Now that you’re a parent, don’t you find it to be quite ironic how incessantly you worry about your kids – especially given how incredibly annoying it was that your parents worried so relentlessly about you? Yep, welcome to parenthood. And when it comes to our kids’ teeth, we might not even know what we should be worrying about – especially during those early months when they don’t even have any teeth, for goodness’ sake.
A quick online search about healthy teeth habits for kids brings up a lot of conflicting information (fluoride or no fluoride? Sealants or skip it?). And since new parents often have a lot of questions when it comes to their kids’ teeth, we’ve tried to answer some of them here, and assist you in putting some of those inevitable worries to rest.
The general rule of thumb, according to Dr. Teresa Fong, pediatric dentist and American Academy of Pediatric Dentistry Fellow, is to bring them in by the time their first tooth erupts or at least by their first birthday. That first dental visit is especially important for first-time parents.
“Your dentist will provide a lot of good information at that first visit about preventing cavities, how to care for your child’s teeth, and best feeding practices,” Dr. Fong says. “She’ll look in your child’s mouth to ensure the teeth are in good condition, that they’re coming in in the right order, that the jaw looks well aligned; and confirm there are no problems under the upper lip or under the tongue.”
The dental team will also answer a lot of your questions and help provide tips about starting good oral habits as your kids grow.
As all new parents know, babies need to eat around the clock, usually every three to four hours. Formula and breast milk both contain sugar, so it’s important for parents to get into the habit of cleaning their babies’ gums after every feeding. A wash cloth or a soft infant toothbrush and a little water is all you need – both help remove sugar from the gums and help get the child used to the idea of oral care even before they have teeth.
Your dentist also will remind you of the dangers of putting the baby to bed with a bottle, or letting the baby snack-nurse while sleeping. “As a baby falls asleep, they stop swallowing as often,” says Dr. Fong, “so the breastmilk and formula pool around the teeth and create a perfect environment for bacteria to have a vacation in the mouth throughout the night – which makes it a lot easier for bacteria to break down sugar in the mouth, creating acids that can weaken the enamel and produce cavities.”
As soon as the first teeth begin to appear, the American Dental Association recommends parents use a fluoride toothpaste to brush their kids’ teeth. The amount of toothpaste you use is important: For children under the age of three, the recommended amount of toothpaste is a “smear,” or about as much as a grain of rice. For three- to six-year-olds, a pea-sized amount is just right.
The most effective way to help prevent cavities is by brushing your kids’ teeth twice a day for two minutes at a time. And remember to help your kids brush their teeth until they’re about eight years old to make sure they’re being brushed effectively and the toothpaste is not being swallowed.
There’s no need to panic, but have a dentist look at those spots right away, says Dr. Fong.
Sometimes it’s simply extra color that shows up as the enamel is developing. But it also can be a sign of early tooth decay – which often can be reversed with fluoride treatments and professional plaque and tartar removal at the dental office. Sometimes the white spots are due to too much fluoride usage. Talk with your child’s dentist about oral care habits and diet, and he or she can help determine the cause and whether anything needs to be done.
Tooth decay in children and teens tends to hone in on the back molars. So sealants – or thin plastic coatings – can be applied to the grooves on the chewing surfaces of the back teeth to protect from decay.
“Sealants are generally reserved for permanent molars, but sometimes we seal the primary molars, too,” says Dr. Fong. “Again, parents should discuss the option of sealants with their child’s dentist. They are a wonderful preventive tool – and help to seal over deep pits and fissures to help prevent plaque and bacteria from building up on the teeth. Sealants help make it easier to clean the teeth, too.”
Each time we get a filling, the tooth gets a little weaker. And since fillings aren’t permanent, additional drilling can further decrease the stability of the tooth – so protecting teeth with sealants can be a good thing. The CDC says that sealants can save time, money and discomfort sometimes associated with dental fillings.
The American Heart Association recommends significantly limiting the amount of added sugars you and your kids consume. Hidden sugars lurk in places we wouldn’t think to look, like barbecue and pasta sauces, fruit yogurt and even bread. When you do indulge in a sweet treat, incorporate it with a meal, and eat it all in one sitting, recommends Dr. Fong.
“The key is to limit the frequency of your teeth coming in contact with sugar,” she says. “Instead of taking one bite of a candy bar now and another bite again in 20 minutes, it’s better to eat it all at once, preferably immediately following your meal.”
Here’s why: While we’re eating a meal, the sugar and acid production levels are already high in our mouths, so that’s as good of a time as any to introduce sugar: The acid is at the ready to break it down. When we continue to create those “sugar and acid attacks” in our mouths, Dr. Fong says it creates a harsh environment for our teeth. That’s why limiting the frequency with which we eat those sugary treats is so important.
Some great non-sugary snacks to offer the kids include hard cheeses, hard-boiled eggs, popcorn and whole fruit (in lieu of fruit juices).
Thumb-sucking and pacifier use can cause no damage at all, or cause an immense amount of damage, says Dr. Fong. It depends on three things: frequency (how often the pacifier is used), intensity (how vigorous her sucking is) and duration (the length of time he keeps the pacifier in his mouth). “Some kids just hold the pacifier in their mouths and don’t really suck on it,” she says. “Other kids, I can see their ‘open bite’ from across the room. The goal is to have them give up the habit as early as possible.”
If your child does have a habit, let your dentist know about it. Together, you can talk about strategies on how to get her to stop sucking. Every situation is different. What’s important is to commit to helping her break the habit and to determine the strategies that you feel will work for you and for your child.
The rule is, there’s no hard or fast rule when it comes to the relationship between baby teeth problems and permanent teeth problems. “Just because you have cavities in your baby teeth doesn’t mean you’re doomed,” says Dr. Fong. “I have some patients that had cavities in baby teeth and then with permanent teeth they have no cavities. And some kids are just more prone to cavities – it can be due to a number of things: the composition of their enamel; their diet, their oral hygiene habits, or even a medical condition.”
If you do know you’re prone to cavities – it’s even more important to be stringent with your oral hygiene, more careful about the things you are eating and drinking and more aware of your sugar intake.
“Generally, when the permanent teeth start erupting and your child starts getting all four teeth on the top and the bottom, that’s a good time to think about going for an orthodontic evaluation,” says Dr. Fong.
Sometimes a child might have just a little bit of crowding, and the orthodontist will want to wait until all the teeth come in before putting on braces. Other times, if the crowding is severe, the orthodontist may want to consider early interventions.
Impress your pediatric dentist by coming to your child’s first appointment armed with a solid understanding of tooth decay and how it proliferates by reading this overview of Early Childhood Caries.