Caring for that first tooth

Ten tips - February 2005


Monica Ginsburg


Early start helps promote lifelong healthy smile As you agonize along with a teething baby, or admire that first lone tooth sticking through, it can seem like a big jump to think about the need to take that baby to the dentist. But pediatric dentists say that first tooth should be accompanied by a first trip to the dentist.

Babies should make their first visit to the dentist as early as 6 months and certainly by their first birthday. By age 3, they should be dental veterans, visiting a pediatric dentist for check-ups twice a year. 

The reason: Children with healthy teeth chew food easily, learn to speak clearly and smile with confidence. According to the American Dental Association, establishing good oral health habits early in life helps put your child on the road to good overall health.

So in honor of National Children’s Dental Health Month, here are some tips to help your child maintain a healthy smile:

1 Wipe teeth and gums. Begin brushing your child’s teeth with a toothbrush or soft cloth as soon as the first tooth appears. Until children are 2 years old, use only water or a tooth-and-gum cleaner without fluoride. “Ideally you would brush after every meal, but right before bed is fine,” says Andrea Lederman, a pediatric dentist in Skokie and mother of three.

2 Prevent baby bottle tooth decay. Once baby teeth start to come in, protect your child from severe tooth decay by putting him to bed with nothing more than a pacifier or bottle of water. Don’t nurse your child to sleep or put your child to bed with a bottle of milk, formula or juice. Any unswallowed liquid in the mouth pools around the upper front teeth and can promote bacteria that produce acids and attack teeth.

3 Break sucking habits. The Chicago-based American Academy of Pediatric Dentistry suggests weaning children from the bottle by the age of 12 to 14 months and from the pacifier at 18 months. Thumb sucking is normal for infants; most stop by age 2. If your child does not, discourage it after age 4. Sticker charts and other forms of positive reinforcement may help break the habit. Sippy cups are another form of sucking.  Limit use to meal and snack times. According to the academy, prolonged sucking habits can create crowded, crooked teeth or bite problems.

4 Seek out a pediatric dentist. “We’re the pediatricians of dentistry,” says Lederman. “We’re used to treating kids and we can usually make the office visit a smoother experience. It’s the equivalent of seeing a pediatrician vs. a general practitioner or family practitioner.”

5 Supervise brushing. Beginning at age 2, with your help, children can begin brushing teeth twice a day with a pea-sized amount of fluoride toothpaste. Brush the inside and outside of all teeth and the chewing surfaces for 2 to 3 minutes. A timer or a tape of a favorite song can help you determine how long to brush. Fruity or other fun toothpaste flavors are fine and may encourage longer brushing. “It’s easier if you make it a game,” says Lederman. “Let the child brush first. Then slowly and gently finish the process, or hold their hand and brush together. Try to make it a positive experience.” Teach your child to rinse with water and spit out, rather than swallow, the remaining toothpaste. At age 5, many dentists recommend using a fluoride rinse for extra protection. Parents should monitor or assist in brushing until children are about 8 years old. “It takes a lot of fine motor skills to brush well, and that’s just not developed yet in younger children,” says Mary Tierney, a pediatric dentist at Pine Dental Care in Chicago. “When kids can write in cursive, they usually can do good brushing.”

6 Steer clear of juice. “Juice, soda and other sugary drinks have no redeeming qualities,” says Lederman. “The sugar and acid eat away teeth, and filling up on juice prevents kids from eating meals.” If you do offer juice, make sure it’s 100 percent fruit juice and water it down, she advises. Water and milk are always the best drink choices.

7 Choose snacks wisely. Children need a balanced diet for teeth to develop properly. Offer well-rounded meals and choose nutritious snacks. Limit “fun foods” to special occasions and limit the number of snacks per day, regardless of what the snack is.

8 Avoid gummy candies. Small signs dangling from the top of every dental chair in Tierney’s office read: “Please: No candy fruit snacks.” Gummies and other sticky foods are not easily washed away from the teeth by saliva, water or milk, so they have more cavity-causing potential than foods more rapidly removed from teeth. Chocolate, ice cream, yogurt and pudding pops are better choices, Tierney says, because they melt or wash off teeth fairly easily. If your child does eat gummies, have him or her rinse or brush afterward.

9 Keep fluoride in water. Tap water typically contains an adequate amount of fluoride to keep teeth healthy. However, some water filters or purifiers take out most, if not all, of the fluoride in tap water. And, unless specifically marked, bottled water contains no fluoride. 10 Floss. Begin flossing your child’s teeth as soon as any two teeth touch, usually by the age of 4 or 5. Flossing removes plaque from between teeth where a toothbrush cannot reach. If your child will cooperate, put his or her head in your lap and gently floss where needed. Let children play with some floss so it becomes familiar to them. By age the age of 8 or 9, most children can floss by themselves. Floss sticks in different shapes, and colors may make the job easier, if not a little bit more fun. 

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