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Baby Teeth, What's The Big Deal? 
top^
Primary "baby" teeth are designed to function throughout the childhood years. Some baby teeth are not lost until age 12. They help in the development of face and jaws, and support facial structures and tissues (just imagine grandpa without his dentures on). They also important for eating, chewing food to aid in proper digestion through those "growing" years. Another vital function of primary teeth is holding space and guiding the permanent teeth in. Baby teeth have relatively thin enamel (hard outer-layer of teeth) and large pulps compared with adult teeth, and can become decayed and infected (abcessed) easily. Infected baby teeth can damage the adult (permanent) tooth developing below them. Healthy decay-free primary teeth create a healthy environment for the permanent teeth and reduce their chance for tooth decay. Teeth are essential to one's appearance and self-esteem.
Look Mom...No Cavities! How To Raise A Cavity-Free Child top^
written by Gregory F. George, DDS and illustrated by John D. Valerio
A guide to raising cavity-free children, written by a pediatric dentist with over 17 years of experience. Details a simple and effective program for cavity-prevention and dental maintenance -- explains how cavities form, what you can do to prevent them for your child, where the most common problems occur, why it is so important to avoid cavities, which foods help prevent cavities, how breast & bottle feeding can cause infant tooth decay.
Click Here to buy from Amazon.com
When Should My Child First Visit The Dentist? top^
As recommended by the AAPD and ADA, you should bring your child in for a first dental visit by no later than their first birthday, or even by the time they get their first tooth, usually between the age of 6 to 12 months. We call this our Infant Oral "Well-baby" Exam.
What Can I Expect At My Child's Infant Oral "Well-baby" Exam? top^
At this visit, the dentist can perform a simple visual exam to evaluate your child's oral health and determine their risk for developing dental disease. A gentle prophy cleaning and fluoride application is performed by one of our child-friendly dental assistants. Usually, no x-rays are taken at this appointment. The dentist will also look for relatively common and uncommon oral conditions affecting infants, such as tongue-tie, missing teeth, abnormal teeth, inclusion cysts (Epstein's Pearls, Bohn's Nodules, Dental Lamina Cysts), natal teeth, iron stain, primary herpetic gingivastomatitis. A dentist can also provide anticipatory guidance to parents to help prevent potential problems and dental disease, and to answer questions parents may have about their child's new teeth and oral health. Also, your infant will become familiarized with the dental office setting in a positive way, before they get bombarded with negative propaganda from their older siblings, peers, or even dental-phobic parents. This is primary prevention where dentistry is "fun", and future dental disease can be prevented!
Special Bonus! Parents will receive a memento of their baby’s first dental visit in a special photo card frame
When Can I Expect My Child's Pearly Whites? top^
When your baby was born, all 20 primary teeth were already present and developing in their jawbones. The first tooth to arrive is usually the lower front incisor which usually erupts into the mouth at around 6 months of age, but could be earlier or later. There are even a very few babies born with lower front teeth, they are called natal teeth. By 3 years of age, all 20 primary teeth are usually in. The first permanent tooth to erupt is also usually the lower front incisor and this occurs approximately at 6 years of age. Girls tend to get their teeth slightly quicker than boys. There is not much difference, but those whose teeth erupt later tend to have somewhat higher resistance to dental decay. By 12-13 years of age, all of the baby teeth are usually gone, and all of the permanent "adult" teeth are in except for the 3rd molars (wisdom teeth) which most often arrive by age 21.
Take a look at these tooth charts.
Look! My Tooth Is Loose! top^
by Patricia Brennan Demuth and
illustrated by Mike Cressy.
"Every kid looks forward to losing that first wobbly, jiggly, loose baby
tooth. But why do we have baby teeth in the first place? And why do they
fall out? And, most of all, is pulling teeth really as painful as-well,
pulling teeth? From getting and losing their first set of teeth to growing
and taking care of their second and last set, kids will learn all about
teeth. In addition, there is a great big full-color poster (16 x 22) of a
great big open mouth. The book comes with 20 "black hole" tooth-shaped
stickers so kids can black out their teeth as they lose them."
