Gentle Family Dental Care - Children's Oral Health

Children's Oral Health
from the Upper Valley Parents Paper, September, 2002

When a child starts to experience his or her first tooth eruption it is a good time to start with their dental care.   The gums will be sore as the new teeth erupt so a gentle cool massage may help to quiet them.   A cold clean wash cloth is an excellent first toothbrush.   You may even freeze a damp washcloth for the child to chew on as a teething toy.   This is the start of a very important hygiene habit, and it needs to be maintained daily for the child to expect it and not to fuss over it.   Be gentle but be religious about it.   The baby teeth must be kept meticulously clean to prevent many problems for plaguing them later.   When a child gets older, fluoride toothpaste can be added to the regimen, so long as the children can control themselves enough to not swallow the paste.   If a child likes the taste of the toothpaste and ingests more than a small amount over a long period of time it may cause some permanent staining or discoloration of the tooth structure.   (I also try to discourage the use of the sweet or 'candy flavored' toothpaste for this reason-- but use what works for you.) Just a pea-sized drop on the brush is enough to start.   Children's teeth are important to keep healthy to prevent infection, pain and crowding of the adult teeth.   Cleaning should happen ideally twice a day and floss should be used starting when the first set of teeth contact each other enough to prevent adequate brushing.   This needs to be done for the child for some time until it can be done effectively alone.   It is a nice care-giving ritual that helps to build emotional bonds as well.

Fluoride supplements should also be part of the child's dietary regimen to ensure good healthy strong teeth later in life.   As the child grows the permanent teeth are developing in the jawbones of the face.   A very small quantity of fluoride everyday will be laid into the developing tooth structure; making it much more resistant to decay.  This is the reason that most large towns fluoridate their water for us.   Many people on town water have the adequate percentage (one part per million) but check with your town officers to find out if it is the case in your town.   If you own a well and the child does not drink much other fluoridated water on a regular basis you can get a test kit from your dental office.   The state of NH will test for adequate Fluoride levels for around $7 whether you live in NH or VT.

Sealants are another important preventive tool at our disposal to keep kids cavity-free.   They are a clear or tooth-colored resin coating that seal the pits and fissures of the teeth that naturally tend to decay without them.   They are relatively inexpensive and can last for many years.

The first dental visit should happen as early as the child will tolerate it.   This is usually about the age of two or three however there may already be problems starting by this age.   We encourage the mother to bring the child along to one of her own appointments first to become familiar with the faces, the smells, the sounds etc.  This usually helps the child have a more positive experience later.   I find it very helpful to build on positive experiences with children, to avoid an uphill battle later.   It is also important to establish a rapport with a Dentist early in the event that the child needs some sort of emergency care and there will be someone who he or she can trust to help.   In our office, we give out a book titled "I Know Why I Brush My Teeth" to all new families; its an excellent first exposure to the topic for kids.   Any interested reader can request a complimentary copy from our office as well.

One of the most unfortunate and yet easily preventable problem that can affect a child's teeth is what is commonly called "bottle syndrome" and occurs when a child is put to bed or allowed to nap with a bottle of milk or juice in the mouth.   The fluids can cause rapid tooth decay that is very difficult to treat and get control over.   In older kids rampant decay is commonly caused by an over-indulgent use of soda, aside from all the other problems that all that sugar and caffeine can cause, the sweet carbonated beverages can cause some really devastating problems in relatively young kids.

For any parents who have bad memories of their experiences in the dental office as a child, it should be encouraging to know that there really doesn't have to be that kind of experience for your own children.   Nowadays, most kids really love their dental visits, and even if treatment is required, kids really don't have to suffer with the fear and discomfort that many adults remember and tell about.   In any case, it is important to get started early with regular dental care both at home and at the dental office.

Read more articles by Dr. Schell here.