Pediatric Dentistry FAQs
- How do I prevent cavities?
- How does a cavity form?
- When do baby teeth form?
- When will my baby’s teeth erupt?
- If my Child gets teeth very early or very late is that a sign of any medical problem?
- What is the sequence of tooth eruption?
- How can teething be made easier for my baby?
- Can babies get sick from teething?
- What are Eruption Cysts?
- How does fluoride help my child’s teeth?
- How can my child get enough fluoride?
- What about fluoride toothpaste?
- What about fluoride rinse?
- Why does the dentist give fluoride treatments?
- Which bottled waters contain fluoride?
- Do home filters remove fluoride?
How do I prevent cavities?
1. Clean Teeth
Goal = to reduce the number of decay bacteria (“sugar bugs”) that produce acid
- Brushing: Two (2) times per day
- Ideally after breakfast and right before bed
- Flossing: One (1) time per day
- Ideally right before bed and never less than THREE (3) times per week
2. Limiting Sugar and Acid Intake
Goal = to reduce the number of times that sugar or acid contacts our teeth (“avoid feeding the Sugar Bugs”).
Recommendation: Avoid eating and drinking sugar and acid between meals (allows teeth to recover from the sugar and acid consumed during meal time)
- Sugar-Containing Food: Candy, cookies, peanut butter & jelly (Laura Scudder’s peanut butter does not contain sugar), dried fruit, fruit snacks and sugar chewing gum.
- Sugar-Containing Beverages: Soft drinks, fruit juice (even if it is diluted) and sports drinks like Gatorade.
- Do not allow child to drink milk while falling asleep past twelve months (12) old. During the day milk is great but when you fall asleep your saliva flow decreases and the milk is not washed off the teeth while sleeping like it is during the day.
- Note: the nutritional guidelines of the American Academy of Pediatrics recommend limiting juice to 4-6 ounces per day for children ages one to six years. If you give your child juice, limit it to meal time only.
- Acid-Containing Food and Beverages: Oranges, lemons, catsup, dill pickles, lemonade, orange juice, sour candy, soft drinks.
Decay Safe Snacks: Carrot sticks, celery filled with cream cheese or sugar-free peanut butter, cheese, apples, nuts, milk.
Xylitol Gum: Xylitol is an artificial sweetener that interferes with the ability of the plaque to adhere to the teeth. Chew xylitol gum for five (5) minutes three times a day.
3. Adequate Fluoride
Goal = to help replace or remineralize the outside part of the tooth (enamel) and inhibit decay bacteria (“sugar bugs”).
Recommendation: Make sure that your child is receiving daily systemic and topical fluoride in the safe and effective range.
- Toothpaste (Topical Fluoride): Start using a pea-size amount of toothpaste at 24 months old.
- Use any fluoridated toothpaste that has the ADA (American Dental Association) seal of approval on it.
- Avoid using the training toothpaste (safe to swallow) due to the sweet taste and difficult transition to normal fluoridated toothpaste.
- Fluoride Drinking Water (Topical and Systemic Fluoride): The safe and effective range of fluoride in water is 0.6-1.2mg/L.
- If your child is only drinking bottled water make sure it says “Fluoride Added”
- Water used to reconstitute powdered baby formula should have a fluoride content less than 0.5mg/L
- Fluoride Rinse (ACT or Fluorigard): For children six years and older with high risk of decay or for children with braces use a fluoride rinse after brushing and flossing right before bed.
- Professional Applications: Higher concentration treatment provided at the dental office
4. Regular Dental Visits
Goal = to reinforce prevention of dental decay and catch problems early.
Recommendation: The first dental examination should be within six (6) months from the eruption of the first tooth or by twelve (12) months old.
- Most children should have regular six (6) month dental examinations.
Goal = to protect deep pits and grooves on teeth from decay bacteria by applying a thin tooth-colored fluoride containing coating.
