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Children’s Dentistry

When Should Children Have Their First Dental Visit?

The American Academy of Pediatric Dentistry (AAPD) suggests that parents should make an initial “well-baby” appointment with a pediatric dentist approximately six months after the emergence of the first tooth, or no later than the child’s first birthday.

Although this may seem surprisingly early, the incidence of infant and toddler tooth decay has been rising in recent years.  Tooth decay and early cavities can be exceptionally painful if they are not attended to immediately, and can also set the scene for poor oral health in later childhood.

Dr. Chris and her entire team will provide strategies for eliminating unwanted oral habits (for example, pacifier use and thumb sucking) and can also help parents in establishing a sound daily oral routine for the child.

What potential dental problems can babies experience?

A baby is at risk for tooth decay as soon as the first tooth emerges.  During the first visit, our dentistry team will help parents implement a preventative strategy to protect the teeth from harm, and also demonstrate how infant teeth should be brushed and flossed.

In particular, infants who drink breast milk, juice, baby formula, soda, or sweetened water from a baby bottle or sippy cup are at high-risk for early childhood caries (cavities).  To counteract this threat, the pediatric dentist discourages parents from filling cups with sugary fluids, dipping pacifiers in honey, and transmitting oral bacteria to the child via shared spoons and/or cleaning pacifiers in their own mouths.

Importantly, our pediatric dentistry team will also assess and balance the infant’s fluoride intake.  Too much fluoride ingestion between the ages of one and four years old may lead to a condition known as fluorosis in later childhood.  Conversely, too little fluoride may render young tooth enamel susceptible to tooth decay. (More info on Fluoride Below)

What happens during the first visit?

All Cedar Hills Dental Care personnel are fully trained to communicate with infants and young children.

During the initial visit, the our team will advise parents to implement a good oral care routine, ask questions about the child’s oral habits, and examine the child’s emerging teeth.  Our staff and the parent sit knee-to-knee for this examination to enable the child to view the parent at all times.  If the infant’s teeth appear stained, our team may clean them.  Oftentimes, a topical fluoride treatment will be applied to the teeth after this cleaning.

What questions may the dentist ask during the first visit?

Dr. Chris and her team will ask questions about current oral care, diet, the general health of the child, the child’s oral habits, and the child’s current fluoride intake.

Once answers to these questions have been established, our team will then advise parents on the following issues:

  • Accident prevention.
  • Adding xylitol and fluoride to the infant’s diet.
  • Choosing an ADA approved, non-fluoridated brand of toothpaste for the infant.
  • Choosing an appropriate toothbrush.
  • Choosing an orthodontically correct pacifier.
  • Correct positioning of the head during tooth brushing.
  • Easing the transition from sippy cup to adult-sized drinking glasses (12-14 months).
  • Eliminating fussing during the oral care routine.
  • Establishing a drink-free bedtime routine.
  • Maintaining and implementing good dietary habits.
  • Minimizing the risk of tooth decay.
  • Reducing sugar and carbohydrate intake.
  • Teething and developmental milestones.

If you have further questions or concerns about the timing or nature of your child’s first oral checkup, please contact Dr. Chris or her team directly.

 

Your Childs First Visit

According to AAPD (American Academy of Pediatric Dentistry) guidelines, infants should initially visit the pediatric dentist around the time of their first birthday.  First visits can be stressful for parents, especially for parents who have dental phobias themselves.

It is imperative for parents to continually communicate positive messages about dental visits (especially the first one), and to help the child feel as happy as possible about visiting the dentist.

How can I prepare for my child’s first dental visit?

There are several things parents can do to make the first visit enjoyable.  Some helpful tips are listed below:

Take another adult along for the visit – Sometimes infants become fussy when having their mouths examined.  Having another adult along to soothe the infant allows the parent to ask questions and to attend to any advice the dentist may have.

Leave other children at home – Other children can distract the parent and cause the infant to fuss.  Leaving other children at home (when possible) makes the first visit less stressful for all concerned.

Cedar Hills Dental Care dentists and staff are trained to avoid the use of threatening language, like drills, needles, injections, and bleeding.  It is imperative for parents to use positive language when speaking about dental treatment with their child.

Provide positive explanations – It is important to explain the purposes of the dental visit in a positive way.  Explaining that the dentist “helps to keep teeth healthy” is far better than explaining that the dentist “is checking for tooth decay, and may have to drill the tooth if decay is found.”

Studies Show: Explain what is going to happen – Anxiety can be vastly reduced if the child knows what to expect. 

What will happen during the first visit?

There are several goals for the first dental visit.  First, the dentist and the child need to get properly acquainted.  Second, the dentist needs to monitor tooth and jaw development to get an idea of the child’s overall health history.  Third, the dentist needs to evaluate the health of the existing teeth and gums.  Finally, the dentist aims to answer questions and advise parents on how to implement a good oral care regimen.

