Oral Health FAQ
When will your child’s teeth start to come in?
- Usually baby teeth (primary teeth) begin to appear when the baby is between 6-12 months of age.
- Most children have a full set of 20 primary teeth by the time they are 2 1/2 to 3 years.
Why is it important to take care of your child’s teeth (primary and permanent)?
Your child’s teeth do at least six important things
- Allow your child to chew food.
- Help your child speak clearly.
- Guide permanent teeth into place.
- Aid in the information of jaw and face.
- Add to your child’s good health and self-esteem.
- Make a beautiful smile!
When and how should you clean your child’s mouth and teeth?
- Wipe your child’s gums daily even before the first tooth comes in.
- Wipe your child’s teeth with a clean, damp washcloth or gauze pad or soft toothbrush and use a fluoridated toothpaste.
- The easiest way to do this is to sit down and place your child’s head in your lap or lay your child on the dressing table or the floor in whatever position allows you to look easily into your child’s mouth.
- Teach your child to brush his/her teeth by showing him/her how to hold the brush (aiming especially where the tooth meets the gum line) and by demonstrating how you brush your teeth. Brushing should be done twice a day (on arising, preferably before breakfast, and at bed time). You should supervise your child’s brushing until your child is 8-9 years old. Before your child is 9-10 years old, close supervision is needed to make certain that all the teeth are brushed well and that your child does not swallow the toothpaste, and teach him/her how to spit out the toothpaste and to rinse with tap water. By 9-10 years of age, children will usually have sufficient manual dexterity to clean their teeth thoroughly without supervision.
What can you do when your child begins teething?
When your child is teething, he/she may have sore gums, be restless and irritable, have difficulty sleeping or eating well, and have loose stools.
- Rub your child’s gums with you thumb/finger or a cold washcloth or allow your child to chew on something cold, such as a chilled teething ring or a clean washcloth.
- To make your child more comfortable, give an appropriate dosage of the non- aspirin medication you use when your child has a fever.
- If your child has more serious symptoms, visit his/her doctor. Teething does not cause fever, ear infections, or long-term diarrhea. Remember: your child is teething from 4-5 months of age until at least 2 years of age so you can blame everything or nothing on teething.
What is early childhood caries?
- Tooth decay in infants and preschool-aged children is called “early childhood caries”. Tooth decay can occur soon after the teeth begin to appear and is caused by frequent and prolonged exposures of the teeth to liquids that contain sugar (e.g., breast milk, formula, sugar water, fruit juice, and other sweetened liquids) and, in the child with chronic illness, to sugar-containing liquid medications which are regularly taken for a long time.
What is dental plaque?
- Plaque is a sticky film on the teeth that contains, among other things, bacteria (germs). It forms daily in the mouth and is hard to see because it is transparent. However, when enough has accumulated, it is visible as a yellowish-brown stain which becomes hard to remove by regular brushing.
- Bacteria which live in plaque may be passed from primary caregiver (usually mother) to child through saliva. If you have had problems with your teeth (multiple caries), take special care not to transmit you saliva to your baby’s mouth. Hence, do NOT wet the pacifier with your saliva; do NOT prechew or taste food and then put it in your child’s mouth.
- Plaque bacteria use sugar as their food. Even a very small amount of sugar is enough for plaque to produce acid. It is this acid that attacks the enamel of the tooth, causing the tooth to decay.
- Frequent eating of sugar-containing foods or taking of sugar-containing liquid medications on a regular, chronic basis leads to frequent acid attacks on the teeth.
What is fluoride varnish?
- Fluoride varnish is a liquid coating that is placed on the surfaces of teeth (just like nail polish on nails).
- Fluoride varnish strengthens your child’s teeth. Remember: the stronger the teeth are, the less chance that your child will get cavities.
- Ask your child’s dentist (or medical provider) whether your child should have a fluoride varnish treatment.
- If fluoride varnish is applied to your child’s teeth, the teeth will not look as bright and shiny as usual after the treatment. They should look normal by the next day and the protective effect of the varnish will continue to work for several months. To achieve the best results:
- Your child should eat only soft foods for the rest of the day
- Your child’s teeth should not be brushed on the day the varnish is applied. You may start brushing the next day in usual fashion.
What is tooth decay?
- If plaque is allowed to stay on the tooth instead of being removed, the acid formed by the bacteria within the plaque will cause the enamel to lose minerals (demineralization). The first visual evidence of demineralization is a “white spot” lesion, usually at the gum line. The white spot lesion can be reversed and the decay process stopped if minerals can be restored to the enamel (remineralization). This can happen if exposure to sugar-containing liquids becomes less frequent and/or if more fluoride is made available to the tooth.
- If remineralization does not occur and decay continues, it will progress to cavitation’s which can only be repaired surgically (drilling and filling). Cavity formation can be stopped by changing diet, practicing good oral hygiene and using fluoride. Once a cavity is formed, it can only be corrected by a dentist with a filling.
- Tooth decay is an infectious disease which is PREVENTABLE.
How can tooth decay be prevented?
- At least twice a day, wipe your child’s mouth with a clean gauze pad or wet cloth.
- Once your child’s teeth start to come in, clean them by using a wet cloth, finger cot or a small, soft brush and a thin film (less than a pea-sized amount) of fluoride toothpaste.
- Teach your child how to brush when he/she seems ready to learn. Supervise brushing to age 8-9 to make sure your child is doing a thorough job and is not swallowing the toothpaste. By age 9-10, most children have sufficient manual dexterity to do it themselves without supervision.
