When the toddler came to her office,
4 of his 16 teeth were so decayed, they required dental crowns.
Although this case may sound
shocking, it's not rare, says Beverly Largent, DMD, the Paducah, Ky., dentist
who cared for the child. She tells parents it's crucial to care for baby teeth.
"You need to brush from the first tooth," says Largent, past president
of the American Academy of Pediatric Dentistry.
In fact, tooth decay -- although
largely preventable with good care -- is one of the most common chronic
diseases of children ages 6 to 11 and teens ages 12 to 19. Tooth decay is five
times more common than asthma and seven times more common than hay fever in
children, according to the American Academy of Pediatrics. By kindergarten age,
more than 40% of kids have tooth decay.
Neglecting baby teeth is not the
only misstep parents can make when it comes to their
child's early oral health.
Here's your 7-step
game plan.
Start Oral Care Early
Your child should see a dentist by
the time he or she is a year old, according to the American Academy of
Pediatrics and the American Academy of Pediatric Dentistry.
Getting preventive care early saves
money in the long run, according to a report published by the CDC. The report
found that costs for dental care were nearly 40% lower over a five-year period
for children who got dental care by age one compared to those who didn't go to
the dentist until later.
Teach the Brush & Floss Habit
Dental visits are just part of the
plan, of course. Tooth brushing is also crucial from the start. "A lot of
people think they don't have to brush baby teeth," Largent says. If your
baby has even one tooth, it's time to start tooth brushing. "If there's
just one tooth, you can use gauze."
Even before your baby has teeth, you
can gently brush the gums, using water on a soft baby toothbrush, or clean them
with a soft washcloth.
Once there are additional teeth,
Largent tells parents to buy infant toothbrushes that are very soft. Brushing
should be done twice daily using fluoridated toothpaste.
Flossing should begin when two teeth
touch each other. Ask your dentist to show you the right flossing techniques
and schedules, Largent says.
Also ask for your dentist's advice
on when to start using mouthwash. "I advise parents to wait until the
child can definitely spit the mouthwash out," says Mary Hayes, DDS, a
pediatric dentist in Chicago and consumer advisor for the American Dental
Association. "Mouthwash is a rinse and not a beverage."
So how long until Junior can be
responsible for brushing his own teeth? "[Parents] have to clean the teeth
until children are able to tie their shoes or write in cursive," says
Largent.
During dental visits, ask your
dentist if your child's teeth need fluoride protection or a dental sealant.
And remember, the most important time to brush and floss is
just before bedtime. No food or drink, except water, should be permitted until
the next morning. This allows clean teeth to re-mineralize during the night,
from the minerals in the saliva and toothpaste.
Avoid "Baby Bottle Decay"
For years, pediatricians and
dentists have been cautioning parents not to put an infant or older child down
for a nap with a bottle of juice, formula, or milk.
Even so, says Largent, many parents
don't realize this can wreak havoc with their child's oral health.
The sugary liquids in the bottle
cling to baby's teeth, providing food for bacteria that live in the mouth. The
bacteria produce acids that can trigger tooth decay. Left unchecked, dental
disease can adversely affect a child's growth and learning, and can even affect
speech.
If you must give your child a bottle
to take to bed, make sure it contains only water, according to American Academy
of Pediatrics guidelines.
Control the Sippy Cup Habit
Bottles taken to bed aren't the only
beverage problem, says Hayes. The other? "Juice given during the day as a
substitute for water and milk," Hayes says.
Often, that juice is in a sippy cup.
It's meant as a transition cup when a child is being weaned from a bottle and
learning to use a regular cup.
Parents mistakenly think juice is a
healthy day-long choice for a beverage, say Hayes and Largent. But that's not
the case.
Largent says she often sees children
walking around all day drinking juices and other sugary beverages from a sippy
cup, and that's hazardous to dental health. "Prolonged use of a sippy cup
can cause decay on the back of the front teeth," if the beverages are
sugary, she says.
Juice consumption has been linked to
childhood obesity and the development of tooth decay, according to the American
Academy of Pediatrics. In its current policy statement on preventive oral
health, the organization advises parents to limit the intake of 100% fruit
juice to no more than four ounces a day. Sugary drinks and foods should be
limited to mealtimes.
"Pediatricians I know are
telling parents to use juice as a treat," Hayes says.
Ditch the Binky by 2 or 3
Pacifiers used in
the first year of life may actually help prevent sudden infant death syndrome,
according to the American Academy of Pediatrics. They suggest using a pacifier
when placing the infant to sleep but not to reinsert once baby has drifted off.
Long-term use can be hazardous to dental
health. Sucking too strongly on a pacifier, for instance, can affect how the
top and bottom teeth line up (the "bite") or can affect the shape of
the mouth.
Largent tells parents of her young
patients: "Pacifiers are for infants, not for toddlers walking around with
them in their mouths." She discourages long-term use of even the
"orthodontically correct" pacifiers.
Largent says she prefers that pacifiers be dropped by age 2.
The American Academy of Pediatrics suggests getting a professional evaluation
if the pacifier habit continues beyond age 3.
Beware of Mouth-Unfriendly Medicines
Many medications that children take
are flavored and sugary, says Hayes. If they stick on the teeth, the risk for
tooth decay goes up.
Children on medications for chronic
conditions such as asthma and heart problems often have a higher decay rate,
she finds.
Antibiotics and some asthma
medications can cause an overgrowth of candida (yeast), which can lead to a
fungal infection called oral thrush. Suspect thrush if you see creamy,
curd-like patches on the tongue or inside the mouth.
"If your child is on chronic
medications, ask your child's dentist how often you should brush," Hayes
says. You may be advised to help your child brush as often as four times a day.
Stand Firm on Oral Hygiene
Parents often tell Hayes that their
children put up a fuss when it comes time to brush, floss, and rinse, so
parents relent and don’t keep up with oral care at home as they should.
Hayes strongly advises these parents
to let their children know they don't have a choice about taking care of their
teeth and gums.
"It has to be done," Hayes
says. But she understands that children can get cranky and difficult. She
suggests these tips to coax reluctant brushers and flossers to get the job done
-- or if they are too young, to allow their parents to help them do it.
·
Plan to help your children longer
than you may think necessary. "Children don't have the fine motor skills
to brush their own teeth until about age 6," says Hayes. Flossing skills
don't get good until later, probably age 10.
·
Schedule the brushing and flossing
and rinsing, if advised, at times when your child is not overly tired. You may
get more cooperation from a child who isn't fatigued.
·
Get your child involved in a way
that's age-appropriate. For instance, you might let a child who is age 5 or
older pick his own toothpaste at the store, from options you approve. You could
buy two or three different kinds of toothpaste and let the child choose which
one to use each time. You may offer him a choice of toothbrushes, including
kid-friendly ones that are brightly colored or decorated.
·
Figure out what motivates your
child. A younger child may gladly brush for a sticker, for instance, or gold
stars on a chart.
