What is really important in keeping my children’s mouth healthy?
I am continually asked this question by patients and friends with very young children, so I figure that the pediatricians aren’t giving specific information. I want to make this very simple for all parents to follow, whether you have a newborn baby, toddler, or school-aged child.
When should I start to brush my child’s teeth?
The answer to this question is…before your child HAS teeth! It’s really important to remove the remnants of breast milk or formula from a baby’s gums to prevent overgrowth of any bacteria in the mouth. the best way to do this is with a very thin, soft washcloth wrapped around your first finger and wet with water only. use a gentle rubbing motion all over the gums and under your baby’s tongue if you can reach. This should be done twice a day, in the morning and at night. It also creates a great habit for life, and babies especially like the rubbing on the gums just before the teeth come in.
Once the first tooth erupts, use a wet baby toothbrush without toothpaste to clean that tooth as well as the others that follow over the next many months. Once your child is old enough to grab things, allow him to guide your hand around his mouth with the toothbrush, but still make sure you brush all areas. Most young children enjoy the toothbrushing routine, but some children can be quite fussy when the teeth are brushed, and I had a very hard time with my son in this regard until about 2 years of age. It often took both parents to hold him securely so we could get the job done without anyone getting hurt. We made sure not to appear frustrated with him, and sang toothbrushing songs and smiled each time while he screamed…the “good news” is that while he was yelling, his mouth was open and we could get the job done! Don’t worry about his psychological development, he is now a very pleasant 12 year old who willingly brushes his teeth at least as often as his pre-teen counterparts.
When should I start having my child use toothpaste?
There are a variety of children’s toothpastes on the market that do not contain fluoride and are safe to use at any age. Some children like to brush with a flavoured toothpaste, but most prefer fruit rather than mint. In a young child, I recommend only touching the tips of the brush to the toothpaste tube for a fine film of paste. Once your child can reliably spit water out of his mouth, you can move to a fluoride-containing toothpaste if you prefer; now the amount you use should be no more than the size of one pea. As your child grows, you can begin to use slightly larger toothbrushes, but small one will remain easier to be able to reach all areas of the teeth.
What about flossing?
If your child’s mouth is developing properly, there should be spaces between all of the baby teeth except between the baby molars. Flossing the front teeth is good because it creates a habit, but for some children brushing between the back teeth can be necessary to prevent decay between the teeth. Remember, each tooth has 5 sides: cheek side, tongue side, biting side, and the sides that touch the tooth in front and in back. The toothbrush only cleans three of the five sides…so floss really is important to protect your child’s teeth (the same can be said for YOU, but that’s for a different blog). As baby teeth fall out and adult teeth come in, the spaces will also close, and flossing becomes extra important. You can buy pre-threaded flossers that look a bit like toothpicks for cocktail sandwiches, and these are much easier to use than string floss for parents and older children. A girl will have the manual dexterity younger than a boy to be able to use string floss properly, and your dental hygienist would love nothing better than to teach her how to use it properly.
Loose teeth…pull them out, or let then come out on their own?
A tooth becomes loose when the adult tooth replacing it has grown enough to move up through the gums. Once a tooth becomes loose, there is nothing wrong with your child wiggling and removing the tooth himself (with clean hands, of course), but it isn’t necessary. When the tooth becomes so loose that eating becomes a problem, it’s good to remove the tooth because bits of food and bacteria can become trapped under the baby tooth and cause a gum infection and soreness. You or your child can accomplish this easily at home, sometimes with a little numbing liquid like Anbesol from the drugstore. If his doesn’t work, your dentist can easily take care of this. Be warned…when I remove a baby tooth in MY office, I tell the child that the tooth fairy brings DOUBLE!
What if teeth don’t get loose, but the adult tooth comes in in front or behind it?
This is very common and happens when the jaw isn’t growing quickly enough for all the teeth to properly fit. This would be a good time to involve an orthodontist, as he can encourage jaw growth to allow all the teeth to fit. Sometimes if an orthodontist is involved early (we call this interceptive treatment), braces may not even be needed later or if they are the job is much simpler to do. Ask your dentist for a referral to her favorite orthodontist who treats younger children, as not all orthodontists do this type of treatment.
Why fix baby teeth with cavities when they will fall out anyway?
A cavity in any tooth is actually rotten bits of tooth mixed with tons of bacteria. That mold inside the tooth continues to eat away at the tooth, which may eventually cause pain and serious infection. Also, when the cavity-causing bacteria stays in the child’s mouth, each time she chews food your child is moving that same bacteria around to other areas of the mouth, where it can infect other, healthy teeth, and even be swallowed with their food! Finally, one of the most important roles of a baby tooth is as a placeholder for the adult tooth later on. If the baby tooth becomes infected under the gum and bone, it can affect the developing adult tooth underneath with serious effects.
In our practice, a general rule of thumb is if the tooth is going to fall out within one year and it is a small painless area of decay, we will not treat the tooth. However, if a more serious amount of decay is present, or if there is decay in several teeth, treatment is required. In fact, sometimes the early removal of that baby tooth is recommended, and often the child will need a retainer to hold everything else in place while awaiting the eruption of the adult tooth.
It is most important that we create great dental patients starting from your child’s first visit to a dentist!
A lifetime of preventative and restorative dental treatment awaits your child, and we feel it is critically important to create great dental patients from the start. We generally recommend a first dental visit no later than 3 years old, and we will only do what is comfortable for that child at that visit, building if needed every six months so that a full exam and cleaning with xrays if recommended can be performed stress-free by the age of 5-6 years old. If there is significant dental treatment necessary at a young age, and we feel that a child may not be mature enough to manage that treatment in our office, we will refer that “pre-cooperative child” (will be an amazing dental patient…later) to a dental specialist for further treatment. Having said this, it is not uncommon for us to treat children in our practice as young as 3 years old very successfully.
Good dental habits and healthy mouths start early. If there are any questions you have regarding your child’s teeth, please feel free to ask your question below or contact our office for more information.
Dr. Andrea Stevens is a cosmetic and family dentist in practice in Kanata, Ontario. If you have dental questions, you can call her at 613-271-7091 or visit her at kanatacosmeticdentist.com Please also feel free to leave comments or questions below, and Dr. Stevens will be happy to answer!