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Caring for Children’s Teeth

Posted on February 11, 2021

Our children are our most important concern in our lives. Their health is utmost in our minds. Having a healthy mouth is a cornerstone to their future success. This article will discuss the very best ways to ensure our children’s beautiful smiles.

1. Clean teeth as soon as they come in

Usually, the two lower front teeth are the first to erupt; this occurs around 6 months. Gently wipe these teeth with a soft cloth, gauze, or even your clean finger. At around 12 months it is possible to start brushing teeth with a soft infant brush. At 18 months we can introduce a pea-sized amount of children’s fluoride toothpaste while brushing. When two teeth touch; that is the time to gently floss between them. Children have twenty primaries (deciduous) teeth. They start to erupt between six and fourteen months. By age two most children have a full set (20) baby teeth.

2. Brush our children’s teeth 2x per day

Make it fun. Stand behind them and make them look in the bathroom mirror. Use positive gentle words to explain what you are doing. Never use double negatives or harsh words such as “this won’t hurt you”. All the child hears is “hurt”; this reinforces a traumatic experience for the child. Explain how the teeth are getting, white, shiny and bright. Use ADA approved child’s toothpaste. By age one try to get the child off the bottle and use a sippy cup. By age two we want our children to be able to spit. This skill is helpful so that the child doesn’t swallow too much toothpaste while brushing.

3. The bottle

After baby teeth come in it is best not to put the child to sleep with a bottle that contains milk or juice. There is sugar present that can lead to a syndrome of rapid decay of the baby’s teeth. This is called nursing bottle syndrome. So we can have water in the bottle. We are in favor of weaning the child off the bottle and into a sippy cup as soon as possible. An orthodontic pacifier may be used (if needed) to soothe the child as they go to sleep.

4. Fluoride and toothpaste

Fluoride has been shown to prevent tooth decay in children. It is important that the right amount of fluoride be delivered at the proper time of our child’s development. Dental decay (caries) affects 25% of our nation’s youngsters as they enter elementary school. So start brushing your child’s teeth as soon as they erupt (at around 6 months). At this early age just wiping the teeth clean with a soft gauze is just as effective as brushing with a small, soft child’s toothbrush. In fact brushing, cleaning, wiping still takes precedence over the concept of fluoride in preventing caries. Many municipalities have fluoride in their drinking water. This practice has lowered the caries level and helps prevent cavities before they start.  There is a 25% decrease in cavity levels just from having fluoride in the drinking water.

The outside of our teeth is made of enamel, this is the hardest substance in our body. Decay starts when bacteria ( that live in our mouth all the time) reacts with sugar (from our food) and forms an acid that eats away at the enamel. This is dental decay. Fluoride combines with the enamel to make it even more resistant to the acid. A tiny smear of ADA approved, children’s toothpaste may be used at one year of age. At age two most children have developed the ability to spit. This is important, for at this age we are increasing the amount of toothpaste to the size of a pea. We don’t want the child to swallow the fluoride paste, so learning to spit is important.

At this age children have 10,000 taste buds, twice as many as an adult. So they taste the fluoride much more than we do. Too much fluoride can lead to a condition called fluorosis. The teeth can discolor or form crazes in the enamel. Proper levels of fluoride greatly reduce dental decay. We advise that at your child’s first well visit to the dentist (usually at around 6-12 months) that dental varnish containing fluoride be gently applied. We feel that doing this two to four times a year will ensure a caries-free mouth for your offspring. So brushing twice a day for two minutes, limiting sugar and fluoride forms the triad of excellent dental health for our most prized possession.

