The Importance of Primary Teeth

Maintaining the health of your child’s primary teeth, or baby teeth is of vital importance to his or her growth and development. Your child’s primary teeth are necessary for proper chewing and eating, guiding the permanent teeth into the correct positions, the healthy development of jaw bones and muscles, as well as affecting speech development and supporting an attractive appearance. If cavities occur and are left untreated this can cause problems for permanent teeth that are developing. Your child’s front four teeth are not replaced until age 6-7, while the back teeth (cuspids and molars) aren’t replaced until age 10-13.

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When do a Child's Teeth Come in?

A child’s teeth begin forming before birth. The first primary teeth erupting through the gums are the lower central incisors, occurring as early as 4 months of age. These are soon followed by the upper central incisors. All 20 primary teeth usually appear by age 3, however the pace and order of their eruption may vary. Permanent teeth, starting with the first molars and lower central incisors, begin to erupt around age 6. This process will continue until the approximate age of 21 when your child will have 28 permanent teeth or up to 32 including the third set of molars (wisdom teeth).

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Are Dental X-Rays Necessary?

Radiographs (X-rays) are a very important part of any dental diagnostic process. They are used to detect far more than cavities alone. For instance, radiographs may be used in surveying erupting teeth, diagnosis of bone disease, examining injuries, or when planning orthodontic treatment. Clinical exams do not reveal all that a radiograph will detect, and early detection and treatment of dental problems is far more comfortable for your child in addition to being more affordable for you. Many pediatric dentists like to obtain radiographs once per year, while approximately every 3 years obtaining a complete set of radiographs, including either panoramic and bitewings or periapicals and bitewings. If your child is at high risk for tooth decay, the American Academy of Pediatric Dentistry recommends radiographs and examinations every six months.

The amount of radiation exposure during a dental radiograph is very minimal, posing negligible risks. Today’s advanced equipment filters out unnecessary x-rays and restricts the x-ray beam to the precise area of interest. Pediatric dentists go to great lengths to minimize the exposure of their patients to radiation, and it is important to note that the radiograph itself is seen as a much smaller risk than an undetected and untreated dental problem. Proper precautions to assure your child’s safety include the wearing of lead body aprons, high-speed film and proper shielding. These will further minimize the amount of radiation exposure your child will experience.

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Your Child's First Visit to the Dentist

The American Academy of Pediatrics (AAP), the American Dental Association (ADA), and the American Academy of Pediatric Dentistry (AAPD) each recommend establishing a "Dental Home" for your child by one year of age. Children who have a dental home are more likely to receive appropriate preventive and routine oral health care.

Your child’s first dental visit should be a positive and enjoyable experience. To make this possible, try to avoid using certain words around your children that could lead to unnecessary fears, such as: needle, pull, drill, or hurt. Also, if your child is old enough, be sure to prepare them in advance for the visit by telling them that the dentist will explain all procedures and answer any questions they may have. Child friendly dental offices make a habit of using words that are pleasant and non-frightening to the children in their care.

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Perinatal & Infant Oral Health Care

The American Academy of Pediatric Dentistry encourages all pregnant women to receive oral healthcare as well as counseling during their pregnancy. Research has shown that periodontal disease poses an increased risk of preterm birth as well as low birth weight. Ask your doctor or dentist about what you can do to prevent periodontal disease during your pregnancy. Mothers with poor oral health, may be at a higher risk of passing along cavity-causing bacteria to their young children. To avoid this risk, mothers should follow a few simple guidelines to protect themselves and their children from the spread of harmful bacteria:

  • Visit your dentist regularly
  • Brush your teeth and floss daily to reduce bacterial plaque
  • Be certain you have a balanced diet, including the reduction of foods and beverages that are high in sugar and starch
  • The American Dental Association recommends using toothpaste with added fluoride and rinsing each night with an alcohol-free, over the counter mouth rinse with a .05% sodium fluoride solution, to help reduce plaque levels
  • Avoid sharing utensils, cups or food with your children which can lead to the exchange of bacteria that causes cavities
  • Chewing xylitol chewing gum (4 pieces per day by the mother) may decrease your child’s caries rate

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Seal Out Decay

The majority of cavities in children form in the back teeth (premolars and molars). A sealant, which is a clear or shaded plastic material, can be applied to the chewing surfaces of these teeth to act as a barrier to food, plaque and acid and protect these teeth from decay.

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How Do I Prevent Cavities?

Proper oral hygiene will remove bacteria and leftover food particles that can combine to create cavities. With infants, try using a wet gauze or clean washcloth to wipe away plaque from teeth and gums. Also, your children should only be put to bed with water in their bottle, as fruit juice and milk in this setting can lead to tooth decay.

Your older children should brush their teeth at least twice per day. Also, limit the amount of sugary snacks you feed to them. The American Academy of Pediatric Dentistry recommends pediatric dental visits every six months, beginning at your child’s first birthday. Start your child on the road to good oral health with routine visits. In some cases, your pediatric dentist may recommend protective sealants or home fluoride treatments for your child. These sealants can be applied directly to the molars to prevent tooth decay on hard to reach surfaces.

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Having a Balanced Diet

The saying, “You are what you eat” has quite a lot of truth to it. Our entire body benefits from a well-balanced diet, and this, of course, includes the teeth, bones and soft tissues of your mouth. Your child’s diet should include an assortment of foods from the five major food groups. It is important to note that frequent snacking lends itself to greater risk for tooth decay. The length of time food remains in the mouth is also an important factor. For example, hard candy and breath mints stay in the mouth a long time, which exposes the teeth to longer acid attacks on tooth enamel. When choosing snacks for your child, select foods such as vegetables, low-fat yogurt, and low-fat cheese. These foods are healthy and better for your child’s teeth.

