NOTHING BUT THE TOOTH
INSURE YOUR CHILD'S DENTAL HEALTH WITH THESE PRACTICAL, PROACTIVE APPROACHES

While you’re usually on top of issues concerning your child’s physical health (“What’s that bump? Is that a rash? Do I
hear a sniffle?”), it’s quite possible that you’re neglecting your child’s oral health needs. Staying on top of your little
one’s dental care—beginning as soon as possible—will not only keep his or her mouth in tip-top shape, but prevent
future dental disasters. Below, find our helpful hints for tending to your child’s teeth.

1. Begin tending to your child’s teeth before they even come in, then continue to carefully clean them
once they first appear

Believe it or not, proper dental care begins even before baby's first tooth appears. Just because you can't see those pearly whites doesn't mean they aren't there and that you shouldn’t take steps to care for them. A child’s teeth begin to form in the second trimester of pregnancy. At birth, your baby has 20 primary teeth, some of which are fully developed in the jaw. Even before your child begins to teethe, you can take steps to care for his or her teeth.

Even in infancy, poor eating habits can lead to menacing tooth problems. While putting your baby to sleep with a bottle in his or her mouth may be convenient, it can be harmful to his or her teeth in the long run, warns Garrett B. Lyons, Jr., D.D.S., Associate Director, Dental Services at the Alfred I. duPont Hospital for Children in Wilmington, DE. When the sugars from juice or milk remain on a baby's teeth for hours, they may erode the tooth’s enamel, creating a condition known as “bottle mouth,” which can lead to pocked, pitted, or discolored front teeth, he explains. Severe cases of bottle mouth can cause cavities and the need to pull all the front teeth until the permanent ones grow in.

To prevent the buildup of such sugars, as well as damaging bacteria inside an infant’s mouth, run a damp washcloth over his or her gums following feedings. Doing so not only removes potentially harmful bacteria, but also gets the child used to having someone poking around inside his or her mouth, says Dr. John A. Bogert, D.D.S., executive director of the American Academy of Pediatric Dentistry. That way, when that first tooth does come in, you can start brushing it right away without a lot of trauma, adds Dr. Bogert, noting that daily massaging also makes for much healthier gum tissue. Begin this practice as soon as possible, he says: “We actually recommend you start doing this the day you get the child home from the hospital,  but you're probably not too late if you begin today. A couple of times a day is good—especially at bedtime.

"Once your baby does begin cutting teeth, practicing regular brushing and even flossing habits with your child is essential for avoiding mouth mishaps. When your child has a few teeth showing, brush them with a soft child's toothbrush or rub them with gauze at the end of the day. “The earlier tooth brushing begins, the better,” says Dr. Michelle Kreiner, a pediatric dentist in New Jersey. “Parents should begin brushing their children's teeth as soon as they are in the mouth.” When brushing, have your child use a non-fluoridated toothpaste—a pea-sized amount is perfect—until two or three years of age, when children can spit out the toothpaste, recommends Dr. Kreiner. A good one to try is First Teeth’s Natural Enzyme Baby Toothpaste ($4, www.drugstore.com). You can even floss in between teeth, whether there are two or 20 —just be as gentle as possible, using a waxed floss so it glides easily.

2. Choose the right dentist, then schedule regular visits

According to the American Academy of Pediatric Dentists, a child should see a dentist shortly after the first tooth appears or by age one. After the child’s initial visit to the dentist, he or she should return every six months to prevent cavities and other dental problems, advises Dr. Kreiner.

When choosing a dentist, it’s a good idea to make an appointment with a pediatric dentist, a professional trained to handle the wide range of issues associated with a child's dental health. A pediatric dentist has two to three years of specialty training following dental school and limits his or her practice to treating children and adolescents only, explains Dr. Kreiner. Because of their specialty in treating children, pediatric dentists are better able than general dentists to identify the need to refer your child to a specialist to receive treatments such as oral surgery for jaw realignment or orthodontics to correct and overbite.

