose.
  • Molars, in the back, are usually shed between ages 10 and 12, and are replaced with permanent teeth by about age 13.
Children usually wiggle their teeth loose with their tongues or fingers, eager to hide them under their pillow for the "tooth fairy." If your child wants you to pull out the already loose tooth, grasp it firmly with a piece of tissue or gauze and remove it with a quick twist. Occasionally, if a primary tooth is not loosening sufficiently on its own, your child's dentist may suggest extracting it.
If your child loses his baby teeth by decay or accident too early, his permanent teeth can erupt prematurely and come in crooked because of limited space. According to orthodontists, 30 percent of their cases have their origins in the premature loss of baby teeth.

Brushing and flossing

Your child may need some help brushing until he is between ages 7 and 10. Even if his intentions are good, he may not have the dexterity to clean his teeth well. Ideally, the teeth should be brushed within five minutes to 10 minutes after eating. Also, for long-term dental health, your child needs to care for his gums as well; he should be taught to floss regularly, preferably once a day, in order to help prevent gum (or periodontal) disease in adulthood.
A tartar-control toothpaste can help keep plaque from adhering to your child's teeth. Also, fluoride in the toothpaste can strengthen the exposed outer enamel of the youngster's teeth and help prevent cavities. Fluoride also has been added to the water supply in many cities. If your own tap water has less than the recommended levels of this nutrient, your pediatrician may suggest that you add fluoride to your child's diet beginning at age 6 months, often as part of a vitamin supplement. Fluoride treatment should continue until age 16. Ask your doctor or dentist for guidance.

Dental checkups

Make sure your youngster has dental checkups twice a year for cleaning, as well as for X-rays as recommended by your dentist. Parents may choose to utilize a pedodontist, a dentist with special interest and expertise in children's dentistry. Regular preventive appointments will significantly decrease your child's chances of ever having to undergo major dental treatment. Also, contact your dentist whenever your child complains of a toothache. This pain could be a sign of a decayed tooth. Until the dentist can see your child, treat the pain with acetaminophen by mouth.

Preventing cavities

Your dentist may also suggest placing sealants on your child's molars. These thin plastic coatings prevent plaque from accumulating and becoming trapped in the pits and fissures of the teeth. They are appropriate for all rear teeth that have grooves in them, and because they are extremely successful in preventing cavities, they are cost-effective too. Sealants may need to be reapplied during adolescence. With a combination of sealants and fluoride treatment, the incidence of cavities can be reduced by 90 percent.
Diet can also play a role in healthy teeth. In particular, minimize your child's contact with high-sugar and sticky sweets and other carbohydrates. Cut back on snacking on sweets between meals, when these foods are more likely to linger in the mouth without brushing.
Last Updated
11/21/2015
Source
Caring for Your School-Age Child: Ages 5 to 12 (Copyright © 2004 American Academy of Pediatrics)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Toothbrushing Tips for Young Children

Each child has different skills and needs that can guide parents in helping him or her brush.

Tips to Help Young Children Practice Brushing & Make It A Good Experience:

  • Choosing a toothbrush. Use a soft-bristled toothbrush designed for brushing an infant’s or child’s teeth.
  • Holding a toothbrush. If the child has trouble holding a toothbrush, try making the handle thicker by putting it inside a tennis ball. The toothbrush handle can also be strapped to the child’s hand with a wide rubber band, a hair band, or Velcro. Toothbrushes with thick handles can also be found in retail and discount stores.
  • Teaching the child how to brush. Break the process into small steps that the child can understand and practice. Ask a dentist, dental hygienist, occupational therapist, or early childhood specialist for help, if needed. Another way is to place a hand over the child’s hand to guide the toothbrush as the child brushes. 
  • Using toothpaste with fluoride. Use toothpaste with fluoride that the child likes and that feels good in his or her mouth. An adult should always place toothpaste on the toothbrush. 
    • For children under age 3: Use a small smear of flouride toothpaste (or an amount about the size of a grain of rice). 
    • For children ages 3–6: Use a pea-size amount of flouride toothpaste. 
    • If a child cannot spit: Have the child tilt his or her mouth down so that the toothpaste can dribble out into the sink, a cup, or a washcloth. Since the fluoride in toothpaste is clearly meant to be swishes but not swallowed, make sure to help or watch the child while brushing. When she is old enough, tell her to spit out the toothpaste after brushing.
  • Positioning the child. There are many ways a child can be positioned to make the child feel comfortable and allow an adult to brush his or her teeth. 
  • Keeping the child engaged in brushing. Use a timer, a short song, or counting as a game to encourage brushing for 2 minutes.

Additional Information:

Last Updated
11/21/2015
Source
Adapted from Brush Up on Oral Health Newsletter (Copyright © 2013 The National Center on Health)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Teeth Grinding in Children

Many children grind their teeth with a loud, grating sound while asleep.


Tooth grinding (or bruxism) is very common, particularly in toddlers and preschoolers. In most children, it goes away by 6 years, but some continue to grind their teeth into adolescence and even adulthood.

Tooth grinding doesn’t mean that your child is having a nightmare or reliving a frustrating event from the daytime. Some causes of tooth grinding include pain (for instance, from an ear infection or teething) and improper alignment of the teeth.

Although stress and anxiety can also increase tooth grinding, there is no connection between tooth grinding and problems of behavior or personality. Since it usually goes away before the permanent teeth are in, in most cases it is unlikely to damage the teeth; however, if you have any concerns, check with your child’s dentist and mention it at each regular dental check-ups.
Last Updated
11/21/2015
Source
Sleep: What Every Parent Needs to Know (Copyright © 2013 American Academy of Pediatrics)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Taking the Mystery Out of Toothbrush Storage

It’s a fact that bacteria can grow on toothbrushes after they’ve been used, especially if wet toothbrushes are kept in closed, dark places. Wet toothbrush bristles should not be covered. They should air dry.

The Centers for Disease Control and Prevention (CDC) Recommends:

After brushing, it’s best to rinse toothbrushes with water to clean off remaining toothpaste and small pieces of food. Then the toothbrushes should be stored in an upright position to air dry. If several toothbrushes are stored in the same holder, make sure there is enough space between the toothbrushes so that they do not touch each other. Remember to label each toothbrush with the child’s name.
Do not soak toothbrushes in bleach water or other disinfecting solutions. And toothbrushes do not need to be placed in dishwashers, microwaves, or ultraviolet devices to disinfect them. These methods may damage the toothbrushes.

