Innumerable studies and research have concluded on the importance of starting children early in their lives with good dental hygiene and oral care. According to research, the most common chronic childhood disease in America is tooth decay, affecting 50 percent of first-graders and 80 percent of 17-year-olds. Early treatment prevents problems affecting a child’s health, well-being, self-image and overall achievement. The National Institute of Dental & Craniofacial Research estimates that children will miss 52 million hours of school each year due to oral health problems and about 12.5 million days of restricted activity every year from dental symptoms. Because there is such a significant loss in their academic performance, the Surgeon General has made children’s oral health a priority. Parents are responsible for ensuring their children practice good dental hygiene. Parents must introduce proper oral care early in a child's life—as early as infancy. The American Dental Hygiene Association states that a good oral hygiene routine for children includes:

• Thoroughly cleaning your infant’s gums after each feeding with a water-soaked infant cloth. This stimulates the gum tissue and removes food.
• Gently brushing your baby’s erupted teeth with a small, soft-bristled toothbrush and using a pea-sized amount of fluoridated toothpaste.
• Teaching your child at age 2 or 3 about proper brushing techniques and later teaching them brushing and gentle flossing until 7 or 8 years old.
• Regular visits with their dentist to check for cavities in the primary teeth and for possible developmental problems.
• Encouraging your child to discuss any fears they may have about oral health visits, but not mentioning words like “pain” or “hurt,” since this may instill the possibility of pain in the child’s thought process.
• Determining if the water supply that serves your home is fluoridated; if not, discussing supplement options with your dentist or hygienist.
• Asking your hygienist or dentist about sealant applications to protect your child’s teeth-chewing surfaces and about bottle tooth decay, which occurs when teeth are frequently exposed to sugared liquids.

Teething

Normally the first tooth erupts between ages 6 to 12 months. Gums are sore, tender and sometimes irritable until the age of 3. Rubbing sore gums gently with a clean finger, the back of a cold spoon or a cold, wet cloth helps soothe the gums. Teething rings work well, but avoid teething biscuits—they contain sugar that is not good for baby teeth. While your baby is teething, it is important to monitor the teeth for signs of baby bottle decay. Examine the teeth, especially on the inside or the tongue side, every two weeks for dull spots (whiter than the tooth surface) or lines. A bottle containing anything other than water and left in an infant’s mouth while sleeping can cause decay. This happens because sugar in the liquid mixes with bacteria in dental plaque, forming acids that attack the tooth enamel. Each time a child drinks liquids containing sugar, acids attack the teeth for about 20 minutes. When awake, saliva carries away the liquid. During sleep, the saliva flow significantly decreases and liquids pool around the child’s teeth for long periods, covering the teeth in acids.

Infant’s New Teeth

The primary, or “baby,” teeth play a crucial role in dental development. Without them, a child cannot chew food properly and has difficulty speaking clearly. Primary teeth are vital to development of the jaws and for guiding the permanent (secondary) teeth into place when they replace the primary teeth around age 6. Since primary teeth guide the permanent teeth into place, infants with missing primary teeth or infants who prematurely lose primary teeth may require a space maintainer, a device used to hold the natural space open. Without a maintainer, the teeth can tilt toward the empty space and cause permanent teeth to come in crooked. Missing teeth should always be mentioned to your family dentist. The way your child cares for his/her primary teeth plays a critical role in how he/she treats the permanent teeth. Children and adults are equally susceptible to plaque and gum problems—hence, the need for regular care and dental checkups.

A Child’s First Dental Visit

A child’s first dental visit should be scheduled around his/her first birthday. The most important part of the visit is getting to know and becoming comfortable with a doctor and his staff. A pleasant, comfortable first visit builds trust and helps put the child at ease during future dental visits. If possible, allow the child to sit in a parent’s lap in the exam room. Children should be encouraged to discuss any fears or anxiety they feel.

Why Primary Teeth Are Important

Primary teeth are important for several reasons. Foremost, good teeth allow a child to eat and maintain good nutrition. Healthy teeth allow for clear pronunciation and speech habits. The self-image that healthy teeth give a child is immeasurable. Primary teeth also guide eruption of the permanent teeth.

Good Diet and Healthy Teeth

The teeth, bones and soft tissue of the mouth require a healthy, well-balanced diet. A variety of foods from the five food groups helps minimize (and avoid) cavities and other dental problems. Most snacks that children eat cause cavities, so children should only receive healthy foods like vegetables, low-fat yogurt and cheeses, which promote strong teeth.

