Prevention Tips for Children
Infants and Toddlers
Infants should be seen by our office after first six months of age and at least by the child's first birthday. By this time, the baby's first teeth, or primary teeth, are beginning to erupt and it is a critical time to spot any problems before they become big concerns.
For example, the most serious and totally preventable problem of infants and toddlers is "baby bottle tooth decay".
This condition is caused by sugary substances in breast milk, baby formula and fruit juices. Babies, who are given a bottle with these liquids while falling asleep, are the prime victims of the disease. In addition, you can make your child prone to decay if you give him or her pacifier that is dipped in sweets, such as honey, syrups, etc. Bacteria that break down sugar in the mouth release acids which in turn erode child's teeth enamel.
To prevent this problem, parents should be aware of some preventive measures, such as:
- Brush your child gums and teeth with "finger brush" that is available at local drug stores. Use just water to do it on children up to 18 mo of age. Brushing must be done at bedtime and then you can give your child some plain water to sip.
- From 18 to 24 mo of age you can introduce a smallest and soft toothbrush and still use water while brushing your child's teeth gently, in small circular motions. The best regimen is to brush twice a day but, if it is seems to you not practical, do it at bedtime every night. Again, give your child only plain water to drink after brushing. It is a good time start telling you kids that after brushing we do not eat.
- At about child's second birthday start introducing"training toothpaste" that does not contain fluoride. These products are sold at drug stores. Please teach your child to spit the paste but do not worry if he or she swallows it, it is harmless. Let your children watch you when you brush and floss, give them toothbrushes to copy your movements. It is the best if you make it fun and not a task.
- Between 18 -24 mo of age you should also start to encourage your child to drink from a cup.
Sometimes you can see white spots on your children's teeth. They would need to be examined in our office to rule out decay. If these turn out to be just decalcified spots (spots with softer enamel), we will offer you an alternative method of treatment. These days we are fortunate to have some dental pastes such as MI paste (without fluoride) and MI PLUS paste (with fluoride) that can "put back" calcium that was lost from teeth. These products are only available at the dental offices and we will give you instructions how to use it.
Primary and Permanent Teeth
Every child grows 20 primary teeth, usually by the age of 3. These teeth are gradually replaced by the age of 12 or so with a full set of 28 permanent teeth, and later on, four molars called "wisdom teeth".
It is essential that a child's primary teeth are healthy, because their development sets the stage for permanent teeth. The "baby teeth" play exactly the same role in the child's mouth as your adult teeth in yours. Kids eat, talk and smile just as we do. Proper nutrition, speech development and confidence in social situations are just as important to them as they are to us, adults. Moreover, baby teeth are natural "space maintainers" for permanent ones.
It is important that you bring your kids to regular check up and cleaning appointments so we can spot problems on time. For example, poorly formed primary teeth that don't erupt properly could crowd out spaces reserved for permanent teeth. We will refer you to an orthodontist for a timely consultation to prevent bigger problems later on.
Young child (2-3 years old) teeth should be brushed in the morning and at bedtime every day. If you are confident that your child is spitting the training toothpaste (see "infants and Toddlers") on routine basis then it is time to switch to a regular fluoride containing paste for kids. You can gradually replace training paste by adding fluoridated paste to the training one, eventually substituting the whole amount on the toothbrush with it.
Fluoride is generally present in most public drinking water systems. If you are unsure about your community's water and its fluoride content, or learned that it has an unacceptable level of fluoride in it, you can add fluoridated rinses to your child oral hygiene routine. Commercially fluoridated mouthwashes are available at local drug stores, i.e."ACT".
Toothaches are common in young children. Most of the time toothaches are caused by erupting teeth but sometimes it could indicate a serious problem.
You can help relieve "teething" pain by allowing your child to suck or chew on a cold teething ring and/or pacifier. If your son or daughter is in great discomfort, you can give them age appropriate dosage of children's Tylenol but do not continue on medication for more than 1-2 days.
If it seems to you that toothache is not associated with teeth eruption then please bring your child for a dental evaluation.
Pacifiers and Thumb-sucking
Pacifiers should be gradually discouraged after age of 2, 5 - 3 years old. They can interfere with normal development of your child's teeth.
Thumb-sucking is always strongly discouraged because it interferes with normal teeth and jaw development. There are some devices that could help your child to fight this habit. Please visit www.onestepahead.com to find out more about them or we can refer your child to the orthodontist office to get some professional help. The best approach, however, is not to allow your child to fall into this habit in the first place.
You can help your child prevent mouth injuries by closely supervising him or her during play and not allowing the child to put foreign objects in the mouth.
Pay attention to the toys your child pays with. There is a reason that manufacturers warn you about small parts and sharp objects! Small kids still explore their world with their mouths.
Keep hot liquids (drinks) out of reach. You are a role model for your children and they want to do the same things you do. Burns to the face and mouth are very painful and serious and could take a long time and lots of medical attention to treat.
If your child's primary (baby) teeth become loose as a result of an accident, do not panic: have your child rinse mouth with clean water or gently wipe his or her mouth with moist cloth to remove any debris. Please call our office immediately so we can take care of the tooth or advise you on the further actions. Do not attempt to remove the tooth or "push it back" by yourself.
If there is a soft tissue injury, such as bite through the lip(s) then wipe the tissue gently with clean moist gauze and see urgent care facility ASAP, especially if the bite went all the way through mucosa and skin.
If a primary tooth is knocked out of the socket, do not attempt to place it back because you can damage the permanent tooth underneath. Call our office and come in for an evaluation.
For information on care for the permanent teeth that were knocked out, please read our "Dental Emergencies" section.
For young kids and teenagers involved in physical activities and sports, mouth guards are strongly encouraged and can prevent many serious injuries to the teeth, jaw bones, gums and lips. You can get those via pharmacies or have it done in our office to fit precisely over your child teeth. As your child grows, you would need to have it done again to accommodate the changes in the mouth.
Sealants are clear or opaque composite (plastic) coating on the chewing surfaces of permanent molars. The goal of sealant is to protect the teeth from food and plaque retention in the naturally occurring groves and pits on the teeth surfaces. Bacteria that live in the mouth break food sugars into acids and those acidic byproducts will dissolve the enamel if left without attention.
The sealant application we do in our office contains the following steps:
- Cleaning the surfaces of the teeth with slurry of pumice;
- Using a small thin special bur we follow each groove to make sure no dark spots are left (those are signs of initial decay);
- We pre-treat the cleaned surfaces with special primers and apply sealant material;
- We "cure" (harden) the sealant with UV light for 20 sec.
As you can see it is a meticulous procedure, but it is well tolerated by the kids and does not require anesthetic (a shot). However, if the dark spots are not removed with the "sealant" bur then the tooth is not a candidate for the sealant anymore and needs a filling.