Additional Information: 

Last Updated
11/21/2015
Source
Brush Up on Oral Health Newsletter (Copyright © 2012 The National Center on Health)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Oral Health Challenges for Children with Disabilities

Some children with disabilities have challenges that affect their oral health. These challenges may include:
  • Children with physical disabilities, such as cerebral palsy, may not have the motor skills needed to use a toothbrush safely or to sit still in a dental chair during dental visits.
  • Children with intellectual disabilities may not know how to brush their teeth, protect their teeth from injury, or cooperate with dental office staff while getting oral health care.
  • Children with communication disorders, such as delayed speech and language development, may not be able to tell their parents that their mouth hurts or they have a toothache.
  • Children who get frequent medical care, such as having many doctor visits or hospital stays, may be afraid of the dental office and may not cooperate during visits.
  • Children who take medicines with added sugars or that cause dry mouth are at high risk for tooth decay. Sugar is added to some medicines to make them taste better. Other medicines used to treat cerebral palsy, seizures, and depression can cause dry mouth by lowering the amount of saliva in the mouth. Saliva plays an important role in preventing tooth decay. Medicines given to children with medical diseases or disorders, such as asthma or allergies, can also cause dry mouth.
  • Children on special diets may be at high risk for developing tooth decay. Foods that are soft or high in starch (for example, potatoes or corn) stick to children’s teeth and give caries-causing bacteria in the mouth more time to cause tooth decay.

Additional Information:

  • Continuing Education: Practical Oral Health Care for People with Developmental Disabilities (NIH.gov)
Last Updated
11/21/2015
Source
Brush Up on Oral Health Newsletter (Copyright © 2013 The National Center on Health)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Mouthguards: Information for Parents

Mouthguards can help protect your child from a dental emergency. They should be worn whenever your child is participating in sports and recreational activities.

Benefit of Mouthguards

Mouthguards, also called mouth protectors, help cushion a blow to the face, minimizing the risk of broken teeth and injuries to your lips, tongue, face or jaw. They typically cover the upper teeth and are a great way to protect the soft tissues of your tongue, lips and cheek lining. Knowing how to prevent injuries like these is especially important if your child participates in organized sports or other recreational activities.
When it comes to protecting your mouth, a mouthguard is an essential piece of athletic gear that should be part of standard equipment from an early age. In fact, studies show that athletes are 60 times more likely to suffer harm to the teeth if they are not wearing a mouthguard. While collision and contact sports, such as boxing, are higher-risk sports for the mouth, you can experience a dental injury in non-contact activities too, such as gymnastics and skating.

Three Types of Mouthguards:

  • Custom-fitted. These are made by your dentist for you personally. They are more expensive than the other versions, but because they are customized, usually offer the best fit.
  • Stock. These are inexpensive and come pre-formed, ready to wear. Unfortunately, they often don’t fit very well. They can be bulky and can make breathing and talking difficult.
  • Boil and bite. These mouth protectors can be bought at many sporting goods stores and drugstores and may offer a better fit than stock mouth protectors. They are first softened in boiling water, then inserted and allowed to adapt to the shape of your mouth.
The best mouthguard is one that has been custom made for your mouth by your dentist. However, if you cannot afford a custom-fitted mouthguard, your child should still wear a stock mouthguard or a boil-and-bite mouthguard from the drugstore. If your child wears braces or another fixed dental appliance on your lower jaw, your dentist may suggest a mouth protector for these teeth as well.

A properly fitted mouthguard may be especially important for people who wear braces or have fixed bridge work. A blow to the face could damage the brackets or other fixed orthodontic appliances. A mouthguard also provides a barrier between the braces and your cheek or lips, limiting the risk of soft tissue injuries.

Talk to Your Child’s Dentist or Orthodontist

Talk to your dentist or orthodontist about selecting a mouthguard that will provide the best protection. Although mouthguards typically only cover the upper teeth, your dentist or orthodontist may suggest that your child use a mouthguard on the lower teeth if you have braces on these teeth too.
If your child has a retainer or other removable appliance, do not wear it during any contact sports.

Tips for Caring for a Mouthguard:

  • Rinse before and after each use or brush with a toothbrush and toothpaste.
  • Occasionally clean the mouthguard in cool, soapy water and rinse thoroughly.
  • Transport the mouthguard in a sturdy container that has vents.
  • Never leave the mouthguard in the sun or in hot water.
  • Check for wear and tear to see if it needs replacing.

Additional Resources:

Last Updated
11/21/2015
Source
Adapted from MouthHealthy.org (Copyright © 2013 American Dental Association)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Brushing Up on Oral Health: Never Too Early to Start

As the American Academy of Pediatrics (AAP) and other children's organizations report, tooth decay (also called early childhood caries, or ECC) is the most common chronic children's disease in the country. As a result, it is very important that parents work with their pediatrician to establish good oral health care from the first weeks of their baby's life. Although most of us think of dental care in relation to our own dentists, parents will be working closely with their pediatrician even earlier than with a dentist.
Since pediatricians see young infants and children frequently for preventive health care visits, they are in an excellent position to identify children at risk for dental health problems, coordinate appropriate care and parent education, and refer affected and high-risk children to pediatric dentists.
The Centers for Disease Control and Prevention (CDC) has stated that dental caries is five times more common than asthma and seven times more common than hay fever in children. More than 40 percent of children have tooth decay by the time they reach kindergarten. Children with dental caries in their baby teeth are at much greater risk for cavities in their adult teeth.
Health care professionals know that tooth decay is a disease that is, by and large, preventable. Because of how it is caused and when it begins, however, steps to prevent it ideally should begin prenatally with pregnant women and continue with the mother and young child, beginning when the infant is approximately 6 months of age. Pediatricians have become increasingly aware that their own proactive efforts to provide education and good oral health screenings can help prevent needless tooth decay in infants.

For parents who wish to establish good dental health for their infants, the following general guidelines may be of help:

  • Fluoride and Your Child: Fluoride is a naturally occurring mineral that is found in many foods, and it also is added to the drinking water in some cities and towns. It can benefit dental health by strengthening the tooth enamel, making it more resistant to acid attacks that can cause tooth decay. It also reduces the ability of plaque bacteria to produce acid. Check with your local water utility agency to find out if your water has fluoride in it. If it doesn't, ask your doctor if you should get a prescription for fluoride drops or chewable tablets for your child.
  • Check and Clean Your Baby's Teeth: Healthy teeth should be all one color. If you see spots or stains on the teeth, take your baby to your dentist. As soon as your child has a tooth begin to use a smear (size of a grain of rice) of fluoride toothpaste. Clean the teeth at least twice a day. It's best to clean them right after breakfast and before bedtime. Once your child turns 3 you can begin to use a pea-sized amount of fluoride toothpaste. When your child is able, teach him to spit out the excess toothpaste, but don't rinse with water. As your child gets older let her use her own toothbrush. It is best if you put the toothpaste on the toothbrush until your child is about age 6. Until children are 7 or 8 years old, you will need to help them brush. Try brushing their teeth first and then letting them finish.
  • Feed Your Baby Healthy Food: Choose drinks and foods that do not have a lot of sugar in them. Give your child fruits and vegetables instead of candy and cookies. Be careful with dried fruits, such as raisins, since they easily stick to the grooves of the teeth and can cause cavities if not thoroughly brushed off the teeth.
  • Prevent Tooth Decay: Do not put your baby to bed with a bottle at night or at naptime. (If you do put your baby to bed with a bottle, fill it only with water). Milk, formula, juices and other sweet drinks, such as soda, all have sugar in them. Sucking on a bottle filled with liquids that have sugar in them can cause tooth decay. During the day, do not give your baby a bottle filled with sweet drinks to use like a pacifier. If your baby uses a pacifier, do not dip it in anything sweet like sugar or honey. Near his first birthday, you should teach your child to drink from a cup instead of a bottle.
  • Talk With Your Pediatrician About Making a Dental Home: Since your pediatrician will be seeing your baby from the first days and weeks of life, plan to discuss when and how you should later develop a "dental home"—a dentist who can give consistent, high-quality, professional care—just as you have a "medical home" with your pediatrician. Usually, your dentist will want to see a child by his first birthday or within six months of the first tooth's emergence. At this first visit, your dentist can easily check your child's teeth and determine the frequency of future dental checkups.
Last Updated
10/3/2014
Source
Adapted from Healthy Children Magazine, Winter 2007
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances

