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Ask the Dentist

How to have great oral care from the get-go.

I recently took Ryan, the oldest of my three boys, to the dentist and was surprised to find out that he had a cavity. This might not seem too out of the ordinary for most parents, but I have been a practicing cosmetic dentist in Manhattan for the past 18 years and I thought I knew everything to keep my son cavity-free for life. After all, I teach people every day how to take care of their teeth to keep them healthy and beautiful.

I treat movie stars, bankers, business leaders and rocker. But on the trip to my friend’s dental office, I was reminded that the care of children’s teeth is a totally different field of dentistry from the oral care of adults. From video games in the waiting room, to toys and stickers when children leave the office, treating kids is an art unto itself.

As oral care at a young age is crucial, I want to share with other parents what I was reminded of when my son went to the dentist. For starters, parents should make their child’s first dental appointment when the child turns 1 or the child gets his first tooth, whichever comes first. This visit accomplishes three essential things:

  1. It allows the pediatric dentist to see the child and examine the mouth for any possible problems.
  2. It introduces the child to the dentist and the office, as well as establishes a positive experience and memory.
  3. It gives the pediatric dentist the opportunity to educate the parents about the care of children’s teeth.

Here are some of the things that your child’s dentist should share with you at the initial visit.

  • By the age of 1, it is advisable that children are no longer using bottles. This is when you should replace them with a sippy cup, preferably one with a straw.
  • Most important is to make sure you clean your child’s teeth before bedtime and never place your child in bed with a drink other than water. Milk and juice at bedtime can cause a rapid breakdown of the enamel and multiple cavities also know as bottle decay.
  • It is recommended that you use a soft toothbrush or cloth along with a non-fluoride toothpaste until your child has the ability to spit out the toothpaste. Once the child can spit on command, switch to a fluoride toothpaste as it helps protect the teeth from cavities.
  • Flossing is not necessary before a child turns 3 years old because there are large spaces between baby teeth. When your child reaches age 3, the teeth begin to move together and it is imperative that flossing is done daily. (Failing to floss my son’s teeth was the mistake I made. Now he has a filling to show for it.) Using pre-loaded floss picks is a great way to make this fun and easy for kids. If you can find flavored floss, your child may even like it.
  • From birth until a child is able to tie his own shoes, parents should always help the child brush his teeth because even with the best intentions, children lack the dexterity to do a superb job. As kids get older and want to brush themselves, let them start the process. Once your child has demonstrated that he can thoroughly clean his teeth, allow him to do it himself.
  • Diet affects dental care. Many parents think they are doing the right thing by giving children 100-percent fruit or organic fruit products, such as fruit juices, fruit roll-ups or yogurt drinks. However, these snacks and drinks have a high sugar content, are sticky in consistency and may lead to abundant tooth decay. Sports drinks have also been linked to an increase in cavities. Water remains the best drink for all of us, including children.

If your child does get a cavity or if early stages of decay are present, there are many suggestions your dentist could give.

When your child gets his permanent teeth or if it seems like your child is prone to cavities in his baby teeth, your dentist may recommend dental sealants. Sealants are a plastic coating that covers the deep grooves that occur naturally in teeth. By covering these grooves, you may prevent your child from getting cavities.

If your child’s dentist finds a cavity, he may recommend a filling. There are two options for filling children’s teeth. The first option is the old metal fillings called amalgams. The second option is the tooth-colored restorations called composites. Discuss with the dentist the pros and cons of each.

If the decay has gotten near the nerve, your child’s dentist may recommend a pulpotomy. This is the removal of the nerve of a baby tooth. After the removal of the nerve, the dentist fills the tooth with either an amalgam or composite. In some cases a crown made especially for baby teeth.

In general, your children can continue seeing a pediatric dentist until they outgrow the office, graduate from college or require more complex dental treatment, like crowns, veneers or implants.

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