Pediatric oral care has two main components: preventative care at the pediatric dentist’s office and preventative care at home. Though infant and toddler caries (cavities) and tooth decay have become increasingly prevalent in recent years, a good dental strategy will eradicate the risk of both.
The goal of preventative oral care is to evaluate and preserve the health of the child’s teeth. Beginning at the age of twelve months, the American Dental Association (ADA) recommends that children begin to visit the pediatric dentist for “well baby” checkups. In general, most children should continue to visit the dentist every six months, unless instructed otherwise.
The pediatric dentist examines the teeth for signs of early decay, monitors orthodontic concerns, tracks jaw and tooth development, and provides a good resource for parents. In addition, the pediatric dentist has several tools at hand to further reduce the child’s risk for dental problems, such as topical fluoride and dental sealants.
During a routine visit to the dentist, the child’s mouth will be fully examined, the teeth will be professionally cleaned, topical fluoride may be coated onto the teeth to protect tooth enamel, and any parental concerns can be addressed. The pediatric dentist can demonstrate good brushing and flossing techniques, advise parents on dietary issues, provide strategies for thumb sucking and pacifier cessation, and communicate with the child on his or her level.
When molars emerge (usually between the ages of two and three), the pediatric dentist may coat them with dental sealant. This sealant covers the hard-to-reach fissures on the molars, sealing out bacteria, food particles and acid. Dental sealant may last for many months or many years, depending on the oral habits of the child. Dental sealant provides an important tool in the fight against tooth decay.
Though most parents primarily think of brushing and flossing when they hear the words “oral care,” good preventative care includes many more factors, such as:
Diet – Parents should provide children with a nourishing, well-balanced diet. Very sugary diets should be modified and continuous snacking should be discouraged. Oral bacteria ingest leftover sugar particles in the child’s mouth after each helping of food – emitting harmful acids that erode tooth enamel, gum tissue, and bone if left unchecked. Space out snacks where possible, and provide the child with non-sugary alternatives like celery sticks, carrot sticks, and low-fat yogurt.
Oral habits – Though pacifier use and thumb sucking generally cease over time, both can cause the teeth to misalign. If the child must use a pacifier, choose an “orthodontically” correct model. This will minimize the risk of developmental problems like narrow roof arches and crowding. The pediatric dentist can suggest a strategy (or provide a dental appliance) for thumb sucking cessation.
General oral hygiene – Sometimes, parents cleanse pacifiers and teething toys by sucking them. Parents may also share eating utensils with the child. Harmful oral bacteria are transmitted from parent-to-child in these ways, increasing the risk of early cavities and tooth decay. Instead, rinse toys and pacifiers with warm water and avoid spoon-sharing wherever possible.
Sippy cup use – Sippy cups are an excellent transitional aid for the baby bottle-to-adult drinking glass period. However, sippy cups filled with milk, breast milk, soda, juice, and sweetened water cause small amounts of sugary fluid to continually swill around young teeth – meaning continuous acid attacks on tooth enamel. Sippy cup use should be terminated between the ages of twelve and fourteen months – or whenever the child has the motor capabilities to hold a drinking glass.
Brushing – Children’s teeth should be brushed a minimum of two times per day using a soft bristled brush and a pea-sized amount of toothpaste. Parents should help with the brushing process until the child reaches the age of seven and is capable of reaching all areas of the mouth. Parents should always opt for ADA approved toothpaste (non-fluoridated before the age of two, and fluoridated thereafter). For babies, parents should rub the gum area with a clean cloth after each feeding.
Flossing – Cavities and tooth decay form more easily between teeth. Therefore, the child is at risk for between-teeth cavities wherever two teeth grow adjacent to each other. The pediatric dentist can help demonstrate correct head positioning during the flossing process, and suggest tips for making flossing more fun!
Fluoride – Fluoride helps prevent mineral loss and simultaneously promotes the remineralization of tooth enamel. Too much fluoride can result in fluorosis, a condition where white specks appear on the permanent teeth, and too little can result in tooth decay. It is important to get the fluoride balance correct. The pediatric dentist can evaluate how much the child is currently receiving and prescribe supplements if necessary.