- Replace your child’s toothbrush when the bristles flare, bend, or become frayed. Such bristles on a toothbrush will not remove plaque effectively and may injure gums.
- If the teeth are touching and have no gaps between them, then you should also floss between them.
- Start teaching you child to drink out of a cup as soon as she/he has coordination of swallowing (about 10 months of age). The sooner your child is off the bottle, the less likely it is that your child will have cavities.
- Don’t give your child a bottle or “sippy” cup filled with a sweet liquid (e.g., juice sweetened water, soda pop, milk) when putting him/her to sleep (nap or bedtime); instead, fill the bottle with plain tap water only. All other liquids should be used at meal-times only.
- Never give your child a pacifier dipped in any sweet liquid, and don’t put your child’s pacifier in your mouth before placing it in your child’s mouth. If you want to moisten it, use tap water.
- Use fluoride to strengthen the tooth enamel against tooth decay. Fluoride is one of the most effective elements for preventing tooth decay and is therefore extremely important. The most effective way for your child to get fluoride’s protection is by drinking plain tap water containing the right amount of the mineral (about one part fluoride per millions part water). Over 98% of public water in Minnesota is fluoridated (2: 0.7-1.2 ppm fluoride); however, most well water does not contain enough fluoride naturally to prevent tooth decay. If you wonder whether your water supply is adequately fluoridated (2: 0.7-1.2 ppm fluoride), ask your city, county or state Health Department. If your water does not have enough fluoride you should consult your child’s physician or dentist about a fluoride supplement. You should also talk to your child’s physician or dentist about fluoride varnish treatments. Avoid giving your child bottled water or water that has been filtered (reverse osmosis (RO) filter), as neither may contain enough fluoride to keep your child’s teeth healthy.
- Keep your child on a healthy diet to maintain good dental and physical health. A child should eat a balanced diet, free from too many sweets. Provide nutritious snacks that are low in sugar. Help your child develop good eating habits.
- Help your child develop a positive attitude towards dental care. Your child’s first visit to the dentist should be around one year of age and then once every six months for checkups, or on whatever schedule your child’s dentist recommends.
What can you do about your child’s nutrition?
- Choose healthy foods and maintain your child on a well-balanced diet to keep good dental and physical health.
- Avoid giving your child foods high in sugar, such as soda pop, candies, sweetened cereals, fruit roll-ups, and pastries between meals.
- Offer your child snacks that are low in sugar such as raw fruits and vegetables, pretzels, cheese, yogurt, and unsweetened applesauce.
- Do not give your child a bottle or “sippy” cup filled with a sweet liquid (e.g., juice, sweetened water, soda pop, milk) when putting him/her to sleep (nap or bedtime); instead, fill the bottle with plain tap water only. Best of all, don’t give any bottle at nap or bedtime; children will go to sleep without a bottle.
- Help your child develop good eating habits.
When should you take your child for his/her first dental visit?
- It is recommended that a child should visit the dentist around their first birthday.
- The primary purpose of this visit is so the dentist or hygienist (or medical provider if dentist is not available) can inform you about risk of cavities, provide you with information (e.g., how to prevent common problems including decay and trauma, what to expect of tooth and bite development), examine your child’s teeth and gums, and the rest of the mouth for abnormalities, refer to a dentist as necessary to ensure that your child gets started in the right direction towards good oral health, and show you how to care for your child’s teeth and recommend how much fluoride your child should use.
- If you think there is a problem, see the dentist at once. DO NOT wait until your child is in pain!
- The screening examination and fluoride varnish treatment by your physician does not substitute for a dental examination by a dentist. Your child should see a dentist by the first year of age.
Should your child use fluoride?
- Fluoride is one of the most effective elements for preventing tooth decay and is therefore extremely important. The most effective way for your child to get fluoride’s protection is by drinking water containing the right amount of the mineral (community water supplies that are fluoridated contain about one part fluoride per million parts water). Avoid giving your child bottled water or water that has been filtered (e.g., with reverse osmosis (RO) filter); neither may contain enough fluoride to be effective against tooth decay.
- It is also beneficial for your child to brush with a fluoride containing toothpaste as soon as the first baby teeth come into the mouth, about 6-8 months of age. If your child is 4-5 years old, you should do the brushing for him/her and you should make sure the toothpaste is not swallowed. Though your child may be able to brush on his/her own once 4-5 years of age, you should supervise until your child is 8-9 to make certain that the teeth are brushed well and the toothpaste is not swallowed. By age 9-10, your child should have sufficient manual dexterity to brush unsupervised. A thin film (less than a pea-sized amount) of toothpaste should be placed on the child’s toothbrush and the child should be taught to spit out the remaining toothpaste.
- There are also fluoride treatments available at school-based programs, at the dentist’s office and at the office of your child’s medical provider. Ask your child’s medical provider which method he/she recommends for your child.
What are dental sealants?
- Dental sealants are thin plastic protective coatings that are applied to protect the pits and fissures of the chewing surfaces of the back teeth (molars). These teeth appear around age 6 and are where most tooth decay occurs. Not every child needs sealants, so the caregiver should ask the child’s dentist if sealants are needed for your child.
When should your child get sealants?
- If needed, sealants are applied when the first permanent molars (back teeth) erupt, usually around 6-7 years.
- Sometimes the dentist will apply sealants to the primary (baby) molars. Ask your dentist about this.
Parents frequently asked questions, childrens oral health section is adapted with permission from Frank Catalanotto, DMD’s, Gator kids healthy smiles program at the University of Florida college of dentistry with some material originally prepared by Dr. Amos deinard and colleagues from Minnesota and materials from the North Carolina "Into the mouths of babes" program.