Dental health is a crucial part of promoting a child’s overall wellness. Parents are urged to take an active role in encouraging children to develop habits that will reduce damage to teeth and gums over a lifetime. This process begins as soon as the baby is born and even before teeth make their first appearance.

Maintaining good dental health is essential for people of all ages, but is particularly important during childhood. Children’s teeth are especially vulnerable to damage of the enamel, which leads to holes known as cavities. This is the most common chronic disease among children in the United States, according to the American Academy of Pediatrics.

Children with poor dental health may also experience associated symptoms, including inadequate nutrition, poor self-esteem and problems with speech development.

Brushing and flossing are essential to maintaining good dental health. Experts generally recommend that children brush their teeth at least twice daily with toothpaste beginning at age 2. Before age 2, parents can wipe a damp cloth over the gums for cleansing. Regular flossing is important as soon as the gaps between the teeth close. Flossing helps to prevent tooth decay by dislodging food that brushing alone cannot remove.

Choosing the right dentist is a cornerstone of good dental health. The American Dental Association recommends that children make their initial visit to a dentist by their first birthday. Parents are urged to look for a dentist who specializes in the care of children, also known as a pedodontist. Dentists will provide children with fluoride treatments and sealants that can dramatically lower the risk of cavities.

Most children will experience dental health problems at some point that will require professional care. In most cases, dental pain is the result of a cavity that needs to be filled. Children who have crooked teeth or a bite that is misaligned may benefit from orthodontic treatment in the form of braces or other dental appliances.

There are several steps that parents and children can take to help keep a child’s teeth healthy. These include not sharing utensils with babies, restricting a baby’s time with feeding bottles, limiting consumption of sweets and starches, and protecting teeth during sporting activities.

Dental health is an important part of the overall good health of every child. Children who have poor dental health may experience pain and infection in their teeth and gums. This can lead to associated symptoms, such as poor nutrition due to mouth pain that prevents a child from eating properly. Poor self-esteem and problems with speech development may also result from poor dental health.

From the time a baby is born, proper care of the teeth and gums is an essential part of maintaining good health. During the second trimester of pregnancy, teeth begin to form in the fetus. When a baby is born, teeth are not usually evident. However, 20 primary teeth lurk just beneath the gums, many of which are in the jaw and fully formed. Dental care is important even before the teeth begin to show. After feedings, parents are urged to run a damp washcloth over the baby’s gums to keep bacteria from building up.

The first tooth usually appears sometime between 5 months and 8 months of age. All primary teeth have usually emerged by the time a child is 30 months old. Once teeth begin to appear, they can be brushed with a soft children’s toothbrush or gauze can be rubbed over the teeth. This should be done at the end of each day.

Although a child’s primary teeth eventually will be replaced by permanent teeth, it is important to care for these initial teeth. Infants can develop a specific condition called bottle mouth which occurs when tooth enamel is degraded. Cavities, discoloration and pock marks are symptoms of the condition. Poor maintenance of primary teeth can cause them to fall out early, which in turn can cause permanent teeth to emerge through the gums prematurely. Premature permanent teeth may not have enough room in the mouth to come in properly, and therefore may appear crooked.

Eventually, a child’s primary teeth begin to fall out. The middle teeth in front (incisors) typically fall out at about age 6. Molars in the back are shed between the ages of 10 and 12. By age 13, children usually have their permanent teeth.

Teeth are vulnerable to plaque, a clear film that sticks to teeth and attracts bacteria and sugar. As the bacteria feed on the sugar, it is broken down into acid that begins to eat into the enamel of the teeth. This causes holes known as cavities that cause pain in the tooth. In addition, plaque can cause gums to become red, swollen and sore. This condition is known as gingivitis, or gum disease. Fluoride varnish on primary teeth and sealants on permanent teeth may help prevent tooth decay and cavities in children. 

Experts generally recommend that children brush their teeth at least twice daily with toothpaste beginning at age 2 or 3. This helps to break down plaque, a clear film that sticks to teeth and attracts bacteria and sugar. If possible, brushing should take place within five or 10 minutes of eating.  

Initially, parents have to brush children’s teeth for them. A pea-sized amount of toothpaste should be used, and brushing should last for at least three minutes. Toothpaste is available in a variety of flavors that may be appealing to children, such as bubble gum and watermelon. Parents are urged to watch to make sure young children spit out their toothpaste instead of swallowing it. Some young children have a strong aversion to toothpaste. In such cases, it is OK to brush a child’s teeth without using toothpaste, as the brushing and rinsing are the most important parts of cleaning the teeth.

