The Dentist Visits You - 2016


Children's Dental Health, Part 2

By Vatsal Suthar

Dental health is important in every stage of life but it is pivotal in early childhood to establish good habits that will stay throughout life. After I covered the baby and infant oral health considerations last time, I want to use this piece to carry on into late childhood and adolescence. While all baby teeth are generally present by age three, the adult teeth begin coming in around the sixth birthday. There is a period of “mixed" baby and adult teeth from about this time onto the pre-teen stage.

Tooth decay is the most common chronic disease in children and second only to the common cold for days missed at school. Unfortunately, children who develop cavities on baby teeth have an increased likelihood to develop cavities on permanent adult teeth. Prolonged exposure to drinks containing sugar is the major risk for teeth to develop decay. The bacteria convert the sugar into acid, which, left alone with poor oral hygiene, can weaken the enamel of teeth and eventually break down the tooth structure to cause a cavity. While juice and milk are part of a balanced diet for growing children, those drinks left in the mouth of a sleeping child does nothing except begin the development for a cavity. Children should learn to use a standard cup as soon as possible. If a sippy cup is absolutely needed, then water should be used to decrease chances of cavities.

Aside from diet, establishing good oral hygiene habits at home will go a long in avoiding a cycle of cavities and fillings. While the first baby teeth begin to appear 6 months after birth, care still should be given to wipe the gums inside the mouth before teeth even appear. Parents should be in charge of oral hygiene needs for the child until she can develop the competence for brushing and flossing. Getting a brush with the children's favorite cartoons or characters can lure the child to begin using the brush. As your child watches the parents diligently brushing and flossing, the attraction for the child to hone care will become stronger. A child under 2 is advised to use a “smear" amount with water to care for the mouth while those over 2 years can graduate into using a “pea" size amount.

The American Academy of Pediatric Dentists recommend that a child be seen by a dentist the sooner of when the first teeth began to appear or first birthday. This way the doctor can give you specific recommendations that address teething irritations, childhood teeth decay, and prolonged thumb or pacifier sucking. The first visit is simply an opportunity for your little one to become acquainted with the office and dentist. You should reassure your child this is not a scary visit or that if they don't behave, the dentist will do something negative to them. Preparing your child before the appointment can be very helpful by reading many children's books that are available about going for a dental check up. This can help in reducing anxiety your child or you may have. Successive appts can build a kid's confidence and comfort at the dental office.

This appointment can last about 15-20 minutes and may include: a gentle but thorough exam inside the mouth, polishing teeth with flavored paste, x-rays, nutritional counseling, and fluoride assessment based on the child's age. Your dentist can answer any and all questions you have to make you feel comfortable through the visit. As the child comes back every six months for a check up, x-rays and medical history will be updated. Around six years of age, new molars in the back will begin to show and the front baby teeth will begin to loosen and fall out to make way for the permanent incisors. From six to 12 years of age is when this “mixed" set of baby and adult teeth will exist.

During the time of mixed teeth, your dentist might make recommendations to have sealants placed on your child's molars. Sealants are essentially a plastic coating that goes into the deep groves of the chewing part of the back teeth to prevent bacteria and sugar from entering. Brush bristles are simply too large to enter these microscopic gaps to stop a cavity from forming which is why sealants are an excellent treatment to prevent cavities.

Studies continually show that sealant application drastically reduces the risk for decay formation. This is an easy procedure: the top of the tooth is cleaned, special bond is placed, and the sealant is “painted" on and allowed to set hard. These are checked every six months and can be repaired easily. Some insurance plans pay for these while others may not. Please do not let this fool you into thinking it is not important. If one sealant can prevent one cavity, it may have at least paid for itself by saving you the co-pay for a future filling.

Other observations made during the child's check-up are identifying growth and development to allow the ideal eruption of permanent teeth and avoiding bad bites. Bad bites can be prevented with early consultations to the orthodontist. Benefits of early intervention include conservative treatment options, cheaper treatment cost, and maybe even avoiding a lifetime of gum disease, fillings, and additional treatment into adult hood.

Most children will have their permanent teeth, excluding wisdom teeth, in by the teenage years. There really is no reason for these teeth to have cavities during this time unless there is poor oral hygiene, bad nutritional habits, or both. Professional cleanings are done twice a year but the burden of oral health prognosis is dependent on what the child does on their own at home. Having sugar-free options in diet, keeping a brush in the backpack to use at school, and drinking water after each meal or snack are all great tips to ensuring the teenager with brand new adult teeth keep it disease free into adult hood.