Let the Brushing Games Begin


Since it’s going to be quite a while before your child masters toothbrushing for herself, we wanted to leave you with several practical suggestions to help you make it more fun and a matter of routine.
  • Start Early. No teeth? No problem. Simply going through the motions by regularly brushing and cleaning gums still serves a very useful purpose.
  • Brush Often. While we’ve focused thus far on bedtime brushing, technically speaking, your goal of brushing teeth is to clean food off of them, and the sooner the better. Yet few adults we know make a regular habit of brushing their teeth throughout the day. Start having your child brush after meals early in life and you stand a fighting chance of creating a lasting habit.
  • Sing, Sing a Song. Or set a timer. Or come up with some other creative way to keep your child engaged in the act of brushing her teeth for the recommended 2 minutes, or for at least as long as it takes to make sure that your combined efforts leave them clean. Some toothbrushes even light up or play music for the amount of time a child should keep brushing, preventing kids from being fooled into thinking that they’ve brushed long enough.
  • Check It Out. If your child is showing signs of independence and insists on brushing on her own, then by all means let her. Just don’t forget to get in the habit of proudly “checking out” her work at the end of each session while casually doing some touch-ups of your own.
  • Appeal to Taste. If Cinderella, the Cat in the Hat, a race car, or an electric toothbrush similar to yours has better prospects of winning your child over than you do, then by all means oblige. Feel free to indulge her tastes by letting her choose toothbrushes and toothpaste that she can really get excited about. There are also many flavored toothpastes that taste great and make it fun to brush. 
  • Hands Off. Right around the age when you’re likely to start brushing, your child is likely to start grabbing. By giving her a soft-bristled brush (or 2) of her own to have and to hold, you will be able to avoid a fight over yours—leaving you well equipped to get the job done. Sure, it may take 3 toothbrushes instead of 1, but it’s a small price to pay for a routine that really works.
  • Go Where No Child Has Gone Before. We suggest you pay particular heed (and direct your child’s attention) to those teeth that are most likely to be neglected. While you’re helping her brush, describe what you’re doing in terms she can relate to by pointing out her “biting” teeth (the chewing surfaces), her “smile teeth” (you guessed it—right in the front), and the tricky teeth in the back. Your goal— to teach your child to leave no plaque unturned.

Toothpaste Temptations

All children can benefit from fluoride, but it’s important to use the right amount of toothpaste. Current recommendations advise using a smear of fluoride toothpaste (or an amount about the size of a grain of rice) for children younger than 3 and a pea-sized amount for children 3 to 6. Since the fluoride found in toothpaste is clearly meant to be swished but not swallowed, make sure to help or watch the child while brushing. When she is old enough, tell her to spit out the toothpaste after brushing. ​
Author
Laura A. Jana, MD, FAAP and Jennifer Shu, MD, FAAP
Last Updated
11/21/2015
Source
Adapted from Food Fights, 2nd Edition (Copyright © 2012 American Academy of Pediatrics)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

How Knowledge, Attitudes & Beliefs Affect Oral Health

Knowledge, attitudes, and beliefs can affect oral health in a variety of ways. For example:
  • Lack of knowledge and beliefs about primary teeth can affect willingness to seek oral health care for children.
  • Beliefs about what causes oral disease and how to prevent it can influence attitudes about adopting good oral care habits and seeking oral health care before pain occurs.
  • Fear, whether from community beliefs or from personal bad experiences, can influence attitudes about where and how to get oral health care.
  • Health and safety concerns carried from immigrants’ countries of origin impact their willingness to use readily accessible resources for good oral health such as drinking fluoridated tap water.
  • Myths and rumors combined with language barriers can prevent parents from embracing proven recommendations such as brushing a child’s teeth with a smear of fluoridated toothpaste as soon as the first tooth appears.

Additional Information on other site :

Healthy Teeth and Your Child's Diet

Besides regular toothbrushing, your child's diet will play a key role in his dental health.

Why Sugar is the Big Villain

The longer and more frequently his teeth are exposed to sugar, the greater the risk of cavities. "Sticky sugar" foods such as sticky caramel, toffee, gum, and dried fruit—particularly when it stays in his mouth and bathes his teeth in sugar for hours—could do serious damage.
  • Make sure to always brush your child's teeth after a sugary food item.
  • Do not allow young children to have any sugar-containing liquid in a sippy cup for a prolonged period. See How to Prevent Tooth Decay in Your Baby.

How to Cut Down on Sweets

Almost everyone naturally enjoys sweets, and your child is no different. Like other human beings, she was born with a taste for sugar, and she's already quite sensitive to different concentrations of sweetness. Offer her a yam and a baked potato, and she'll take the yam every time. Give her a choice between the yam and a cookie, and the cookie will win.
Rest assured, it's not your fault if she makes a beeline for the candy and ice cream when you'd rather she take a piece of cheese. But it is your responsibility to limit her access to sweets and to provide a diet made up primarily of more nutritious foods that promote growth, not tooth decay.

TV advertising

Television advertising, incidentally, can be a serious obstacle to your child's good nutrition. Some studies show that children who watch over twenty-two hours of TV per week (over three hours of screen time a day) have a greater tendency to become obese. Children are extremely receptive to ads for sugary cereals and sweets, especially after they've visited other homes where these foods are served. Obesity is a growing problem among children in America. For this reason, you need to be aware of your young child's eating habits, at home and away, and monitor them to make sure she's eating as healthy as possible.

At home

To combat outside influences, keep your own home as healthy as possible. Stock up on low-sodium, low-sugar, and low-fat products. Eventually he'll become accustomed to healthful foods, which may make him less susceptible to the temptation of the more sugary, salty, or greasy ones.

