Pediatric Dental Care
A Guide to Your Child’s Teeth
In recent years, preventive care has improved the oral health of many American children. However, tooth decay is still a serious public health problem. It is five times more common than asthma.
Children learn healthy habits from their parents. Here are some simple steps you can take to help your child have a lifetime of healthy smiles.
Teething
As teeth begin to emerge, some babies may have sore or tender gums. Contrary to common belief, fever is not normal for a teething baby. If your baby has an unusually high or persistent fever while teething, call your physician. Rubbing your child’s gums with a clean wet gauze or finger may relieve some of the soreness. A clean, chilled teething ring — don’t dip it in sugar, syrup, honey or other foods — may also ease tender gums. If the child is still cranky and uncomfortable while teething, consult your dentist or physician.
First Dental Visit
When your child’s first tooth appears, talk to your dentist about scheduling the first dental visit. Treat the first dental visit as you would a well-baby checkup with the child’s physician. It’s beneficial for the first dental visit to occur within six months after the first tooth appears, but no later than your child’s first birthday. Although this may seem early, starting early is the key to a lifetime of good dental health.
During the first visit, the dentist can do several things, such as:
- Review the medical and dental histories
- Give a complete oral exam to check growth and development, oral hygiene, injuries, cavities or other problems
- Determine your child’s risk of developing tooth decay
- Clean the teeth and provide suggestions for daily care
- Evaluate your child’s fluoride needs to optimize the preventive benefits
- Review feeding practices that may lead to tooth decay
- Discuss teething, pacifier use, or finger/thumb sucking habits
- Talk with you about common dental injuries and what to do if one happens
- Discuss treatment if needed and schedule the next check-up
Cleaning Your Child’s Teeth
Good news: Cavities are almost completely preventable. Cleaning your child’s teeth is an important step to prevent cavities. After each feeding, wipe the baby’s gums with a clean, damp gauze pad or washcloth. This will remove plaque and bits of food that can harm erupting teeth. When your child’s teeth begin to erupt, brush them gently with a child’s size toothbrush and water. (Consult with your child’s dentist or physician if you are considering using fluoride toothpaste before age two.) By spending a few minutes each day to care for your baby’s teeth, you can help ensure that your child’s smile gets off to a healthy start.
When your child can be counted on to spit and not swallow toothpaste (usually not before age two), begin brushing the teeth with a pea-sized amount of toothpaste. The American Dental Association recommends fluoride toothpaste; ask your dentist about your child’s fluoride needs. Use a child-sized toothbrush and replace it when it is worn. Bent, frayed bristles may not remove plaque effectively. Brush your child’s teeth until he or she is at least six years old.
Diet
As soon as teeth erupt through the gums, decay can occur. One risk factor for decay, also called early childhood caries or baby bottle tooth decay, is the frequent, prolonged exposure of the baby’s teeth to liquids that contain sugar, like sweetened water and fruit juice and potentially milk, breast milk and formula. Tooth decay can occur when the baby is put to bed with a bottle, or when a bottle is used as a pacifier for a fussy baby. The sugary liquids pool around the teeth while the child sleeps.
If your child uses a pacifier, provide one that is clean — don’t dip it in sugar or honey, or put it in your mouth before giving it to the child. The cavity-causing bacteria in your mouth can be transferred to your baby.
Encourage children to drink from a cup by their first birthday and discourage frequent or prolonged use of a training (sippy) cup.
Healthy eating habits also include a diet with plenty of vegetables, fruits and whole grains. Serve nutritious snacks and limit sweets to mealtimes.
Sucking Habits
Sucking is a natural reflex, and infants and young children may suck on thumbs, fingers, pacifiers and other objects. It may make them feel safe and happy or provide a sense of security. Since thumb sucking is relaxing, it may induce sleep.
Problems with tooth alignment and the proper growth of the mouth may result from a child’s sucking habits. The frequency, duration, and intensity of sucking will determine whether or not dental problems will result. Children who rest their thumbs passively in their mouths are less likely to have difficulty than those who vigorously suck their thumbs.
Sucking habits usually stop between the ages of two and four. If your child uses a pacifier or sucks his or her fingers, talk to your dentist about how to wean your child of this habit. Pacifiers should not be used after age two, and finger or thumb sucking should be eliminated by age four.
Baby’s First Teeth
Your child’s baby teeth are important in helping your child chew and speak normally. They also hold space in the jaws for the adult teeth that come in later. We usually think of a newborn baby as having no teeth, but the teeth are already developing in the baby’s jawbones and will erupt during the first three years of childhood. Starting infants off with good oral care can help protect their teeth for decades to come.
A baby’s front four teeth usually come in first. This typically happens when the baby is about six months old. Don’t worry if the teeth don’t appear exactly by six months. Some children may not have a first tooth until they reach 12 or 14 months of age. By the time they are age three, most children have a full set of 20 primary teeth.
As the child grows, the jaws also grow, making room for the adult teeth that begin to appear around age six. By age 12 to 14, children typically have 28 of their 32 adult teeth. The remaining four molars, often called wisdom teeth, erupt between the ages of 17 and 25.