Dentistry & Children

Infant & Toddler Oral Care

There are a total of 20 primary (baby) teeth, and all should have erupted by the age of 3. They are very important as they help children eat, speak and they also hold space for the permanent teeth, as well as help guide them into the proper position. Unhealthy or injured primary teeth can affect the health of the permanent teeth that follow.

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​TEETHING
 

Teeth usually start to erupt around 6 months, but can be appear as early as 3 months and as late as 12 months of age.  Common signs of teething are discomfort, drooling and chewing on things.  For discomfort, parents can try rubbing the gums with a clean finger or a cool teething ring for a couple of minutes. Providing a clean teething ring to chew on can also help, sometimes an over the counter pain medicine suitable for the child’s age may be needed.

Please:

• do not rub a painkiller on the gums as swallowing it could harm your child

• do not give a teething cookie as it can cause cavities

• never ignore a fever as erupting teeth DO NOT cause fevers.

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CLEANING YOUR INFANT'S TEETH & GUMS  

Start before teeth have erupted to get your child used to having a toothbrush in the mouth.  Lay your baby down and gently wipe the gums with a clean damp cloth or a  toothbrush specifically made for a baby.  Do not use toothpaste until your child has teeth.

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CLEANING YOUR TODDLER'S TEETH

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Even when your child squirms and fights brushing teeth, it is important to brush their teeth twice a day. You can stand and have them tip their head back to you or have them lay in your lap, this helps you control their movements.  Use a rice grain amount of fluoridated toothpaste and brush all the surfaces of the teeth right down to the gums.  

After brushing have your child spit out the toothpaste but do not rinse the mouth with water.

*FIRST TOOTH, FIRST VISIT* 
Bring your child to the dentist within 6 months of the arrival of their first tooth, or no later than their first birthday!

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​SCHOOL AGED CHILDREN ORAL CARE

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Primary teeth start to be lost from about age 6-7 until about age 12 and all permanent teeth usually erupt between the ages of 6 and 13, except for wisdom teeth (or third molars).  Sometimes your child’s permanent tooth will have erupted and the primary tooth has not yet fallen out.  In this case your dentist may allow some time to see if the primary tooth will fall out on its own, or advise extracting the primary tooth if it is affecting the eruption of the adult tooth.

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Permanent teeth often appear discoloured in comparison to primary teeth.  This is normal in most cases but could be caused by a medicine your child took, an accident that injured  a primary tooth, sickness in the toddler years or too much fluoride.  Ask your dentist if you are concerned.

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Oral Care Routine for Children

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• use a small soft bristled toothbrush and the size of a rice grain of fluoridated toothpaste, at age three onwards use a small pea sized portion of toothpaste. Brush at a 45 degree angle to the teeth, half on the teeth, half on the gums and make little circles, not scrubbing.  Clean the cheek side, tongue side and biting surface of all the teeth.  You may need to hold the lips to clean everywhere if the lips push the toothbrush out of the way.

• brushing should take two minutes and be done twice a day.  An electric toothbrush can make this much easier, especially when your child wants to have a go themselves.

• when finished, have your child spit out the toothpaste.  

• Until the age of 9 or 10, your child does not have the manual dexterity to brush properly so will need a parent’s help.

• Flossers with a handle are a great way to have your child floss their teeth.  Ensure they are gentle getting the floss between their teeth and rub each tooth from top to bottom a few times.
   

EARLY CHILDHOOD TOOTH DECAY

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• Sugar is found in breastmilk, formula and juice and can mix with bacteria in the mouth.  This produces an acid which softens the enamel of the tooth and can lead to cavities over time.  Our saliva helps neutralize this acid.  When we sleep, saliva production slows and if your child falls asleep with breastmilk, formula, juice or any drink other than water in their mouth, it can lead to cavities.  

• Do not put your child to bed with anything other than water in a bottle.

• Also, if your child drinks between meals, ensure that it is water as constant bathing of the teeth in sugary drinks can cause tooth decay.

• Never put sugar, honey, or other sweet liquids on a soother

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Signs of Tooth Decay

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• dull or chalky white spots or lines

• brown spots

• dark teeth

• crying when eating cold, sweet or hard foods

If you see any of these signs, see your dentist right away.

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Treating Early Childhood Tooth Decay​ 

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HEALTHY EATING HABITS FOR CHILDREN

Sugars  - These are hidden in natural fruit drinks, and all processed starchy snacks like chips, cookies, dried fruit, granola bars, crackers, bread and processed cereals.

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This is the main cause of cavities in children.  When your child eats and drinks foods containing sugars, it mixes with bacteria in the mouth that then produce acid that softens the enamel and can eventually cause a cavity. The more sugar containing food we eat the higher the numbers of these acid producing bacteria.  Sugar damage depends on how long and how frequently sugar is in the mouth.  

Acids can also be harmful to the teeth and can cause erosion (the hard part of the tooth, enamel, dissolving  away). Some acid containing foods and drinks include carbonated soft drinks, sports drinks, citrus fruits, and vinegary foods.