Typically, children gain the dexterity to brush their own teeth sometime between the ages of 7 and 10. Children may want to use a tartar-control toothpaste, which is especially effective at keeping plaque off the teeth.

Children should try to brush after breakfast and after dinner. If possible, it is also a good idea to brush after lunch and after eating sweets. Toothbrushes should be changed every three months. Most dentists provide a free toothbrush during checkups.

Tooth discoloration can also result from use of certain antibiotics, which often contain large amounts of sugar. For this reason, it may be a good idea for children to brush their teeth soon after taking these medications. In addition, the antibiotic tetracycline is not usually prescribed to children under age 8 because permanent tooth discoloration is a common side effect.

Regular flossing also helps to prevent tooth decay and gum disease. Flossing should involve moving the floss between each tooth and up to the gum line. This helps dislodge food that brushing cannot remove.

The American Dental Association recommends that children make their initial visit to a dentist by their first birthday or within six months of the child’s first tooth. Choosing the right dentist is a cornerstone of good dental health. However, one in 10 children in the United States ages 5 to 11 have never visited a dentist, according to the American Academy of Pediatrics.

Parents are urged to look for a dentist who specializes in the care of children, also known as a pediatric dentist (pedodontist). These dentists are experts in the specific issues that arise in caring for a child’s teeth, and offer care that helps prevent dental problems while maintaining good dental health. Their expertise also helps them to know when it is appropriate to recommend other dental experts such as orthodontists or oral surgeons.

Parents of children with heart conditions are urged to consult their child’s new dentist and cardiologist about the need to take antibiotics prior to the dental appointment. Dental procedures such as teeth cleaning, scaling or periodontal surgery lead to an increased risk of bacterial infection for such patients. A dose of antibiotics one hour before the appointment and six hours after can help reduce this risk. Other conditions that may require use of antibiotics before dental visits include sickle cell anemia, immune system problems and rheumatic fever.

During the initial visit, the dentist examines the baby’s teeth. Oftentimes, the baby remains on the parent’s lap throughout this initial examination. The dentist also instructs the parent on how to care for a child’s teeth. This includes proper brushing techniques and suggestions for flossing, which should begin as soon as two teeth appear adjacent to one another.

Early visits to a dentist not only help ensure good dental health, but also have the benefit of making children more comfortable around the dentist beginning at a young age. Children should visit the dentist at least twice a year, or more often if the dentist recommends it.

Around the age of 30 months, all of a child’s primary teeth will have emerged through the gums. At this time, a dentist is likely to begin applying topical dental fluoride to the teeth. This will help to strengthen the teeth by hardening the enamel and making it less vulnerable to cavities, also known as caries. Cavities occur when bacteria and food left on teeth create acid that collects and begins to soften and break down the enamel. Eventually, a hole forms, and is known as a cavity. Fluoride may also be applied in the form of a varnish. Fluoride varnishes are painted onto the teeth and generally need to be re-applied each year.

Fluoridation of teeth is another important part of dental health. About 60 percent of children in the United States live in communities in which tap water is fluoridated to provide extra protection for residents’ teeth. Fluoridated water can reduce cavities by 35 percent to 40 percent.

Families living in communities that do not fluoridate their water – or families who use purified water – are urged to consult with their dentist about using fluoride supplements. These supplements can reduce tooth decay by up to 50 percent, according to the American Academy of Pediatric Dentistry. Dentists will often prescribe fluoride tablets for children who are 6 months old and older and who are not receiving adequate fluoride through their water. These supplements – which come in chewable tablet or liquid form – should be used carefully, as too much fluoridation can lead to a type of  tooth discoloration (e.g., bright white spots on teeth) called fluorosis. Fluoride treatments usually continue until the child is about 16.

Dentists may recommend applying a thin wash of resin to a child’s back teeth once the child’s permanent teeth come in. This clear, odorless protective plastic coating is known as a dental sealant, and it helps prevent bacteria from damaging crevices in the molars. A combination of fluoride tablets and sealants can reduce the incidence of cavities by about 90 percent, according to the American Academy of Pediatrics.

Most children will experience dental health problems that require professional care. In some cases, these problems are discovered during a routine visit to the dentist. In other cases, children may complain of tooth pain, which is a sign that a visit to the dentist is warranted. Pain usually can be treated with a non-aspirin painkiller (e.g., ibuprofen). However, parents should not give their children any medication without first consulting a physician or dentist.

