Did you know that tooth decay is the most common chronic childhood disease in the U.S.? It is five times as widespread as asthma and seven times as common as hay fever — but the good news is that tooth decay is preventable!
Mouths are full of bacteria. Most bacteria are harmless and can be kept under control by the body’s natural defenses, coupled with routine dental care. However, if harmful bacteria get out of control, health problems — such as tooth decay and gum disease — may begin. Gum disease, dental procedures that cut the gums or vigorous tooth brushing may allow bacteria to enter the bloodstream. Then the bacteria can travel to various organs in the body and cause disease.
Research suggests that chronic inflammation caused by the bacteria of gum disease may result in heart disease and stroke. In addition, scientists suggest that tooth loss before the age of 35 may be a risk factor for Alzheimer’s disease. Therefore, teaching your kids to take care of their teeth from a very early age is in their best interest!
Here are answers to questions parents frequently have about their children’s teeth.
When do infants get their first teeth?
Your infant may start drooling around two months of age. This indicates she is teething! The first teeth may not cut through for several months. The first teeth erupt between six and nine months of age. However, if you have a family history of early teeth, your child may get them early, too.
Which of my baby’s teeth will erupt first?
Between five and ten months of age, babies get their upper and lower central incisors, then lateral incisors, canines and first and second molars. Primary tooth emergence is completed by age three.
When do baby teeth fall out?
Primary teeth start to fall out between six and eight years of age, and they follow the order in which they erupted: central incisors, lateral incisors, canines, first and second molars.
The second upper molars fall out between 9 and 12 years of age, and the lower second molars fall out between 11 and 13 years of age.
When should I begin brushing my child’s teeth?
Dental care should start right after your baby is born. Starting early will help prevent tooth decay later.
• During bottle feedings, hold your infant and the bottle, instead of letting your baby hold the bottle.
• Avoid bathing your baby’s teeth in formula by not letting your infant fall asleep when drinking a bottle.
• Never try to encourage sucking by dipping pacifiers in sugar or any other sweet substances.
• Introduce your baby to a sippy cup at six months, and wean her off the bottle right after the first birthday.
• When the first tooth erupts, clean it with a wet washcloth or a soft toothbrush and water or baby toothpaste after each feeding.
Why can’t my infant use my toothpaste?
Adult toothpastes contain fluoride, and they are not recommended for children until they learn to spit them out. Avoid letting your child use your toothpaste, because swallowing fluoride will cause permanent white spots on the teeth.
How can I soothe my teething baby?
Teething causes gum pain and sometimes pain in the ears. If your baby is cranky, an appropriate dose of acetaminophen or ibuprofen (if your child is older than six months) might be helpful. Check with your health care provider for a weight-based dose for your infant. Teething infants love to chew on things to soothe their gums. Offer your baby a teething ring that was kept in the fridge (don’t freeze teething rings, as they can cause frostbite on the already-tender gums!). You can also refrigerate a couple of wet washcloths. Your baby will love their cold-yet-soft feel.
When should my child see a dentist for the first time?
The American Academy of Pediatrics (AAP) recommends that every child have the first dental appointment right after the first birthday. However, many dentists don’t feel comfortable seeing young children because of their fidgeting and inability to follow directions, and recommend the first visit around the second birthday. Ask your health care provider for a list of pediatric dentists in your area. Or, to locate a pediatric dentist, visit:http://www.aapd.org/finddentist/ or http://www.dentists4kids.com/.
When should my child start to floss?
Teach your child to floss as soon as she is able to understand directions and has adequate fine motor skills to begin flossing. Studies show that brushing teeth alone removes only about 40 percent of food that sticks to them. Without daily flossing, your child’s teeth will succumb to cavities and to bad breath fairly quickly.
Are there any dental assistance programs available for the uninsured?
If you do not have dental insurance, contact your local dental society to inquire about community dental assistance plans and programs. To locate the dental society in your state, go to:http://www.animated-teeth.com/dental_insurance/ t5_dental_insurance.htm.
What can I do to help prevent tooth decay?
Studies show that Streptococcus mutans, bacteria responsible for tooth decay in young kids, is transferred from other people through saliva when sharing utensils, blowing on food or kissing babies on the mouth. Only people with active tooth decay can spread S. mutans. Developing the habit of not sharing utensils, cups and straws, as well as not kissing kids on the mouth, may prevent tooth decay.
Brushing teeth twice daily and flossing regularly are crucial to maintaining a cavity-free mouth. However, experts say that doing so may not be enough. Dentists caution that diets full of carbonated beverages and juice contribute to acid erosion of tooth enamel. Soft, chewable, gummy candies contribute to tooth decay. Even healthy diets can be full of acidic foods high in ascorbic acid — such as citrus fruits, berries and juice — which softens enamel. Kids should avoid brushing teeth immediately after meals.
You should not allow your children to skip meals, as doing so is not good for their oral health. Skipping meals could allow the mouth to become basic, which leads to bacterial proliferation. However, bacteria in a basic environment differ from bacteria thriving in an acidic environment. Instead of causing enamel erosion, they cause gum disease and bad breath. They are also responsible for hardening of plaque, a sticky mixture of bacteria and food proteins that forms on teeth. Plaque is difficult to remove by brushing alone, and causes enamel destruction, cavities and gum disease.
How does fluoride prevent tooth decay in children?
Fluoride, when ingested in drinking water, enters the bloodstream and binds to calcium and phosphate as the teeth are formed. Studies show that teeth exposed to fluoride at all ages are more resistant to decay.
Is fluoride safe?
According to the AAP, optimal exposure to fluoride is important to infants and children. The use of fluoride for the prevention and control of cavities is documented to be both safe and effective.
Should I supplement my child’s diet with fluoride?
If you and your family drink city water, you may not need to take fluoride supplements. The new recommendation for fluoride content in the drinking water is 0.7 milligrams per liter. Verify the fluoridation level of your water with your city. If the city does not provide fluoridated water or if you drink well water, check with your health care provider regarding whether you should take supplements.
When should my child see an orthodontist?
Orthodontists are dentists with training in realigning crooked teeth into a straight, healthy smile. They can correct your child’s bite by correcting alignment of the jaw and teeth.
Crooked or crowded teeth, as well as overbites and underbites, can lead to tooth decay, gum disease, and even tooth loss. That’s because overlapping teeth can be tough to clean. A bad bite also can cause problems when chewing and talking. Not to mention too much wear, grinding and clenching.
The American Association of Orthodontists recommends that children see an orthodontist no later than age seven, even if there are no problems. That’s because the jaw is still developing, and it’s best to catch issues early.
Monika Pis, PhD, CPNP, is a primary care pediatric clinician in Palm Beach Gardens, FL.