Information for Parents of

Young Children

 

PREVENTING CAVITIES IN YOUNG CHILDREN


  1. Q. What is Baby Bottle Tooth Decay?

A.  Early Childhood Caries (ECC), formerly known as, Baby bottle tooth decay (BBTD) is a condition that causes severe and rapid destruction of baby teeth.  ECC is the result of a combination of frequent consumption of sugary liquids like: breast milk, soda, juice, etc.)  and poor oral hygiene.  Feeding on such liquids through a bottle or sippy cup results in a distinct pattern of caries, in which the upper front teeth are first to decay.  As the disease spreads, other teeth may be involved as well.  It is important to understand that frequency of feeding is more important than what the child is actually feeding on.


Q. How can I prevent cavities in my child?

A. Cavities in children can be avoided by monitoring a child’s diet, their frequency of food/liquid intake, and good oral hygiene.  A bottle or sippy cup with sugary liquids should not be used to put children to sleep or for long periods during the day.  If a bottle is used to put a child to bed, it should be removed when the baby falls asleep.  The baby’s gums and teeth should be wiped with a damp washcloth when done feeding.  If the bottle is not removed after the child has fallen asleep, the liquid pools in the child’s mouth, the teeth are likely to cause cavities as shown above.  If a child wants to sleep with or to sip on a drink throughout the day, the bottle or sippy cup should contain water.  Additionally, it is recommended for all children to visit a dentist by the age of one year. 


Q. How should I clean my baby’s teeth?

A.  Before your child gets her primary teeth, you can brush the gums with a soft infant toothbrush and water. Do not use fluoridated toothpaste until your child is 2-3 years of age, unless advised by your pediatric dentist.


Q.  How much fluoride should my child get?

A.  Your pediatric dentist can evaluate the amount of fluoride your child receives from your primary source of drinking water. If your child is not receiving the adequate amount of fluoride through your water source or if your child drinks bottled water without fluoride, your pediatric dentist can prescribe fluoride supplements.


Q.  What are some helpful oral hygiene tips?

A.  Once your child has reached the age of 2 or 3, he should brush his teeth at least twice a day with a soft toothbrush and pea size amount of fluoridated toothpaste. Until your child has the proper dexterity to brush on his own (around age 6), you need to supervise his brushing and prevent swallowing of any excess toothpaste.


Q. What are sealants?

A. Sealants are clear or shaded plastic material that are placed on the grooves and pitted surfaces of teeth to prevent decay in your child’s teeth. Sealants block out food and plaque from reaching these hard to clean areas. They are commonly placed on the chewing surfaces of molars where children most often get decay and will last for many years when properly cared for.



Good dietary and feeding practices


Q.  What are some cavity causing foods that I should be aware of?

A: Your child must have a healthy, balanced diet for proper tooth development and healthy gums.  A healthy diet includes fruits and vegetables, breads and cereals, milk and dairy products, and meat.  Also, a diet full of carbohydrates, such as sugar and starches, can increase the risk of tooth decay for your child. 


Q.  Can I give my child a sippy cup to help them sleep at night?

A.  Don't nurse your child to sleep or leave a bottle of milk, formula, juice, or sweetened liquid in bed.  Any unswallowed liquid in the mouth promotes bacteria growth, which produce acids that attack the teeth. You can protect your child from severe tooth decay by putting him to bed with a pacifier or water.


Here are some practical tips to prevent tooth decay associated with bottles:

•Encourage your child to drink from a cup around the time of his first birthday.

•Don’t let your child fall asleep with a bottle.

•Avoid at-will nighttime breast feeding after the teeth begin to erupt.  Avoid giving your child juice in a bottle.  When you give your child juice, make sure it’s in a cup.


Q: What diet is best for my child’s teeth?

A:  Foods with starches and sugars in them can lead to tooth decay, so you should limit the amount of these foods that your child eats.  Examples of starchy foods are bread, pasta, crackers, pretzels, and potato chips.  Also, sugar isn’t just in cookies and candy.  Sugar is found in fruits, most milk products, and many processed foods, even when they don’t taste sweet.  For example, sugar is found in ketchup, salad dressing, and peanut butter.


Here are a few easy ways to improve your child’s diet and prevent tooth decay:

•If your child chews gum or sips soda, buy the sugar-free kinds.

•Don’t stock your pantry with sugary or starchy snacks.  Save these foods for special occasions.

•Limit the number of snack times and choose healthy snacks.


Q: Should I limit all sugars and starches from my child’s diet?

A: No, you simply need to select them and serve them wisely.  Save foods with sugars and starches for mealtimes, because it’s safer for your child’s teeth.  Sticky foods, such as dried fruit or toffee, are not easily washed away from the teeth by saliva, water or milk.  The sugar stays in the mouth longer and has more potential to cause cavities.



Dental growth and development:

The effects of oral habits


Q.  When should I expect the first tooth to erupt?

A. A child’s four front teeth are the first to erupt, starting around 6 months of age. If the first tooth erupts a few months before or after six months, it’s nothing to be worried about—it’s normal. 


As soon as the first tooth breaks through the gum, parents can begin cleaning a baby's tooth on a regular basis with an infant toothbrush and water or a moist washcloth. Unless it is advised by your child’s pediatric dentist, do not use fluoridated toothpaste until age 2-3.


