It is our number one goal to make dentistry fun for kids.  I have had many patients tell me how scared they were of their dentist when they were young because the dentist was either not friendly or caused them pain. With that in mind, I try to:

How can I reduce the risk of early caries (cavities)?

Primary teeth preserve space for permanent teeth and guide their later alignment.  In addition, primary teeth help with speech production, prevent the tongue from posturing abnormally, and play an important role in the chewing of food.  For these reasons, it is critically important to learn how to care for the child’s emerging teeth.

Here are some helpful tips:

1. Brush twice each day – The AAPD recommends a pea-sized or less amount of ADA approved (non-fluoridated) toothpaste for children under two years old, and the same amount of an ADA approved (fluoridated) toothpaste for children over this age.  The toothbrush should be soft-bristled and appropriate for infants.
2. Start flossing – Flossing an infant’s teeth can be difficult but the process should begin when two adjacent teeth emerge.  Dahm Dental will happily demonstrate good flossing techniques.
3. Provide a balanced diet – Sugars and starches feed oral bacteria, which produce harmful acids and attack tooth enamel.  Ensure that the child is eating a balanced diet and work to reduce sugary and starchy snacks. 
4. Set a good example – Children who see parents brushing and flossing are often more likely to follow suit.  Explain the importance of good oral care to the child; age-appropriate books often help with this.
5. Visit the dentist – Dahm Dental monitors oral development, provides professional cleanings, applies topical fluoride to the teeth, and coats molars with sealants.  Biannual trips to the dental office can help to prevent a wide range of painful conditions later.

What can I do at home to prevent baby bottle tooth decay?

Baby bottle tooth decay can be prevented.  Making regular dental health appointments and following the guidelines below will keep each child’s smile bright, beautiful, and free of decay:

• Try not to transmit bacteria to your child via saliva exchange.  Rinse pacifiers and toys in clean water, and use a clean spoon for each person eating.
• Clean gums after every feeding with a clean washcloth.
• Use an appropriate toothbrush along with an ADA-approved toothpaste to brush when teeth begin to emerge.  Fluoride-free toothpaste is recommended for children under the age of two.
• Use a pea-sized amount of ADA-approved fluoridated toothpaste when the child has mastered the art of “spitting out” excess toothpaste.  Though fluoride is important for the teeth, too much consumption can result in a condition called fluorosis.
• Do not place sugary drinks in baby bottles or sippy cups.  Only fill these containers with water, breast milk, or formula.  Encourage the child to use a regular cup (rather than a sippy cup) when the child reaches twelve months old.
• Do not dip pacifiers in sweet liquids (honey, etc.).
• Review your child’s eating habits.  Eliminate sugar-filled snacks and encourage a healthy, nutritious diet.
• Do not allow the child to take a liquid-filled bottle to bed.  If the child insists, fill the bottle with water as opposed to a sugary alternative.
• Clean your child’s teeth until he or she reaches the age of seven.  Before this time, children are often unable to reach certain places in the mouth.
• Ask us to review your child’s fluoride levels.

 

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How can thumb sucking and pacifier use damage children’s teeth?

For most infants, the sucking of thumbs and pacifiers seems to be a happy, everyday part of life.  However, these habits have very harmful effects on the growth of your child's face and cause improper jaw and bite development when continued past 6 - 12 months from birth.  According to research from the American Academy of Pediatric Dentistry (AAPD), pacifiers should be discontinued by the age of 12 months to avoid the complications which we see all to often.  

Pacifier and thumb sucking damage can be quite insidious.  Both can be difficult to assess with the naked eye, and both tend to occur over a prolonged period of time.  Below is an overview of some of the risks associated with prolonged thumb sucking and pacifier use:

Jaw misalignment – Pacifiers come in a wide range of shapes and sizes, most of which are completely unnatural for the mouth to hold.  Over time, pacifiers and thumbs can guide the developing jaws out of correct alignment.

Tooth decay – Many parents attempt to soothe infants by dipping pacifiers in honey, or some other sugary substance.  Oral bacteria feed on sugar and emit harmful acids.  The acids attack tooth enamel and can lead to pediatric tooth decay and childhood caries.

Roof narrowing – The structures in the mouth are extremely pliable during childhood.  Prolonged, repeated exposure to thumb and pacifier sucking actually cause the roof of the mouth to narrow (as if molding around the sucking device).  This can cause later problems with developing teeth.

