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          Notes & Other Queries

          12 Most Commonly Asked Questions About Children’s Oral Health

          1. At what age should a child have their first dental visit?

          As per the American Academy of Pediatric Dentistry (AAPD), the first visit should be by the time the first tooth is in the mouth and the latest being one year of age. The first X-ray should be taken at age 3 or when the molars touch or have established contact.

          2. What should the kids expect to happen at the check-up?

          Check-ups usually involve looking at the teeth and counting them. If the child is 2.5 to 3 years, there might be X-rays needed. However, it depends on the child and how accepting he or she is.

          3. How often should kids visit the dentist?

          Children should visit their dentist every 6 months. If a child has cavities or history of cavities, we take X-rays every visit. If they don’t have any cavities or a tendency for cavities, X-rays can be taken once a year.

          4. What is pain-free dentistry?

          Pain-free dentistry is a combination of things. This includes the techniques we use in order to avoid local anesthetics such as laser dentistry and SDF (silver diamine fluoride), a painless treatment that stops the progress of cavities. We also use sedation (using nitrous oxide or laughing gas) to try to make the environment and experience as pleasant to the child as possible. For invasive treatments, we can use sedation and we numb the areas well, so they don’t feel any pain.

          5. What age should children start brushing their teeth?

          Parents should brush their baby’s teeth as soon as the first tooth erupts. However, even before the first tooth comes out, parents should use a finger brush or massager to wipe their gums.

          6. Are dental X-rays safe for kids?

          Yes, dental X-rays are safe for children. They’re only needed every six months or every year. Now with digital X-rays, patients are exposed to very minimal exposures (very low radiation).

          7. What are the most common dental problems for children?

          Dental caries or tooth decay is the most prevalent disease in children. A rapid form of tooth decay, known as early childhood caries (ECC), is the most common disease faced by young children, and the main cause is putting children to bed with a bottle of juice or milk.

          8. What is tooth decay and how can I help my child prevent it?

          Tooth decay is caused by bacteria that attack the teeth - dissolving them and creating lesions in them. There are many factors involved in these bacteria-causing cavities – genetics, the composition of the teeth, the saliva, the microbial flora, the diet, and the oral hygiene. All these factors together play a role in the development of tooth decay.

          9. At what age can a child be left to brush their own teeth without supervision?

          Parents should be in charge of brushing and flossing their children’s teeth until they’re old enough to do it by themselves. In general, children can brush on their own when they’re 7, and can floss on their own when they’re 10.

          10. Why is it so important to look after baby teeth when they fall out anyway?

          Baby teeth are very important. First, they are the natural space maintainers for the permanent teeth. Losing a baby tooth early can cause the adjacent teeth to drift into the space left behind (area of less resistance). When this happens, there will be no space for the permanent tooth to grow. This may cause malocclusions.

          Second, the root of the baby tooth is the pathway that guides the new permanent tooth to erupt. Basically, when the new tooth erupts, it gradually dissolves the roots of the baby tooth and then come and replace them. That’s why when a baby tooth falls, you only see a crown and you don’t see the roots.

          Third, from when the child is age 6 until the age of 12, they have “mixed dentition’ which means they’ll will have some baby teeth and some permanent teeth. Bacteria by nature is contagious and it spreads, so all the teeth, baby and new, are pooling in the same saliva that contains bacteria which puts the permanent teeth at risk of getting cavities.

          11. What are dental sealants? Do children need them? How often should they be applied?

          The back teeth, the 6-year molars and the 12-year molars, and in some cases, even the baby teeth, have deep grooves and pits, that make it difficult to brush them efficiently. Food gets easily stuck in them and they create areas where bacteria start to grow.

          Dental sealant is a liquid that we apply on the chewing surfaces of the tooth and dried with a curing light. Sealants make these areas “smooth” to lower the chances of cavities.

          I have seen children who don’t really need sealants. But for those who do, sealants have to be retouched every two years.

          If they are done well, or if the child does not eat a lot of sticky food, they can last much longer.

          12. What are dental sealants? Do children need them? How often should they be applied?

          Thumb sucking is a bad habit. We usually recommend a pacifier to prevent babies from sucking their fingers.

          Breaking the habit of pacifier is easier on the parents than thumb sucking. However, the use of pacifier should be stopped by 18 months. There is a less likely chance of the baby sucking their fingers past this age.

          We discourage the use pacifiers or thumb sucking after one and a half years because this non-nutritive sucking exerts an extra force that “molds” the jaw to develop in the wrong way. Over time, it causes the upper jaw to be the narrow and the upper teeth to be pushed forward putting it at a risk of breakage.

          These habits can cause a crossbite and may necessitate an orthodontic correction at an early age.

          Kids with toothbrushes
          1. Parents should focus more on instilling oral hygiene habits in their kids rather than worrying which brands to use.

            It’s very important that we establish our children to like brushing their teeth. At a very early age (babies 2 years and under), give them a brush that they like, have them play with it during bath times, and let them have a grip on it. This is the most effective one way to enforce good habits because then, your child will enjoy keeping their teeth clean.

          2. Parents should start flossing their children’s teeth daily as soon two teeth touch each other.
          3. Parents should take their children to a pediatric dentist for a regular check-up every six months.
          4. X-rays are safe for children and will give your pediatric dentist a complete view of what’s happening in between the teeth.
          5. Avoid non-nutritive habits which are thumb sucking and the use of pacifiers. Pacifier is okay before 1.5 years, but not after.
          6. Minimize the sweets that you give your child and be sure to clean the teeth after having a sweet snack.
          7. Brushing at night is very critical. The flow of saliva is reduced at night and means that bacteria is not continually being washed away the way it is during the day.
          8. Don't let your baby fall asleep with a bottle of milk or juice.