5. Maintain a diet that is low in sugar

We are trying to prevent dental decay in your children. Without sugar, specifically, a simple form called Sucrose, decay cannot take place.  Your child should NOT eat processed or refined sugar such as candy (gummy bears), ice cream, potato chips, prepackaged snacks, soda, soft drinks, sports drinks, dried fruit, honey, citrus drinks, fruit juice, milk, raisins, cake, sugary cereals, and even some bread. Good luck in this endeavor. Obviously, moderation is key. The sugars from these foods are broken down by the enzymes in our saliva to form sucrose. Bacteria that live in balance in our mouths (especially Streptococcus Mutans) will connect to the sugar. This mush is called dental plaque. The reaction of the bacteria on the sugar produces an acid. It is this acid that starts to eat away at the outer surface of the teeth (the enamel). This process is known as dental decay which goes on to form cavities. If the cavities are not treated promptly serious infections can arise. This leads to involved dental work such as crowns, root canal therapy, or even extractions.

There is a sweetener known as Xylitol. This is a sugar alcohol found in sugarless gum. In moderation, this has been shown to be an acceptable replacement for sugar. There is sugar in milk. The milk sugar is known as Lactose. Nursing bottle caries can occur from prolonged exposure of a baby’s teeth with a bottle filled with milk, fruit juice, or another sugary liquid. We have even seen it with pacifiers dipped in sugar at nap time. We strongly advise that if you are using a bottle as a  pacifier, fill it with water. If your infant is going to sleep with milk in the bottle, remove the bottle as soon as the baby falls asleep. This prevents the upper teeth from soaking in the lactose from the milk. The sooner your infant is off the bottle and on to a sippy cup the happier we are. So cleaning the mouth with wipes, gentle brushing, flossing if teeth are touching, fluoride, and reduction of sugar in the diet are the magic keys to keeping your child’s mouth happy and healthy.

6. Healthy foods for healthy teeth

  • Water (lots of water all day long)
  • High Fiber Vegetables
  • nuts/seeds
  • Fruits that have Vitamin C (berries best, apples, pears, oranges)
  • Banana ( contain Vit C, B6, fiber, potassium and magnesium, I like them because they have “a peel”)
  • Sugarless gum containing xylitol
  • Dairy Products
  • Protein (fish, chicken, lean meats)

7. Sealants

They are thin plastic, white coverings that are painted onto the cracks and fissures on the top surface of permanent teeth; between the ages of 5-14 years. They harden in seconds when a curing light is placed upon them. This is a totally painless and inexpensive procedure. We feel that is very worthwhile. Statistically sealants prevent 80% of cavities from forming on posterior molars for two years. They prevent 50% of cavities forming for four years.

8. Regular checkups

We want to see your child at age one, which is six months after the first lower baby teeth have erupted. It is important that the child gets used to coming to the dentist under the most pleasant of conditions. So the child bonds with our dentist and looks forward to their visits. Usually we want the children to come in two times per year. They will receive a detailed exam of their mouth, a gentle cleaning (polishing) of their teeth and as they get older fluoride will be applied. Any tiny pathologies are nipped in the bud. An example is interceptive orthodontics. Here the guidance of teeth eruption and correction of malocclusion (poor bite) by early intervention in order to improve future outcomes. This is usually done with a simple fixed or removable appliance. A stitch in time saves nine. This is the time for you, the parent to bring up any concerns like excessive thumb sucking or teething problems. Any cavities will be diagnosed and treated. Cavities in baby teeth should be treated so that the permanent teeth (lying below them) in the jaw will not be harmed. We will also reaffirm preventative measures to stop cavities from forming.

It is best not to schedule their visits during their naptime. Preparation by the parent (in terms of talking, reading books) helps in making the first visit a fun experience.

Our dedicated, experienced and caring team of pediatric dentists and hygienists are looking forward to rendering gentle, comprehensive dental care to your child. Please call us at 212-355-2290 for an appointment.

About Dr. Liza Horbar

Meet Dr. Liza Horbar, one of the best prosthodontists in NYC. Dr. Horbar practices at 209 NYC Dental in Midtown East Manhattan, where we have multiple specialists. She received a Bachelor of Science from Northwestern University, where she graduated magna cum laude. Dr. Horbar moved to New York to pursue her Doctor of Dental Surgery degree, which she received at Columbia University. She continued her studies at Columbia and earned a Master of Science in Prosthodontics in 2019. While she was taking DDS classes, she journeyed to Guatemala with KIDS International Dental Services on a humanitarian mission.

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