From baby teeth to braces, oral health needs to grow with children

May 25 2014

From baby teeth to braces, oral health needs to grow with children

By Erinn Hutkin, Special to U-T San Diego 6 A.M. MAY 20, 2014

Many parents mark a child’s first birthday with a party and a cake for them to smash into, but when it comes to their baby’s health, that first birthday is also when parents should begin taking their infants to the dentist.

Children should visit a dentist twice a year starting at a very young age.

Dr. Parvathi Pokala, president of the College of Diplomates of the American Board of Pediatric Dentistry and a dentist in private practice in Clairemont and Kearny Mesa, said groups such as the American Academy of Pediatric Dentistry and the American Academy of Pediatrics suggest that children see a dentist by their first birthday.

While those first few visits likely won’t involve much cleaning or cavity-filling, they can go a long way in making kids comfortable with the dentist, educating parents on what they can do to promote oral health and establishing patterns for kids when it comes to caring for their teeth.

As children grow, their dental needs change. Here’s a look at what’s important for oral health as they progress toward adulthood.

Infancy and toddlerhood

The aim of child’s first visit, said Dr. Jossein Shahangian, a board-certified dentist at Scripps Pediatric Dentistry, is to get kids comfortable with the dentist. He said he dedicates about an hour to a child’s first visit. There are stuffed animals to keep kids busy, and he spends most of the visit talking to parents about oral hygiene topics, such as how to brush a baby’s teeth, ways to keep kids cavity-free, guidelines for fluoride, and how to handle mouth injuries when kids fall.

He said educating the parents is as important as checking the little one’s teeth. He said many parents may not know that a 2-year-old needs to have their teeth flossed daily or that putting a baby to bed with a bottle of juice leaves sugar on delicate baby teeth, which can lead to cavities or tooth decay.

In addition, Pokala said this is a time when parents should establish good diet guidelines to promote not only oral health, but overall wellness. She said moms and dads should look for “hidden” sugar in food and avoid high-fructose corn syrup and refined carbohydrates, acidic food and drinks and sticky, sweet foods, “especially gummy vitamins, raisins and dried fruit.”

During this time, said Dr. Jeff Gray, a San Diego dentist, parents need to be careful about not spreading fear of the dentist. Highlight the positives – tell kids they can ride up and down in the dentist’s chair, and explain that the dentist will use a “special toothbrush” to look at their teeth instead of the word “pick.”

“Kids pick up on the things you say,” he said. “You want to be careful.”

Gray said by the time a child is 2 or 3, parents should bring them to the dentist for twice yearly visits. At this point in toddlerhood, he said parents should note if their kids’ teeth look like “picket fences.” He said big spaces between teeth are good at this age – baby teeth will fall out and be replaced by permanent teeth that are bigger and take up more room in the mouth.

“If baby teeth are perfect,” he said, “you might as well start saving money for the orthodontist.”

Childhood and preteen years

As they grow, Gray said parents should help kids with brushing until age 6 or 7.

“It’s a pain in the butt at bedtime, but it could be a great gift for your child,” he said.

To encourage brushing and flossing during childhood, he said there are tools such as water picks designed for kids and items such as GumChucks – a colorful, mini device that makes flossing fun.

The elementary school years, Shahangian said, are also when kids should get sealants applied during dental visits. He said it’s a clear liquid that’s painted on the teeth and cured with a light that prevents bacteria from moving into crevices in the teeth and creating cavities.

He said many dentists begin giving attention to possible orthodontic needs when children are age 6 or 7, adding that children ages 11 and 12 are the most common time to begin treating kids who need braces or other corrective measures.

Shahangian said kids with orthodontics are at a higher risk for cavities since hardware in the mouth allows more plaque to accumulate, traps bits of food and makes cleaning harder. For that reason, he said it’s important to keep up with regular checkups and for parents to make sure kids are brushing and flossing daily.

And since childhood is also a time when many kids are active in sports, Pokala said families should purchase a mouth guard from a sports store. She said parents should encourage kids to wear it during any contact sport, or when cycling, skate boarding, rollerblading and more.

If a child does lose or break a tooth, Gray said to find the missing or broken part of the tooth if possible and avoid touching the root. If a whole tooth is lost, he recommends placing it back in the mouth or putting it in milk or a wet paper towel and calling the dentist. The younger the child is, he said the higher the chances of putting the tooth back into place. And he said finding a knocked-out tooth is not always as hard as it may sound – he once saw a boy in his office who had help retrieving a lost tooth from a swimming pool.

Teen years and young adulthood

Teens are not known among dentists for being the best at brushing and flossing, and their diets, which often include lots of energy drinks, soda and fast food, don’t help.

This is the time, however, when Shahangian said teens also need to pay attention to their gums because gum health is a lifelong part of oral health, and the risk for gum disease only increases with age.

Pokala said it’s important for parents to monitor their teens, and there are measures that can be done at home such as buying fluoridated toothpaste or tablets and solution to use before brushing to identify plaque.

She also advocates products containing xylitol, which she said may make plaque less sticky and reduce tooth decay. She said it’s a natural sugar found in sugar-free gum and mints.

Parents can also encourage teens to drink more water and maintain diets low in refined carbohydrates, while also incorporating cheese, fruits and nuts.

And of course, she said, parents should continue to make sure teens keep up with annual visits to the dentist well into high school, college and beyond.

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