The following sequence of events is typical of an initial “well baby checkup”:

  1. Our Cedar Hills Dental Care staff will greet the child and parents.
  2. The infant/family health history will be reviewed (this may include questionnaires).
  3. Dr. Chris and team will address parental questions and concerns.
  4. More questions will be asked, generally pertaining to the child’s oral habits, pacifier use, general development, tooth alignment, tooth development, and diet.
  5. Our Team will provide advice on good oral care, how to prevent oral injury, fluoride intake, and sippy cup use.
  6. The infant’s teeth will be examined. Generally, the dentist and parent sit facing each other.  The infant is positioned so that his or her head is cradled in the dentist’s lap.  This position allows the infant to look at the parent during the examination.
  7. Good brushing and flossing demonstrations/tips will be provided.
  8. The state of the child’s oral health will be described in detail, and specific recommendations will be made.  Recommendations usually relate to oral habits, appropriate toothpastes and toothbrushes for the child, orthodontically correct pacifiers, and diet.
  9. Dr. Chris and team will detail which teeth may appear in the following months.
  10. Dr. Chris and team will outline an appointment schedule and describe what will happen during the next appointment.

If you have questions or concerns about your child’s first dental visit, please contact the Dr. Christine Chin or her team directly, we will be glad to chat with you anytime to discuss in detail any concerns you may have.

 

Sealing out Tooth Decay

Tooth decay has become increasingly prevalent in preschoolers.  Not only is tooth decay unpleasant and painful, it can also lead to more serious problems like premature tooth loss and childhood periodontal disease.

Dental sealants are an important tool in preventing childhood caries (cavities) and tooth decay.  Especially when used in combination with other preventative measures, like biannual checkups and an excellent daily home care routine, sealants can bolster the mouth’s natural defenses, and keep smiles healthy.

How do sealants protect children’s teeth?

In general, dental sealants are used to protect molars from oral bacteria and harmful oral acids.  These larger, flatter teeth reside toward the back of the mouth and can be difficult to clean.  Molars mark the site of four out of five instances of tooth decay.  Decay-causing bacteria often inhabit the nooks and crannies (pits and fissures) found on the chewing surfaces of the molars.  These areas are extremely difficult to access with a regular toothbrush.

If Dr. Chris and her team evaluates a child to be at high risk for tooth decay, we may choose to coat additional teeth (for example, bicuspid teeth).  The sealant acts as a barrier, ensuring that food particles and oral bacteria cannot access vulnerable tooth enamel.

Dental sealants do not enhance the health of the teeth directly, and should not be used as a substitute for fluoride supplements (if the dentist has recommended them) or general oral care.  In general however, sealants are less costly, less uncomfortable, and more aesthetically pleasing than dental fillings.

How are sealants applied?

Though there are many different types of dental sealant, most are comprised of liquid plastic.  Initially, the Dr. Chris and team must thoroughly clean and prepare the molars, before painting sealant on the targeted teeth.  Some sealants are bright pink when wet and clear when dry.  This bright pink coloring enables the dentist to see that all pits and fissures have been thoroughly coated.

When every targeted tooth is coated to the dentist’s satisfaction, the sealant is either left to self-harden or exposed to blue spectrum natural light for several seconds (depending on the chemical composition of the specific brand).  This specialized light works to harden the sealant and cure the plastic.  The final result is a clear (or whitish) layer of thin, hard, durable sealant.

It should be noted that the “sealing” procedure is easily completed in one office visit, and is entirely painless.

When should sealants be applied?

Sealants are usually applied when the primary (baby) molars first emerge.  Depending on the oral habits of the child, the sealants may last for the life of the primary tooth, or need replacing several times.  Essentially, sealant durability depends on the oral habits of the individual child.

Pediatric dentists recommend that permanent molars be sealed as soon as they emerge.  In some cases, sealant can be applied before the permanent molar is full grown.

The health of the sealant must be monitored at biannual appointments.  If the seal begins to lift off, food particles may become trapped against the tooth enamel, actually causing tooth decay.

If you have questions or concerns about dental sealants, please contact Dr. Chris or one of the helpful team members.

 

Fluoride

Fluorine, a natural element in the fluoride compound, has proven to be effective in minimizing childhood cavities and tooth decay.  Fluoride is a key ingredient in many popular brands of toothpaste, oral gel, and mouthwash, and can also be found in most community water supplies.  Though fluoride is an important part of any good oral care routine, overconsumption can result in a condition known as fluorosis.  The Cedar Hills dental team is able to monitor fluoride levels, and check that children are receiving the appropriate amount.

How can fluoride prevent tooth decay?

Fluoride fulfills two important dental functions.  First, it helps to staunch mineral loss from tooth enamel, and second, it promotes the remineralization of tooth enamel.

