Pediatric Dentistry
Your child won't keep his or her first teeth forever, but that doesn't mean those tiny pearly whites don't need conscientious care. Maintaining your child's dental health now will provide health benefits well into adulthood, as primary (baby) teeth serve some extremely important functions.
Age One Dental Visit
When it comes to your child's oral health, there's plenty of help available. It all begins when you bring your youngster in for his or her first visit to the dentist.
According to the American Academy of Pediatric Dentistry, a child's first checkup should occur by age one. Surprised? You shouldn't be! Even though there may only be a few baby teeth visible at that age, there are plenty of things to start working on — including the development of healthy habits that will make future visits to the dentist far more pleasurable.
Generally, this first visit involves simply talking to you and your child, looking in his or her mouth, and making oral health assessments. It's best to tell your child what to expect beforehand, without making too big a fuss about it. You could even build some excitement by helping them get ready for “the big day.”
It's a good idea to bring a comforting toy, a snack, and an extra diaper or two, just in case of fussiness. If possible, leave other kids at home, so the new patient can get all the attention. If not possible, bringing another adult along, however, may free your attention to focus on your child's oral health. Likewise, filling out forms in advance may save time and effort on the day of the visit.
When you and your child are comfortably seated in the office, a gentle examination of your child's mouth will be performed to uncover any early signs of dental problems such as tooth decay, and assess the risk that your child may develop the disease in the future. Often, this kind of risk assessment can help prevent — and even reverse — the early stages of tooth decay, without any drilling.
Finally, various ways to keep your child's oral health in top condition will be discussed. This may include how diet, eating habits and oral hygiene practices can help prevent tooth decay, the most common chronic disease of childhood. That's an important subject for everyone — even more so if your child is at greater risk. If any treatments (such as fluoride) are needed, a full explanation will be given. Tips on cleaning and brushing effectively will be reviewed and a follow-up visit will be scheduled as required.
Fluoride
The protective outer layer of teeth, called enamel, is often subject to attacks from acids. These can come directly from acidic foods and beverages, such as sodas and citrus fruits — or sometimes through a middleman: the decay-causing bacteria already in the mouth that create acid from sugar. These bacteria congregate in dental plaque and feed on sugar that is not cleansed from your child's mouth. In metabolizing (breaking down) sugar, the bacteria produce acids that can eat through tooth enamel. This is how cavities are formed. When fluoride is present, it becomes part of the crystalline structure of tooth enamel, hardening it and making it more resistant to acid attack. Fluoride can even help repair small cavities that are already forming.
Fluoride ingested by children in drinking water or supplements can be taken up by their developing permanent teeth. Once a tooth has erupted, it can be strengthened by fluoride topically (on the surface). Using a fluoride-containing toothpaste is one way to make sure your children's teeth receive helpful fluoride exposure daily. We recommend using only a pea-sized amount for children ages 2-6 and just a tiny smear for kids under two. Fluoride should not be used on children younger than six months. A very beneficial way to deliver fluoride to the teeth is with topical fluoride applications painted right onto your child's teeth and allowed to sit for a few minutes for maximum effectiveness.
The risk for fluorosis ends by the time a child is about 9 and all the permanent teeth have fully formed. Since fluoride use is cumulative, all the sources your child comes in contact with — including powdered infant formula mixed with fluoridated tap water — need to be evaluated. While caution is advised, however, it would be a mistake to forgo the benefits that this important mineral can bring to your child's teeth — and his or her overall health.
Sealants
The most likely location for a cavity to develop in your child's mouth is on the chewing surfaces of the back teeth. Run your tongue over this area in your mouth, and you will feel the reason why: These surfaces are not smooth, as other areas of your teeth are. Instead, they are filled with tiny grooves referred to as “pits and fissures,” which trap bacteria and food particles. The bristles on a toothbrush can't always reach all the way into these dark, moist little crevices. This creates the perfect conditions for tooth decay.
What's more, a child's newly erupted permanent teeth are not as resistant to decay as adult teeth are. The hard enamel coating that protects the teeth changes as it ages to become stronger. Fluoride, which is found in toothpaste and some drinking water — and in treatments provided at the dental office — can strengthen enamel, but, again, it's hard to get fluoride into those pits and fissures on a regular basis. Fortunately, there is a good solution to this problem: dental sealants.
Dental sealants are invisible plastic resin coatings that smooth out the chewing surfaces of the back teeth, making them resistant to decay. A sealed tooth is far less likely to develop a cavity, require more expensive dental treatment later on, or, most importantly, cause your child pain.
You can think of a sealant as a mini plastic filling, though please reassure your child that it doesn't “count” as having a cavity filled. Because tooth enamel does not contain any nerves, placing a sealant is painless and does not routinely require numbing shots. First, the tooth or teeth to be sealed are examined, and if any minimal decay is found, it will be gently removed. The tooth will then be cleaned and dried. Then a solution that will slightly roughen or “etch” the surface is applied, to make the sealing material adhere better. The tooth is then rinsed and dried again. The sealant is then painted on the tooth in liquid form and hardens in about a minute, sometimes with the help of a special curing light. That's all there is to it!
Sealed teeth require the same conscientious dental hygiene as unsealed teeth. Your child should continue to brush and floss his or her teeth daily and have regular professional cleanings. Checking for wear and tear on the sealants is important, though they should last for up to 10 years. During this time, your child will benefit from a preventive treatment proven to reduce decay by more than 70 percent.
Teething
New parents sometimes anticipate their baby's first tooth with a mixture of excitement and worry. While reaching a new developmental milestone is always a cause for celebration, this particular one can come with considerable discomfort. However, teething is different for each baby, and need not be painful at all; plus, there are steps you can take to make the process easier for your baby — and yourself.
Teething refers to the process by which primary (baby) teeth emerge through the gums and become visible in the mouth. This usually begins between six and nine months of age, though it may start as early as three months or as late as one year. Usually, the lower front teeth erupt first, followed by the ones directly above. Most children have all 20 of their primary teeth by the age of 3.
Teething babies get the most relief from cold and/or pressure on the affected area. This can be applied with:
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Chilled teething rings
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Cold, wet washcloths
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Chilled pacifiers
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Massaging baby's gums
Make sure not to actually freeze your baby's teething ring or pacifier because this could burn if left in the mouth for too long. The outmoded “remedy” of rubbing whiskey or other alcohol on the gums is neither effective nor appropriate. Over-the-counter medication may be helpful, but always check the correct dosage with your pediatrician or pharmacist.