6. Advanced Prevention
Goal = for children with severe decay problems a more aggressive prevention plan may include:
- Enhanced use of Professional Fluoride:
- Fluoride Varnish for longer retention
- Prescription strength fluoride toothpaste
- Chlorhexidene Antibacterial Rinse: Reduces the amount of decay bacteria
- This is for older children and is available by prescription only
- Measuring Bacteria in Saliva: This is a simple test allows a direct measure of the number of decay bacteria in the mouth.
How does a cavity form?
Decay bacteria (“Sugar Bugs”) use the carbohydrates and sugar that we eat and produce an acid that weakens the outside (enamel) of our teeth and over time the weak spot becomes a cavity.
When do baby teeth form?
- Baby teeth start forming early around 6 weeks in-utero.
- Adult teeth start to form at birth. When teeth start to erupt the roots are still forming and provide the force to push the teeth through the gums (erupt).
When will my baby’s teeth erupt?
Usually at six (6) months old. There is a big variation; some babies start getting teeth soon after they are born and some are toothless until they are 18 months old.
If my Child gets teeth very early or very late is that a sign of any medical problem?
No. Some rare problems include late or early tooth eruption but other signs are more noticeable than the tooth eruption pattern.
What is the sequence of tooth eruption?
- The front teeth come in first, the bottom and then the top usually by 9 months old.
- Around 12 months the first primary molars start to erupt (skipping the third tooth from the middle-canine).
- The canines then erupt and by 24 months the second primary molars start to erupt for a total of twenty (20) primary (baby) teeth.
How can teething be made easier for my baby?
- Teething rings are a great way to help the teeth work through the gums. As soon as the teeth penetrate the gums, the discomfort begins to go away. Try cooling the teething ring in the refrigerator (not the freezer).
- Ask your pediatrician’s advice about whether to give Tylenol, and how much and how often to give it.
- A topical anesthetic like Orajel for teething may be useful at bedtime or when the baby is particularly upset, but washes away in a short time. Be sure to follow according to the directions.
Can babies get sick from teething?
- All kinds of problems such as colds, rashes and diarrhea have been blamed on teething. The safest approach is to think of these problems as just accidentally occurring at the same time as teething.
- If your baby has a fever or actually seems sick, check with your pediatrician.
What are Eruption Cysts?
- When a baby is teething the tooth may have trouble erupting through the gums and a soft bluish dome may appear on the gums. This is called an “eruption cyst” but it is not really a cyst. It is caused by a small blood vessel being broken by the erupting tooth and fluid puffing up the gums.
- Usually no treatment is needed, the teeth will penetrate the dome.
How does fluoride help my child’s teeth?
- Fluoride can be incorporated into enamel while the teeth are forming and also after they have erupted (systemic and topical effect)
- When fluoride is incorporated into enamel it becomes less soluble to decay acid.
How can my child get enough fluoride?
- The most natural and effective way to receive a safe amount of fluoride is to drink water that has fluoride in it.
- Fluoride content in tap water can vary and we will look up the fluoride level in your water for you (safe and effective range = 0.6-1.2mg/L)
- If the tap water supply is deficient in fluoride, the alternatives are bottled fluoride water and doctor-prescribed fluoride supplements.
What about fluoride toothpaste?
- Use any fluoride toothpaste that says American Dental Association Approved (ADA Approved). Tom’s of Maine (Silly Strawberry) is popular with children.
- Unless your child is at high risk for cavities, don’t start to use toothpaste until 24 months old. Use a pea-size amount of toothpaste from ages 2-5yrs and teach your child to spit out the toothpaste.
What about fluoride rinse?
- Effect at helping to prevent decay. Use on children six (6) years and older.
- If your child has braces, this will help reduce the risk of demineralization (“white marks”) around the braces.
Why does the dentist give fluoride treatments?
Experienced personnel and professional equipment allow the application of a more concentrated form of fluoride than would be wise in the home setting.
Which bottled waters contain fluoride?
- Most brands of bottled water have a “Fluoride Added” option.
- The most common brands: Sparkletts with fluoride (1.0mg/L), Nursery Brand (0.7mg/L), Gerber Baby Water (0.5mg/L).
Do home filters remove fluoride?
- Only reverse osmosis filters remove fluoride
- Filters in the refrigerator, Brita and Pur filters, do not remove fluoride.