Healthy Children Radio: Your Teen's Beautiful Smile and Fresh Breath

Adriana Segura DDS, MS, FAAP answers hot questions such as:
  • How can parents help teens bring a healthy smile into adulthood?
  • Does what they eat matter?
  • What is fluoride varnish, and what does it do for kids?
  • Why are x-rays needed, and how often should they be done?
  • When your child needs braces, what are the options?
Dr. Segura is a professor in the Department of Comprehensive Dentistry and the Department of Pediatrics at the University of Texas Health Science Center at San Antonio (UTHSCSA) and is currently the Associate Dean of Student Affairs.

Good Reasons to Smile

A healthy mouth and teeth are an important part of a child’s wellness. So when should a child go in for his first dental exam? What’s the best way to take care of a baby’s teeth? How can you build good dental habits with your children, regardless of their ages? Here’s what you need to know.
Do you remember learning how to take care of your teeth as a child? Perhaps there was an upbeat rhyme that kept you on task when brushing, or maybe cartoon images of milk come to mind. Maybe you’re old enough to remember those red tablets that, once chewed, showed where you missed brushing. Though this time marked a turning point in your independence, the road to your oral health began much sooner.
Even babies’ mouths can develop a buildup of damaging bacteria along the gums, a problem that can be preventing by wiping them with a soft, damp cloth after feedings. Some of the advice pediatricians include in a total wellness plan also speaks to keeping baby’s mouth and teeth healthy. Nutritional needs come into play. And for all the advice you might have received about helping your child sleep by putting her to bed with a bottle, this is perhaps the biggest contributor to preventable decay and early cavities.
“In our clinic at Duke Children’s Hospital, we see children under age 3 every week with significant tooth decay. Restoring these teeth to a healthy state is not only emotionally challenging for the child but a major financial burden to the family,” says Martha Ann Keels, DDS, Ph.D., a pediatric dentist in Durham, N.C., who treats baby bottle tooth decay.  Getting Dental Help
Healthy teeth are crucial for speaking and for chewing solid food. Whether you’re in the midst of the long nights that might accompany infant teething or your child has a full set of pearly whites, it’s a good idea to brush up on just what to do next.
And according to Dr. Keels, there’s now consensus among four major national entities all recommending that children should have an oral health risk assessment by their first birthday.
A child’s first trips to a pediatric dentist can give parents good guidance for taking care of a child’s teeth, gums, and mouth. It’s a good time to find out how to encourage your child to be proactive about dental hygiene, and get answers to your questions about everything from feeding to using pacifiers.
The dentist also will explain how to spot potential problems, such as the white chalky spots that indicate dental caries, an early dental disease. According to Dr. Keels, caries is the most common problem diagnosed in young patients. “Parents need to know that the white spot lesions are reversible — they can be re-mineralized with a combination of remedies, such as diet changes and fluoride varnish,” explains Dr. Keels. “If the white spot is left unattended, it may quickly advance into an irreversible cavity.”Peace of Mind
Even for adults who haven’t been faithful in getting their own routine checkups, parents often want what’s best for their children, and this includes getting appropriate dental care. Adding a dental professional as a resource to your support system can provide ongoing peace of mind for your entire family.
Dr. Keels relates her experience of examining a 12-month-old for the first time on a recent morning. Later that same day, the child fell and pushed her teeth up into her gums.
“It is not uncommon for a toddler to fall and have dental trauma when learning to walk. In the scenario where the child already has a dental home at age one, that family knows where to go for help,” says Dr. Keels. “In the scenario where they have not seen a dentist yet, it will be doubly stressful to find a provider.”

Finding the Right Dentist

David M. Krol, M.D., FAAP, associate professor and chair of pediatrics at University of Toledo College of Medicine, says that he “wholeheartedly” supports an oral health risk assessment by one year of age. It’s the best way to build knowledge about how to care for a child’s teeth, and to build the good habits that are key to prevention, he says. “This is the ideal, as children will hopefully be connecting with a dental home before they need any serious intervention and can develop a strong and positive relationship with a dentist,” Dr. Krol points out.
Experts suggest that you approach locating a pediatric dentist with the same seriousness and energy you invested when finding a primary care physician. Obtain names of area pediatric dentists from trusted friends, professionals, and health organizations. Your child’s existing pediatrician, along with your own research on the Internet and through your dental insurance provider, can serve as solid starting points, too.
Dr. Krol advises parents to ask themselves some simple questions after selecting a pediatric dentist for a first-year visit, such “How does the dentist interact with children? Will they see the same dentist each time they come in?” Most importantly, he points out, parents should not underestimate their own comfort level when committing to a regular dental provider.

The Exam: What to Expect

Almost all pediatric dentists will perform a thorough exam of the mouth and teeth while the child is comfortably situated on the parent’s tap. Using a lap pillow as a prop, some dentists may have the child lean back onto the pillow while holding his parent’s hands.
As further comfort to hesitant moms and dads, Dr. Keels says, “I reassure parents that it is completely normal for the child to get upset with having to lean backwards, but that the exam is very quick and the toddlers quickly recover once the child is allowed to sit up.”
If you’re at all worried about the prospects of a squirmy baby or rambunctious toddler in a quiet office setting, you’re not alone. It might help to remember that you are seeking the expertise of a professional whose career is dedicated to working with kids. A pediatric dentist receives an additional two to three years of specialized training over that of a non-specialized dentist. And while maintaining a toy-filled waiting room might not be necessary to obtaining credentials, it most certainly is the norm.

The Golden Rules for Raising Cavity-free Kids

  • Support good dental health by taking care of your child’s gums and teeth on a daily basis. Once the child is old enough to “do it by herself,” continue monitoring daily habits and self-care.
  • Be selective about any type of beverage you put in your child’s bottle or sippy cup besides water. Remember, dentists often refer to juice and soda as “liquid candy.”
  • Keep a bottle or sippy cup away from your child’s naptime and nighttime slumbers. Liquids tend to stick to the teeth because the mouth is drier during sleep.
  • Reward children with hugs, stickers, and toys instead of desserts and candy. Sugary foods leave behind a sticky coating that converts to harmful bacteria and enamel-eating acid. But if you feel compelled to give your child an occasional sweet, choose one that melts rapidly instead of gummy candy.
  • Serve up calcium-rich foods such as yogurt, cheese, and milk, along with plenty of vitamin-heavy vegetables to help your child maintain strong, healthy teeth. Build good habits early by giving your child healthy treats in place of sweets at snack time.
  • Talk to your child’s pediatrician or dentist about the appropriate amount of fluoride your child needs.

Fluorosis Facts: Information Parents & Caregivers

Fluoride is an important mineral for all children. Our mouths contain bacteria that combine with sugars in the foods we eat and the beverages we drink. The acid that is produced harms tooth enamel and damages teeth. Fluoride protects the teeth and can even help reverse early signs of decay. But the increased availability of fluoride today has resulted in more of something called dental fluorosis.

What is Dental Fluorosis?