Infant Tooth Eruption

A child’s teeth actually start forming before birth. As early as 4 months of age, the primary or “baby” teeth push through the gums—the lower central incisors are first, then the upper central incisors. The remainder of the 20 primary teeth typically erupt by age 3, but the place and order varies. Permanent teeth begin eruption around age 6, starting with the first molars and lower central incisors. This process continues until around age 21. Adults have 28 secondary (permanent) teeth—32 including the third molars (wisdom teeth).

Preventing Baby Bottle Tooth Decay

Tooth decay in infants can be minimized or totally prevented by not allowing sleeping infants to breast or bottle-feed. Infants that need a bottle to comfortably fall asleep should be given a water-filled bottle or a pacifier. Our office is dedicated to fighting baby bottle tooth decay. Let us know if you notice any signs of decay or anything unusual in your child’s mouth.

Brushing

Use a toothbrush with soft bristles and a small strip of fluoride toothpaste. When you brush your teeth, move the brush in small circular motions to reach food particles that may be under your gum line. Hold the toothbrush at an angle and brush slowly and carefully, covering all areas between teeth and the surface of each tooth. It will take you several minutes to thoroughly brush your teeth. Brush up on the lower teeth, down on the upper teeth and the outside, inside and chewing surface of all of your front and back teeth. Brush your tongue and the roof of your mouth before you rinse. Brush your teeth four times daily to avoid the accumulation of food particles and plaque:

• In the morning after breakfast
• After lunch or right after school
• After dinner
• At bedtime

As soon as the bristles start to wear down or fray, replace your toothbrush with a new one. Do not swallow any toothpaste; rinse your mouth thoroughly with water after you finish brushing. It is important to carefully floss and brush daily for optimal oral hygiene.

Flossing

For areas between the teeth that a toothbrush can’t reach, dental floss is used to remove food particles and plaque. Dental floss is a thin thread of waxed nylon that is used to reach below the gum line and clean between teeth. It is very important to floss between your teeth every day. Pull a small length of floss from the dispenser. Wrap the ends of the floss tightly around your middle fingers. Guide the floss between all teeth to the gum line, pulling out any food particles or plaque. Unwrap clean floss from around your fingers as you go, so that you have used the floss from beginning to end when you finish. Floss behind all of your back teeth. Floss at night to make sure your teeth are squeaky clean before you go to bed. When you first begin flossing, your gums may bleed a little. If the bleeding does not go away after the first few times, let a staff member know at your next appointment.

Tooth Decay

Caries, or tooth decay, is a preventable disease. While caries might not endanger your life, they may negatively impact your quality of life. When your teeth and gums are consistently exposed to large amounts of starches and sugars, acids may form that begin to eat away at tooth enamel. Carbohydrate-rich foods such as candy, cookies, soft drinks and even fruit juices leave deposits on your teeth. Those deposits bond with the bacteria that normally survive in your mouth and form plaque. The combination of deposits and plaque forms acids that can damage the mineral structure of teeth, with tooth decay resulting.

Sensitive Teeth

Your teeth expand and contract in reaction to changes in temperature. Hot and cold food and beverages can cause pain or irritation to people with sensitive teeth. Over time, tooth enamel can be worn down, gums may recede or teeth may develop microscopic cracks, exposing the interior of the tooth and irritating nerve endings. Just breathing cold air can be painful for those with extremely sensitive teeth.

Gum Disease

Gum, or periodontal, disease can cause inflammation, tooth loss and bone damage. Gum disease begins with a sticky film of bacteria called plaque. Gums in the early stage of disease, or gingivitis, can bleed easily and become red and swollen. As the disease progresses to periodontitis, teeth may fall out or need to be removed by a dentist. Gum disease is highly preventable and can usually be avoided by daily brushing and flossing. One indicator of gum disease is consistent bad breath or a bad taste in the mouth.

Bad Breath (Halitosis)

Daily brushing and flossing helps to prevent the buildup of food particles, plaque and bacteria in your mouth. Food particles left in the mouth deteriorate and cause bad breath. While certain foods, such as garlic or anchovies, may create temporary bad breath, consistent bad breath may be a sign of gum disease or another dental problem.

Canker Sores

Canker sores (aphthous ulcers) are small sores inside the mouth that often recur. Generally lasting one or two weeks, the duration of canker sores can be reduced by the use of antimicrobial mouthwashes or topical agents. The canker sore has a white or gray base surrounded by a red border.

