First-Tooth Protocol
See a tooth? Get a dentist.
For Jim Steiner, DDS, that sums up the timing for parents wondering about their child's first dental exam. "When that first tooth comes in, at about six months, ideally that infant should go to a pediatric dentist. Your child should definitely see a dentist by one year of age."
The dentist wants to look at the child and talk with the parent. "We want to make sure the parent isn't putting the child down with a bottle of milk or juice, because liquid pools against the teeth all night, and the germs in the mouth change the liquid to acid. That acid dissolves the teeth. We've seen 2-year-olds who've lost their four front teeth because they're so badly decayed," says Dr. Steiner, director of Pediatric Dentistry at Cincinnati Children's Hospital Medical Center.
When to Start Brushing
As soon as that pearly white breaks through the gum, parents can begin cleaning a baby's tooth on a regular basis with an infant toothbrush and water, or a moist washcloth or gauze. By age 2, parents can add a pea-sized dab of fluoride toothpaste to the brush.
Dr. Steiner is all for mixing fun with hygiene. "Use a spin brush if the child likes it, one with a race car handle or a Barbie doll. Pick child-flavored fluoride toothpaste, such as bubble gum, and a soft-bristled brush. Try using an egg timer so the child can see how long to brush. Use stickers to reward a good job.
"Parents can let the child brush first, then follow up behind," Dr. Steiner says, "as long as the child brushes twice a day."
When can children brush all by themselves? "When they can tie their shoes, they can brush their teeth. Then they will have the fine motor control."
With a parent's careful guidance and a child's diligence, tooth decay may become extinct in this century for many American children. "Decay is very preventable now, with fluoridated water, fluoride toothpaste and sealants," Dr. Steiner says.
Protective Sealants
"Before fluoride, most tooth decay was between the teeth. Now, fluoride protects the smooth surfaces, but the biting surfaces are not as protected. That's why sealants are important for the permanent molars."
Sealants are recommended for a child's 6-year and 12-year molars. In the procedure, the dentist applies a very mild acid gel over the biting surface of the molars, to etch slightly into the enamel. The gel is rinsed off, then a liquid plastic is applied in a flowing motion. A light hardens the sealant.
"If the child is cooperative with the steps involved, a skilled practitioner can do a sealant in a minute per tooth. Then it can last into the teen years," he explains.
One aspect of modern life, however, can defeat even the most tenacious fluoride. "People are becoming grazers," says Dr. Steiner. "They eat all day long, or children have sippy cups with apple juice all day. They are at high risk for decay.
"Everything we eat turns into acid after about a half-hour in our mouths. If you eat five times a day, fluoride will protect you against that acid. But if you eat 10 to 15 times a day, the acid overpowers the effect of fluoride. Grazers either need to cut back on the drinks and meals or increase their brushing."
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