by Richard Baxter DMD, MS | Feb 27, 2015 | Cavities, Dental Health, Infant oral health, Parent Questions, Pediatric Dentistry
FAQ: How Does My Child Get Cavities?
Cavities
The two ways that your child can get cavities are by not brushing (or flossing) his or her teeth, and by consuming too much sugar. Sugar can be in many forms, either liquid (milk, juice, or other sugary drinks) or solid (sweets and candy). Typically the liquid form of sugar can cause cavities quicker in children. Often when we see decay in a young child, they have had access to a bottle or sippy cup whenever they want it, or they drink from a bottle at nighttime with milk in it. Milk contains a natural sugar, lactose, which can be changed into an acid by the bacteria in the mouth and cause cavities when it sits on the child’s teeth. Juice, chocolate milk, sweet tea, or even Coca Cola are often given to children to drink. These all contain similar amounts of sugar and can cause tooth decay extremely rapidly. (Side note: Juice contains more sugar than Coca Cola!) If this process of changing sugars from the diet into lactic acid by the bacteria in the mouth happens often over time, the enamel will begin to weaken. The rate of cavity formation is based on the frequency of sugar intake. If the tooth is exposed to sugar (and therefore acid) more frequently, the enamel will dissolve faster, and cavities will form rapidly. So the best time for a child to drink a beverage containing sugar (even milk) is just with meals, rather than throughout the day. At night, if a child has milk or juice, it stays on the teeth for a very long time, and there is not much saliva produced at night to wash it off the teeth. Therefore, children should only drink water at night and should drink water throughout the day as much as possible.
The frequency of sugar consumed is only one piece of the puzzle. We also need to have high amounts of bacteria that can convert the sugar to acid. The main way we can reduce the bacteria in the mouth is by brushing and flossing. It’s important to start brushing a child’s teeth as soon as they enter the mouth, typically around six months. You can begin using a fluoride toothpaste (which makes the enamel stronger and harder to dissolve) as soon as you start brushing by using a smear of toothpaste. As soon as teeth begin to touch, most often where the back molars meet or where the two front teeth meet, it’s a good idea to start flossing. You can use little flossers with handles, and wipe the piece of floss off after going between each set of teeth.
The final piece of the puzzle is the part that you cannot really change. Your child will get bacteria in their mouth that can cause cavities (typically from mom, but sometimes from dad or another relative). So it’s important for everyone around the baby to have excellent oral health to minimize the bacteria transferred when you kiss your baby, they try your food, or any other activities where saliva may be transferred from parent to baby. However, you cannot change the genetics that influence the hardness of the teeth. Some people’s teeth are a little softer (and more likely to get cavities), and we don’t yet know why. BUT the important thing to realize is that if you or your spouse have “bad teeth” or if you have a history of “soft teeth” in the family, be sure to be extra careful with sugar in the child’s diet and be extra careful to brush your child’s teeth very well, twice a day. Even if the child has “softer teeth”, he or she can still be cavity free with good brushing and limiting sugar intake.
If you have any other questions about cavities in young children, we would be happy to answer them for you. Call our office at 205-419-7444.
by Richard Baxter DMD, MS | Feb 18, 2015 | Dental Health, Infant oral health, Parent Questions, Pediatric Dentistry
Frequently Asked Question: When should my child first go to the dentist?
FirstDentalVisit
The old answer was to see the dentist by age three. This recommendation was because most dentists who see kids are general dentists who did not want to see small, crying, uncooperative children, nor were their offices equipped to see small children. Most general dentists (family dentists) are doing crowns, dentures, fillings, and seeing anyone from age 3 to 100. Recently, pediatric dentists have changed the recommended first age to “First Visit by the First Birthday”. This change was in response to us seeing so many children at age three (the traditional first visit) who already had severe decay. Typically this was due to taking a bottle at night and not brushing the teeth due to a lack of education. We have seen countless children in our six months of being open who already have a mouthful of cavities by the time we first see them at age three. So we agree with the AAPD and ADA which recommend the first visit by age 1. Pediatric Dentists (like Dr. Baxter) receive special training in residency to examine and work with small children under age three.
What do we do at our age one visit? We will focus on prevention and education of the parent. This educational component is the most important part of the visit (not the actual tooth cleaning). We will discuss dietary habits, drinking with a bottle or sippy cup, any thumb sucking or pacifier habits, and review brushing habits. We will typically do a knee to knee exam (lap exam) and cleaning with children age 3 and under. This is where the child lays in the parent’s lap and leans back into the hygienist or dentist’s lap to clean and examine the teeth more easily. This is less threatening to a child than getting in a chair. Sometimes children will jump up on our benches (which don’t move) because they are used to getting on the exam table at the pediatrician’s office. If they jump up there, we will brush their teeth on our regular benches if they are comfortable. We try to make the visit as easy and comfortable for both child and parent as possible, but even still, most children do cry (some more than others!). Sometimes the children do cry and scream, but in a pediatric office we are used to this behavior and it doesn’t disrupt our office like it would a more cosmetic focused, general dentistry office. We will brush their teeth with a gentle toothbrush and examine the teeth and gums for any cavities or anything that doesn’t look normal. The last step is to paint the fluoride varnish, which is a sticky fluoride that will protect the teeth and make them stronger.
