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Your Child’s First Dental Visit According
to the American Academy of Pediatric Dentistry (AAPD), your child should visit
the dentist by his/her 1st birthday. You can make the first visit to
the dentist enjoyable and positive. Your child should be informed of the visit
and told that the dentist and their staff will explain all procedures and answer
any questions. The less to-do concerning the visit, the better. It
is best if you refrain from using words around your child that might cause unnecessary
fear, such as needle, pull, drill or hurt. Pediatric dental offices make a practice
of using words that convey the same message, but are pleasant and non-frightening
to the child.
What dental problems could my child have? Some
dental problems begin very early in life. One concern is baby bottle tooth decay,
a serious condition caused by a child staying on the bottle (or breast) too long.
Another problem is gum disease. About 40% of children 2-3 years old have at least
mild inflammation of gum tissues. Oral habits (such as thumb-sucking) should also
be checked. The earlier the dental visit, the better the chances of preventing
problems. Strong, healthy teeth help your child chew food easily, speak clearly
and feel good about his or her appearance.
Dental
Radiographs (X-Rays) Radiographs
(X-Rays) are a vital and necessary part of your child’s dental diagnostic process.
Without them, certain dental conditions can and will be missed. Radiographs
detect much more than cavities. For example, radiographs may be needed to survey
erupting teeth, diagnose bone diseases, evaluate the results of an injury, or
plan orthodontic treatment. Radiographs allow dentists to diagnose and treat health
conditions that cannot be detected during a clinical examination. If dental problems
are found and treated early, dental care is more comfortable for your child and
more affordable for you. The American
Academy of Pediatric Dentistry recommends radiographs and examinations every six
months for children with a high risk of tooth decay. On average, most pediatric
dentists request radiographs approximately once a year. Approximately every 3
years it is a good idea to obtain a complete set of radiographs, either a panoramic
and bitewings or periapicals and bitewings. Pediatric
dentists are particularly careful to minimize the exposure of their patients to
radiation. With contemporary safeguards, the amount of radiation received in a
dental X-ray examination is extremely small. The risk is negligible. In fact,
the dental radiographs represent a far smaller risk than an undetected and untreated
dental problem. Lead body aprons and shields will protect your child. Today’s
equipment filters out unnecessary x-rays and restricts the x-ray beam to the area
of interest. High-speed film and proper shielding assure that your child receives
a minimal amount of radiation exposure.
Care
of Your Child’s Teeth Begin daily
brushing as soon as the child’s first tooth erupts. A pea size amount of fluoride
toothpaste can be used after the child is old enough not to swallow it. By age
4 or 5, children should be able to brush their own teeth twice a day with supervision
until about age seven to make sure they are doing a thorough job. However, each
child is different. Your dentist can help you determine whether the child has
the skill level to brush properly. Proper
brushing removes plaque from the inner, outer and chewing surfaces. When teaching
children to brush, place toothbrush at a 45 degree angle; start along gum line
with a soft bristle brush in a gentle circular motion. Brush the outer surfaces
of each tooth, upper and lower. Repeat the same method on the inside surfaces
and chewing surfaces of all the teeth. Finish by brushing the tongue to help freshen
breath and remove bacteria. Flossing
removes plaque between the teeth where a toothbrush can’t reach. Flossing should
begin when any two teeth touch. You should floss the child’s teeth until he or
she can do it alone. Use about 18 inches of floss, winding most of it around the
middle fingers of both hands. Hold the floss lightly between the thumbs and forefingers.
Use a gentle, back-and-forth motion to guide the floss between the teeth. Curve
the floss into a C-shape and slide it into the space between the gum and tooth
until you feel resistance. Gently scrape the floss against the side of the tooth.
Repeat this procedure on each tooth. Don’t forget the backs of the last four teeth.
Good
Diet = Healthy Teeth Healthy
eating habits lead to healthy teeth. Like the rest of the body, the teeth, bones
and the soft tissues of the mouth need a well-balanced diet. Children should eat
a variety of foods from the five major food groups. Most snacks that children
eat can lead to cavity formation. The more frequently a child snacks, the greater
the chance for tooth decay. How long food remains in the mouth also plays a role.
For example, hard candy and breath mints stay in the mouth a long time, which
cause longer acid attacks on tooth enamel. If your child must snack, choose nutritious
foods such as vegetables, low-fat yogurt, and low-fat cheese which are healthier
and better for children’s teeth.