Dental fluorosis is a change in the appearance of the tooth's enamel surface. The most common types do not affect the function of the tooth and don't cause pain.
Most dental fluorosis is either very mild or mild. Mild forms of fluorosis appear as white, lacy markings on the tooth's enamel and are difficult to see with the untrained eye.
Fewer instances of fluorosis are categorized as moderate. Moderate fluorosis looks just like mild but covers more of the tooth.
In rare cases, fluorosis is described as severe. When fluorosis is severe, the enamel may have pitting and brown spots.

What Causes Dental Fluorosis?

Dental fluorosis is caused by consuming too much fluoride over the period of time when teeth are forming but before they appear in the mouth. This takes place before 8 years of age. To avoid this possibility, supervise brushing so that children do not use too much toothpaste, mouthwash, or mouthrinse and learn to spit, not swallow.

How Much Fluoride Should My Child Have to Protect His Teeth Without the Risk of Fluorosis?

Children who consume a typical diet, drink fluoridated water, and use fluoridated dental products properly will get the fluoride they need for healthy teeth. It is not necessary to monitor water or food consumption since your child ingests low levels of fluoride from these sources. Parents will want to ensure that children do not swallow toothpaste or mouthrinse, which contain more concentrated amounts of this important mineral.

How Do I Know if My Child Has Dental Fluorosis?

Since there are many possible causes of changes in the appearance of the teeth, you may want to see a dental professional to have the teeth checked for fluorosis or other issues. The American Academy of Pediatrics recommends that all children begin regular visits to the dentist by their first birthday. Ask your pediatrician's office if they offer referrals.

Sources of Fluoride

  • Beverages, including fluoridated tap water
  • Foods processed with fluoridated water
  • Toothpaste and other oral care products
  • Topical fluoride & dietary supplements

How Do I Protect My Child's Teeth without Causing Fluorosis?

Here are three things you can do:

1.       Follow these guidelines on the proper use of dental products such as toothpaste. Children under the age of 6 should avoid the use of mouthwash and mouthrinse. 
  • Children younger than age 3 should use a "smear" of toothpaste containing fluoride.
  • Limit tooth brushing to 2 times a day for this age group.
  • Children aged 3-6 years should use a slightly larger, "pea-sized" amount of toothpaste containing fluoride.
  • Supervise and help young children with tooth brushing. Since most young children will instinctively swallow water, they should be encouraged to spit out excess toothpaste, but not rinse with water.
  • Keep all dental products out of the reach of young children to avoid accidental ingestion.
2.       Determine whether your primary source of water is fluoridated.
  • For information on local water systems see the CDC My Water's Fluoride.
  • For information on well water, see Private Well Water & Fluoride.
  • Most bottled water in the U.S. does not contain an optimal level of fluoride.
  • If your water is not fluoridated, speak to your child's doctor or dentist about ways to ensure your family is getting enough fluoride from other sources.
3.       Start regular visits to the dentist by your child's first birthday. If you do not have a dentist yet, your child's doctor can refer you to a dental home. He can also check her teeth, talk to you about taking care of her oral health, and make sure she is getting enough fluoride.

What about Infant Formula?

According to the American Dental Association, it is safe to mix infant formula with fluoridated water.

Not All Sugars are Sweet!

Starchy foods, including snacks kids like such as pretzels, crackers, and chips, contain sugars, and sugar contributes to tooth decay!
Limit sweet and salty snacks, and offer water instead of sweetened beverages like soda pop and juice.

Fluoride Varnish: What Parents Need to Know

Healthy gums and teeth are important to your child's overall health. This is why your child's doctor will talk with you about good dental habits even before your child's first tooth appears.
Once your child has a tooth, your doctor may recommend that your child receive fluoride varnish treatments in the pediatrician's office to help prevent tooth decay. This can be done 2 to 4 times per year. The number of treatments depends on how likely it is that your child may get a cavity.
Pediatricians are trained to apply fluoride varnish because many young children do not see or have access to a dentist until they are older. If your child is seeing a dentist at a young age, as recommended by the American Academy of Pediatrics, fluoride varnish may be applied in a dental office instead.
Read on for more information from the American Academy of Pediatrics about fluoride varnish.

What is Fluoride Varnish?

Fluoride varnish is a dental treatment that can help prevent tooth decay, slow it down, or stop it from getting worse. Fluoride varnish is made with fluoride, a mineral that can strengthen tooth enamel (outer coating on teeth).
Keep in mind that fluoride varnish treatments cannot completely prevent cavities. Fluoride varnish treatments can best help prevent decay when a child is also brushing using the right amount of toothpaste with fluoride, flossing regularly, getting regular dental care, and eating a healthy diet.

Is Fluoride Varnish Safe?

Fluoride varnish is safe and used by dentists and doctors all over the world to help prevent tooth decay in children. Only a small amount is used, and hardly any fluoride is swallowed. It is quickly applied and hardens. Then it is brushed off after 4 to 12 hours.
Some brands of fluoride varnish make teeth look yellow. Other brands make teeth look dull. However, the color of your child's teeth will return to normal after the fluoride varnish is brushed off. Most children like the taste.

How is Fluoride Varnish Put on the Teeth?

Fluoride varnish is painted on the top and sides of each tooth with a small brush. It is sticky but hardens once it comes in contact with saliva. Your child may feel the hardened varnish with his tongue but will not be able to lick the varnish off.
It does not hurt when the varnish is applied. However, young children may still cry before or during the procedure. Fortunately, brushing on the varnish takes only a few minutes. Also, applying the varnish may be easier when a child is crying because his mouth will be slightly open.
You may be asked to hold your child in your lap while you are placed knee-to-knee with the person applying the varnish.

How Do I Care for My Child's Teeth After Fluoride Varnish is Applied?

Here are general guidelines on how to care for your child's teeth after fluoride varnish is applied. Check with your child's doctor for any other special instructions. 

  • Your child can eat and drink right after the fluoride varnish is applied. But only give your child soft foods and cold or warm (not hot) foods or liquids.
  • Do not brush or floss teeth for at least 4 to 6 hours. Your child's doctor may tell you to wait until the next morning to brush or floss. Remind your child to spit when rinsing, if he knows how to spit.

Remember:

Steps to good dental health include: 

  • Regular care by a dentist trained to treat young children
  • Getting enough fluoride
  • Regular brushing and flossing
  • Eating right
The American Academy of Pediatrics recommends that all infants receive oral health risk assessments by 6 months of age. Infants at higher risk of early dental caries should be referred to a dentist as early as 6 months of age and no later than 6 months after the first tooth erupts or 12 months of age (whichever comes first) to establish their dental home. Every child should have a dental home established by 12 months of age.

FAQ: Fluoride and Children

Fluoride from drinking water and other sources such as toothpaste can strengthen tooth enamel and help prevent tooth decay. Below is a list of questions that parents frequently ask about fluoride and how it can help their children.

Q: Why do children need fluoride?

A: Fluoride is an important mineral for all children. Bacteria in the mouth combine with sugars and produce acid that can harm tooth enamel and damage teeth. Fluoride protects teeth from acid damage and helps reverse early signs of decay. Make sure your children are drinking plenty of water and brushing with toothpaste that has fluoride in it.

