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.