When Neely Waters took her 5-year-old daughter, Sarah, to the dentist she was shocked. Sarah had four cavities which would require laughing gas and Novacain to fill. Neely thought she had done everything she could to safeguard her child's teeth from issues, but it happened anyway. In fact, one-quarter of 2- to 5-year-olds have cavities, says the Centers for Disease Control and Prevention, but why? When nearly all tooth decay is preventable, what's going on?
According to the American Academy of Pediatric Dentistry (AAPD), teeth problems for kids can result when there's a lack of awareness about early dental care: many parents may think it's OK to skip dental care as long as no teeth are present. But Baby’s first teeth — and the permanent teeth that come after — will fare much, much better in the long run if you start good dental care early — before the teeth come in — and keep up with good dental oversight over the years.
BEFORE TEETH COME IN
A baby's primary teeth are already fully formed at birth (that's a good argument for a healthy diet in pregnancy); permanent teeth begin forming immediately after birth. Primary teeth are best protected by fluorides obtained either from drinking water, infant formula or a liquid dietary supplement (sold by prescription). Breastmilk has very little fluoride, so an additional source of fluoride may be good when a baby is only fed breastmilk. Talk to your pediatrician about offering fluoridated water for babies 6 months or older.
TO DO: Start dental care for your infant long before the first tooth comes in. Hold a gauze pad between your thumb and forefinger and wipe your baby's gum pads (the ridge where the teeth will come through) twice a day. Use the same cleaning routine when the first teeth start arriving. Discuss fluoride with your pediatrician.
WHEN BABY TEETH ARE PRESENT
The baby — or primary teeth — usually appear between 3 and 9 months of age. By age 1-and-a-half, most babies have 12 teeth, and by age 2 or 3, all 20 primary teeth should be in. The AAPD recommends taking Baby for his first visit when his first tooth comes in and definitely by age 1.
Flourides, diet and oral hygiene are the main factors in keeping primary teeth in good shape (in addition to permanent teeth). Until a child is brushing his teeth responsibly, it's up to you to do the daily tooth cleaning. Make it a part of your morning and evening routine to help it stick. Other recommendations from the AAPD include: 1) Regular dental check ups every 6 months for cavity detection and fluoride application; 2) Dental sealants on all 6 year molars; 3) An orthodontic screening by age 7.
When teeth are not cared for, what's termed "early dental caries" — the first stage of tooth decay — can destroy tiny teeth and lead to infection, pain and lifelong consequences.
TO DO: Brush/wipe baby teeth and gums for all of your toddlers.
AVOID TOOTH DECAY
The most common cause of tooth decay in babies is giving a baby a bottle of milk when he goes to sleep. While dentists say widespread decay won't show up until age 3 or 4, it is caused by the pooling of sugar-containing fluids around the teeth. Bacteria uses the sugar to produce decay-causing acids. It's best to feed Baby before bedtime, then take away the bottle. Also know that it's never a good idea to let your baby constantly maintain a bottle of juice. Always clean Baby's gums afterward.
Assist children as needed with daily brushing and flossing as soon as teeth begin touching, says the AAPD. Monitor children with these tasks until they are fully ingrained and a part of your children's routines.
"You have to brush their teeth for them," says Kevin Donly, DDS, president of the AAPD. "Kids don't have the manual dexterity until they're between 5 and 7. I think a lot of parents don't realize that. Even when your child thinks he can brush his own teeth, your job is to go back and re-brush for them," he says.
TO DO: Brush/floss/monitor all of your children's teeth!
SCHEDULE THE FIRST APPOINTMENT AT AGE 1
Don’t be nonchalant about the first appointment if you want the best outcome for your child’s teeth. Simply seeing the dentist with your child will help you both get on a healthy schedule of good hygiene practices. Middle Tennessee has some wonderful pediatric dentists if you're searching for care for your child.
While not a substitute for good brushing and hygiene, pediatric dentists can put sealants on your child’s teeth to prevent the development of cavities. Sealants work by filling in the crevasses on the chewing surfaces of the teeth, shutting out food particles that can get caught in teeth. Applying them is fast and easy, and sealants can protect teeth for many years.