Our Concern for Your Health and Well-being

 CAVITY PREVENTION IN CHILDREN
 
 

Despite the early use of fluoride toothpaste in children, pediatric decay still persists at an alarming rate.  Pediatricians often lack the knowledge, concern, or the time to educate new parents about cavity prevention.  By the time a child is seen for their first dental examination, they may already have advanced decay.  

Baby bottle decay, although much less prevalent, is still seen from time to time.  An infant or toddler should never be put to bed with a bottle containing anything other than plain water.  Otherwise, the sugars that milk and juice contain will bathe the teeth all night long.  This type of decay can be very severe, often resulting in the need for crowns, even the use of general anesthesia, on a very small child.  

We recommend wiping an infant’s gums with a small washcloth, piece of gauze, or one of the soft fingertip toothbrushes that are available.  This should be done at least once a day, increasing to twice a day when the first incisors erupt.  As more teeth erupt into the mouth, you’ll want to switch to a pediatric toothbrush. The rounded, teething type of brush is a nice one to start with.  Plain water is fine to use, or a pediatric toothpaste that does not contain fluoride, will also suffice.  You should not use a fluoridated  toothpaste on your child until they are at least 2 years of age. It is important that only a very small amount (the size of a small pea) be used.  Young children will swallow the paste and excessive ingestion of fluoride can cause permanent damage to their developing teeth.  Fluoride rinses such as Act or Fluorigard are also not recommended until the child has demonstrated the ability to swish and spit, without swallowing.

Multi-vitamins containing fluoride (Poly-Vi-Fluor) or chewable fluoride lozenges (Luride) can also promote the formation of strong enamel on the developing teeth.  Consult with your pediatrician.  He or she should be able to prescribe the proper dosage based on your child’s weight and the fluoride content of your drinking water.  Although only Mt. Laurel currently fluoridates their public water supply, fluoride also is naturally present in water at different levels.  This should be taken into consideration in order to prevent excessive fluoride ingestion.  

The child’s first dental check-up should be scheduled at the age of 3.  It can be earlier or later, depending upon the child’s personality, ability to follow directions and to cooperate.  Of course, If you notice something wrong with your child’s smile, they should be seen as early as possible.  We recommend that you prepare the child for the first visit by reading them children’s books about going to the dentist (ex: “The Berenstein Bears”).  Barney and Tommy the Tooth videos are also popular.  

Examinations and cleanings should be performed every six months.  It is crucial that decay is diagnosed early.  Baby teeth do have nerves and a large cavity will cause your child pain.  A baby tooth lost prematurely, without holding that space with a retainer, will cause crowding and eruption problems with the permanent teeth.  Topical applications of fluoride are usually started at the age of five, when there is little risk of ingestion.  Professional fluoride is applied to the surface of the existing teeth, making them more resistant to decay.  It is not ingested, therefore it will not affect teeth that are unerupted and should be performed, even if a child is taking an oral fluoride supplement.

Sealants, a plastic resin applied to the biting surface of permanent molars, is recommended as soon as these teeth fully erupt.  They prevent bacteria from invading the narrow pits and fissures of these teeth, therefore preventing cavities from forming.

You should continue to brush your child’s teeth, or at least follow-up their brushing until they have demonstrated the ability to thoroughly brush their teeth by themselves, regardless of their age.  We recommend the use of a two-minute toothbrush timer or sand timer.  That ensures that the child is brushing long enough.  Adults could benefit from its use, too!  

Flossing is often overlooked as an essential part of a child’s oral hygiene.  The most common and severe type of cavity that we see in children forms between their baby molars, where the teeth touch.  Parents should floss between these teeth and any others that are contacting.  Flossing should be performed at least several times a week, but daily is recommended.  There are flosses for kids now, in flavors that will appeal to them.

Fluoride rinses can also be very beneficial in making the enamel more resistant to plaque acids. Act and Fluorigard are popular brands.

Between meal snacking should be limited. Recent research indicates that sweet snacks are not the only reason that we get cavities.  A very important factor that we often overlook is how frequently we snack.  Research has shown that most snacks promote tooth decay and contrary to popular belief it is difficult to determine which snacks are the most damaging.

Soda is a no-no.  It contains sugar and acid, which will dissolve enamel.  Juices that contain sugar should be watered down.  Raisins and fruit roll-ups contain sugar and are very sticky.  Potato chips and pretzels are high in starch and tend to stick to the teeth for longer periods of time.  Chewing gum should be limited to only sugarless.  Children’s antibiotics and medications are often liquids, and made with a sugary suspension.  You should have your child rinse with water or brush after each dose.