HOW TO PREVENT CAVITIES
Childhood cavities, also known as childhood tooth decay and childhood caries, are common in children all over the world. There are two main causes of cavities: poor dental hygiene and sugary diets.
Cavities can be incredibly painful, often leading to tooth decay and childhood periodontitis if left untreated. Ensuring that children eat a balanced diet, embarking on a sound home oral care routine, and visiting the pediatric dentist biannually, are all crucial factors for both cavity prevention and excellent oral health.
Cavities form when children’s teeth are exposed to sugary foods on a regular basis. Sugars and carbohydrates (like the ones found in white bread) collect on and around the teeth after eating. A sticky film (plaque) then forms on the tooth enamel. The oral bacteria within the plaque continually ingest sugar particles and emit acid. Initially, the acid attacks the tooth enamel, weakening it and leaving it vulnerable to tooth decay. If conditions are allowed to worsen, the acid begins to penetrate the tooth enamel and erodes the inner workings of the tooth.
Although primary (baby) teeth are eventually lost, they fulfill several important functions and should be protected. It is essential that children brush and floss twice per day (ideally more), and visit the dentist for biannual cleanings. Sometimes the pediatric dentist coats teeth with a sealant and provides fluoride supplements to further bolster the mouth’s defenses.
Large cavities can be excruciatingly painful, whereas tiny cavities may not be felt at all. Making matters even trickier, cavities sometimes form between the teeth, making them invisible to the naked eye. Dental X-rays and the dentist’s trained eyes help pinpoint even the tiniest of cavities so they can be treated before they worsen.
Some of the major symptoms of cavities include:
- Heightened sensitivity to cool or warm foods
- Nighttime waking and crying
- Sensitivity to spicy food
If a child is experiencing any of these symptoms, it is important to visit the pediatric dentist. Failure to do so will make the problem worse, leave the child in pain, and could possibly jeopardize a tooth that could have been treated.
Biannual visits with the pediatric dentist are only part of the battle against cavities. Here are some helpful guidelines for cavity prevention:
- Analyze the diet – Too many sugary or starchy snacks can expedite cavity formation. Replace sugary snacks like candy with natural foods where possible, and similarly replace soda with water.
- Cut the snacks – Snacking too frequently can unnecessarily expose teeth to sugars. Save the sugar and starch for mealtimes, when the child is producing more saliva, and drinking water. Make sure they consume enough water to cleanse the teeth.
- Lose the sippy cup – Sippy cups are thought to cause “baby bottle tooth decay” when they are used beyond the intended age (approximately twelve months). The small amount of liquid emitted with each sip causes sugary liquid to continually swill around the teeth.
Avoid stickiness – Sticky foods (like toffee) form plaque quickly, and are extremely difficult to pry off the teeth. Avoid them where possible.
- Rinse the pacifier – Oral bacteria can be transmitted from mother or father to baby. Rinse a dirty pacifier with running water as opposed to sucking on it, to avoid contaminating the baby’s mouth.
Drinks at bedtime – Sending a child to bed with a bottle or sippy cup is bad news. The milk, formula, juice, or sweetened water basically sits on the teeth all night – attacking enamel and maximizing the risk of cavities. Ensure the child has a last drink before bedtime, and then brush the teeth.
Don’t sweeten the pacifier – Parents sometimes dip pacifiers in honey to calm a cranky child. Do not be tempted to do this. Use a blanket, toy, or hug to calm the child instead.
Brush and floss – Parents should brush and floss their child’s teeth twice each day until the child reaches the age of seven years old. Before this time, children struggle to brush every area of the mouth effectively.
Check on fluoride –When used correctly, fluoride can strengthen tooth enamel and help stave off cavities. Too much or too little fluoride can actually harm the teeth, so ask the pediatric dentist for a fluoride assessment.
Keep to appointments – The child’s first dental visit should be scheduled around his or her first birthday, as per the American Academy of Pediatric Dentistry (AAPD) guidelines. Keep to a regular appointment schedule to create healthy smiles!
If you have questions or concerns about how to care for your child’s teeth or about cavity prevention, please ask us.