How Do I Prevent Cavities? Good
oral hygiene removes bacteria and the left over food particles that combine to
create cavities. For infants, use a wet gauze or clean washcloth to wipe the plaque
from teeth and gums. Avoid putting your child to bed with a bottle filled with
anything other than water. For older
children, brush their teeth at least twice a day. Also, watch the number
of snacks containing sugar that you give your children. The
American Academy of Pediatric Dentistry recommends six month visits to the pediatric
dentist beginning at your child’s first birthday. Routine visits will start your
child on a lifetime of good dental health. Your
pediatric dentist may also recommend protective sealants or home fluoride treatments
for your child. Sealants can be applied to your child’s molars to prevent decay
on hard to clean surfaces.
Seal
Out Decay A sealant is a clear
or shaded plastic material that is applied to the chewing surfaces (grooves) of
the back teeth (premolars and molars), where four out of five cavities in children
are found. This sealant acts as a barrier to food, plaque and acid, thus protecting
the decay-prone areas of the teeth.
Baby
Bottle Tooth Decay (Early Childhood Caries) One
serious form of decay among young children is baby bottle tooth decay. This condition
is caused by frequent and long exposures of an infant’s teeth to liquids that
contain sugar. Among these liquids are milk (including breast milk), formula,
fruit juice and other sweetened drinks. Putting
a baby to bed for a nap or at night with a bottle other than water can cause serious
and rapid tooth decay. Sweet liquid pools around the child’s teeth giving plaque
bacteria an opportunity to produce acids that attack tooth enamel. If you must
give the baby a bottle as a comforter at bedtime, it should contain only water.
If your child won't fall asleep without the bottle and its usual beverage, gradually
dilute the bottle's contents with water over a period of two to three weeks. After
each feeding, wipe the baby’s gums and teeth with a damp washcloth or gauze pad
to remove plaque. The easiest way to do this is to sit down, place the child’s
head in your lap or lay the child on a dressing table or the floor. Whatever position
you use, be sure you can see into the child’s mouth easily.
When Will My
Baby Start Getting Teeth? Teething,
the process of baby (primary) teeth coming through the gums into the mouth, is
variable among individual babies. Some babies get their teeth early and some get
them late. In general the first baby teeth are usually the lower front (anterior)
teeth and usually begin erupting between the age of 6-8 months. See "Eruption
of Your Child’s Teeth" for more details.
Dental
Emergencies Toothache: Clean
the area of the affected tooth thoroughly. Rinse the mouth vigorously with warm
water or use dental floss to dislodge impacted food or debris. If the pain still
exists, contact your child's dentist. DO NOT place aspirin on the gum or
on the aching tooth. If the face is swollen apply cold compresses and contact
your dentist immediately. Cut or Bitten
Tongue, Lip or Cheek: Apply ice to bruised
areas. If there is bleeding apply firm but gentle pressure with a gauze or cloth.
If bleeding does not stop after 15 minutes or it cannot be controlled by simple
pressure, take the child to hospital emergency room. Knocked
Out Permanent Tooth: Find the tooth. Handle
the tooth by the crown, not the root portion. You may rinse the tooth but DO NOT
clean or handle the tooth unnecessarily. Inspect the tooth for fractures. If it
is sound, try to reinsert it in the socket. Have the patient hold the tooth in
place by biting on a gauze. If you cannot reinsert the tooth, transport the tooth
in a cup containing the patient’s saliva or milk. If the patient is old enough,
the tooth may also be carried in the patient’s mouth. The patient must see a dentist
IMMEDIATELY! Time is a critical factor in saving the tooth.
Fluoride Fluoride
is an element, which has been shown to be beneficial to teeth. However, too little
or too much fluoride can be detrimental to the teeth. Little or no fluoride will
not strengthen the teeth to help them resist cavities. Excessive fluoride ingestion
by preschool-aged children can lead to dental fluorosis, which is a chalky white
to even brown discoloration of the permanent teeth. Many children often get more
fluoride than their parents realize. Being aware of a child’s potential sources
of fluoride can help parents prevent the possibility of dental fluorosis. Some
of these sources are: - Too much fluoridated
toothpaste at an early age.
- The inappropriate
use of fluoride supplements.
- Hidden sources
of fluoride in the child’s diet.
Two
and three year olds may not be able to expectorate (spit out) fluoride-containing
toothpaste when brushing. As a result, these youngsters may ingest an excessive
amount of fluoride during tooth brushing. Toothpaste ingestion during this critical
period of permanent tooth development is the greatest risk factor in the development
of fluorosis. Excessive and inappropriate
intake of fluoride supplements may also contribute to fluorosis. Fluoride drops
and tablets, as well as fluoride fortified vitamins should not be given to infants
younger than six months of age. After that time, fluoride supplements should only
be given to children after all of the sources of ingested fluoride have been accounted
for and upon the recommendation of your pediatrician or pediatric dentist. Certain
foods contain high levels of fluoride, especially powdered concentrate infant
formula, soy-based infant formula, infant dry cereals, creamed spinach, and infant
chicken products. Please read the label or contact the manufacturer. Some beverages
also contain high levels of fluoride, especially decaffeinated teas, white grape
juices, and juice drinks manufactured in fluoridated cities. Parents
can take the following steps to decrease the risk of fluorosis in their children’s
teeth: - Use baby tooth cleanser on
the toothbrush of the very young child.