Slanting teeth – Growing teeth can be caused to slant or protrude by thumb and pacifier sucking, leading to poor esthetic results.  In addition, thumb sucking and pacifier use in later childhood increases the need for extensive orthodontic treatments.

 

   This picture is an example of what can happen to the teeth with thumb sucking.

Care for your child's teeth

Pediatric oral care has two main components: preventative care at our office and preventative care at home.  Though infant and toddler caries (cavities) and tooth decay have become increasingly prevalent in recent years, a good dental strategy will eradicate the risk of both.

The goal of preventative oral care is to evaluate and preserve the health of the child’s teeth.  Beginning at the age of twelve months, the American Dental Association (ADA) recommends that children begin to visit the dentist for “well baby” checkups.  In general, most children should continue to visit the dentist every six months, unless instructed otherwise.

The dentist examines the teeth for signs of early decay, monitors orthodontic concerns, tracks jaw and tooth development, and provides a good resource for parents.  In addition, we have several tools at hand to further reduce the child’s risk for dental problems, such as topical fluoride and dental sealants.

During a routine visit to the dentist: the child’s mouth will be fully examined; the teeth will be professionally cleaned; topical fluoride might be coated onto the teeth to protect tooth enamel, and any parental concerns can be addressed.  The dentist can demonstrate good brushing and flossing techniques, advise parents on dietary issues, provide strategies for thumb sucking and pacifier cessation, and communicate with the child on his or her level.

When molars emerge (usually between the ages of two and three), the dentist may coat them with dental sealant.  This sealant covers the hard-to-reach fissures on the molars, sealing out bacteria, food particles, and acid.  Dental sealant may last for many months or many years, depending on the oral habits of the child.  Dental sealant is an important tool in the fight against tooth decay.

 How can I help at home?

Though most parents primarily think of brushing and flossing when they hear the words “oral care,” good preventative care includes many more factors, such as:

Diet – Parents should provide children with a nourishing, well-balanced diet.  Very sugary diets should be modified and continuous snacking should be discouraged.  Oral bacteria ingest leftover sugar particles in the child’s mouth after each helping of food, emitting harmful acids that erode tooth enamel, gum tissue, and bone.  Space out snacks when possible, and provide the child with non-sugary alternatives like celery sticks, carrot sticks, and low-fat yogurt.

Oral habits – Pacifier use and thumb sucking may cease over time, but both can cause the teeth to misalign.  Stopping these harmful habits as early as possible can prevent severe consequences to the proper development of your child's face and bite. The dentist can suggest a strategy (or provide a dental appliance) for thumb sucking cessation.

General oral hygiene – Sometimes, parents clean pacifiers and teething toys by sucking on them.  Parents may also share eating utensils with the child.  By performing these acts, parents transfer harmful oral bacteria to their child, increasing the risk of early cavities and tooth decay.  Instead, rinse toys and pacifiers with warm water, and avoid spoon-sharing whenever possible.

Sippy cup use – Sippy cups are an excellent transitional aid when transferring from a baby bottle to an adult drinking glass.  However, sippy cups filled with milk, breast milk, soda, juice, and sweetened water cause small amounts of sugary fluid to continually swill around young teeth – meaning acid continually attacks tooth enamel.  Sippy cup use should be terminated between the ages of twelve and fourteen months or as soon as the child has the motor skills to hold a drinking glass.

Brushing – Children’s teeth should be brushed a minimum of two times per day using a soft bristled brush and a pea-sized amount of toothpaste.  Parents should help with the brushing process until the child reaches the age of seven and is capable of reaching all areas of the mouth.  Parents should always opt for ADA approved toothpaste (non-fluoridated before the age of two, and fluoridated thereafter).  For babies, parents should rub the gum area with a clean cloth after each feeding.

Flossing – Cavities and tooth decay form more easily between teeth.  Therefore, the child is at risk for between-teeth cavities wherever two teeth grow adjacent to each other.  The dentist can help demonstrate correct head positioning during the flossing process and suggest tips for making flossing more fun!

Fluoride – Fluoride helps prevent mineral loss and simultaneously promotes the remineralization of tooth enamel.  Too much fluoride can result in fluorosis, a condition where white specks appear on the permanent teeth, and too little can result in tooth decay.  It is important to get the fluoride balance correct.  The dentist can evaluate how much the child is currently receiving and prescribe supplements if necessary.