Click Here to buy from Amazon.com
What Are Cavities (Tooth Decay), And How Are They Formed? top^
Dental caries (the technical name for the disease that can lead to cavities) is an infectious disease caused by bacteria. It is also the most common chronic disease among school-age children (5 times more prevalent than childhood asthma). Over 51 million school hours are missed each year in the U.S. due to dental related problems! There are good and bad bacteria in the mouth. The bad bacteria are transferred to a child during infancy from parent (usually mother) or caregiver. If the good bacteria colonize teeth before the bad ones do, then the bad ones have a hard time taking hold on the teeth. That is why some people hardly brush their teeth and eat sweets but never seem to get cavities. If the bad bacteria do colonize your baby’s teeth, then they will remain there for the rest of their life! Some of the major bacterial culprits associated with dental caries are: streptococcus mutans, streptococcus sobrinus, lactobacilli casei, actinomyces naeslundii, and actinomyces vicosus. Tooth decay is a process in which the acid byproduct of these bacteria feeding on the fermentable carbohydrates (refined sugars and cooked starches) on teeth demineralize and subsequently weaken the tooth surface and thus form a cavity! Saliva is a protective factor that helps to wash away plaque, food, and cavity-causing bacteria, while minerals in saliva replenish and remineralize tooth structure. Saliva also helps buffer (neutralize) acids in the mouth to counteract demineralization of teeth.
A Helpful Tip: Teeth cannot remineralize in an acidic environment. When you or your child eat a meal, the pH level drops and acidity rises in your mouth and takes several hours to return to normal levels. That's why snacking between meals is such a bad idea. Try placing a small bottle of water with 2 teaspoons of baking soda in your child's lunchbox and have him or her shake the bottle and rinse with the solution after his or her meal to help return oral pH levels to normal quickly!
How Can I Prevent Cavities For My Baby? top^
Prolonged exposure ("pooling") of sugary liquids such as milk, formula, juice, soda, and other sweetened drinks, on the upper front teeth during bottle-feeding or breastfeeding can cause a serious dental condition where the upper front teeth, and sometimes upper and lower baby first molars and lower canines decay rapidly. This is known as early childhood caries (ECC), or baby bottle tooth decay (BBTD), or informally as "bottle rot". In order to prevent this from happening, do not let your infant/toddler go to bed at night or naptime with a bottle; or if you must, then use water only. Anything else will cause their teeth to decay. Do not use the feeding bottle as a pacifier! If you breastfeed at night, please wipe their teeth afterwards with a damp cloth/gauze. Bottle-feeding and breastfeeding beyond age 12 months is associated with a much higher likelihood of bottle rot, thus it is recommended that infants are weaned off the bottle and/or breastfeeding by 12 to 14 months of age. Infants should not have juice in a sippy cup, bottle, or other easily transportable container that would allow them to easily consume juice throughout the day.
What Is Early Childhood Caries (ECC) And How Can I Tell If My Child Has It? top^
The first sign a parent might see, that a cavity may be starting, is the presence of a brown or white spot on the surface of the tooth that cannot be brushed away. In the primary incisors (upper front teeth), early decay can appear as brown/black or white spots on the enamel. Check the back of the upper incisors for any color changes. This is the most common area for decay to begin when a baby has been put to bed with a bottle of juice or milk. The “chipping “away of the front teeth (not related to trauma) is usually a result of advanced decay. A white line appearing at the gum line of any tooth is the first sign of decalcification or the first stage of the decay process. This type of white spot lesion is the first visible indication that the bacterial infection called caries is present. Caries is defined by the American Academy of Pediatric Dentistry (AAPD) as, “a…biofilm (plaque)-mediated acid demineralization of enamel or dentin”. What used to be termed Baby Bottle Tooth Decay (BBTD) is now known as Early Childhood Caries (ECC), and the severe form of that as Severe-Early Childhood Caries (S-ECC). By AAPD definition, ECC is the diagnosis when there is the presence of at least one white spot lesion (non-cavitated) or cavitated lesion, or missing tooth (due to caries), or filled tooth surface in any baby tooth in a child under 6 years of age. Severe-ECC is diagnosed by any sign of caries on a smooth (non-pit, or fissure) enamel surface which can simply be a non-cavitated white spot lesion.
How Should I Take Care Of My Child's Teeth? top^
Decay causing bacteria can colonize on your infant's gums even before the first teeth erupt, as early as 3 months of age (recent research suggests this may even occur shortly after birth). Thus, it is important to clean your infants gums before their first teeth arrive. You can use a clean damp cloth or gauze wrapped around your index finger and rub all gum surfaces, particularly after feedings. Alternatively, there are also a variety of infant teeth cleaning products available at the local drugstore such as tenders that work well too. When their first teeth arrive, you may use a small dab of fluoride-free toothpaste (such as Orajel® Toddler training Toothpaste) when cleaning their teeth. Baby can be placed with head on lap and legs facing outward to facilitate cleaning.