In most cases, dental pain is the result of a cavity that needs to be filled. Cavities – also known as caries – are the most common chronic condition among children in the United States, according to the American Academy of Pediatrics. Among 3-year-olds, 18.7 percent have at least one tooth with a cavity that has yet to be treated. By age 8, 51.6 percent have an unfilled cavity or at least one filling. Children who were born prematurely or who had a low birth weight are at increased risk for cavities. Other factors that increase the risk of cavities include:

• Inadequate brushing and flossing
• History of ongoing health care needs
• White spots or brown areas on teeth
• Failure to regularly see the dentist
• Poor socioeconomic status

Silver, a silver-colored alloy, is the most frequently used material for filling cavities, although composite resins and other materials are becoming more popular. These materials bond to the teeth, preventing fillings from popping out. Resin materials can also be used to reconstruct damaged teeth. Composite resins are the same color as teeth, making them a more attractive option to those who are concerned about the cosmetic appearance of their fillings.

Children who have crooked teeth or a bite that is misaligned may benefit from orthodontic treatment in the form of braces. In the past, these were made of metals and wire. Today, plastic-based materials are often used. Children as young as age 7 are candidates for braces.

Sometimes, an accident will jar a tooth loose. Parents should seek immediate emergency help if the child’s:

• Permanent tooth is knocked loose
• Jaw has swelling or pain, which may indicate a fracture
• Gums continue to bleed despite applying pressure

A loose tooth can usually be successfully reimplanted if the procedure is performed within 30 minutes after the tooth falls out. If a child’s tooth is completely knocked free (avulsed), the tooth should be placed in milk and the child and tooth should be rushed to a dentist. In handling the tooth, parents should be careful not to touch the root or to wash the tooth. If milk is not available, the tooth should be wrapped in a clean tissue.

There are several steps that parents and children can take to help keep a child’s teeth healthy. They include:

• Avoid sharing utensils with children, or cleaning a pacifier by sucking on it. Parents’ mouths are a source of bacteria that can be passed on to children, leading to cavities.
  
  
• Avoid leaving a bottle in a baby’s mouth for long periods of time during the day, or for hours at a time while the baby sleeps. Sugars from milk or juices that remain on the teeth for hours at a time begin to eat away at the enamel. Pocked, pitted or discolored front teeth are signs of a condition known as bottle mouth. Baby bottle tooth decay is frequently unnoticed by parents because it often affects the back of teeth rather than the visible front. In its most extreme form, this condition can lead to a need to pull a baby’s front teeth until permanent teeth grow in. As a rule, parents should only allow a baby to have a bottle during meals.
  
  
• Teach children to drink from a cup as soon as possible. Liquid consumed from a cup does not collect around the teeth, as it does with bottles. Children are usually able to drink from a cup by age 1.
  
  
• Encourage children to drink water instead of soda and snack on fruits and vegetables instead of sweets. Snacks that are nutritious help the body to build strong teeth. Limit snacking to three or four times a day.
  
  
• Promote snacking on cheese, which has properties that hinder the development of cavities. Other good snacks include yogurt and milk.
  
  
• Avoid feeding children cooked starches. Foods such as breads, crackers and pretzels may remain in the mouth even longer than sugary snacks.
  
  
• Try to limit sweets and starches to mealtimes. The acid that forms as a result of sweets and starches attacks teeth for about 20 minutes. Therefore, it is better to limit these types of foods to mealtimes rather than having several snacks that repeatedly cause the teeth to be under attack.  
  
  
• Insist that children wear protection such as a mouth guard during sporting activities.

Preparing questions in advance can help parents to have more meaningful discussions with their child’s dentist regarding their conditions. Parents and children may wish to ask their dentist the following questions related to dental health:

1. When should I start cleaning my child’s teeth?
   
   
2. How many teeth does my child need before I begin to use a toothbrush on his/her teeth?
   
   
3. When should my child make an initial visit to a dentist?
   
   
4. How can I find a dentist who has experience with children?
   
   
5. How can I find out whether or not my water supply is fluoridated?
   
   
6. Should I give fluoridation supplements to my child?
   
   
7. What other steps can I take to encourage my child’s dental health?
   
   
8. Is my child a candidate for orthodontics?
   
   
9. Should my child get braces at a young age, or should I wait until he/she is a bit older?
   
   
10. My child is older than 4 and still uses a pacifier. Should I be concerned about the potential impact on his/her teeth?