Everything you need to know about caring for your kids'teeth
For the first time in decades, cavities in kids are on the rise. As many as 28 percent of children ages2 to 5 have cavities in their baby teeth. What can you do to keep your child's teeth healthy? Answersto your most pressing dental questions, for babies on up:
Q: What's the best way to keep my child from getting cavities?
Kids should brush at least twice a day and, ideally, after snacking, too.
A: The health of your child's teeth is largely dependent on four things: diet, oral hygiene, toothmakeup, and the amount and quality of her saliva (which helps rinse away food and bacteria). Sincesaliva and the strength of her teeth are based mainly on genes -- and out of your control -- focus onwhat you can influence: eating and cleaning.
The kind of food in your child's diet -- and how frequently she eats it -- matters. When sugar andstarch meet up with normal bacteria in the mouth, they can create acids that dissolve the tooth'sstructure and cause cavities. The more a child eats sugar and starches (processed snacks are theworst offenders), the more often her teeth are exposed to the acids. Eating regular healthy meals,rather than lots of small portions throughout the day, and drinking water (the fluoridated kind, forkids older than 1), will help prevent acids from settling on the teeth and stave off tooth decay. Whilea no-snack rule is unrealistic, offer more fruits and vegetables, as opposed to processed treats.
Just as crucial: Kids should brush at least twice a day and, ideally, after snacking, too. Keep in mindthat the most important time to brush is before a nap or bedtime because saliva production slowsduring sleep (it's linked to blood pressure and heart rate), giving acids far more opportunity todamage teeth. Parenting.com: Can sippy cups cause cavities?
At what age should I start taking my child to the dentist -- and how often should he go?
A: Babies should see the dentist within six months of their first tooth's appearance (usually around 6months of age), and no later than age 1. Stick to that time frame and your child may need fewerfillings than kids who wait until age 2 or 3, says a recent study. At the visit, as long as there are nomajor problems, the dentist will typically count and inspect your child's teeth (or tooth!), start to gethim used to the office and staff, and talk with you about preventive care. The main goal is that achild have a happy and comfortable experience, says Beverly Mittelman, coauthor, along with dentistJerome Mittelman, of "Healthy Teeth for Kids." The rule of thumb is to bring your child back everysix months or so for a routine cleaning and checkup. Parenting.com: Easy baby dental care
Q: Are electric toothbrushes a good idea for kids?
A: They Click for a List of Cosmetic Dentist by State can be helpful for children who aren't yet
coordinated enough to brush thoroughly with a manual toothbrush (kids under 4 sometimes aren't).They also often come with a two-minute timer that lets your child know when she can stop brushing.If you choose an electric model, make sure your child doesn't apply too much pressure when she'susing it. If she does, the head of the toothbrush may not rotate and won't be as effective. No matterwhich kind of brush you pick, be sure that she's getting to those hard-to-reach places in the back ofher mouth; this might require a little extra help from you until she's 5 or 6 years old.
Q: Should my child get dental sealants to prevent cavities?
A: They're no substitute for good oral hygiene. But sealants -- thin plastic barriers that are paintedonto the chewing surface of the back teeth -- can help fend off decay if your child has deep groovesin his molars. Bacteria, plaque, and food particles can get into those grooves and are difficult toremove with a toothbrush. Though some research supports using sealants as a routine part of dentalcare for babies, baby teeth are less likely to be heavily grooved, and many insurance companies willpay for sealants only on adult teeth. If some (or all) of your child's permanent teeth are in, talk toyour dentist about whether he recommends sealants. There's no drilling or anesthetic required, theywon't show when your child talks or smiles, and they aren't painful -- though he may be able to feelthem with his tongue at first. Prices vary; if you have dental insurance, check to see if sealants arecovered.
Q: I see a lot of natural toothpastes in the store these days that don't contain fluoride. Are they OKfor kids to use?