More importantly, when a child’s first tooth erupts, it’s time to schedule baby’s first appointment with a pediatric dentist. A child should see a pediatric dentist by one year of age. A pediatric dentist will look at the child and talk with the parents about what they can do to maintain the baby’s oral health.


Q.  What should I give my child to soothe them during teething?
  1. A.  From six months to age 3, your child may have sore gums when teeth erupt. To soothe a teething child, many children like a clean teething ring, cool spoon, or cold wet washcloth. Some parents swear by a chilled ring; others simply rub the baby’s gums with a clean finger.  During this time, babies will likely chew on everything!  Make sure all objects are safe and wiped clean, especially their hands. 



Q.  How can I protect my child’s teeth during sports?

A.  Soft plastic mouthguards can be used to protect a child's teeth, lips, cheeks and gums from sport related injuries. A custom-fitted mouthguard developed by a pediatric dentist will protect your child from injuries to the teeth, face and even provide protection from severe injuries to the head.


Q.  What should I do if my child’s teeth get knocked out?

A.  If the tooth is a baby tooth, contact your pediatric dentist as soon as possible.


If the tooth is a permanent tooth, find the tooth and rinse it gently in cool water. (Do not scrub it or clean it with soap -- use just water!) If possible, replace the tooth in the socket and hold it there with clean gauze or a wash cloth. If you can't put the tooth back in the socket, place the tooth in a clean container with milk, saliva, or a tooth-preserving liquid (e.g. Save-A-Tooth, Hank’s Salt Solution), but do not soak it in water.  Get to the pediatric dental office immediately. (Call the emergency number if it's after hours.) The faster you act, the better your chances of saving the tooth. 


Q.  Are pacifiers and thumb sucking bad for my child’s teeth?

A.  You may be concerned about your child’s thumb sucking and wonder if it is harmful, at what age your child should stop, or what could happen if your child doesn’t stop.

Children suck on things because sucking is one of a baby’s natural reflexes and as infants get older it serves many purposes. It may make them feel secure and happy and helps them learn about their world to suck on their thumbs, fingers, pacifiers or other objects. Young children may also suck to soothe themselves. Since thumb sucking is relaxing, it may help induce sleep.


Q.  When should I worry about this habit?

A. After the permanent teeth come in, sucking may cause problems with the proper growth of the mouth and alignment of the teeth. It can also cause changes in the roof of the mouth. The intensity of the sucking is a factor that determines whether or not dental problems may result. If children rest their thumbs passively in their mouths, they are less likely to have difficulty than those who vigorously suck their thumbs. Some aggressive thumbsuckers may cause problems with their baby (primary) teeth. If you notice changes in your child’s primary teeth, consult your dentist.  Many times sucking habits will lead to an open bite (a situation when the front teeth do not touch when the back are in contact) as is shown here at the right.


Children should have ceased sucking by the time the permanent front teeth are ready to erupt. Usually children stop between the ages of two and four years.

Pacifiers can affect the teeth essentially the same ways as sucking fingers and thumbs. However, it is often an easier habit to break.

Tips:

•Praise children for not sucking, instead of scolding them when they are.

•Children often suck their thumbs when feeling insecure or needing comfort. Focus on correcting the cause of the anxiety and provide comfort to your child.

•For an older child, involve him or her in choosing the method of stopping.

•Your dentist can offer encouragement to a child and explain what could happen to their teeth if they do not stop sucking.

•If the above tips don’t work, remind the child of their habit by bandaging the thumb or putting a sock on the hand at night. Your dentist or pediatrician may prescribe a bitter medication to coat the thumb or the use of a mouth appliance.


Q.  When should a child stop sucking their thumb?

A. Children should have ceased sucking by the time the permanent front teeth are ready to erupt. Usually children stop between the ages of two and four years


Q.  What can I do to encourage my child to quit the habit?

A.  Praise children for not sucking, instead of scolding them when they do suck their thumbs.  Children often suck their thumbs when feeling insecure or needing comfort. Focus on correcting the cause of the anxiety and provide comfort to your child.  For an older child, involve him or her in choosing the method of stopping.  Your dentist can offer encouragement to a child and explain what could happen to their teeth if they do not stop sucking.  If the above tips don?t work, remind the child of their habit by bandaging the thumb or putting a sock on the hand at night. Your dentist or pediatrician may prescribe a bitter medication to coat the thumb or the use of a mouth appliance



Preparing for a pediatric dental visit


Q.  When should my child have their first dental visit?

A. The American Academy of Pediatric Dentistry recommends that a pediatric dentist see a child by the age of one. The first tooth usually comes in between six and twelve months of age. An early examination and good preventive care will keep your child’s oral health in great condition.


Q.  How often should we visit the dentist?

A.  The American Academy of Pediatric Dentistry recommends that most children see a pediatric dentist at least twice a year. Children at higher risk for tooth decay, unusual growth patterns, or poor oral hygiene may be advised to visit more frequently. Consult with your pediatric dentist to find out the best appointment schedule for your child.  For information about our Pediatric Dental Clinic, click here.



This website was created by the AAPD student chapter at Columbia University, College of Dental Medicine.  If you have any further questions, please visit the following sources:


American Academy of Pediatric Dentistry, FAQ

American Academy of Pediatrics

American Dental Association

 

Many new parents have questions about how to care for their children’s oral health care needs.  Below you will find answers to many of these frequently asked questions.