February is National Children's Dental Health Month
Published: January 29, 2016
By: Lori Chandler Pruitt
While having healthy teeth and gums is important at any age, young children especially need to get an early start on regular dental care.
We asked pediatric dentists in the area about the top things parents should know about their child’s dental care:
What are some of the biggest issues in the care of children’s teeth?
Tooth decay, says Kasey Davis, DMD of Kasey Davis Dentistry in Bluff Park. “It is the number one chronic health problem in American children, according to the American Dental Association, and much of the time, it goes undiagnosed and untreated, which can lead to serious health issues due to infection.”
Even if a child’s teeth look good at first glance, x-rays may reveal decay that is “hidden” between the teeth, due to lack of flossing and too many sugary drinks and snacks, Davis says.
Such problems can adversely affect learning, communication, nutrition and other activities necessary for normal growth and development, adds Dr. Olga M. Sanchez-Hernandez, D.M.D., M.S. M.S. of McCalla Orthodontics and Pediatric Dentistry. Dental caries, periodontal disease and other oral conditions, if left untreated, can lead to pain, infection and loss of function.
Parents should never underestimate the effect of their children’s diet on their teeth, says Dr. Angelica Rohner, Angelica Rohner Pediatric Dentistry. “Not everyone looks at food or beverage labels to check sugar or carbohydrate content,” Rohner says. “For example, fruit juices are full of sugar and are super harmful to our teeth.” She recommends parents give fruit instead of the sugary juices, and limit sweet beverages to one a day.
With such busy family schedules, many kids don’t take the time for brushing teeth that they used to, says Dr. Lauten Johnson of Dr. Clark Thomas, Dentist and Dr. Lauten Johnson, Dentist, Pediatric and Adolescent Dentistry. Dr. Clark Thomas adds that the sugar in many diets not only feeds bacteria that causes cavities, but the acid dissolves tooth enamel.
At what age should a child start visiting the dentist?
The American Academy of Pediatric Dentistry recommends children visit the dentist for the first time six months after the first primary tooth appears, and no later than their first birthday. “This dental visit should be thought of as a well-baby checkup,” says Sanchez-Hernandez.
At this first visit, dentists review medical and dental histories, an oral examination to check growth and development, oral hygiene, injuries, cavities or other problems, clean teeth and more. Dentists also will discuss a child’s diet, fluoride needs, brushing technique, habits that may affect the mouth (teething, pacifier use, finger or thumb sucking) and what parents can do to help prevent tooth decay, she says.
The American Dental Association recommends children visit the dentist after the first tooth erupts, Rohner says. All children should be seen by age 1, she says. “The purpose is to teach prevention, because decay/cavities are becoming more prevalent in our society,” she adds.
When do you start looking at possible orthodontics for children?
The American Association of Orthodontics recommends children have an orthodontic evaluation by age 7. Although most children do not need treatment at this age, pediatric dentists say it’s important to have a relationship established so that the dentist can evaluate the need over time. “Every child is unique and dental development varies,” Johnson says. “It’s appropriate for children to be evaluated by a dentist regularly so that development can be continually assessed.”
Davis adds such an evaluation by age 7 is important because tooth development and loss is varied at that age, and a specialist can determine if a problem is orthodontic or a normal development variation. “At this point, it usually can be determined whether or not the child will have room for their permanent teeth to erupt,” she says. “Some things also are much easier to treat the earlier they’re diagnosed.”
Rohner says dentists evaluate such things as a child’s jaw structure, bite shape, tooth eruption stage and x-rays before determining if it’s time for a child to be seen by an orthodontist. Some problems that might require an early orthodontic intervention are crossbites, severe crowding, open bite, severe teeth protrusion, ectopic eruption and oral habits, says Sanchez-Hernandez.
What are the top things you wish parents would do/what do you want parents to know?
The earlier you establish the relationship with the dentist, the less likely there will be fears and tears, but dentists stress that they’re used to it and understand there may be some apprehension for parent and child. “Coming to the dentist can be a fun and positive experience!” Sanchez-Hernandez says. “In fact, pediatric dentists and their teams work really hard to ensure that the visit is a positive one. Some children need more time to figure out what we do can be fun and not harmful.”
Sanchez-Hernandez adds that some behaviors are age-appropriate and parents need not avoid taking children to the dentist because of it. “We patiently expose them to what we do, and the majority of children over time to enjoy coming to the dentist. Children who learn to be comfortable in the dental chair become adults who seek regular dental care.”
Pediatric dentistry has come a long way over the years, which includes advanced technology and a comfortable environment, Rohner says. “Parents are often shocked at the ease of the dental procedures and soothing environment that we provide,” she says.
Parents also need to know that the job of their children’s dental health begins at home. Dentists stress that even with regular visits, parents need to help their children brush and floss their teeth until age 8 to 10, when they understand the importance, have the physical dexterity and have been trained properly. “Most kids can’t effectively maintain good oral hygiene without parental guidance,” Johnson says. Parents need to be good examples of dental hygiene, too, dentists say.
Rohner agrees that parents must help. “We find a lot of parents are very surprised when we tell them that they still need to be helping their child all the way up to age 8! Children often do not have enough manual dexterity to be able to rotate their hand around and brush all their teeth correctly.” An informal guideline for readiness is around third grade.
Parents should choose a fluoridated toothpaste, brush at least twice daily (preferably after breakfast and before bed), with only water to drink after the bedtime brushing. Home care, good nutrition and prevention are key – along with being very conscious of the sugar in children’s diets, Davis says.
“Get kids a timer or an electric toothbrush that plays music to help make brushing and flossing fun,” Davis adds. “You can’t expect young kids to fully grasp the seriousness of the consequences of neglecting their oral hygiene, so it’s so worth taking just a little extra time each day to oversee this task.”
Are there any new things that parents may not be aware of?
Dentists have access to new toothpastes that kids who are prone to cavities can use, Thomas says. And fluoridated water is safe to drink, even though some cities are removing fluoride from water, which makes the use of fluoride toothpaste and mouth rinse that much more important, Johnson says.
In general, the fluoride issue is not new, but dentists stress that it is vital for a healthy mouth. “I know there are schools of thought against the use of fluoride, and there has been a rise in all-natural products, but systemic fluoride has been shown to reduce cavities between 50 and 70 percent,” Davis says.
According to the Birmingham Water Works Board website (www.bwwb.org), one gallon of fluoride is added to every million gallons of water – the Alabama Department of Health asked the board to do this more than 20 years ago. Fluoride also is recommended by the American Dental Association.
For a list of water systems in your community that contain fluoride, go to the Centers for Disease Control and Prevention at http://www.cdc.gov, and search fluoridation. The information is available under the topic “Community Water Fluoridation,” and parents can search by county for water systems that, according to the CDC, do and do not contain fluoride.
Lori C. Pruitt is associate editor of Birmingham Parent.