Orthodontic Problems

A bite that does not meet properly (a malocclusion) can be inherited, or some types may be acquired. Some causes of malocclusion include missing or extra teeth, crowded teeth or misaligned jaws. Accidents or developmental issues, such as finger or thumb sucking over an extended period of time, may cause malocclusions.

Tooth Ache

Begin by cleaning around the sore tooth meticulously. Using warm salt water, rinse the mouth to displace any food trapped between teeth. UNDER NO CIRCUMSTANCES should you use aspirin on the aching tooth or on the gum. In the event of facial swelling, apply a cold compress to the area. For temporary pain relief, acetaminophen is recommended. See a dentist as soon as possible.

Cut or Bitten Tongue, Lip or Cheek

Ice can be applied to any bruised areas. For bleeding, apply firm (but gentle) pressure with sterile gauze or a clean cloth. If the bleeding does not stop with pressure or continues after 15 minutes, go to an emergency room.

Broken Braces and Wires

Remove a broken appliance only if it comes out easily. If it is lodged or painful to remove, cover any protruding edges with wax, cotton balls, gauze or chewing gum. DO NOT REMOVE any wire caught in the gums, cheek or tongue; see a dentist immediately. Emergency attention is usually not required for loose or broken appliances that cause no discomfort.

Broken Tooth

Rinse the area with warm water. Put a cold compress over the facial area of the injury. Recover any broken tooth fragments. Get immediate dental attention.

Knocked Out Permanent Tooth

Recover the tooth, making sure to hold it by the crown (top) and not the root end. Rinse, but do not clean or handle the tooth more than necessary. Reinsert the tooth in the socket and hold it in place using a clean piece of gauze or cloth. If the tooth cannot be reinserted, carry it in a cup containing milk or water. Because time is essential, see a dentist immediately.

Other Emergency Conditions:

Possible Broken Jaw

In the event of jaw injury, tie the mouth closed with a towel, tie or handkerchief. Go immediately to an emergency room.

Bleeding After a Baby Tooth Falls Out

Fold a piece of gauze and place it (tightly) over the bleeding area. Bite down on the gauze for 15 minutes; if bleeding continues, see a dentist.

Cold or Canker Sores

Over-the-counter medications will usually provide temporary relief. If sores persist, visit your dentist.

Tooth Decay Prevention

Tooth decay is a progressive disease resulting in the interaction of bacteria that naturally occur on the teeth and sugars in the everyday diet. Sugar causes a reaction in the bacteria, causing it to produce acids that break down the mineral in teeth, forming a cavity. Dentists remove the decay and fill the tooth using a variety of fillings, restoring the tooth to a healthy state. Nerve damage can result from severe decay and may require a crown (a crown is like a large filling that can cap a tooth, making it stronger or covering it). Avoiding unnecessary decay simply requires strict adherence to a dental hygiene regimen: brushing and flossing twice a day, regular dental checkups, diet control and fluoride treatment. Practicing good hygiene avoids unhealthy teeth and costly treatment.

Sealants

The grooves and depressions that form the chewing surfaces of the back teeth are extremely difficult (if not impossible) to clean of bacteria and food. As the bacteria reacts with the food, acids form and break down the tooth enamel, causing cavities. Recent studies indicate that 88 percent of total cavities in American school children are caused this way. Tooth sealants protect these susceptible areas by sealing the grooves and depressions, preventing bacteria and food particles from residing in these areas. Sealant material is a resin typically applied to the back teeth, molars and premolars and areas prone to cavities. It lasts for several years but needs to be checked during regular appointments.

Fluoride

Fluoride is a substance that helps teeth become stronger and resistant to decay. Regularly drinking water treated with fluoride and brushing and flossing regularly ensures significantly lower cavities. Dentists can evaluate the level of fluoride in a primary drinking water source and recommend fluoride supplements (usually in tablets or drops), if necessary.

Thumb Sucking

Sucking is a natural reflex that relaxes and comforts babies and toddlers. Children usually cease thumb sucking when the permanent front teeth are ready to erupt. Typically, children stop between the ages of 2 and 4 years. Thumb sucking that persists beyond the eruption of primary teeth can cause improper growth of the mouth and misalignment of the teeth. If you notice prolonged and/or vigorous thumb sucking behavior in your child, talk to your dentist. Here are some ways to help your child outgrow thumb sucking:

• Don’t scold a child when they exhibit thumb sucking behavior; instead, praise them when they don’t thumb suck.
• Focus on eliminating the cause of anxiety—thumb sucking is a comfort device that helps children cope with stress or discomfort.
• Praise them when they refrain from the habit during difficult periods.
• Place a bandage on the thumb or a sock on their hand at night.