Q: Is fluoridated water safe for my children?

A: Yes. The American Academy of Pediatrics (AAP), along with the American Dental Association (ADA) and the Centers for Disease Control and Prevention (CDC), agree that water fluoridation is a safe and effective way to prevent tooth decay

Q: Should I mix infant formula with fluoridated water?

A: According to the ADA, it is safe to use fluoridated water to mix infant formula. The risk if mixing infant formula with fluoridated water is mild fluorosis (see below for more information on this condition). However, if you have concerns about this, talk with your pediatrician or dentist.

Q: What if I prefer not to use fluoridated water for infant formula?

A: If you prefer not to use fluoridated water with formula, you can:
  • Breastfeed your baby.
  • Use bottled or purified water that has no fluoride with the formula.
  • Use ready-to-feed formula that does not need water to be added.

Q: What if we live in a community where the water is not fluoridated? What can we do?

A: Check with your local water utility agency to find out if your water has fluoride in it. If it doesn't, ask your pediatrician or dentist if your child is at HIGH risk for dental caries (also known as tooth decay or a cavity). He or she may recommend you buy fluoridated water or give you a prescription for fluoride drops or tablets for your child.

Q: How else can my child get fluoride?

A: There are many sources of fluoride. Fluoridated water and toothpaste are the most common. It is also found in many foods and beverages. So making sure your child eats a balanced diet with plenty of calcium and vitamin D is a great way to keep teeth healthy. Your dentist or pediatrician may also recommend a topical fluoride treatment during well child or dental visits at various stages of your child's development.

Q: When should my child start using fluoride toothpaste?

A: The AAP and the ADA recommend using a "smear" of toothpaste on children once the first tooth appears and until your child is 3. Once your child has turned 3, a pea-sized amount can be used.

Q: What is dental fluorosis and will fluoridated water mixed with infant formula increase the risk?

A: Although using fluoridated water to prepare infant formula might increase the risk of dental fluorosis, most cases are mild.
Fluorosis usually appears as very faint white streaks on the teeth. Often it is only noticeable by a dental expert during an exam. Mild fluorosis is not painful and does not affect the function or health of the teeth.
Once your child's adult teeth come in (usually around age 8), the risk of developing fluorosis is over.

Diet Tips to Prevent Dental Problems

A balanced diet, with plenty of calcium and vitamin D to increase calcium absorption, should provide all the nutrients necessary to build strong teeth and keep gums and mouth tissues healthy. Young people can get adequate calcium from 3 or 4 daily servings of dairy foods, as well as from many other sources (eg, calcium-processed tofu, calcium-fortified orange juice, green vegetables such as broccoli).

The Benefits of Fluoride

Fluoride reduces dental decay by making the enamel harder, reducing the ability of bacteria to produce acid that erodes enamel, and by replacing minerals in the teeth after they have been lost. In areas where the natural fluoride content of the water is low and water supplies are not fluoridated, or if your household uses bottled or reverse osmosis filtered water, pediatricians and dentists may advise fluoride supplements, fluoride toothpaste, or fluoride treatments to strengthen children’s tooth enamel against decay. Most bottled water does not contain adequate amounts of fluoride. Home water treatment systems like reverse osmosis and distillation units remove much of the fluoride from tap water. However, carbon or charcoal water filtration systems generally do not remove substantial amounts of fluoride.

Too Much Fluoride & Fluorosis

One of the complications of too much fluoride is dental fluorosis. Fluorosis ranges from minor white lines that run across the teeth to a chalky appearance of the teeth with brown staining. Fluorosis can be caused by prescribing fluoride supplements in communities with fluoridated water, or young children swallowing fluoridated toothpaste. To avoid this latter problem, children should use no more than a smear of fluoridated toothpaste before age 2, if your child’s pediatrician or dentist suggests using fluoridated toothpaste. For children older than age 2, use only a small pea-sized amount of fluoridated toothpaste. Also, your pediatrician or pediatric dentist will know the fluoride content of your local water and can advise you if a supplement is necessary or excessive.

Damaging Sugars

All sugars promote the growth of mouth bacteria that produce acid and cause tooth decay. Unrefined sugars such as honey, maple syrup, and molasses are just as damaging as refined white sugar in this respect. The worst offenders are the sugars in sticky foods that cling to teeth, such as dried fruit leathers and candies. Sodas and sweetened juice drinks leave the teeth awash in sugar. Cereals and other starchy foods, such as popcorn, leave a residue that bacteria rapidly convert to sugar.

Dental Sealants for Children

Sealants are a fast and easy way of protecting your child’s teeth that act as barriers to cavity-prone areas. They are usually applied to the chewing surfaces of back teeth and sometimes used to cover deep pits and grooves. Both primary and permanent teeth can benefit from sealants.

Toothbrushes Cannot Reach Everything

Thorough brushing and flossing help remove food particles and plaque from smooth surfaces of teeth. But toothbrush bristles cannot reach all the way into the depressions and grooves to extract food and plaque. Sealants protect these vulnerable areas by "sealing out" plaque and food.

About Sealants

Sealants are easy for your dentist to apply. The sealant is painted onto the tooth enamel, where it bonds directly to the tooth and hardens. This plastic resin bonds into the depressions and grooves (pits and fissures) of the chewing surfaces of back teeth. The sealant acts as a barrier, protecting enamel from plaque and acids. As long as the sealant remains intact, the tooth surface will be protected from decay. Sealants hold up well under the force of normal chewing and may last several years before a reapplication is needed. During your regular dental visits, your dentist will check the condition of the sealants and reapply them when necessary.
The likelihood of developing pit and fissure decay begins early in life, so children and teenagers are obvious candidates. But adults can benefit from sealants as well.

Key Ingredients in Preventing Tooth Decay and Maintaining a Healthy Mouth:

  • Brushing twice a day with an ADA-accepted fluoride toothpaste
  • Cleaning between the teeth daily with floss or another interdental cleaner
  • Eating a balanced diet and limiting snacks
  • Visiting your dentist regularly
Ask your dentist about whether sealants will help your child.

