National Children’s Dental Health Month: Q&A with Dr. Roger P. Dotsey
February 1, 2020
February 1, 2020
February is National Children’s Dental Health Month! In honor of the occasion, we sat down with Dr. Roger Dotsey from our Westport Village practice to answer some questions around oral health in children.
Great question! The simple answer is that I recommend a child start seeing a dentist as soon as they get their first tooth, which is usually around age 1. The main reasons are to establish a dental home, to educate parents on the best way to meet the dental needs of their child, and to of course make sure there are no developing problems.
Here’s a question I get ALL THE TIME. And it’s a great one. Sure, it makes sense that because baby teeth are going to be replaced that they “don’t matter.” But boy, is that a mistake. First of all, yes we start losing teeth around age 5 or 6, but we don’t finish until 12 or 13. That’s a long time. And a lot can happen in that time. Baby teeth can easily get cavities, and untreated cavities can lead to pain, infection, and/or premature tooth loss. Plus, the habits we establish as young children carry on into adulthood. So take care of your baby teeth!
Simple! Just wipe it down. Even though they don’t have teeth, we still want to keep our childrens’ mouths clean. The sugars we have in our diet, be it breast milk, formula, or baby foods, can still cause bacterial growth, creating a perfect environment for cavities to be formed on new teeth. So just take a damp washcloth or gauze and wipe down the gums, cheeks, and even tongue.
The negative dental effects of thumb sucking and pacifier habits are nearly all related to the position of the teeth. Long-term effects include open bites (the upper teeth do not overlap the lower teeth), posterior crossbites (the palate is narrowed, so the upper back arch is more narrow than the lower), and incisor flaring (the upper front teeth are flared out). The good news is that if the habit is stopped by age 3, there is a good chance that the muscles of the lips and tongue will move the teeth back into (or near) the normal position.
There are multiple causes of cavities in kids, but what it all boils down to is sugar. The bacteria that cause cavities get their fuel from the sugar in our diets. They use that energy to produce acid that eats away at the enamel, causing cavities.
There are two things that are within our control: diet and hygiene. Hygiene is simple enough in concept, but tough in execution, especially on unwilling kids. But it basically entails brushing teeth twice a day (after breakfast and before bed are best) and flossing daily.
As far as diet, it’s much more complicated and still being studied. What we know for sure is that carbohydrates (sugars) lead to cavities. Most people in my practice are aware that candy and sodas cause cavities, but there’s so much more. Lots of drinks have sugar: juices, energy drinks, sports drinks, sweet tea, lemonade, etc. Also, the stickier and sweeter it is, the more likely it is to stick to your teeth and cause cavities. Thus, raisins and fruit snacks are just as (if not more) likely to cause cavities than, say, chocolate. Finally, it’s not necessarily how much sugar your child consumes, but how often they consume it. An example I give to my patients is it’s better (for your teeth) to eat all of your Halloween candy in one half-hour sitting than have a few pieces every hour. It may be more likely to give you a bellyache, but less likely to give you cavities!
The beauty of toothpaste is that you can’t really go wrong! There are two important considerations. The first is fluoride. YES! Use a fluoride toothpaste. You don’t need much. Up until the point where a child can spit, just use an amount the size of a grain of rice. They can swallow this with no adverse effects. When they can spit adequately, move up to the size of a pea. Most toothpastes do contain fluoride, but always check the tube to be sure. The second consideration is taste. Find a toothpaste that he or she likes the taste of because if they can’t stand the taste, it’ll be much harder to brush!
My recommendation is later than you would think. Here’s the deal: kids don’t often have the motor skills, the concentration, or the persistence to brush properly. The age that I feel most comfortable allowing kids to brush on their own is 7, and even then I recommend that parents monitor their brushing. Now, I’m sympathetic to the fact that it’s important to teach kids independence and life lessons on how to properly take care of themselves. However, the consequences of not brushing their teeth properly are more serious that putting their shirt on backwards or putting their shoes on the wrong feet.
Call the dentist! There are a lot of reasons for tooth pain, and a cavity is only one of them. However, there’s no way to know what’s causing the pain without a thorough dental exam. Here’s what you can do at home: First, check for any swelling around the painful tooth, or any facial swelling. Swelling is often an indication of dental infection. Secondly, swelling or no, I recommend children’s ibuprofen to help with dental pain until the child can be seen in the office. Thirdly, schedule an appointment with your child’s dentist for an evaluation. The dentist will be able to diagnose and if necessary, treat the problem.
In all seriousness (and not just because I am one), my main advice would be to take your child to the dentist regularly! If you go two times a year, we can typically monitor your child with enough regularity that we can catch any issues with the teeth and gums before they become major problems. We also have the expertise on how to take care of your teeth, and are good at teaching kids how to do just that. Plus, if your child has a dental home, you will always know where to turn in case of emergency or if you have a dental question!
Learn more about Dr. Roger Dotsey by clicking here.
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