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Four things are necessary for cavities to form – a tooth, bacteria, sugars or other carbohydrates and time. Dental plaque is a thin, sticky, colorless deposit of bacteria that constantly forms on everyone’s teeth. When you eat, the sugars in your food cause the bacteria in plaque to produce acids that attack the tooth enamel. With time and repeated acid attacks, the enamel breaks down and a cavity forms.
Primary, or “baby,” teeth are important for many reasons. Not only do they help children speak clearly and chew naturally, they also aid in forming a path that permanent teeth can follow when they are ready to erupt. Some of them are necessary until a child is 12 years old or longer. Pain, infection of the gums and jaws, impairment of general health and premature loss of teeth are just a few of the problems that can happen when baby teeth are neglected. Also, because tooth decay is really an infection and will spread, decay on baby teeth can cause decay on permanent teeth. Proper care of baby teeth is instrumental in enhancing the health of your child.
Usually, the space will close in the next few years as the other front teeth erupt. We can determine whether there is cause for concern.
Sore gums when teeth erupt are part of the normal eruption process. The discomfort is eased for some children by use of a teething biscuit or a cold (never frozen) teething ring. To help with pain from teething a dose of acetaminophen can be administered according to your baby’s weight.
Even before your baby’s first tooth appears (or, in dental jargon, “erupts”), her gums can benefit from your careful attention. After breast- or bottle-feeding, wrap one finger with a clean, damp washcloth or piece of gauze and gently rub it across your baby’s gum tissue. This practice both clears your little one’s mouth of any fragments of food and begins the process of building a good habit of daily oral care.
First of all, remain calm. If possible, find the tooth and hold it by the crown rather than the root. Replace the tooth in the socket and hold it there with clean gauze or a washcloth. If you can’t put the tooth back in the socket, place the tooth in a clean container with water or milk and take your child and the container immediately to the pediatric dentist. The faster you act, the better your chances of saving the tooth.
At about 6 months, the two lower front teeth (central incisors) will erupt, followed shortly by the two upper central incisors. The remainder of the baby teeth appear during the next 18 to 24 months but not necessarily in an orderly sequence from front to back. At 2 to 3 years, all of these 20 primary teeth should be present.
It is estimated that 30 million children in the US participate in organized sports programs. All sporting activities have an associated risk of injuries due to falls, collisions, and contact with hard surfaces. The Academy for Sports Dentistry (ASD) recommends the use of a properly fitted mouthguard to help prevent broken teeth, injuries to the lips, tongue, face and jaw. A properly fitted mouth guard will stay in place while your child is wearing it, making it easy for them to talk and breathe. Due to the continuous growth changes in young children, mouthguards should be custom fitted and continuously checked by a pediatric dental home. Schools participating in sports must be prepared to manage bodily and facial injuries if they occur. An injury management plan must be prepared and implemented when necessary. For more information, please see “Emergency Info.”
Radiographs (x-rays) are a vital and necessary part of your child’s dental examination. Without them, certain dental conditions can and will be missed. Radiographs allow to diagnose and treat conditions that cannot be detected during a visual examination. They are needed to survey cavities and erupting teeth, to diagnose bone diseases, to evaluate the results of an injury, and to plan orthodontic treatment. The American Academy of Pediatric Dentistry recommends radiographs for initial examinations and at 6-12 month intervals for children at high risk of decay when proximal tooth surfaces cannot be visualized. Although the amount of radiation received in a dental radiographs is extremely small, we have taken extra precautions to protect our families from radiation exposure. Our facility is completely computerized utilizing the latest dental technologies. We offer digital radiography for both intra-oral and extra-oral views, and we only take x-rays when absolutely necessary.
To comfort your child, rinse his/her mouth with warm salt water and apply a cold compress or ice wrapped in a cloth on your child’s face if it is swollen. Do not put heat or aspirin on the sore area, but you may give the child acetaminophen for pain. See us as soon as possible.
A toothbrush with soft bristles and a small head, especially one designed for infants, is the best choice for infants. Brushing at least once a day, at bedtime, will remove plaque bacteria that can lead to decay.
When a few more teeth appear, you can start using toothpaste with your child’s brush. However, for the first three years, be sure to choose toothpaste that does not contain fluoride, because too much fluoride can be dangerous for youngsters. At this stage, use only a tiny amount of toothpaste. From the beginning, have your little one practice spitting the toothpaste out after brushing, to prepare her for fluoride toothpaste, which should not be swallowed at any age.