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Smart Snacking

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• limit the number of times your child eats or drinks sugar containing items during the day

• avoid sugary things that stay in the mouth for a long time (hard candy) or sticky things that get stuck in the teeth (dried cereals, crackers, raisins, granola bars, all other dried fruit and fruit candy)

• If needed drink milk or juice at meals and serve sweets as an occasional treat only at the end of meals rather than snack time, when there is lots of saliva to help wash away sugars.  

• between meals drink water and snacks should be things like FRESH fruit and vegetables, cheese, meats, nuts and seeds that will not harm teeth.
   

FLUORIDE

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Fluoride is a natural element found in soil, water and some foods.  Almost everyone ingests some fluoride on a daily basis.  More than 50 years of research has demonstrated the safety and effectiveness of fluoride in prevention of tooth decay.

Fluoride helps to harden the enamel, making it more resistant to acids and tooth decay.  It also reduces the ability of plaque to produce the acid that causes decay and remineralizes enamel that has been softened by acid. The fluoride varnish applied at the dental office delivers it to any weak areas on the tooth surface, helping to prevent cavities.  In adults, fluoride can also help reduce sensitivity and reverse small cavities that have formed.

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Fluoride Toothpaste

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Brush twice a day using a fluoridated toothpaste.  Children should uses a grain of rice sized amount of fluoride toothpaste from the time their first tooth erupts up to age 3.  From age 3-6, children should use a small pea sized amount of toothpaste.  All children should be supervised and assisted until about age 9 or 10 when they have the dexterity to be able to brush properly.  

NON-INVASIVE CAVITY TREATMENT - SDF, ANOTHER REVERSAL AGENT 

AVAILABLE AT MAPLES DENTAL CLINIC

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SILVER DIAMINE FLUORIDE

Silver Diamine Fluoride is an antimicrobial liquid that is able to treat cavities in a non-invasive, fast, affordable, and painless manner. 

Some patients who have active tooth decay may be suitable for an alternative treatment that uses Silver Diamine Fluoride.  Compared to a traditional filling that requires shots of local anesthetic and drilling of tooth structure, this treatment is non-invasive and more comfortable for the patient.  It is a liquid that is simply brushed on to the cavity that can stop current decay and also prevent new decay in the future. Unfortunately, tooth decay remains the number one most common disease of childhood, five times more common than asthma.  Readily available snacks, frequent consumption of sugary and acidic beverages, bottled water without fluoride, infrequent or delayed trips to the dentist have all contributed to this situation. This technique is very exciting for young, fearful or pre-cooperative children, special needs patients, and medically compromised individuals who may otherwise require sedation for traditional dental restorations.

Pros: SDF has very low toxicity, it is quick, painless, non-invasive, affordable, and can stop tooth decay and help prevent recurrent decay.

Cons: SDF permanently stains cavities black. SDF does not restore tooth form or function, so large holes that trap food may still eventually require a filling or traditional restorations. SDF requires repeat application for maximum efficacy.

SDF can not be used in the presence of infection or decay into the nerve.

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ORTHODONTICS

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Orthodontic treatment straightens teeth and allows the top and bottom teeth to fit together better.  This can make them easier to clean and less likely to get tooth decay and gum disease.  Teeth can be moved at any age so orthodontic treatment can also be done later in life.

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DENTAL SAFETY AND DENTAL TRAUMA

Children learning to walk often fall and this can break or crack teeth or cause them to become loose or knocked out.  Always see the dentist, no matter how minor the injury may seem.  Damage to primary teeth can sometimes result in damage to the permanent tooth since it is developing in the jaw bone beneath the primary tooth.

If your child is active in sports where contact is a possibility, a mouthguard is an important piece of equipment. The mouthguard reduces the risk of dental injuries and protects the soft tissues of the mouth as well.  A mouthguard has also been shown to decrease the risk of concussions.  Custom mouthguard can be made at the dentist by taking an impression of the teeth and tend to be the most comfortable type.

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Accidents Happen…

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• • Knocked Out Tooth 

    • Call your dentist ASAP.

    • rinse the tooth quickly and gently with water (try not to touch the root, this can damage the ligament) and try to put it back into the socket.  

    • If you cannot put it into the socket, put it in a container of cold milk and take it to the dentist immediately.  Rinse the mouth gently if there is bleeding and place some gauze or tissue on the socket and apply pressure.  If the tooth can be replaced in the socket in a short period of time there is a small chance the tooth will be saved.
       

  • Chipped or Broken Tooth

    • see the dentist right away.  If possible, bring the piece of the chipped or broken tooth as the dentist may be able to put it back on. Otherwise, a filling may be all that is required.  If the break is serious root canal therapy may be needed.
       

  • Badly Bitten Tongue or Lip

    • apply pressure with a clean cloth or gauze

    • if the lip is swollen, use an ice pack

    • go to the emergency room if bleeding does not stop

Some times antibiotics may be needed and it is important that tetanus vaccination is up to date.

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