Innumerable studies and research have concluded on the importance of starting children early in their lives with good dental hygiene and oral care. According to research, the most common chronic childhood disease in America is tooth decay, affecting 50 percent of first-graders and 80 percent of 17-year-olds. Early treatment prevents problems affecting a child’s health, well-being, self-image and overall achievement.
The National Institute of Dental & Craniofacial Research estimates that children will miss 52 million hours of school each year due to oral health problems and about 12.5 million days of restricted activity every year from dental symptoms. Because there is such a significant loss in their academic performance, the Surgeon General has made children’s oral health a priority.
Parents are responsible for ensuring their children practice good dental hygiene. Parents must introduce proper oral care early in a child’s life—as early as infancy. The American Dental Hygiene Association states that a good oral hygiene routine for children includes:
- Thoroughly cleaning your infant’s gums after each feeding with a water-soaked infant cloth. This stimulates the gum tissue and removes food.
- Gently brushing your baby’s erupted teeth with a small, soft-bristled toothbrush and using a pea-sized amount of fluoridated toothpaste.
- Teaching your child at age 2 or 3 about proper brushing techniques and later teaching them brushing and gentle flossing until 7 or 8 years old.
- Regular visits with their dentist to check for cavities in the primary teeth and for possible developmental problems.
- Encouraging your child to discuss any fears they may have about oral health visits, but not mentioning words like “pain” or “hurt,” since this may instill the possibility of pain in the child’s thought process.
- Determining if the water supply that serves your home is fluoridated; if not, discussing supplement options with your dentist or hygienist.
- Asking your hygienist or dentist about sealant applications to protect your child’s teeth-chewing surfaces and about bottle tooth decay, which occurs when teeth are frequently exposed to sugared liquids.
Normally the first tooth erupts between ages 6 to 12 months. Gums are sore, tender and sometimes irritable until the age of 3. Rubbing sore gums gently with a clean finger, the back of a cold spoon or a cold, wet cloth helps soothe the gums. Teething rings work well, but avoid teething biscuits—they contain sugar that is not good for baby teeth.
While your baby is teething, it is important to monitor the teeth for signs of baby bottle decay. Examine the teeth, especially on the inside or the tongue side, every two weeks for dull spots (whiter than the tooth surface) or lines. A bottle containing anything other than water and left in an infant’s mouth while sleeping can cause decay. This happens because sugar in the liquid mixes with bacteria in dental plaque, forming acids that attack the tooth enamel. Each time a child drinks liquids containing sugar, acids attack the teeth for about 20 minutes. When awake, saliva carries away the liquid. During sleep, the saliva flow significantly decreases and liquids pool around the child’s teeth for long periods, covering the teeth in acids.
Infant’s New Teeth
The primary, or “baby,” teeth play a crucial role in dental development. Without them, a child cannot chew food properly and has difficulty speaking clearly. Primary teeth are vital to development of the jaws and for guiding the permanent (secondary) teeth into place when they replace the primary teeth around age 6.
Since primary teeth guide the permanent teeth into place, infants with missing primary teeth or infants who prematurely lose primary teeth may require a space maintainer, a device used to hold the natural space open. Without a maintainer, the teeth can tilt toward the empty space and cause permanent teeth to come in crooked. Missing teeth should always be mentioned to your family dentist. The way your child cares for his/her primary teeth plays a critical role in how he/she treats the permanent teeth. Children and adults are equally susceptible to plaque and gum problems—hence, the need for regular care and dental checkups.
A Child’s First Dental Visit
A child’s first dental visit should be scheduled around his/her first birthday. The most important part of the visit is getting to know and becoming comfortable with a doctor and his staff. A pleasant, comfortable first visit builds trust and helps put the child at ease during future dental visits. If possible, allow the child to sit in a parent’s lap in the exam room. Children should be encouraged to discuss any fears or anxiety they feel.
Why Primary Teeth Are Important
Primary teeth are important for several reasons. Foremost, good teeth allow a child to eat and maintain good nutrition. Healthy teeth allow for clear pronunciation and speech habits. The self-image that healthy teeth give a child is immeasurable. Primary teeth also guide eruption of the permanent teeth.
Good Diet And Healthy Teeth
The teeth, bones and soft tissue of the mouth require a healthy, well-balanced diet. A variety of foods from the five food groups helps minimize (and avoid) cavities and other dental problems. Most snacks that children eat cause cavities, so children should only receive healthy foods like vegetables, low-fat yogurt and cheeses, which promote strong teeth.
Infant Tooth Eruption
A child’s teeth actually start forming before birth. As early as 4 months of age, the primary or “baby” teeth push through the gums—the lower central incisors are first, then the upper central incisors. The remainder of the 20 primary teeth typically erupt by age 3, but the place and order varies.
Permanent teeth begin eruption around age 6, starting with the first molars and lower central incisors. This process continues until around age 21. Adults have 28 secondary (permanent) teeth—32 including the third molars (wisdom teeth).
Preventing Baby Bottle Tooth Decay
Tooth decay in infants can be minimized or totally prevented by not allowing sleeping infants to breast or bottle-feed. Infants that need a bottle to comfortably fall asleep should be given a water-filled bottle or a pacifier. Our office is dedicated to fighting baby bottle tooth decay. Let us know if you notice any signs of decay or anything unusual in your child’s mouth.
As neuromuscular dentists, we have the opportunity to impact the lives of our patients for the better. One way we can do this is by identifying children with potential airway obstructions due to enlarged tonsils and adenoids. If untreated, this situation can sentence the child to a life of chronic ear, sinus and throat infections, increased risk of sleep apnea, TMJ pain and dysfunction and chronic mouth breathing causing poor arch form and midface development leading to excessive orthodontic intervention, etc. With our timely referral to an ENT, the child can be evaluated for airway obstruction caused by enlarged tonsils and or adenoids. The ENT can surgically remove the offending tissue and the child can be freed of their limitations imposed on them by poor airway.
To make the referral of a child in need of an ENT evaluation go as smooth as possible. I recommend a local ENT which understands the impact of a healthy patent nasal airway on the ideal growth and development of the midface and airway, the position of the teeth and in turn the systemic long term health of the child and the TMJ complex. I give the parents a packet to take to the ENT from me when they take their child. In the packet I send the ENT's business card, a referral slip from me with some symptoms checked off as they relate to the child with a handwritten note from me describing briefly what I would like the ENT to evaluate, a copy of Dr. Bill Dickerson's "Why Are We So Screwed Up? "and a copy of the Academy of Otolaryngology's clinical indications for surgical removal of tonsils and or adenoids in Children. In this last document, I usually circle 1.-g as that is the indication that mentions the appropriate nature of the child's dentist making a referral of this nature.
I usually ask the parent to do me the favor and delivery the packet to the ENT on my behalf as it has important information that relates to their child. That is usually enough to get the parent to read the enclosed material and go to the appointment as an informed parent acting as an advocate on behalf of their child. The ENT will usually follow through on my treatment recommendations as they know that I can properly identify children who indeed need their help and make a timely referral. In the end it is all good. Sick children are treated by skillful caring professionals and get better so the can grow up and become healthy adults that can enjoy and appreciate life and health. I hope most of you find this information helpful and can use it to better the life and health of your children.
(With permission and courtesy of Miami Designer Smiles Dentist, Dr. Conchi Sanchez-Garcia, www.miamidesignersmiles.com)