Toddler teeth traumas

Several months ago, my 2-year-old son tripped and fell face first on our kitchen floor, breaking his two front teeth in half. I rushed him to my dentist, who examined him and had me bring him back 10 days later.

At that checkup, the dentist found no nerve damage or infection, and smoothed down the rough edges where his teeth were chipped. Today, six months later, Ryan’s front teeth are a little shorter than usual, but otherwise they’re fine.

Ryan’s experience was all too common. By the time they are 5, one-third of all kids will suffer an injury to their primary, or baby, teeth. New studies show that preschoolers are also more likely to have cavities than ever before, with more than one-quarter having a cavity by the time they’re 5.

Baby teeth: Not just for babies

Healthy baby teeth are important for several reasons, says American Dental Association spokesperson and pediatric dentist Mary J. Hayes, who practices in Chicago."Baby teeth are the pattern for the permanent teeth. They’re important for function, important for speech and important for aesthetics.” While some primary teeth are lost early, kids often keep their"baby” second molars until their early teens.

Yet baby teeth are more likely to be injured than permanent teeth for several reasons, says Buffalo Grove-based pediatric dentist Fred Margolis."The enamel [outer surface] on the primary or baby tooth is much thinner and therefore it fractures much easier,” Margolis says."And the roots aren’t as long, so sometimes if a baby tooth is hit wrong, it can be knocked all the way out.”

If your child suffers an injury to her mouth, don’t panic. Calm her down, evaluate the problem, check whether any teeth have been displaced and take your child to her dentist immediately. If she hasn’t been to the dentist yet, call your dentist and ask for an emergency appointment—the sooner she’s seen, the better.

While your dentist won’t implant a tooth that’s been knocked out, teeth can be smoothed down, or in the case of a large chip, bonded or fixed. For any injury that’s"from the lips on in,” call your dentist first (before the doctor or emergency room), Margolis says.

Healthy habits, healthy smiles

Even if your child never has a dental trauma, you can help her take good care of her baby teeth—and permanent teeth—from now on. The American Academy of Pediatrics, the American Academy of Pediatric Dentistry and the American Dental Association all recommend that children be seen by age 1, or after the first tooth has emerged. In addition to a simple exam, your dentist will talk to you about fluoride, brushing techniques and diet.

Fluoride helps make enamel harder and stronger, and cities in Illinois are required to have adequate fluoride in the water. Some home water filtration devices filter out fluoride, so if you use one, check to see if that’s the case."Fluoride is important, not only for the teeth that are in the mouth, but also for the teeth that are growing in the jaws,” says Margolis.

Good brushing habits are only part of the equation. Your child’s diet can also play a major role in cavities. Bacteria that live in the mouth thrive on sugary foods, and when they digest sugars, they create acid that can etch away the enamel, Hayes says. And cavities can cause bigger problems: if they get deep enough, they can cause abscesses or infections.

The more frequently your child snacks on sugary foods, the more often bacteria have to cause decay—and even"healthy” snacks like raisins and fruit rollups contain a lot of sticky sugars. Limit these snacks and skip the juice—or serve it at a meal instead of a snack by itself.

Brushing your child’s teeth helps remove plaque, a soft, gooey substance made of bacteria and food residue. Cleaning your child’s first few teeth with a washcloth or gauze is sufficient; once your child has four teeth, you can start using a very soft toothbrush, at morning and night.

Regular tooth brushing is the best way to keep your child’s teeth healthy for life."If we can remove the plaque every 24 hours, [your child will have] no gum disease and no tooth disease ever,” Margolis says."That’s pretty cool.”

Tooth-brushing tips for toddlers

Brushing a typical toddler’s teeth well takes about a minute. If you’re having trouble with your tyke, try these tips:

• Keep tooth brushing separate from your going-to-bed routine.

• Hold your child’s head steady while you brush.

• Count out loud, sing a song or otherwise distract your child while you brush.

• Have her choose her own toothbrush and non-fluoride toothpaste and make a big deal of her learning to brush like a"big girl.”

• Focus on brushing the top teeth well, then if you have to bail out, brush the bottom teeth well the next time.

• Aim at the gumline, not just the teeth themselves."As the child grows, that changes, and that’s where the plaque grows,” Hayes says.

Kelly James-Enger is the daughter of a dentist. She lives with her husband and son in Downers Grove.

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