When carbohydrates (sugars) are consumed, oral bacteria feed on them and produce harmful acids.  These acids attack tooth enamel – especially in children who take medications or produce less saliva.  Repeated acid attacks result in cavities, tooth decay, and childhood periodontal disease.  Fluoride protects tooth enamel from acid attacks and reduces the risk of childhood tooth decay.

Fluoride is especially effective when used as part of a good oral hygiene regimen.  Reducing the consumption of sugary foods, brushing and flossing regularly, and visiting the pediatric dentist biannually, all supplement the work of fluoride and keep young teeth healthy.

How much fluoride is enough?

Since community water supplies and toothpastes usually contain fluoride, it is essential that children do not ingest too much.  For this reason, children under the age of two should use an ADA-approved, non-fluoridated brand of toothpaste.  Children between the ages of two and five years old should use a pea-sized amount of ADA-approved fluoridated toothpaste on a clean toothbrush twice each day.  They should be encouraged to spit out any extra fluid after brushing.  This part might take time, encouragement, and practice.

The amount of fluoride children ingest between the ages of one and four years old determines whether or not fluorosis occurs later.  The most common symptom of fluorosis is white specks on the permanent teeth.  Children over the age of eight years old are not considered to be at-risk for fluorosis, but should still use an ADA-approved brand of toothpaste.

Does my child need fluoride supplements?

The pediatric dentist is the best person to decide whether a child needs fluoride supplements.  First, the dentist will ask questions in order to determine how much fluoride the child is currently receiving, gain a general health history, and evaluate the sugar content in the child’s diet.  If a child is not receiving enough fluoride and is determined to be at high-risk for tooth decay, an at-home fluoride supplement may be recommended.

Topical fluoride can also be applied to the tooth enamel quickly and painlessly during a regular office visit.  There are many convenient forms of topical fluoride, including foam, liquids, varnishes, and gels.  Depending on the age of the child and their willingness to cooperate, topical fluoride can either be held on the teeth for several minutes in specialized trays or painted on with a brush.

If you have questions or concerns about fluoride or fluorosis, please contact Dr. Christine Chine or her team directly, we will walk you through all of the information and possible options it any are needed.

 

What’s the Best Toothpaste for My Child?

Evaluating the many brands of oral products claiming to be “best for children” can be an overwhelming task.  Selecting an appropriately sized toothbrush and a nourishing, cleansing brand of children’s toothpaste is of paramount importance for maintaining excellent oral health.

Why brush primary teeth?

The importance of maintaining the health of primary (baby) teeth is often understated.  Primary teeth are essential for speech production, chewing, jaw development, and they also facilitate the proper alignment and spacing of permanent adult teeth.  Brushing primary teeth prevents bad breath and tooth decay, and also removes the plaque bacteria associated with childhood periodontal disease.

What differences are there among toothpaste brands?

Though all toothpastes are not created equal, most brands generally contain abrasive ingredients to remove stains, soapy ingredients to eliminate plaque, fluorides to strengthen tooth enamel, and some type of pleasant-tasting flavoring.

The major differences between brands are the thickness of the paste, the level of fluoride content, and the type of flavoring.  Although fluoride strengthens enamel and repels plaque bacteria, too much of it can actually harm young teeth – a condition known as dental fluorosis.  Children between the ages of one and four years old are most at risk for this condition, so fluoride levels should be carefully monitored during this time.

Be aware that adult and non-ADA approved brands of toothpaste often contain harsher abrasives, which remove tooth enamel and weaken primary teeth.  In addition, some popular toothpaste brands contain sodium lauryl sulfate (shown as “SLS” on the package), which cause painful mouth ulcers in some children.

So which toothpaste brand should I choose?

The most important considerations to make before implementing an oral care plan and choosing a toothpaste brand is the age of the child.  Home oral care should begin before the emergence of the first tooth.  A cool clean cloth should be gently rubbed along the gums after feeding to remove food particles and bacteria.

Prior to the age of two, the child will have many teeth and brushing should begin.  Initially, select fluoride-free “baby” toothpaste and softly brush the teeth twice per day.  Flavoring is largely unimportant, so the child can play an integral role in choosing whatever type of toothpaste tastes most pleasant.

Between the middle and the end of the third year, select an American Dental Association (ADA) accepted brand of toothpaste containing fluoride.  The ADA logo is clear and present on toothpaste packaging, so be sure to check for it.  Use only a tiny pea or rice-sized amount of fluoride toothpaste, and encourage the child to spit out the excess after brushing.  Eliminating the toothpaste takes practice, patience, and motivation – especially if the child finds the flavoring tasty.  If the child does ingest tiny amounts of toothpaste, don’t worry; this is perfectly normal and will cease with time and encouragement.

Dental fluorosis is not a risk factor for children over the age of eight, but an ADA accepted toothpaste is always the recommended choice for children of any age.

If you have questions or concerns about choosing an appropriate brand of toothpaste for your child, Dr. Chris and team will be happy to make recommendations.

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