- Place
only a pea sized drop of children’s toothpaste on the brush when brushing.
- Account for all of the sources of ingested fluoride
before requesting fluoride supplements from your child’s physician or pediatric
dentist.
- Avoid giving any fluoride-containing
supplements to infants until they are at least 6 months old.
- Obtain
fluoride level test results for your drinking water before giving fluoride supplements
to your child (check with local water utilities).
What is Pulf Therapy? The
pulp of a tooth is the inner central core of the tooth. The pulp contains
nerves, blood vessels, connective tissue and reparative cells. The purpose
of pulp therapy in Pediatric Dentistry is to maintain the vitality of the affected
tooth (so the tooth is not lost). Dental
caries (cavities) and traumatic injury are the main reasons for a tooth to require
pulp therapy. Pulp therapy is often referred to as a "nerve treatment",
"children's root canal", "pulpectomy" or "pulpotomy". The two common forms
of pulp therapy in children's teeth are the pulpotomy and pulpectomy. A
pulpotomy removes the diseased pulp tissue within the crown portion of the tooth.
Next, an agent is placed to prevent bacterial growth and to calm the remaining
nerve tissue. This is followed by a final restoration (usually a stainless
steel crown). A pulpectomy is required
when the entire pulp is involved (into the root canal(s) of the tooth).
During this treatment, the diseased pulp tissue is completely removed from both
the crown and root. The canals are cleansed, disinfected and in the case
of primary teeth, filled with a resorbable material. Then a final restoration
is placed. A permanent tooth would be filled with a non-resorbing material.
What’s the Best Toothpaste for
my Child? Tooth brushing is one
of the most important tasks for good oral health. Many toothpastes, and/or tooth
polishes, however, can damage young smiles. They contain harsh abrasives which
can wear away young tooth enamel. When looking for a toothpaste for your child
make sure to pick one that is recommended by the American Dental Association.
These toothpastes have undergone testing to insure they are safe to use. Remember,
children should spit out toothpaste after brushing to avoid getting too much fluoride.
If too much fluoride is ingested, a condition known as fluorosis can occur. If
your child is too young or unable to spit out toothpaste, consider providing them
with a fluoride free toothpaste, using no toothpaste, or using only a "pea size"
amount of toothpaste. Does
Your Child Grind His Teeth At Night? (Bruxism) Parents
are often concerned about the nocturnal grinding of teeth (bruxism). Often, the
first indication is the noise created by the child grinding on their teeth during
sleep. Or, the parent may notice wear (teeth getting shorter) to the dentition.
One theory as to the cause involves a psychological component. Stress due to a
new environment, divorce, changes at school; etc. can influence a child to grind
their teeth. Another theory relates to pressure in the inner ear at night. If
there are pressure changes (like in an airplane during take-off and landing when
people are chewing gum, etc. to equalize pressure) the child will grind by moving
his jaw to relieve this pressure. The
majority of cases of pediatric bruxism do not require any treatment. If excessive
wear of the teeth (attrition) is present, then a mouth guard (night guard) may
be indicated. The negatives to a mouth guard are the possibility of choking if
the appliance becomes dislodged during sleep and it may interfere with growth
of the jaws. The positive is obvious by preventing wear to the primary dentition.
The good news is most children outgrow
bruxism. The grinding gets less between the ages 6-9 and children tend to stop
grinding between ages 9-12. If you suspect bruxism, discuss this with your pediatrician
or pediatric dentist.
What
is the Best Time for Orthodontic Treatment? Developing
malocclusions, or bad bites, can be recognized as early as 2-3 years of age. Often,
early steps can be taken to reduce the need for major orthodontic treatment at
a later age. Stage I – Early Treatment:
This period of treatment encompasses ages 2 to 6 years. At this young age, we
are concerned with underdeveloped dental arches, the premature loss of primary
teeth, and harmful habits such as finger or thumb sucking. Treatment initiated
in this stage of development is often very successful and many times, though not
always, can eliminate the need for future orthodontic/orthopedic treatment. Stage
II – Mixed Dentition: This period covers the ages of 6 to 12 years, with the eruption
of the permanent incisor (front) teeth and 6 year molars. Treatment concerns deal
with jaw malrelationships and dental realignment problems. This is an excellent
stage to start treatment, when indicated, as your child’s hard and soft tissues
are usually very responsive to orthodontic or orthopedic forces. Stage
III – Adolescent Dentition: This stage deals with the permanent teeth and the
development of the final bite relationship. | 