Dental Health and Orthodontic Problems

Dental Health

Twin studies conducted by the Centers for Disease Control and Prevention show that the average U.S. adolescent of the 1970s had six or seven cavities; his 1990s counterpart, just three. Today’s teenagers are twice as likely to return from the dentist and report, “Look, Ma, no cavities!”—to quote a famous toothpaste commercial of yesteryear.
Dr. Jim Steiner, director of pediatric dentistry at Children’s Hospital in Cincinnati, Ohio, attributes the improvement in young people’s dental health primarily to increased access to fluoridation. “Fluoride reduces tooth decay as well as slows down the decaying process,” he explains. “More than 95 percent of all toothpastes now have fluoride in them, and about 65 percent of our population drinks fluoridated water.”
A related advance is the use of dental sealants, clear or white thin plastic coatings that can be painted onto permanent teeth. As Dr. Steiner explains, “Fluoride protects the areas between the teeth. But it can’t always reach the chewing surfaces of the back molars.” Sealants fill the tiny pits and grooves of those teeth, the site of most cavities. Second molars typically arrive around age twelve. One sealant application costs roughly half the price of a filling.
Teens who do develop cavities have less reason to dread the dentist’s chair than you might have when you were their age. New dental instruments such as the laser and the air abrasion unit make getting fillings virtually painless. Laser therapy doesn’t require anesthesia. Nor do many treatments with the air abrasion handpiece, which resembles a tiny sandblaster. However, the devices can’t be used in all situations, so don’t expect to see the high-speed drill become obsolete anytime soon.
Another advance of interest to young patients is cosmetic. Beside the traditional silver-colored metal alloy used to fill cavities, a composite material can be used so that the color can be tinted to match the teeth.

Orthodontic Problems

Crooked teeth, overbites and underbites are best corrected with braces during puberty, while the facial bones are still growing. These are usually inherited traits, although some orthodontic problems stem from injuries, years of thumb-sucking or losing one’s baby teeth earlier or later than normal.

How Orthodontic Problems Are Diagnosed

  • Oral examination and thorough medical/dental history
  • X rays of mouth and head
  • Photos of face and teeth
  • Plaster models of the teeth are made

How Orthodontic Problems are Treated

If you were a “metal mouth” as a teenager, you’ll immediately notice that modern dental appliances are less conspicuous than the braces you wore. “Years ago,” says Dr. Jim Steiner, director of pediatric dentistry at Children's Hospital in cincinnati, Ohio, “the silver bands that hold the wires had to be placed around all the teeth. That’s no longer done. Nowadays we might band only the first and second molars, and bond brackets directly to the rest of the teeth.” The brackets can be colored to match the teeth. They also come in a clear material, as well as metal. Some patients may be candidates for “invisible braces,” which are worn on the inside of the teeth.
On average, youngsters can expect to wear the appliances for about two years. During that time, they return to the orthodontist on a monthly basis. The doctor will usually tighten the wires at these appointments, in order to increase the tension on the teeth. Any discomfort or soreness afterward can usually be alleviated with an over-the-counter pain reliever.
When braces alone aren’t sufficient to straighten the teeth, a child may have to wear a night brace to bed, to apply pressure externally. Two prongs on the headgear are inserted into a pair of cylinder-shaped metal receptacles constructed on the outer surface of the back molars. Then an elastic band wraps around the back of the head to keep the apparatus in place. Understandably, teens usually aren’t too happy about having to put on the night brace, but parents can reassure them that this is a temporary measure.
After the orthodontist removes the braces, the young person is given a removable retainer to wear for the next six to twelve months in order to maintain the alignment of the teeth. The simple device consists of a metal wire attached to a plastic plate that has been conformed to fit against the roof of the mouth.

Dental Health & Hygiene for Young Children

As you might guess, the number-one dental problem among preschoolers is tooth decay.
  • One out of 10 two- year-olds already have one or more cavities
  • By age three, 28% of children have one or more cavities
  • By age five, nearly 50% of children have one or more cavities
Many parents assume that cavities in baby teeth don't matter, because they'll be lost anyway. But that's not true. Dental decay in baby teeth can negatively affect permanent teeth and lead to future dental problems.

Teaching Good Dental Habits

The best way to protect your child's teeth is to teach him good dental habits. With the proper coaching he'll quickly adopt good oral hygiene as a part of his daily routine. However, while he may be an enthusiastic participant, he won't yet have the control or concentration to brush his teeth all by himself. You'll need to supervise and help him so that the brush removes all the plaque—the soft, sticky, bacteria- containing deposits that accumulate on the teeth, causing tooth decay. Also, keep an eye out for areas of brown or white spots which might be signs of early decay.

Toothbrushing

As soon as your child has a tooth you should be helping your child brush her teeth two times a day with a smear (size of a grain of rice) of fluoride toothpaste on a child-sized toothbrush that has soft bristles. There are brushes designed to address the different needs of children at all ages, ensuring that you can select a toothbrush that is appropriate for your child.

Amount of Toothpaste

At age 3, you can start using a pea-size amount of fluoride toothpaste, which helps prevent cavities. If your child doesn't like the taste of the toothpaste, try another flavor. Also try to teach your child not to swallow it, although at this age they are often still too young to learn to rinse and spit. Swallowing too much fluoride toothpaste can make white or brown spots on your child's adult teeth.

Brushing Motion

You'll hear all kinds of advice on whether the best brushing motion is up and down, back and forth, or around in circles. The truth is that the direction really doesn't matter. What's important is to clean each tooth thoroughly, top and bottom, inside and out. This is where you'll encounter resistance from your child, who probably will concentrate on only the front teeth that he can see. It may help to turn it into a game of "find the hidden teeth." Incidentally, a child cannot brush his teeth without help until he's older—about six to eight years old. So be sure to supervise or do the actual brushing if necessary.

Too Much Sugar

Besides regular toothbrushing with the right amount of fluoride toothpaste, your child's diet will play a key role in his dental health. And, of course, sugar is the big villain. The longer and more frequently his teeth are exposed to sugar, the greater the risk of cavities. "Sticky sugar" foods such as sticky caramel, toffee, gum, and dried fruit—particularly when it stays in his mouth and bathes his teeth in sugar for hours—could do serious damage. Make sure to always brush your child's teeth after a sugary food item. In addition, do not allow your child to have any sugar-containing liquid in a sippy cup for a prolonged period.

Dental Checkups

During regular well-child visits, the pediatrician will check your child's teeth and gums to ensure their health. If she notices problems, she may refer your child to a pediatric dentist (pedodontist) or a general dentist with an interest in treating the dental needs of children. Both the American Academy of Pediatrics and the American Academy of Pediatric Dentistry recommend that all children see a pediatric dentist and establish a "dental home" by age one.
As part of her dental checkup the dentist will make sure all teeth are developing normally and that there are no dental problems and give you further advice on proper hygiene. She also may apply a topical fluoride solution to provide extra protection against cavities. If you live in an area where the water is not fluoridated, she may prescribe fluoride drops or chewable tablets for your toddler. For more guidance on fluoride supplements, talk to your pediatrician.

