Pediatric oral care has two main components: preventative care at the 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.

How do dentists care for my child’s teeth?

Dentists examines the teeth for signs of early decay, monitors orthodontic concerns, tracks jaw and tooth development, and provides a good resource for parents.  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 dentist or hygienist 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 dentist may recommend dental sealants.  Sealants 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.

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. 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 can I help at home?

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.

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.  

If you have questions or concerns about how to care for your child’s teeth, please ask your  dentist.