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What About Fluoride?

Fluoride is an element, which when administered in proper amounts, has been shown to be beneficial to teeth and is believed to help strengthen the teeth in resisting cavities. Too little or too much fluoride can, however, be detrimental. Many children often receive more fluoride than their parents realize. Fluoride consumption in excess can lead to what is known as dental fluorosis, which is a chalky, white or brown discoloration of the permanent teeth. Becoming aware of potential sources of fluoride can aid you in preventing the possibility of fluorosis, such as:

  • Too much fluoridated toothpaste at an early age
  • The inappropriate use of fluoride supplements
  • Sources of hidden fluoride in your child’s diet

Young children, ages 2-3, may not be able to properly expectorate (spit out) fluoridated toothpaste while brushing. This could lead to excessive amounts of fluoride ingestion while brushing, which poses the greatest risk in the development of fluorosis. Excessive and inappropriate use of fluoride supplements are also contributors to fluorosis. Avoid giving fluoride drops, tablets, and fluoride fortified vitamins to infants younger than 6 months of age. In addition, fluoride supplements should only be given to children after all sources of fluoride have been accounted for and upon the recommendation of your pediatrician or pediatric dentist. High levels of fluoride can be found in powdered concentrate infant formulas, soy-based infant formula, infant dry cereals, creamed spinach, and infant chicken products. Some beverages also contain high levels of fluoride, especially decaffeinated teas, white grape juices, and juice drinks manufactured in fluoridated cities. Reading food labels can help you pinpoint which beverages and foods contain fluoride, or you can also contact the manufacturer.

Here are some precautions parents can take to reduce the risk of fluorosis:

  • With young children, use a fluoride-free baby tooth cleanser
  • Place only a pea-sized amount of toothpaste on your child’s brush
  • Avoid giving infants under 6 months of age fluoride supplements
  • Account for all sources of ingested fluoride before administering fluoride supplements to older children
  • Check with your local utility to obtain a fluoride level test for your drinking water

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Are Tongue Piercings OK??

Fluoride is an element, which when administered in proper amounts, has been shown to be beneficial to teeth and is believed to help strengthen the teeth in resisting cavities. Too little or too much fluoride can, however, be detrimental. Many children often receive more fluoride than their parents realize. Fluoride consumption in excess can lead to what is known as dental fluorosis, which is a chalky, white or brown discoloration of the permanent teeth. Becoming aware of potential sources of fluoride can aid you in preventing the possibility of fluorosis, such as:

  • Too much fluoridated toothpaste at an early age
  • The inappropriate use of fluoride supplements
  • Sources of hidden fluoride in your child’s diet

Young children, ages 2-3, may not be able to properly expectorate (spit out) fluoridated toothpaste while brushing. This could lead to excessive amounts of fluoride ingestion while brushing, which poses the greatest risk in the development of fluorosis. Excessive and inappropriate use of fluoride supplements are also contributors to fluorosis. Avoid giving fluoride drops, tablets, and fluoride fortified vitamins to infants younger than 6 months of age. In addition, fluoride supplements should only be given to children after all sources of fluoride have been accounted for and upon the recommendation of your pediatrician or pediatric dentist. High levels of fluoride can be found in powdered concentrate infant formulas, soy-based infant formula, infant dry cereals, creamed spinach, and infant chicken products. Some beverages also contain high levels of fluoride, especially decaffeinated teas, white grape juices, and juice drinks manufactured in fluoridated cities. Reading food labels can help you pinpoint which beverages and foods contain fluoride, or you can also contact the manufacturer.

Here are some precautions parents can take to reduce the risk of fluorosis:

  • With young children, use a fluoride-free baby tooth cleanser
  • Place only a pea-sized amount of toothpaste on your child’s brush
  • Avoid giving infants under 6 months of age fluoride supplements
  • Account for all sources of ingested fluoride before administering fluoride supplements to older children
  • Check with your local utility to obtain a fluoride level test for your drinking water

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Effects of Tobacco Use in Any Form

Tobacco use in any form can endanger your child’s health and result in irreparable damage. It is important to teach your child the risks involved in the use of tobacco products. Smokeless tobacco, or spit, chew or snuff, is often used by teens who believe that it may be a safe substitute for smoking cigarettes. Unfortunately this is a wild misunderstanding. Research shows that smokeless tobacco may be even more addictive than cigarettes and difficult to quit. Did you know that one can of snuff per day is equal to the amount of nicotine in 60 cigarettes? In as little as three to four months, smokeless tobacco use can cause periodontal disease and the production of pre-cancerous lesions called leukoplakias. If you have a child who uses tobacco products, watch out for these early signs of oral cancer:

  • A sore throat that won’t heal
  • White or red leathery patches on the lips, and on or under the tongue
  • Pain, tenderness or numbness anywhere in the mouth or lips
  • Difficulty chewing, swallowing, speaking or moving the jaw or tongue; or a change in the way the teeth fit together

Since the early signs of oral cancer are often not painful, many times people ignore them. However, if it’s not caught in the early stages, oral cancer can require extensive, sometimes disfiguring, surgery and at worst, it can cause death. Help your child avoid tobacco in any form, and thereby, they will avoid the introduction of cancer-causing chemicals to their tongue, gums and cheek.

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