How can I prepare for my child’s first dental visit?

There are several things parents can do to make the first visit enjoyable.  Some helpful tips are listed below:

Take another adult along for the visit – Sometimes infants become fussy when having their mouths examined.  Having another adult along to soothe the infant allows the parent to ask questions and to attend to any advice the dentist may have.

Leave other children at home – Other children can distract the parent and cause the infant to fuss.  Leaving other children at home (when possible) makes the first visit less stressful for all concerned.

Avoid threatening language – Dentists and staff are trained to avoid the use of threatening language like “drills,” “needles,” “injections,” and “bleeding.”  It is imperative for parents to use positive language when speaking about dental treatment with their child.

Provide positive explanations – It is important to explain the purposes of the dental visit in a positive way.  Explaining that the dentist “helps keep teeth healthy” is far better than explaining that the dentist “is checking for tooth decay and might have to drill the tooth if decay is found.”

Explain what will happen – Anxiety can be vastly reduced if the child knows what to expect.  Age-appropriate books about visiting the dentist can be very helpful in making the visit seem fun. Here is a list of parent and dentist-approved books:

• The Berenstain Bears Visit the Dentist – by Stan and Jan Berenstain.
• Show Me Your Smile: A Visit to the Dentist – Part of the “Dora the Explorer” Series.
• Going to the Dentist – by Anne Civardi.
• Elmo Visits the Dentist – Part of the “Sesame Street” Series.

 What will happen during the first visit?

There are several goals for the first dental visit.  First, the dentist and the child need to get properly acquainted.  Second, the dentist needs to monitor tooth and jaw development to get an idea of the child’s overall health history.  Third, the dentist needs to evaluate the health of the existing teeth and gums.  Finally, the dentist aims to answer questions and advise parents on how to implement a good oral care regimen.

The following sequence of events is typical of an initial “well baby checkup”:

1. Dental staff will greet the child and parents.
2. The infant/family health history will be reviewed (this may include questionnaires).
3. The dentist and dental hygienist will address parental questions and concerns.
4. More questions will be asked, generally pertaining to the child’s oral habits, pacifier use, general development, tooth alignment, tooth development, and diet.
5. The dentist will provide advice on good oral care, how to prevent oral injury, fluoride intake, and sippy cup use.
6. The infant’s teeth will be examined. Generally, the dentist and parent sit facing each other.  The infant is positioned so that his or her head is cradled in the dentist’s lap.  This position allows the infant to look at the parent during the examination.
7. Good brushing and flossing demonstrations will be provided.
8. The state of the child’s oral health will be described in detail, and specific recommendations will be made.  Recommendations usually relate to oral habits, appropriate toothpastes and toothbrushes for the child, orthodontically correct pacifiers, and diet.
9. The dentist will detail which teeth may appear in the following months.
10. The dentist will outline an appointment schedule and describe what will happen during the next appointment.

How do sealants protect children’s teeth?

Due to too much sugar in our diets, tooth decay has become increasingly prevalent in preschoolers.  Not only is tooth decay unpleasant and painful, it can also lead to more serious problems like premature tooth loss and childhood periodontal disease.

Dental sealants are an important tool in preventing childhood caries (cavities) and tooth decay. Especially when used in combination with other preventative measures, like biannual checkups and an excellent daily home care routine, sealants can bolster the mouth’s natural defenses, and keep smiles healthy.

In general, dental sealants are used to protect molars from oral bacteria and harmful oral acids.  These larger, flatter teeth reside toward the back of the mouth and can be difficult to clean.  Molars mark the site of four out of five instances of tooth decay.  Decay-causing bacteria often inhabit the nooks and crannies (pits and fissures) found on the chewing surfaces of the molars.  These areas are extremely difficult to access with a regular toothbrush.

If the dentist evaluates a child to be at high risk for tooth decay, he or she may choose to coat additional teeth (for example, bicuspid teeth).  The sealant acts as a barrier, ensuring that food particles and oral bacteria cannot access vulnerable tooth enamel.

Dental sealants do not enhance the health of the teeth directly, and should not be used as a substitute for fluoride supplements (if the dentist has recommended them) or general oral care.  In general however, sealants are less costly, less uncomfortable, and more aesthetically pleasing than dental fillings.