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When should I schedule my child's first trip to the dentist? Should my 3-year-old be flossing? How do I know if my child needs braces? Many parents have a difficult time judging how much dental care their children need. They know they want to prevent cavities, but they don't always know the best way to do so.
When Should I Start Caring for My Child's Teeth?
Proper dental care begins even before a baby's first tooth appears. Remember that just because you can't see the teeth doesn't mean they aren't there. Teeth actually begin to form in the second trimester of pregnancy. At birth your baby has 20 primary teeth, some of which are fully developed in the jaw.
Running a damp washcloth over your baby's gums following feedings can prevent buildup of damaging bacteria. Once your child has a few teeth showing, you can brush them with a soft child's toothbrush or rub them with gauze at the end of the day.
Even babies can have problems with dental decay when parents do not practice good feeding habits at home. "Putting your baby to sleep with a bottle propped in his mouth may be convenient in the short term - but it is bad news for the baby's teeth," explains pediatric dentist Garrett B. Lyons, DDS.
When the sugars from juice or milk remain on a baby's teeth for hours, they may eat away at the enamel, creating a condition known as bottle mouth. Pocked, pitted, or discolored front teeth are signs of bottle mouth. Severe cases result in cavities and the need to pull all the front teeth until the permanent ones grow in. Parents and child care providers should also help young children develop set times for drinking during the day as well because sucking on a bottle throughout the day can be equally damaging to young teeth.
What Kind of Dentist Should My Child See?
You may want to take your child to a dentist who specializes in treating children. Pediatric dentists are trained to handle the wide range of issues associated with your child's dental health. They also know when to refer you to a different type of specialist, such as an orthodontist to correct an overbite or an oral surgeon for jaw realignment.
A pediatric dentist's primary goals are prevention, heading off potential oral health problems before they occur, and maintenance, ensuring through routine checkups and proper daily care that teeth and gums stay healthy.
How Can I Prevent Cavities?
The American Dental Association recommends that your child's first visit to the dentist take place by her first birthday. At this visit, your child's dentist will explain proper brushing and flossing techniques (you need to floss once your baby has two teeth that touch) and conduct a modified exam while your baby sits on your lap. Such visits can help in the early detection of potential problems. Your child also will become accustomed to visiting the dentist, which means she'll have less fear as she grows older.
When all of your child's primary teeth have come in (usually around age 2 1/2) your dentist may start applying topical fluoride during your child's visits. Fluoride hardens the tooth enamel, helping to ward off the most common childhood oral disease, dental caries, or cavities. Cavities are caused by bacteria and food that are left on the teeth after eating. When these are not brushed away, acid collects on a tooth, softening its enamel until a hole - or cavity - forms. Regular use of fluoride toughens the enamel, making it more difficult for acid to penetrate.
Although many municipalities require tap water to be fluoridated, other communities have no such regulations. "Parents must ask, especially when you move to a new community," Dr. Lyons says. If the water supply is not fluoridated, or if your family uses purified water, ask your dentist for fluoride supplements. Even though most toothpastes contain fluoride, toothpaste alone will not fully protect a child's mouth. Be careful, however, since too much fluoride can cause tooth discoloration. Check with your dentist before supplementing.
Discoloration can also occur as a result of prolonged use of antibiotics. "Some children's medications are almost 75% sugar," says Dr. Lyons. He suggests that parents encourage children to brush after they take their medicine, particularly if the prescription will be long term.
Brushing at least twice a day and routine flossing will help maintain a healthy mouth. Children as young as age 2 or 3 can begin to use toothpaste when brushing, as long as they are supervised. "Children should not ingest large amounts of toothpaste - a pea-sized amount for toddlers is just right," Dr. Lyons suggests. He cautions parents to make sure that the child spits the toothpaste out, instead of swallowing.
As your child's permanent teeth grow in, her dentist can help seal out decay by applying a thin wash of resin to the back teeth, where most chewing occurs. Known as a sealant, this protective coating keeps bacteria from settling in the hard-to-reach crevices of the molars. "Most kids can benefit from sealants, unless the tops of their molars are unusually smooth and flat," explains Constance Killian, DDS, a pediatric dentist and trustee of the American Academy of Pediatric Dentistry.
Although dental research has resulted in increasingly sophisticated preventative techniques, including fillings and sealants that seep fluoride, a dentist's care is only part of the equation. Follow-up at home plays an equally important role. For example, the sealants on a child's teeth do not mean that she can eat sweets uncontrollably or slack off on the daily brushing and flossing. "We can only do so much at the office - parents must work with children to teach good oral health habits," says Dr. Killian.
What Should I Do if My Child Has a Problem?
If you are prone to tooth decay or gum disease, your child may be at higher risk as well. "Dental caries is an infectious disease, so if the parents carry high levels of the disease in their mouths, the kids are at higher risk," Dr. Killian says. Therefore, sometimes even the most diligent brushing and flossing will not prevent a cavity. Be sure to call your dentist if your child complains of pain in her teeth. The pain could be a sign of a cavity that needs to be treated.
New materials have given the pediatric dentist more filling and repair options than ever before. Silver remains the substance of choice for the majority of fillings in permanent teeth. Other materials, such as composite resins, also are gaining popularity. "The beauty of the composite resins is that they bond to the teeth, so the filling won't pop out," Dr. Killian says. "They can be used to rebuild teeth damaged through injury or conditions such as cleft palate."
Tooth-colored resins are also more attractive. But in cases of fracture, extensive decay, or malformation of baby teeth, dentists often opt for stainless steel crowns. "A small amount of decay will destroy a baby tooth very quickly. The crown maintains the tooth while preventing the decay from spreading," Dr. Killian says.
As your child grows older, you may be concerned about her bite and the straightness of her teeth. Orthodontic treatment begins earlier now than it once did. What once was a symbol of preteen anguish - a mouth filled with metal wires and braces - has become a relic of the past. Kids as young as age 7 are now sporting corrective appliances. Efficient, plastic-based materials have replaced old-fashioned metal contraptions. Dentists now understand that manipulation of teeth at a younger age can be easier and more effective in the long run. Younger children's teeth can be positioned with relatively minor orthodontia, thus preventing major orthodontia later on.
In some rare instances, usually when a more complicated dental procedure is to be performed, a dentist will recommend general anesthesia to put the child to sleep. "When there is a severe behavioral problem, for instance, or a child has multiple lesions in the mouth, we will use anesthesia," Dr. Lyons explains.
Parents should make sure that the professional who administers the medicine is a trained anesthesiologist or oral surgeon before agreeing to the procedure. Don't be afraid to question the dentist. "General anesthesia use is relatively safe, as long as licensed, trained professionals follow proper guidelines and maintain appropriate equipment," Dr. Killian says. Giving your child an early start on check-ups and good dental hygiene is an effective way to help prevent this kind of extensive dental work. Encouraging your child to use a mouth guard during sports can also prevent serious dental injuries.
As your child grows, plan on routine dental check-ups anywhere from once every 3 months to once a year, depending on her dentist's recommendations. Limiting intake of sugary foods, and regular brushing and flossing all contribute to your child's dental health. Your partnership with your child's dentist will help keep your child's teeth healthy and her smile beautiful.
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