Tuesday, July 31, 2007

Caring for Your Child's Teeth featured in Kids Life Magazine, Tuscaloosa

Caring for Your Child’s Teeth
By Leigh Rutledge Bratina and Dr. Stan Turnipseed

You can see it in their smile…that is, whether your child is properly caring for his teeth. Parents often have questions about how to take care of their children's teeth. When should you start brushing? What kind of toothpaste is best? When should you go to the dentist? Knowing the answers to these questions can help you keep your child’s teeth healthy and cavity free. Freelance write, Leigh Bratina of Kids Life Magazine asked Dr. Stan Turnipseed of University General Dentistry in Tuscaloosa these important questions:

What is the best way I can care for my child's teeth?

I recommend that children brush their teeth at least twice a day including once after breakfast and most importantly, before bedtime at night. It is vital that the child has nothing to eat or drink, except water (even milk contains sugar) from the time of brushing until bedtime. The body's natural production of saliva that is responsible for "bathing" the teeth shuts down during sleep and allows bacteria to run wild during sleep.
Be involved when your child brushes their teeth! For infants and toddlers, parents should find a comfortable position and a position to see clearly inside the toddlers mouth. Hold the child in your lap, straddling and facing the parent. Use one hand to support the head. This allows a clear view of the child's mouth and teeth.

A non-fluoride toothpaste or a very small amount of fluoride toothpaste should be used until the child is old enough to expectorate (spit out) the excess, usually age 2-3.
Fluoride toothpaste should be kept in a secure location as it is potentially toxic, causing severe gastrointestinal upset, or lethal in very high doses. To be lethal a small child would have to ingest most of a large tube, so parents don’t panic, but be advised!A regular, small, soft bristle brush is adequate. Be certain that the toothbrush is suitable for the age of your child. There are some really great children’s toothbrushes on the market. All are brightly colored and many have a child’s favorite cartoon character on them. Some toothbrushes even change color, will spin or have timers! Have your child pick out their own toothbrush from a line made especially for children. Beginning at age 2-3 the parent should allow the child to brush their own teeth first then the parent should follow up thoroughly. The ADA research suggests that parental supervision is needed until age nine because until that point children do not possess the dexterity to or the understanding of how to properly remove soft plaque.

You should also talk with your dentist about using sealants in your school age child. A sealant is a plastic material that is applied to the teeth, hardens, and provides a barrier against plaque and other harmful substances. Sealants can be applied to the 1st and 2nd permanent molars to help protect the grooves and pits of these teeth that can be hard to clean and are prone to developing cavities, and appropriate premolars as soon as possible after they erupt (usually after 6 years of age).

What is your opinion on fluoride tablets?
A normal fluoridated water supply should provide adequate amounts of fluoride for the developing dentition of a child. However, the are some cases where a supplement of a gel or tablet is required. These include: a family living in a rural area on a nonfluoridated water supply such as well water, a child from a family history of tooth decay and poor oral hygiene habits.The danger in over fluoridation during tooth formation is that the teeth can develop fluorosis. Fluorisis is the often seen, white "chalky" or "snowflake" looking spots on the edges of permanent teeth. These are actually over calcified areas caused by excess fluoride during tooth formation. An adequate amount in water supply is anywhere from 1-3 PPM (parts per million) of fluoride.

Does my child's diet affect his teeth?
Diet definitely affects a child’s teeth! The two main factors are foods high in sugar and foods that are "sticky" i.e. candy, raisins that stay on the teeth for long periods. Examples of good snacks are fruit, meat or cheese slices, nuts, popcorn, pickles. Examples of bad snacks are cookies, chewy candy, raisins and white bread. Avoid between meals snacking if possible. Also, promote water and milk, even over juices. Water and milk are definitely preferred over soft drinks and punch.

If you must give your baby a bottle at nap or bed time, fill it with plain water -- not milk, formula or juice. This will keep from having the sugar from these drinks settle onto your child’s teeth, providing just the right properties for a cavity. When the sugars from juice or milk remain on a baby's teeth for hours, they may eat away at the enamel, creating a condition known as bottle mouth. Pocked, pitted, or discolored front teeth are signs of bottle mouth. Severe cases result in cavities and the need to pull all the front teeth until the permanent ones grow in. Parents and child care providers should also help young children develop set times for drinking during the day as well because sucking on a bottle throughout the day can be equally damaging to young teeth

Can teething make my baby sick?
Teething can definitely make an infant sick. This usually occurs between four and ten months. Symptoms include: fever, diarrhea, excessive drooling, generalized irritability, and loss of appetite. Treatment is palliative with Tylenol or ibuprofen, teething tablets, chew toys or gum massaging. One danger is that parents should be careful not to dismiss or allow symptoms of a serious sickness to progress while thinking that it is only teething related. If there is any doubt, be sure to seek medical attention to rule out systemic viruses or bacterial infections such as meningitis or septicemia.

Is thumb sucking bad for my child? What about pacifiers?
Generally, thumb sucking habits are not considered harmful before 18 months. However, research has shown that after about age 3 1/2 that it can lead to deformity of the maxilla (upper jaw) and cause flaring and protrusion of the upper teeth that could potentially require orthodontic and or surgical treatment to repair. Continued thumb sucking past age 6 is often treated by placement of a deterrent device in the palate. Early treatment and encouragement of the parents is always the best option in treating thumb sucking.

When should a child first see a dentist? Should they go to a dentist the specializes in children's dentistry?

The American Academy of Pediatric Dentistry suggests that an initial dental exam be performed at around age 1 for most children. The full set (20) of "baby teeth" is usually in by age 2. Children usually do well if they accompany a parent or older sibling to a visit and observe first and then have "their turn" in the chair.At our practice at University General Dentistry, we see children for routine maintenance, emergency exams, and simple treatments such as fillings, extractions, or silver crowns. However, if children have extensive decay, are very young, or present behavior management problems, they are usually referred to a pediatric specialist. A specialist can offer a wider array of treatment options including sedation and or general anesthesia in a hospital setting if needed.

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