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Keeping Your Child's Teeth Healthy


When should I schedule my child's first trip to the dentist? Should my 3-year-old be flossing? How do I know if my child needs braces?

Many parents have a tough time judging how much dental care their kids need. They know they want to prevent cavities, but they don't always know the best way to do so. Here are some tips and guidelines.

When Should Kids Start Brushing Their Teeth?

Good dental care begins before a baby's first tooth appears. Just because you can't see the teeth doesn't mean they aren't there. Teeth actually begin to form in the second trimester of pregnancy. At birth, your baby has 20 primary teeth, some of which are fully developed in the jaw.

Here's when and how to care for those little choppers:

Even babies can develop tooth decay if good feeding habits aren't practiced. Putting a baby to sleep with a bottle might be convenient, but can harm the baby's teeth. When the sugars from juice or milk remain on a baby's teeth for hours, they can eat away at the enamel, creating a condition known as bottle mouth. Pocked, pitted, or discolored front teeth are signs of bottle mouth. Kids with severe cases might develop cavities and need all of their front teeth pulled (permanent teeth will grow in later).

Parents and childcare providers should help young kids set specific times for drinking each day because sucking on a bottle throughout the day can be equally damaging to young teeth. Babies as young as 6 months are encouraged to switch from a bottle to a sippy cup (with a straw or hard spout). By 12 months of age, they'll have the motor skills and coordination to use the cup on their own.

When Should Kids See a Dentist?

The ADA recommends that children see a dentist by their first birthday. At this first visit, the dentist will explain proper brushing and flossing techniques and do a modified exam while your baby sits on your lap.

These visits can help find problems early and help kids get used to visiting the dentist so they'll have less fear about going as they get older. Consider taking your child to a dentist who specializes in treating kids. Pediatric dentists are trained to handle the wide range of issues associated with kids' dental health. They also know when to refer you to a different type of specialist, such as an orthodontist to correct an overbite or an oral surgeon for jaw realignment.

If a child seems to be at risk for cavities or other problems, the dentist may start applying topical fluoride even before all teeth come in (this also can be done in the pediatrician's office). Fluoride hardens the tooth enamel, helping to ward off the most common childhood oral disease — dental cavities (also called dental caries).

How Can We Prevent Cavities?

Cavities happen when bacteria and food left on the teeth after eating are not brushed away. Acid collects on a tooth, softening its enamel until a hole — or cavity — forms.

dental cavity illustration

Here's how to keep cavities away:

As your child's permanent teeth grow in, the dentist can help prevent decay by applying a thin wash of resin (called a sealant) to the back teeth, where most chewing is done. This protective coating keeps bacteria from settling in the hard-to-reach crevices of the molars. But make sure that kids know that sealants aren't a replacement for good brushing and regular flossing.

What Dental Problems Can Happen?

If you are prone to tooth decay or gum disease, your kids might be at higher risk as well. So sometimes even the most best brushing and flossing habits can't prevent a cavity. Be sure to call your dentist if your child complains of tooth pain, which could be a sign of a cavity that needs treatment.

New materials mean pediatric dentists have more filling and repair options than ever. A silver-colored material called amalgam (a special mix of metals) was once the substance of choice for most fillings in permanent teeth. But now, other materials like composite resins are becoming popular. Resins bond to the teeth so the filling won't pop out, and also can be used to rebuild teeth damaged through injury or conditions like a cleft palate. Because resins are often tooth-colored, they're considered more attractive.

But in cases of fracture, extensive decay, or malformation of baby teeth, dentists often opt for stainless steel or ceramic crowns. Crowns maintain the tooth while preventing the decay from spreading.

In some rare instances, usually when a more complicated dental procedure is to be done, a dentist will recommend using general anesthesia. Parents should make sure that the professional who gives the medicine is a trained anesthesiologist or oral surgeon before agreeing to the procedure. Don't be afraid ask your dentist questions.

Regular checkups and good dental hygiene can help prevent the need for this kind of extensive dental work. Also, encourage your kids to use a mouthguard during sports, which can prevent serious dental injuries.

What Is Orthodontia?

As kids get older, their bite and the straightness of their teeth can become an issue. Orthodontic treatment begins earlier now than it used to, and braces have changed too. The embarrassing old gear — a mouth filled with metal wires and braces — is in the past. Kids as young as age 7 now wear corrective appliances, and plastic-based (sometimes clear) materials have replaced metal.

Orthodontists know that manipulation of teeth at a younger age can be easier and more effective in the long run. Younger children's teeth can be positioned with fairly minor orthodontic devices, preventing major treatment later on.

Looking Ahead

As kids grow, plan on routine dental checkups anywhere from once every 3 months to once a year, depending on your dentist's recommendations. Keeping sugary foods in check, encouraging regular brushing and flossing, and working with your dentist will lead good dental health.

Date reviewed: May 2015


Note: All information on KidsHealth® is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor.

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