If you have any questions about oral health for infants and young children, please give us a call, or if you would like to set up an appointment, you can call us at 205-419-7444.
by Richard Baxter DMD, MS | Feb 4, 2015 | Dental Health, Parent Questions, Pediatric Dentistry
FAQ: Should my child use a fluoride toothpaste?
Shelby Pediatric Dentistry Birmingham AL Fluoride
We have parents ask this question daily as well. The answer may surprise you! We follow the American Academy of Pediatric Dentistry and American Dental Association recommendations of starting a fluoride toothpaste as soon as you start brushing the teeth.
Wait! I thought fluoride is dangerous if you swallow it! Yes, you are correct; it can be dangerous, just like any other substance or medication. If you drink too little water, you will die. If you drink too much water, you can die too. If you have too much fluoride (eat tubes and tubes) you can get very sick, but for most people this is not the concern.
When people are concerned about children swallowing toothpaste, it is more likely that they are worried about the child getting fluorosis on their teeth. Most fluorosis is very mild to mild and is small white dots or lines on the teeth. Many studies have found that people actually find the teeth with mild fluorosis more attractive than the normal teeth without it! In more severe fluorosis, this can be yellow to brown stains on the teeth which many people would find unattractive (see chart below).
This only truly occurs in places where there is unmonitored well water, out in the countryside, and the amount of fluoride in the water is extremely high (this is very rare). Most water that is fluoridated is around 0.7ppm, but can range from 0.7ppm – 1.2ppm, which is enough to get a dental benefit, but would not cause fluorosis even if a large amount of water is consumed.
This brings us to the question of whether we should use fluoride toothpaste in your children. For most people, the answer is YES; start using fluoride as soon as the first tooth comes in. This is a new recommendation, so don’t feel bad if you haven’t done so yet! The AMOUNT is critical. For children age 2 and under, a smear is recommended to prevent cavities and also be a safe amount if they swallowed the whole thing.
If they are age 2-5, then a pea-size amount is recommended. If your child has had cavities in the past, then having them spit out the extra toothpaste, but NOT rinsing with water afterward will allow the toothpaste to remain on the teeth, and allow the teeth to take up the fluoride for a longer period of time. This habit of not rinsing will strengthen the teeth against the bacteria in your mouth that produce cavities. This will save you money (in dental bills), and time! Dentistry is one of the only professions trying to work ourselves out of a job!
Fluoride facts
- Every $1 invested in water fluoridation saves approximately $38 in dental treatment costs.
- The cost of oral health care for children can be reduced as much as 50% if you drink fluoridated water.
- None of fluoride’s supposed risks (government plot, mass medication, causes AIDS, cancer, heart disease, etc.) have ever been established in scientifically valid studies.
- Fluoride has been in 70% of water supplies, and has been around since the 1940s, so if there was a major concern, it would have surfaced by now!
- Fluoride mainly acts topically, so taking fluoride supplements don’t do much good unless you chew them first.
by Shelby Pediatric Dentistry | Jan 26, 2015 | Pediatric Dentistry
Grinding Teeth
Shelby Pediatric Dentistry is starting a new blog! In this blog, we will feature news in the world of pediatric dentistry and answer questions frequently asked by parents. If you have any questions for Dr. Baxter, please post them on our Facebook page or in the blog comments below.
Frequently asked question:
Is it ok that my child grinds his / her teeth?
Our parents ask us many variations of this question, but the answers are all the same. Often, a parent notices their child grinding his or her teeth at night while sleeping. This can sound similar to “nails on a chalkboard” and can be disruptive to sleep habits for the parent or the child. Typically, nighttime grinding will cause no real harm to the child but can cause sleepless nights for the parent if they are co-sleeping or in the same room. Daytime grinding is an easier habit to break, but it can still be difficult to change for the young child who doesn’t even realize he is doing it.
How can you know if your child is grinding his or her teeth? If you hear a noise at night like two teeth rubbing together, that would be your biggest clue! If the baby teeth look very worn or are flat on top, then the chances are good that you have a grinder. There could also be tenderness or tightness in the jaw after waking up from sleep.
Some studies have noted that children with enlarged tonsils have disruptive sleep habits, wake frequently from sleep, and grind their teeth. These same studies have also noted a higher incidence of ADD/ADHD in these children. If your child does grind their teeth significantly at night, have your pediatrician or pediatric dentist check their teeth for wear, and check their tonsils to see if they are enlarged. This may be something to discuss with your pediatrician if your child does have larger than normal tonsils.
So what should you do if your child is grinding his or her teeth? First, try to determine when it is happening and if there are any triggers (food, stress, etc.). Some people notice increased tooth grinding with gluten or dairy, or with increased stress from school, peers, or changing home situations. Next, alert your dentist at your next dental health visit to see if it is causing any real harm to the teeth. Most of the time, there is no need to intervene, and the child will grow out of it. Once the child has all of his or her permanent teeth (around age 12), a dentist can make a night guard for the child to use at nighttime so they grind the plastic instead of their teeth. Before all the permanent teeth erupt, short of providing some kind of stress reduction, or identifying triggers, the only treatment would be to provide the child with medication to stop the grinding. In almost all cases, this would not be recommended unless the child had other special needs and was grinding all of the time. If the teeth are severely worn, a filling or crowns may be needed, and sometimes a baby tooth root canal would be needed if the nerve of the tooth is exposed.
The good news is that most kids outgrow tooth grinding by age 12, and it is significantly less by age 6-9.