It’s recommended that you bring your baby in for a visit within six months of the first tooth’s eruption — usually around her first birthday. Therefor, “First visit by first birthday” is the general rule. Since decay can occur in even the smallest of teeth, the earlier your baby visits us, the more likely she is to avoid problems. We’ll look for any signs of early problems with your baby’s oral heath, and check in with you about the best way to care for her teeth. Remember that preparing for each dental visit with a positive attitude goes a long way toward making your child comfortable with regular check-ups.
Pediatric dentistry is a dental specialty that focuses on the oral health and growth of young children and adolescents. Following dental school, a pediatric dentist has two to three years additional specialty training in the unique needs of infants, children and adolescents, including those with special health needs.
Baby bottle tooth decay is a pattern of rapid decay associated with prolonged nursing. It happens when a child goes to sleep while breast-feeding and/or bottle-feeding. During sleep, the flow of saliva is reduced and the natural self-cleansing action of the mouth is diminished. Avoid nursing children to sleep or putting anything other than water in their bedtime bottle. Encourage your child to drink from a cup as they approach their first birthday. He/she should be weaned from the bottle at 16-18 months of age.
Certain types of bacteria live in our mouths. When these bacteria come into contact with sugary foods left behind on our teeth after eating, acids are produced. These acids attack the enamel on the exterior of the teeth, eventually eating through the enamel and creating holes in the teeth, which we call cavities.
Thumb and pacifier sucking habits that go on for a long period of time can create crowded, crooked teeth or bite problems. If they are still sucking their thumbs or fingers when the permanent teeth arrive, a retainer may be recommended by your pediatric dentist. Most children stop these habits on their own.
Sealants are clear or shaded plastic applied to the teeth to help keep them cavity-free. Sealants fill in the grooved and pitted surfaces of the teeth, which are hard to clean, and shut out food particles that could get caught, causing cavities. Fast and comfortable to apply, sealants can effectively protect teeth for many years.
According to the American Academy of Pediatric Dentistry, the adjustment of the fluoride level in community water supplies to optimal concentration is the most beneficial and inexpensive method of reducing the occurrence of cavities. Fluoride is an important part of the crystalline structure of enamel and makes teeth less soluble to decay acids. The enamel can incorporate fluoride at different stages of tooth development. This means systemic and topical fluoride can be beneficial.
Fluoridated Drinking Water: Some local water companies provide tap water naturally high in fluoride. However, if you have a home filter of the reverse osmosis type, this fluoride will be removed by the filtering process. In other areas it is necessary to purchase bottled fluoridated water. All major suppliers have fluoridated water for home delivery. Bottled water with fluoride is available at most markets. The most common brands are Sparkletts with Fluoride (1.0 mg/L), Dannon Fluoride to Go (1.0 mg/L) and Gerber Baby Water (0.5 mg/L). Fluoridated water can be used for drinking and cooking. Frequency is more important than the amount of water consumed. Ideal fluoride content is 0.8-1.0mg/L of fluoride except for water used to reconstitute powdered baby formula, which should not have fluoride content greater than 0.5mg/L.
Toothpaste: Use an American Dental Association (ADA) approved toothpaste for brushing your child’s teeth. Do not start fluoridated toothpaste until two years of age because the fluoride concentration is high and young children can swallow it. A half-pea sized amount of paste is sufficient for small children.
Fluoride Rinse: Once your child has learned how to expectorate properly, a fluoride rinse may be added to the oral hygiene plan. It is important that your child is able to spit out the rinse because swallowing it would cause ingestion of high levels of fluoride.
Professional Applications: Higher concentrations of fluoride treatment are available for professional use in the dental office. The newest type of these products comes in a varnish form and is able to stick to your child’s teeth for several hours providing more benefit to the enamel. Applications are part of a comprehensive prevention program in the dental home.
Supplements: A careful evaluation of all sources of fluoride, your child’s risk for cavities and the frequency of dental visits is required before your child is placed on fluoride supplements. Fluoride works in optimal concentrations. If fluoride levels are too low, the benefits are reduced. If fluoride levels are too high, there will be a risk of fluorosis. Fluorosis is a chalky white or brown discoloration of the permanent teeth. Many children often get more fluoride than their parents realize. Being aware of a child’s potential sources of fluoride can help parents prevent the possibility of this problem.
Your child does not need to use fluoridated toothpaste until age 2. Earlier than that, clean your child’s teeth with water and a soft-bristled toothbrush. After age 2, parents should supervise brushing. Use no more than a pea-sized amount of toothpaste and make sure children do not swallow excess toothpaste.