During your child’s first visit, you can expect the dentist to explain proper brushing and flossing techniques and conduct a modified exam while your baby sits on your lap. The exam will allow for the early detection of potential problems, as well as allow your child to become accustomed to visiting the dentist, hopefully easing any fear of dental visits as he or she grows older.

3. Help manage teething pain with a range of soothers

While some babies have a difficult time teething, others are barely fazed by it. "You could be in for nothing or for a little fussiness that goes along with the discomfort," says Dr. Bogert. "However, most infants are a little fussy and cranky with the first two to four teeth."

Fortunately, there are remedies to alleviate the discomfort associated with teething. Chilled teething toys like Luv ‘n Care’s Ice Gel Teething Keys ($4, www.buybuybaby.com) or a cold, wet washcloth work well to alleviate the discomfort, recommends Dr. Kreiner. Also effective—yet messy—are melt-in-baby’s-mouth teething biscuits like the organic Maple Biscuits for Teethers from Healthy Times ($2.35, www.healthytimes.com). Another suggestion: "Take a piece of cold apple and wrap it in a wet, child-size washcloth," suggests Helen Neville, a pediatric advice nurse at Kaiser Permanente Hospital in Oakland, CA. As most standard teething rings have no flavor, an apple will give the baby a little more incentive to bite down and work those teeth through the gums, she says.

If you’re concerned about using over-the-counter medicine to treat teething pain, fear not. "I recommend trying the types of things most parents already keep handy for pediatric pain like Children’s Tylenol," says Dr. Bogert. "However, there are also a number of topical anesthetics that are good for relieving teething pain and are available over-the-counter at any drugstore. Just wipe some on the gum pads and they'll bring quick relief." Good ones to try include Hyland’s Teething Gel, a homeopathic, 100% natural remedy or Baby Anbesol Oral Anesthetic Gel, which comes in tasty grape flavor ($7 and $5, www.drugstore.com)

                 

4. Prevent cavities and tooth discoloration with the help of your dentist

Most of your child's primary teeth will have come in by the time he or she is two and a half. At this time, your dentist may start applying topical fluoride during your child's visits. “Fluoride hardens the tooth enamel, helping to ward off the most common childhood oral disease, cavities, “ says Dr. Lyons. Cavities occur when bacteria and food left on the teeth after eating are not brushed away. The acid in the remaining food and/or bacteria collects on teeth, softening their enamel until a hole—or cavity— forms. Regular use of fluoride toughens the enamel, making it more difficult for such acid to penetrate, explains Dr. Lyons.

Although many municipalities require tap water to be fluoridated, other communities have no such regulations. “If your water supply is not fluoridated, or if your family uses purified water, ask your dentist for fluoride supplements,” suggests Dr. Lyons, noting that even though most toothpastes contain fluoride, toothpaste alone will not fully protect a child's mouth. “Be careful, however, since too much fluoride can cause tooth discoloration,” he advises. Aviod self-supplementing on behalf of your child and instead leave the particulars to the discretion of your dentist. A note: tooth discoloration can also occur as a result of prolonged use of antibiotics. “As some children's medications contain a large amount of sugar, encourage your child to brush after he or she takes medicine, particularly if the prescription will be long-term,” recommends Dr. Lyons.

As your child's permanent teeth grow in, his or her dentist can help prevent decay by applying a thin wash of resin to the back teeth, where most chewing occurs. Known as a sealant, this protective coating keeps bacteria from settling in the hard-to-reach crevices of the molars, explains Dr. Lyons.

Although numerous techniques to starve off dental disasters exist, a dentist's care is only part of the prescription for a healthy mouth, notes Dr. Lyons:  “Follow-up at home plays an equally important role. For example, the sealants on a child's teeth do not mean that he or she can eat sweets uncontrollably or slack off on the daily brushing and flossing.” To insure that this happens, it’s important that you play an active role in working with your child to instill good oral health habits.

