Dental Health

Dental health is the product of sound dental practices that begin at the time your child’s first teeth begin to come in. Below is a guide to these practices from infancy through the teen years.

Dental Practices For Each Stage Of Childhood

Infancy (Birth Until Age Two)

A baby’s first tooth will begin to erupt (come in) around six months of age but can come in as late as 10 months of age. When the teeth begin to erupt, the baby may have sore or tender gums, be irritable and may have their sleeping or eating patterns disrupted. You can select from  several methods to aid your child in getting through this period, such as letting him or her teethe on a cool spoon or a teething ring (ones that have been chilled seem to work even better), or gently rubbing your child’s gums with a clean finger.

Contrary to popular belief, a fever is not normal for a teething baby. If your infant develops a fever while teething, please contact your pediatrician. Most children will have their full set of 20 primary teeth by the time they are three years old.

You can start caring for you baby’s teeth as soon as the first one erupts. Sugars in food, milk and formula can cause the formation of plaque. Removing this plaque film is necessary for good oral hygiene at an early age. For children under a year, you may start using either a soft washcloth or a soft infant toothbrush with water to wipe their gums clean after feeding. As soon as teeth appear, start brushing twice daily using a fluoridated toothpaste with an age-appropriate toothbrush.

Bottles and Cavities

Never put your child to bed with a bottle unless it contains only water. While asleep, saliva flow decreases. and sugar in formula, milk, or juice will pool around the teeth. If these liquids pool for long periods of time, the teeth will be attacked by acids and a condition called Early Childhood Caries (ECC: cavities) may develop.

Breastfeeing can also cause ECC. Children who continue to breastfeed at will once teeth have erupted (six months of age), especially at night, are susceptible to this same type of tooth decay.

Known by many other names including, “Baby Bottle Tooth Decay,” “Nursing Caries” and “Nursing Bottle Caries,” ECC can rapidly destroy the teeth of an infant or young child. The teeth most often affected are the upper front teeth (incisors), but other teeth can be damaged as well. Dental decay in the primary teeth can affect your child’s erupting permanent teeth, causing pain. Preserving primary teeth is important in helping your child chew food effectively, develop speech, and maintain overall self esteem.

To help parents reduce the risk of cavities in children, the American Academy of Pediatric Dentistry (AAPD) also offers the following guidelines for using sippy cups properly:

  • The sippy cup is a training tool to help children transition from a bottle to a cup. It shouldn’t be used for a long period of time because it’s not a bottle and it’s not a pacifier.
  • Unless being used at mealtime, the sippy cup should only be filled with water.
  • Frequent drinking of any other liquid, even if diluted, from a bottle or sippy cup should be avoided.

The First Visit

The American Association of Pediatric Dentisty (AAPD) recommends that your child should see a dentist by their first birthday. You can establish a positive relationship between your child and the dentist by starting visits early.

The first dental visit tends to serve as a “well baby check” for the teeth. In addition to checking for any problems your child may have, the dentist can advise you on cleaning your child’s teeth, evaluate any non-nutritive sucking habits your child may have, identify their fluoride needs as well as offer you guidance about your child’s development.

Childhood (Ages Three to Nine)

The AAPD recommends the following activities to help prevent tooth decay:

  • Avoid frequent snacking
  • Brush twice daily with a pea-sized amount of fluoride toothpaste
  • Floss daily
  • Have sealants applied when appropriate (when six-year molars erupt)
  • Have regular dental visits every six months
  • Be evaluated for adequate fluoride intake through sources such as drinking water and prescribed supplements
  • Avoid fruit juice except in a cup with meals or at snack time

Around age six, children will start erupting permanent molar teeth as well as losing their primary teeth as they enter a developmental stage called mixed dentition. Typically, the lower incisor teeth are the first to fall out. Over the next few years, children will lose their front eight incisor teeth (four on the top and four on the bottom). Hand and eye coordination still may not be perfected, so it is recommended you still assist your child with brushing. Orthodontists (braces specialists) recommend that children should be evaluated at age seven for overall development of the child’s dental arches (jaws) and face.

Adolescence (Ages 10-18)

Around age 10, children will typically start losing their remaining primary (baby) teeth. At this stage, children are are starting the transition to having only permanent teeth. Children should continue to brush at least twice daily and use dental floss.

Late adolescence brings specific dental needs due to increasing independence. Higher risk for traumatic injury, increases in tooth decay, potential tobacco use and eating disorders, as well as  unique social and psychological needs may become issues during this time. The complexity of the teenage years increases the need for consistent dental care and a thorough medical history to address these conditions. Evaluation of the jaw, the temporomandibular joint (TMJ) and the development of the third molars (wisdom teeth) are also important to consider during this time as well.

Sources

American Academy of Pediatric Dentistry 

AAPD Reference Manual 2012/2013

“Baby Bottle Tooth Decay”, American Dental Association, 1997.

“Why Baby Teeth Are Important”, American Dental Association, 1999.

“Your Child’s First Visit to the Dentist”, American Dental Association, 1997.

“Thumbsucking: Rules of Thumb for Parents”, American Dental Association, 1994.

“The Developing Smile”, American Dental Association, 1993.

“Infant Oral Health: A Parent’s Guide for Raising Children Free of Tooth Decay”, University of Iowa, Department of Pediatric Dentistry, 1985.

Centers for Disease Control, Childhood Dental Health [link to:  http://www.cdc.gov/oralhealth/topics/child.htm]

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