Starting at age 2 (and up until age 5), you should use a tiny smear or (less than “pea”-sized) dab of child fluoride toothpaste pushed into the bristles of a small child-sized toothbrush with your finger (to minimize swallowing the toothpaste) and brush over all tooth surfaces after breakfast and right before bedtime for 1 minute each time. Although your toddler will likely not be able to “spit out” the toothpaste after brushing at this age; if you persevere and keep trying to teach your young child to spit out, they’ll acquire the skill much faster. It is important to minimize swallowing of toothpaste while your toddler is learning to spit out. The last thing your child’s teeth should touch before going to bed and for the rest of the night is the toothpaste from their brush. This is because at night your saliva-producing glands shut down and you don’t get the protective effect of saliva so your teeth are at their most vulnerable state. Change your child’s toothbrush once every 3 months because worn bristles can diminish effective plaque removal, and also after each flu or cold episode. Make brushing fun for them by using an electric toothbrush, or let them choose a toothbrush with their favorite character (e.g.- Sponge Bob, Dora). You can also sing songs to them while brushing their teeth, please see the “Dental Songbook”. Find a way to brush your toddler’s teeth even if he/she resists. Proper hygiene habits need to be established at an early age to provide the foundation for a lifetime of great oral health.
Up until your child is 7 years old, you should assist them while they brush since they often lack the motor skills to do it right. After that, you should observe their technique and assist where necessary until they can effectively brush on their own. You may teach them by letting them mimic you. Brush your teeth at the same time they do. Although a regular children's brush is perfectly fine for cleaning their teeth, sometimes a children's electric brush can make the experience more fun for your child and keep them motivated to brush. Once again, toothbrushing should happen twice a day; once in the morning after breakfast, and right before bedtime. Brushing after snacks would be ideal too. At age 6 and above, brushing should take 2 minutes each time.
When brushing the teeth, angle the toothbrush at a 45˚ angle towards the gum-line and use small circular strokes. Brush the front of the teeth, behind the teeth, and the chewing surfaces, Then brush the tongue to remove potential bad breath bacteria, and other harmful microorganisms. It should take 2 full minutes to brush properly.
Flossing should begin when and where teeth are touching. Back molars usually begin touching at age 3 or 4. At this point, food can easily get trapped between the teeth and lead to cavities. Baby teeth, in particular, have wider contact areas than adult teeth do, and have thinner enamel which can make those tight areas between the teeth especially problematic. Carefully slide the floss through the point where the teeth contact and wrap it around each tooth in a "C" shape, then gently glide the floss up and down to clean the surface of their teeth. After you are done, gently pull the floss straight out, not through the contact area so that debris on the floss does not get pushed back into the contact.
MOTIVATIONAL CHARTS
Parents can use these charts as they wish to create their own reward system for forming healthy habits.
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What Should I Do When My Child Is Teething? top^
Teething is usually the first oral event that you will have to deal with as a parent. It usually happens without problem, and is a completely natural occurrence. However, during the time your infant's teeth start to come out, they may become restless and fretful. They may also start to salivate excessively and exhibit the desire to put their hands and fingers into their mouth. At this point, your baby can often get relief from a clean teething ring, chilled teething ring, cool spoon, cold wet washcloth, or toothbrush. If your infant has a fever, diarrhea, abdominal discomfort, or other unusual problems; it may not be related to their teething, and they should be examined by a physician as soon as possible to rule out any other common diseases and conditions of infancy.
What Are Tooth Friendly And Unfriendly Foods? top^
Unfriendly Foods:
Carbohydrates are the food of choice for decay-causing bacteria; the acid they produce while feeding causes demineralization and leads to tooth decay. There are two basic types of carbs:
Sugars - simple carbohydrates like candies, sweets, juice, sodas.
Cooked Starches - complex carbohydrates like bread, crackers, chips An enzyme in saliva breaks down cooked starches into simple sugars.
Basically, sticky foods (raisins, fruit roll-ups, chips, crackers, cheetos) are bad for teeth!
Friendly Foods:
Some cheeses (aged chedder, mozzarella, swiss, monterey jack) have properties that help prevent the development of cavities when eaten as a snack, or at the end of a meal. They increase the flow of saliva which acts to cleanse the teeth, and neutralize the acids that attack them. Plain milk, or chocolate milk if they prefer it, contains proteins, calcium, and vitamins essential for tooth development. Just don't stick it in a bottle at nightime! Sugar-free gum after a meal also stimulates saliva production which can help protect against cavities. Sugar-free gum containing the sugar-substitute xylitol can be particularly helpful by helping to prevent decay-causing bacteria to stick to teeth.
