Great Smiles Start Early

When should my child first see a dentist, and why?

The ideal time is six months after your child's first (primary) teeth erupt. This time frame is a perfect opportunity for the dentist to carefully examine the development of your child's mouth. Because dental problems often start early, the sooner the visit the better. To safeguard against problems such as baby bottle tooth decay, teething irritations, gum disease, and prolonged thumb-sucking, the dentist can provide or recommend special preventive care.

What will happen on the first visit?

Many first visits are nothing more than introductory icebreakers to acquaint your child with the dentist and the practice. If the child is frightened, uncomfortable or non-cooperative, a rescheduling may be necessary. Patience and calm on the part of the parent and reassuring communication with your child are very important in these instances. Short, successive visits are meant to build the child's trust in the dentist and the dental office, and can prove invaluable if your child needs to be treated later for any dental problem. Child appointments should always be scheduled earlier in the day, when your child is alert and fresh. For children under 24-36 months, the parent may need to sit in the dental chair and hold the child during the examination. Also, parents may be asked to wait in the reception area so a relationship can be built between your child and the dentist.

If the child is compliant, the first session often lasts between 15-30 minutes and may include the following, depending on age:

• A gentle but thorough examination of the teeth, jaw, bite, gums and oral tissues to monitor growth and development and observe any problem areas
• If indicated, a gentle cleaning, which includes polishing teeth and removing any plaque, tartar build up and stains
• X-rays
• A demonstration on proper home cleaning
• Assessment of the need for fluoride.

The dentist should be able to answer any questions you have and try to make you and your child feel comfortable throughout the visit. The entire dental team and the office should provide a relaxed, non- threatening environment for your child.

Six ways to protect your child's oral health at home

Parents typically provide oral hygiene care until the child is old enough to take personal responsibility for the daily dental health routine of brushing and flossing. A proper regimen of preventive home care is important from the day your child is born.

1. Clean your infant's gums with a clean, damp cloth. Ask your
dentist if you may rub a tiny dab of toothpaste on the gums.

2. As soon as the first teeth come in, begin brushing them with a small, soft-bristled toothbrush and a pea-sized dab of fluoride toothpaste. Remember, most children are also getting fluoride from the community water supply.

3. To avoid baby bottle tooth decay and teeth misalignment due to sucking, try to wean your child off of the breast and bottle by one year of age, and monitor excessive sucking of pacifiers, fingers and thumbs. Never give your child a bottle of milk, juice or sweetened liquid as a pacifier at naptime or bedtime.

4. Help a young child brush at night - the most important time to brush, due to lower salivary flow and higher susceptibility to cavities and plaque. Perhaps let the child brush their teeth first to build self confidence, then the parent can follow up to ensure that all plaque is removed. Usually by age 5 or so the child can learn to brush his or her own teeth with proper parental instruction.

5. The best way to teach a child how to brush is to lead by good example. Allowing your child to watch you brush your teeth teaches the importance of good oral hygiene.

6. Encourage healthy food choices and low sugar snacks such as carrots, celery, apples and nuts. Avoid sugary juices and sodas.

What's baby bottle tooth decay?

Baby bottle tooth decay is caused by the frequent and long-term exposure of a child's teeth to liquids containing sugars. Among these liquids are milk, formula, fruit juice, sodas, and other sweetened drinks. The sugars in these liquids pool around the infant's teeth and gums, feeding the bacteria that cause plaque. Every time a child consumes a sugary liquid, acid attacks the teeth and gums. After numerous attacks, tooth decay can begin.
The condition also is associated with breast-fed infants who have prolonged feeding habits or with children whose pacifiers are frequently dipped in honey, sugar or syrup. The sweet fluids left in the mouth increases the chances of cavities while the infant is sleeping.

How can I prevent baby bottle tooth decay?

• Never allow children to fall asleep with a bottle containing milk, formula, juice or other sweetened liquids.
• Clean and massage the baby's gums to help establish healthy teeth and to aid in teething. Wrap a moistened gauze square or washcloth around the finger and gently massage the gums and gingival tissues. This should be done once a day.
• Plaque removal activities should begin upon eruption of the first baby tooth. When brushing a child's teeth, use a soft toothbrush and a pea-shaped amount of fluoride toothpaste.
• Parents should first bring their child to the dentist when the child is between six and 12 months old.

Will changes in my child's diet help prevent baby bottle tooth decay?

Preventing baby bottle tooth decay involves changes in a child's diet. A series of small changes over a period of time is usually easier, and eventually leads to better oral health.

To incorporate these changes:

• Gradually dilute the bottle contents with water over a period of 2-3 weeks.
• Once that period is over, if you give a child a bottle, fill it with water or give the child a clean pacifier recommended by a dentist. The only safe liquid to put in a bottle to prevent baby bottle tooth decay is water.
• Decrease consumption of sugar, especially between meals.
• Children should be weaned from the bottle as soon as they can drink from a cup, but the bottle should not be taken away too soon,since the sucking motion aids in the development of facial muscles, as well as the tongue.

Why should I be worried about baby bottle tooth decay?

Giving an infant a sugary drink at nap or nighttime is harmful because during sleep, the flow of saliva decreases, allowing the sugary liquids to linger on the child's teeth for an extended period of time. If left untreated, pain and infection can result. Severely decayed teeth may need to be extracted. If teeth are infected or lost too early due to baby bottle tooth decay, your child may develop poor eating habits, speech problems, crooked teeth, and damaged adult teeth. Healthy baby teeth will usually result in healthy permanent teeth.

When should I give my child toothpaste?

One should only give toothpaste to a child when the child is safely able to hold water in their mouth and spit it out. Put less than a pea-size amount on their toothbrush. The child should not swallow the toothpaste. If too much toothpaste is ingested, it can lead to a condition called fluorosis. If your child eats a tube of toothpaste, seek immediate medical attention.

What is fluorosis?

Fluorosis is the condition where teeth become stained or mottled. Excessive fluoride intake during the development stage of the teeth (from birth to age 10) can cause the teeth to have brown stains and pitting.