Practicing Good Dental Hygiene
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| James Moss, DDS, is a pediatric dentist at the Somerville office. |
By James Moss, DDS
Practicing good oral hygiene is a lifelong commitment, not something that begins when your child is old enough to brush his or her teeth. As parents, it is your responsibility to ensure that your child's teeth and gums are clean of excess bacteria, which can lead to tooth decay. That responsibility involves cleaning your baby's gums with a damp clean washcloth or gauze after every feeding. Doing this prevents buildup of harmful bacteria and reduces discomfort from teething and also helps your child prepare for future dental hygiene. Later, when primary teeth come in, usually at 6-7 months, wipe or brush your child's teeth at least twice a day.
A child's first visit to the dentist
A child's first visit to the dentist should take place about six months
after the first tooth breaks out from the gums, or by age 1. At that
time, the pediatric dentist will assess your child's oral health, instruct
you further on how to clean your baby's teeth, and discuss diet and
dental health.
The child's teeth typically will not be cleaned during this appointment. Most of the time the child will sit on the parent's lap and be shown the dental light and mirror. The child will also get the chance to meet the dentist.
Many practices, like ours, offer First Visit to the Dentist classes. Held for several families simultaneously, the program uses videos and "show and tell" methods for the children. The visit provides both parents and their kids with an opportunity to get familiar with the dental staff and equipment in a less-threatening environment. Often, a hygienist or dental assistant will teach the class, and introduce the dentist.
The ABCs of good oral hygiene
For children, brushing the teeth twice a day is sufficient. A pea-sized
amount of toothpaste is all that is required since toothpaste is a detergent
with a low concentration of fluoride. It is important that children
expectorate or rinse their mouth, and that's where you as parents can
supervise this activity. This supervision is needed until the child
is old enough to do this on his own, usually around the age of 7-8.
When cleaning the teeth, children should aim the toothbrush at a 45-degree angle, to where the teeth grow out of the gums. This will help children learn to clean their gums, as ignoring them can lead to chronic gingivitis or gum disease. Periodontal disease is a major cause of tooth loss in adults, so practicing good oral hygiene early will pay off down the road.
Flossing is also important when adjacent teeth touch. Using floss to reach between teeth that the toothbrush can't reach will help keep the mouth healthy and free of plaque and bacteria that leads to decay. Eating healthy foods is not only good for your child's entire body, it also helps protect the teeth. Most food has sugar in it, including milk, and too much sugar can damage teeth. A diet rich in fruits and vegetables will help keep both the body and teeth healthy. Of course, sweets like candy and cakes are hard to avoid entirely, so limit your child's intake of these. Children should snack in moderation, and avoid foods that take a long time to clear the mouth.
One of the biggest mistakes a parent can make is sending a child to bed with a bottle of milk or juice. Sucking on a bottle for long periods of time, or using the bottle as a pacifier provides a constant supply of sugar for the bacteria to produce the acid that attacks teeth. This type of decay is called "baby bottle tooth decay" and follows a typical pattern: the upper front teeth, followed by the rear molars. Treatment of this condition usually requires day surgery and general anesthesia.
Finally, visiting the dentist twice a year for a good, thorough cleaning and review of oral hygiene habits is also recommended.
On guard
If your children play sports, it is essential for them to wear a mouthguard.
Contact sports like football and hockey do a great job in protecting
players' mouths by requiring the use of mouthguards. But I am seeing
more mouth-related injuries from so-called non-contact sports such as
soccer, basketball and softball.
To be frank, it is hard to get kids to wear mouthguards, because they don't think it's cool. But if you can convince them that they are jeopardizing their teeth and smile, then we have won half the battle. As a parent, be proactive in this area by encouraging coaches and leagues to adopt mandatory mouthguard rules.
Mouthguards help cushion blows that might otherwise cause broken teeth, jaws or a tempormandibular joint injury. Also, the presence of a mouthguard can lessen the severity of a concussion should that occur.
Mouthguards come in three types:
- The custom-made version by the dentist. Typically, these are the most expensive, but they also provide the most protection. They fit better, are the most comfortable and children wear them more than the other kinds of mouthguards.
- The "boil and bite" mouthguard which are heated in boiling water and then formed in the mouth. Have the child gently bite into the soft material.
- The stock mouthguard found in most sporting goods stores. While it is the least expensive, it also offers the least protection.
The dreaded cavity
Despite advances made in dentistry, water fluoridation, fluoride toothpaste
and younger children visiting the dentist, kids still get cavities occasionally.
Having that first cavity filled can be an emotional experience, especially
for the parent. I advise parents not to discuss the upcoming appointment,
and not to mention the drills or cavities.
I always talk to the child in a positive manner, and explain in simple terms what I am going to do. For example, I won't use the words "hurt," "shot" or "needle." We talk about "dropping sleepy water behind their tooth" and having a "tingly, sparkly" lip and using a "raincoat" on their tooth. We also use "Mr. Thirsty." New to the cavity-filling process are white, tooth-colored fillings that can be done without anesthesia. If we catch the cavities when they are very small and use the newer material that requires less tooth preparation, then we can often avoid the anesthesia.