Other Dietary Recommendations And Information:
Infants get all the nutrients they need from breastmilk up until 6 months of age; conversely, fruit juice provides no nutritional benefit for infants under 6 months of age. After 6 months of age, supplements of iron (brain, mental development), vitamin D (bone/teeth growth), and fluoride ought to be considered (consult with the child's pediatrician and dentist). Infants should not consume more than 4 to 6 oz of fruit juice per day, and should not drink powdered beverages or soda pop at all. Only iron-fortified infant cereals mixed with breastmilk or formula should be given to infants older that 6 months of age. Cow's milk should be completely avoided in the first year of life, and restricted to less than 24 oz per day in the second year of life. Infants should be weaned from the bottle or breastfeeding at 12 to 14 months of age.
The table below shows the relative cariogenicity (ability to produce cavities) of various snacks as determined by the Palmer Classification.
Snack Item |
Score (lower #’s are better) |
Peanut Butter, Nuts, Vegetables |
0 |
Cheese |
1 |
Milk |
2 |
Fruit Juice, Fresh Fruit (excluding Bananas) |
3 |
Tortillas, Pasta, Rice, Beans |
4 |
Cereal |
5 |
Crackers |
6 |
Bread |
7 |
Soda, Kool-Aid® |
8 |
Apple Sauce, Yogurt, Ice Cream, Pudding, Jell-O® |
9 |
Cookies, Donuts, Chips |
10 |
Banana, Raisins, Jam |
11 |
Candy |
12 |
Should I Be Concerned About Dental Health During Pregnancy? top^
Yes! Hormonal changes during pregnancy can make your mouth more susceptible to disease. Gums may bleed and become inflamed and you may get a cavity or cavities even though you haven’t had one for a while. Proper dental care is especially important at this time because periodontal disease (a serious progressive gum disease where there is loss of attachment of bone and gums to the roots of teeth) can lead to premature and low birth weight births; as well as increase the risk for cardiovascular disease, diabetes, and respiratory infection in the mother. In general though, avoid x-rays during pregnancy, and elective dental treatment that requires the use of local anesthetic (particularly containing epinephrine) in the first trimester and second half of the third trimester. But do continue regular dental visits! Another important consideration for maintaining good oral health during pregnancy is that the bacteria that causes tooth decay has been shown to be transmitted from mother to child at a very early age. In fact there is recent evidence that there is colonization of the bacteria on oral soft tissues as early as around the time of birth! It has also been shown that the more of this bacteria the mother has in her mouth when the child is an infant, the more likely that child will have cavities in the future. One thing a proactive mom-to-be may consider is to chew 5 gms (the recommended dosage for caries prevention) of xylitol gum per day (which is available in cost-effective bulk quantities at The Silver Star Dental Practice) during pregnancy and even through the infant years of your child’s life. This can be accomplished by chewing the gum for about 5 minutes (or until the sweetness is gone) after each meal plus shortly before bedtime. This dosage of xylitol has been shown by research to greatly reduce the child’s risk of future cavities.
What To Do About Pacifiers Or Thumbsucking? top^
Thumb sucking is a habit that often starts while the child is still in the womb. It is a natural instinct that helps prepare an infant for nursing. Infants and young children will often use thumbs, fingers, pacifiers or other available objects to satisfy their sucking needs. This gives them a sense of security, happiness, and relaxation that can even lull them to sleep. Most children will quit their thumb/pacifier sucking by age 4, or at least by school age (due to peer pressure). At this stage, any dental problems (tooth movement, jaw-shape changes) that have resulted from the sucking habit will usually correct on its own. If thumb sucking or pacifier use continues past 5 years of age (or when permanent teeth arrive), full self-correction is far less likely, and there are possibly other issues that are perpetuating the habit that should be explored. Stress may exacerbate the thumb-sucking problem, thus scolding the child for thumb sucking is not recommended. It is better to use positive reinforcement to motivate a child to quit the habit. Finding, and eliminating the source of stress can also be really helpful.
If your child is over 5 years of age, and all other attempts to help your child stop their thumb sucking fails, a more aggressive approach is indicated to stop the habit. If their habit is with a pacifier, there is a simpler solution to the problem (please consult Dr. Hsu).
There is a very good book with information and tips on breaking the habit of thumb sucking entitled “David Decides About Thumbsucking: A Story For Children, A Guide For Parents” written by Susan Heitler, PhD. It is available on amazon.com for $13.95.
Click Here to buy from Amazon.com
Spiffies Baby Tooth Wipes™
The safe, convenient, easy way to clean your baby's mouth and gums. Spiffies™ are designed for children 4 months and older and used by everyone when brushing is not available.
Spiffies™ contains xylitol , a natural, good tasting substance that babies love and is also a powerful cavity fighter. Spiffies are an easy way to get baby started on an oral hygiene routine which is so important for overall great health.
Great grape flavor infants love; more flavors available soon.
$8 per box - www.drraysproducts.com
