Nothing But The Tooth Part III
In the first two parts, we covered some good concepts on how toddlers can get cavities so early in life and went on to make suggestions on how we can keep those preschoolers cavity free. In this segment, we’re going to focus on school aged children. They definitely give us a whole new set of challenges with oral hygiene, diet, and cavities.
Don’t Be Fooled-
While the youngest kids protest everything (including nightly brushing) with noise and tantrums, as they get older, elementary kids do less protesting and more fooling. I’m always impressed at the elaborate schemes I hear from parents who struggle with this age group. Some kids just hide and dodge the brushing routine, while others jump in and out of the bathroom with little more than running the water. I’ve heard of second graders who just rinse their toothbrush to make it seem like they have used it. Others swish mouth rinse to mask the odor of their gunky teeth. You name it, I’ve heard it. Here’s the reality; elementary schoolers should still be brushed or at least closely supervised by their parents. Which means the parent is either holding the toothbrush (at some point before or after the child gives it a whirl) or at least they watch their fourth grader brush, then they check to make sure there is no plaque in those hard to get to teeth. Of course the busy lifestyles of families with working parents and multiple kids will need to make a special effort to put time aside for this nightly routine, but its well worth it.
Just Keep Calm And Floss On-
By this age, those wide opens gaps between the teeth are quickly disappearing. The back teeth called molars are touching their adjacent teeth as early as age 3-4 and have been accumulating plaque. Now, its really important for all parents to realize that flossing isn’t “getting rid of food that is stuck in between teeth”. It can help with food debris too, but there is way more to it than that. Floss is made to do the same exact thing as the toothbrush, just in the areas where the brush cant access. In fact, the next time you wonder how well you’re brushing in between your teeth, afterwards, floss and check out the odor that the floss picks up along with millions of bacteria. Take away point, floss on or the cavities will start, stay hidden, and set you up for a very unwelcome surprised.
The thought of xrays is always cause for alert to any parent. There is no doubt that no xray is a good xray. But there is a reason and benefit that clearly outweighs the cons of radiation. So lets consider why xrays are a part of most routine check ups. The two big things that cant be seen without an xrays are cavities in between teeth and important dental development milestones of unerupted teeth. So, while it really isn’t advisable to skip xrays all together, parents should consider discussing technology used in the office, number of xrays planned during the visit, and schedule of xrays in the future from their child’s dentist. We typically advise that the schedule of xrays used spreads out the number of exposures during each visit. In other words, instead of taking ten xrays every January, five are taken in January and five in June.
Best Approach For More Smiles-
Trying to control the dietary habits of a growing eight year old boy is no easy task. They are always hungry and grazing like cows. I’ve watched parents struggle through episodes of family feud trying to convince their child that fruit roll ups aren’t really fruits and goldfish snacks don’t meet the daily requirements for Omega 3. My suggestion for teaching a child “cavity-aware” dietary habits may seem simple, but it is in its simplicity that it works. I never argue or battle with my daughters about not eating candy or sticky carbs. Instead, our simple rule is, if you want to snack between meals, you got to have your toothbrush ready for use. If they want that fruit roll up, they will consider if they have a toothbrush handy and if the sweet mushy yard stick is worth their 2 minutes in the bathroom brushing. It’s amazing to watch them benefit from putting a thought into what they will be munching. They definitely don’t graze and when Halloween is in full force, instead of spending a lot of time chewing Tootsie Rolls, they select their favorite chocolates and gladly give up the majority of candies that are hard or sticky. Less fighting, more smiling.
Dr J is a board certified pediatric dentist, serving his hometown in San Diego at one the most respected specialty practices, Scripps Pediatric Dentistry. He is an honors graduate of UC Berkeley, and UCLA School of Dentistry. His specialty training was completed as Chief Resident at UNC, one of only 2 three year pediatric programs in the US. He is an associate professor at UCLA in pediatric dentistry and on staff at Rady Children’s Hospital. He is also a proud father to two girls.