A: While fluoride protects enamel,non-fluoridated toothpastes are bestfor kids who can't yet spit. Why?Swallowing fluoride and getting toomuch of it can lead to fluorosis, whichcauses stains on the enamel ofpermanent teeth. (What's mostimportant, whichever toothpaste youchoose, is the action of brushingteeth, which does most of thecleaning.) When your child's oldenough to spit, talk to your dentist;she may be getting plenty of fluoride through tap water, fluoride treatments, and food. Also note:Infants under 1 do not need fluoride and are particularly vulnerable to fluorosis. The AmericanDental Association recommends that you use water that has no fluoride, or only a low level of it, forformula that needs to be reconstituted. Best bets are purified, deionized, demineralized, distilled, orreverse osmosis filtered water. Parenting.com: Teething time answers
Q: Is it true that chewing xylitol gum can help reduce the risk of tooth decay?
A: Yes. The physical motion of chewing produces more saliva, which helps neutralize pH balance toprevent cavities. And studies have shown that xylitol, a natural sweetener that tastes like sugar, maysuppress the growth of bacteria in the mouth.
For kids under 4, any type of gum is a choking hazard. But babies and toddlers can still reap thebenefits of xylitol: If Mom chews it during her pregnancy and up to two years postpartum, her child's
less likely to develop tooth decay down the road (the bacteria that cause it are often passed frommother to baby through kissing or sharing food).
Q: My toddler grinds his teeth. Should I be concerned?
A: Tooth grinding (bruxism) happens occasionally in young kids. As your child's mouth grows andchanges, he may grind his teeth in order to comfortably align them with his jaw. While it candamage the enamel on baby teeth, they usually fall out before it becomes a problem. And experts sayit's uncommon for grinding to do serious harm to permanent teeth because the habit usually goesaway on its own by age 6. If you're still worried, or your child hasn't outgrown it by then, talk to yourdentist. She may suggest a mouth guard to wear at night, or she may refer you to a myofunctionaltherapist, who can work with him to balance the muscles in the mouth and get at the cause of thegrinding. Parenting.com: Treating a knocked-out baby tooth
Q: Do I really need to wipe my baby's gums with gauze before his teeth come in?
A: It's a good idea. It will help your baby get used to the feeling of brushing, and sometimes there's asmall opening in the gum before the tooth erupts -- a perfect hiding place for bacteria, which thegauze will wipe away. Payman Pirnazar, a pediatric dentist in Los Angeles and the founder ofBabyTeeth.com, recommends that you start wiping your baby's gums after each feeding at around 6months (it takes just a few seconds). Dentists say it may even have the added benefit of makingteething more comfortable for your baby, since as you're cleaning you're also massaging the gums.
Q: What are the best kinds of fillings for children -- and are there any new, less painful ways to drillfor them?
A: Often it comes down to aesthetics. "If you have a child walking around with metal crowns, it's notuncommon for other kids to start teasing him," says Dr. Pirnazar.
And then there are practical issues: Filling a cavity with composite (a tooth-colored material made ofquartz and resin) may take up to 40 minutes -- as opposed to about ten minutes for an amalgam(metal) filling -- which is a challenge when the patient is a wiggly kid. On the other hand, compositerestorations don't require the dentist to drill as much. And while the ADA maintains that the mercurycontent in metal fillings is safe, this has been debated, and some parents prefer to skip them.
Laser surgery is the newest way to drill and is said to be less painful, though it's not yet widelyavailable. Because the equipment is expensive, if your dentist offers laser drilling, ask whetherthere's an extra fee for it.
Q: How is a pediatric dentist different from a family-practice dentist?
A: Pediatric dentists receive additional training in caring for children's oral health. And they tend tomake their offices child-friendly by offering videos, special chairs, or music. The caveat: Sincepediatric dentistry is a specialty, there may be fewer practitioners to pick from in your area.Ultimately, though, sizing up any prospective dentist comes down to this: How does she relate toyour children? Is she competent? Does she listen to your concerns? The answers to these questionsare more important than her title. E-mail to a friend
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Meagan Francis is the author of "The Everything Health Guide to Postpartum Care" and the mom offour boys, ages 9, 7, 3, and 1, who work hard to give the tooth fairy shiny teeth.