5. Take immediate action when problems arise

You gotta love heredity: if you're prone to tooth decay or gum disease, your child may be at a higher risk as well. Therefore, sometimes even regular dental visits coupled with the most precise brushing and flossing won't prevent a cavity.
If your child complains of pain in his or her teeth, call the doctor immediately, advises Dr. Lyons, as such pain could be a sign of a cavity that needs to be treated. The treatment of cavities has come a long way since you were a child; silver remains the substance of choice for the majority of fillings in permanent teeth, but other materials, such as composite resins, which bond to the teeth so the filling won’t pop out, are also are gaining popularity, notes Dr. Lyons.

6. Brace them earlier on

As your child grows older, you may be concerned about his or her bite and the straightness of his or her teeth. “Orthodontic treatment begins earlier now than it once did, explains Dr. Lyons. “What once was a symbol of preteen anguish—a mouth filled with metal wires and braces—has become a relic of the past. Children as young as age seven are now sporting corrective appliances.” As a result of extensive research, pediatric dentists and orthodontists now believe that manipulation of teeth beginning at a younger age can be easier and more effective in the long run. “Younger children's teeth can be positioned with relatively minor orthodontia, thus preventing the need for major orthodontia later on,” explains Dr. Lyons. Lucky for your child, the nickname “metal-mouth” may not be in his or her future, as plastic-based materials have replaced old-fashioned metal as the braces material du jour.

While talking care of your baby’s teeth, why not tend to yours too?
If years of enjoying darkly-colored food and drink like coffee, tea and red wine has taken a toll on your chompers, why not visit a cosmetic dentist and treat yourself to a lightening-fast yet unbelievably effective whitening treatment? The Zoom! Whitening treatment, which is performed in a dentist’s office and costs around $600, takes only 45 minutes out of your jam-packed day, yet results in teeth that are instantly, dramatically whiter.

While over-the-counter whitening treatments are plentiful, in-office treatments are your best bet for top-notch whitening, says Dr. Jeff Golub-Evans, a cosmetic dentist who offers the treatment in his New York City office. Because many over-the-counter whitening treatments contain abrasives to remove surface stain only, they don’t provide long-term effectiveness. Additionally, whitening toothpastes, whitening gum, whitening mints, whitening mouthwashes are merely maintenance products, none staying on the teeth long enough to have any therapeutic effect, Dr. Golub-Evans explains. “Of the over the counter whitening products, I believe the worst are open gels without trays and the gels that come with do-it-yourself, potentially ill-fitting trays. These peroxide gels are free to wander about the mouth, potentially oxidizing soft tissue, causing irritations, and getting into the sensitive areas of the teeth,” he says.

Dr. Golub-Evans explains that in-office procedures and products are preferable, as they are monitored by professional staff; you should be able get an evaluation as to how effective the whitening treatment will be and specifically which of your teeth may or may not whiten. With the Zoom! Whitening treatment, gums are protected and then a whitening solution is applied to the front surfaces of the teeth and activated with a safe, cool lamp designed especially for the procedure. As the process is closely monitored, the instance of hyper-sensitivity following treatment is minimized (though, if you do experience sensitivity following the procedure, try Orajel’s Advanced Tooth Desensitizer, ($5, www.drugstore.com). To extend the effectiveness of the treatment, Dr. Golub-Evans’ clients take home a whitening solution and customized whitening trays made to fit from molds taken in the office prior to the whitening procedure.

One busy mom who checked out this treatment emerged with teeth that were three shades—a mile on the teeth-lightening scale—lighter than they were just an hour earlier before the procedure. Now that’s something to smile about! For more information on the procedure, check out www.nyccd.com or www.zoomnow.com.

—Chelsea Kaplan

Read all about Chelsea's life with child in her blog, “I'm Somebody's Mother?”