Brushing Up on Oral Health: Never Too Early to Start

As the American Academy of Pediatrics (AAP) and other children's organizations report, tooth decay (also called early childhood caries, or ECC) is the most common chronic children's disease in the country. As a result, it is very important that parents work with their pediatrician to establish good oral health care from the first weeks of their baby's life. Although most of us think of dental care in relation to our own dentists, parents will be working closely with their pediatrician even earlier than with a dentist.
Since pediatricians see young infants and children frequently for preventive health care visits, they are in an excellent position to identify children at risk for dental health problems, coordinate appropriate care and parent education, and refer affected and high-risk children to pediatric dentists.
The Centers for Disease Control and Prevention (CDC) has stated that dental caries is five times more common than asthma and seven times more common than hay fever in children. More than 40 percent of children have tooth decay by the time they reach kindergarten. Children with dental caries in their baby teeth are at much greater risk for cavities in their adult teeth.
Health care professionals know that tooth decay is a disease that is, by and large, preventable. Because of how it is caused and when it begins, however, steps to prevent it ideally should begin prenatally with pregnant women and continue with the mother and young child, beginning when the infant is approximately 6 months of age. Pediatricians have become increasingly aware that their own proactive efforts to provide education and good oral health screenings can help prevent needless tooth decay in infants.

For parents who wish to establish good dental health for their infants, the following general guidelines may be of help:

  • Fluoride and Your Child: Fluoride is a naturally occurring mineral that is found in many foods, and it also is added to the drinking water in some cities and towns. It can benefit dental health by strengthening the tooth enamel, making it more resistant to acid attacks that can cause tooth decay. It also reduces the ability of plaque bacteria to produce acid. Check with your local water utility agency to find out if your water has fluoride in it. If it doesn't, ask your doctor if you should get a prescription for fluoride drops or chewable tablets for your child.
  • Check and Clean Your Baby's Teeth: Healthy teeth should be all one color. If you see spots or stains on the teeth, take your baby to your dentist. As soon as your child has a tooth begin to use a smear (size of a grain of rice) of fluoride toothpaste. Clean the teeth at least twice a day. It's best to clean them right after breakfast and before bedtime. Once your child turns 3 you can begin to use a pea-sized amount of fluoride toothpaste. When your child is able, teach him to spit out the excess toothpaste, but don't rinse with water. As your child gets older let her use her own toothbrush. It is best if you put the toothpaste on the toothbrush until your child is about age 6. Until children are 7 or 8 years old, you will need to help them brush. Try brushing their teeth first and then letting them finish.
  • Feed Your Baby Healthy Food: Choose drinks and foods that do not have a lot of sugar in them. Give your child fruits and vegetables instead of candy and cookies. Be careful with dried fruits, such as raisins, since they easily stick to the grooves of the teeth and can cause cavities if not thoroughly brushed off the teeth.
  • Prevent Tooth Decay: Do not put your baby to bed with a bottle at night or at naptime. (If you do put your baby to bed with a bottle, fill it only with water). Milk, formula, juices and other sweet drinks, such as soda, all have sugar in them. Sucking on a bottle filled with liquids that have sugar in them can cause tooth decay. During the day, do not give your baby a bottle filled with sweet drinks to use like a pacifier. If your baby uses a pacifier, do not dip it in anything sweet like sugar or honey. Near his first birthday, you should teach your child to drink from a cup instead of a bottle.
  • Talk With Your Pediatrician About Making a Dental Home: Since your pediatrician will be seeing your baby from the first days and weeks of life, plan to discuss when and how you should later develop a "dental home"—a dentist who can give consistent, high-quality, professional care—just as you have a "medical home" with your pediatrician. Usually, your dentist will want to see a child by his first birthday or within six months of the first tooth's emergence. At this first visit, your dentist can easily check your child's teeth and determine the frequency of future dental checkups.

Brush, Book, Bed: How to Structure Your Child’s Nighttime Routine

Brush, Book, Bed, a program of the American Academy of Pediatrics (AAP), has a simple and clear message for parents:
  1. Each night, help your children to brush their teeth.
  2. Read a favorite book (or two)!
  3. Get to bed at a regular time each night.
Having a predictable nighttime routine will help them understand and learn to expect what comes next. Additionally, routines may ease the stress that some families experience at nighttime.
The resources below will help you get started with your child's Brush, Book, Bed routine!

All young children need help with brushing from an adult to make sure a good job is done. When possible, teach children to spit out extra toothpaste, but don't rinse with water first. The little bit of toothpaste left behind is good for their teeth! Once teeth touch, they can also be flossed. Visit your dentist regularly starting with your child's first birthday or sooner if there are concerns. Your pediatrician can answer questions about oral health, too. Remember, the last thing to touch the teeth before bed is the toothbrush!
  • As soon as baby is born, you can start good oral health practices. If possible, use a soft washcloth to wipe your baby's gums after feedings. Remember not to put babies to bed with a bottle filled with milk. And, when it is time to introduce solids, choose healthy foods to reduce the risk of tooth decay
  • For children under age 3: As soon as you see a tooth in your baby's mouth you can start to BRUSH! Use a smear (grain of rice) of toothpaste with fluoride 2 times per day.
  • For children ages 3–6: Use a pea-sized amount of fluoride toothpaste. It is OK to let them practice with the brush, but you get your turn too.

After toothbrushing and before bed, find a comfortable spot to sit and read with your child. Spending some time, even just 15 minutes each day, to read aloud together will help improve your child's language development and social-emotional skills. Make up your own stories, use silly voices, sing songs, and just enjoy this special bonding time with your child. Visit your local library or bookstore, and give your child the opportunity to explore different kinds of books.
Remember, it is never too early to share books with your child. As your child ages, so will the kind of books he or she enjoys. Take a look at these tips for sharing books with your child at each stage of development!
  • 6 to 8 Month Olds
  • 9 to 11 Month Olds
  • 12 to 14 Month Olds
  • 15 to 17 Month Olds
  • 18 to 23 Month Olds
  • 2 and 3 Year Olds
  • Preschoolers


Sleep is very important to your child's health and well-being. In fact, good sleep habits start from birth. However, getting young children to sleep (and to stay asleep) is often one of the most daunting tasks of parenthood. Regardless of your child's age, the key is to have a predictable series of steps that help him wind down from the day.
Set regular bedtimes (and, if appropriate, nap times) and stick to them. Do not wait for your child to start rubbing his eyes or yawning — that's probably too late. Putting your child to bed even 15 to 20 minutes earlier can make a big difference and ensure everyone has a good night's rest.

Bottlemouth Syndrome

Bottlemouth Syndrome

 

Bottlemouth syndrome is a special form of tooth decay in very young children. It is caused by prolonged exposure to milk or sugary liquids. Children at risk for bottlemouth syndrome take bottles of milk or juice to bed at naptime and bedtime. They also carry sugary beverages or milk around during the day. It is most common in the upper front teeth. Children with bottlemouth syndrome often need oral surgery with general anesthesia.

What to Look For:

  • Red gums 
  • Irritated mouth 
  • Teeth that do not look normal

What You Should Do: 

Parents or primary caregiver should:
  • Do not give your child a bottle of milk or juice (or any fluid containing sugar) at naptime, bedtime, or to carry around during the day. Only feed your child at specific meal and snack times.
  • Give your child water after a feeding to rinse sugary liquid off the teeth.
  • Give only water or don’t give a sleep-time bottle.

Other Caregivers Should:

  • Talk with parents about the need to have the child’s teeth examined by a medical provider.