Pediatric Dentistry
Common Issues
Thumb Sucking
What Problems does Thumb Sucking Cause?
Oral habits such as thumb/finger sucking are habits that can occur early in life. The good news is that most kids give up this habit by age four. If your child continues beyond this age, don’t get discouraged, it can still discontinue on its own. Of course there can be oral/dental consequences with continued sucking habits in the form of malformed or crooked teeth and palate but don’t be dismayed, all these malformations can be corrected with time. The duration, frequency, and intensity seem to be the most important factors in determining the extent of malformation of the teeth and mouth bones.
How can I stop it?
You can’t. That is to say, the best method is to use some simple tools to help your child discontinue the habit when they are ready. When looking at many of the studies that have been done on oral habits, there seems to be a consensus that your child will stop the habit when they are ready. Positive or negative attention to the habit seems to make the habit continue longer. If your child is having a hard time stopping and they want to stop, there are appliances that we can fabricate to help remind them to stop. The best results of these appliances are in late childhood to the early teen years. Positive reinforcement seems to be the most effective method to help your child discontinue the habit.
Baby Bottle Decay
What causes baby bottle tooth decay?
It is not the bottle that causes the decay. It is the substance inside. The most detrimental time to feed the bacteria in the mouth is during bedtime at night and during nap time. Nightime breast feeding, milk feeding, or juice can be very damaging to some children, especially if they are genetically predisposed to dental decay.
Tips to avoid baby-bottle decay:
- If you child must go to sleep with a bottle, only use water. Any amount of milk or juice can be very detrimental.
- Try to remove any milk off of teeth if they fall asleep during feedings.
- Try not to let your child walk around using a bottle of milk or juice as a pacifier.
- Make the goal to discontinue all bottles and sippy cups by 12-14 months of age.
- Avoid any sugary substance on their pacifier or bottle.
Tooth Eruption
When should my child’s tooth begin to erupt?
The average age of first tooth eruption in infants is around 6-8 months. The two lower front teeth are the most common teeth to erupt first. About every 6 months another set of four teeth usually erupt finishing by age 3 in most kids with 20 teeth. The most common tooth eruption sequence in kids is: the lower front teeth, followed by the upper front teeth, followed by the first molars, then the canines, and then the second molars
Why do we care about baby teeth?
Primary teeth or baby teeth, are important for function, esthetics, and space maintenance for the permanent teeth.
What about permanent teeth?
Usually around age 6 your child will begin to loose their first tooth beginning with the lower front teeth and the eruption of the 6 year molars at the back of their baby molars. Some children complain of tooth pain during this time. If the pain seems unusual you should see your dentist.
Tooth Brushing
How should my child brush?
As you know, a child’s hand dexterity and mouth are different than their parents. It is important to make sure that your child is using the right toothbrush for them. In both cases, adults and kids should use a soft, rounded bristle toothbrush, with gentle cleaning.
How often should I change my toothbrush?
The typical toothbrush should latest 3 months.
What about my infant?
Before tooth eruption and shortly after you can use a moistened, soft cloth or square gaze to gently wife their teeth and gums after feedings. Once teeth start to erupt, a small, soft toothbrush can be used to clean their teeth.
How much toothpaste should my child use?
According to the AAPD “no more than a smear or rice-sized amount for children less than 3 years of age and no more than a pea-sized amount for children aged 3-6″ twice daily.
When can my child brush on their own?
It can take many years for a child to learn how to brush their teeth and gums well. Sometimes well into their teenage years. Therefore, it is recommended that you help your child daily to brush their teeth in all areas that they have missed.
How do you brush well?
Placing the tooth brush at a 45 degree angle towards the teeth and gums and gentle brushing back and forth with short strokes and in small circles, seems to be most effective. Make sure to touch all the teeth in the area where the tooth and the gums meet, on the top and bottom teeth and on the front and back teeth. Don’t forget to brush all the food debris out of the chewing surfaces of the teeth also.
What about flossing?
The only effective way to clean between teeth is with flossing. Sorry, you just have to do it! You should begin flossing when you can no longer see space between the teeth.
What can I do if my child will not brush their teeth?
Try any or all of the following:
1. Try to let him/her to brush your teeth at the same time you brush their teeth.
2. Take them to the store to let them pick out their favorite toothbrush, for some kids they would prefer a mechanical toothbrush with a timer.
3. Let them begin brushing and then you follow-up brushing after they are done.
4. There is a large resource of books that you can read with your child to teach them about the importance and fun of brushing.
5. Stick to the same routine daily. I know some children who prefer sitting the bathtub and brushing their teeth.
Cavity Prevention
What causes cavities?
Cavities are caused by specific bacteria found in the mouth. They can grow to large numbers especially if the conditions are right. They love sugar in all forms. When we consume sugar, the bacteria use this sugar to survive and replicate and as a by product of their metabolism they produce acid. This acid is what dissolves away the hardest substance in our body, which is our enamel on the outer surface of our teeth
How can I prevent cavities in my child?
Cavities are caused by specific bacteria found in the mouth. They can grow to large numbers especially if the conditions are right. They love sugar in all forms. When we consume sugar, the bacteria use this sugar to survive and replicate and as a by product of their metabolism they produce acid. This acid is what dissolves away the hardest substance in our body, which is our enamel on the outer surface of our teeth. Proper diet, proper timing, and frequent toothbrushing can significantly help in reducing dental decay
Here are a few tips:
- Limit sugar foods to meal time.
- Snacks that are higher in fat and protein appear to be less damaging.
- Brush all the debris off the teeth.
- Avoid sipping throughout the day on substances with sugar or that are acidic.
- Avoid sticky foods.
- Drink lots of water
What is fluoride?
Fluoride is a naturally occurring mineral in our earths crust. The American Academy of Pediatrics recommends the proper use of fluoride in prevention to reduce dental decay. This is based on the evidence of many long-term studies that have demonstrated the safety and efficacy of fluoride use in dental decay prevention. They also attest that the cost of oral health care for children can be reduced by as much as 50 percent with proper use of fluoride
Gum Diease
My Child Has A Gum Disease?!?
Gum disease in children is very rare. Inflammation of the gums or chronic gingivitis is very common in children. It presents as gum tissue that is swollen, red and bleeds easily. It can easily be corrected with proper brushing and flossing and routine dental care.
Other forms of aggressive periodontitis can affect healthy children but it is uncommon also. It is most common in teenagers and young adults and mainly affects the incisors and first molars. It is characterized by loss of bone and ironically, these patients generally present with very little dental calculus or plaque
When gum disease is present it is usually associated with a systemic medical condition like the following below:
- Type 1 Diabetes
- Down’s Syndrome
- Papillon – Lefevre syndrome
Adolesence And Oral Care
Advice for Parents:
- Educate your teen on the importance of oral health. Boyfriends and Girlfriends don’t like bad breath. Poor choices in the teen years regarding sugary drinks, and foods (ie. soda, coffee shops, frequent candy, etc) can lead to costly dental visits in the adult years.
- Routine dental visits can help impress upon your teenagers mind the importance of oral health.
- Routine fluoride exposure professionally applied have been shown to be highly effective in prevention.
- Model good dental habits.
