Early Dental Care

Dr. Donaldson: The American Academy of Pediatric Dentistry recommends every child see a dentist by their first birthday.

nbf: What should parents expect at their child’s first dental exam?

Dr. Cowley: At this visit the dentist will typically count the teeth and do an oral exam. This first visit should provide an introduction to the office and should be a positive experience for the child.

nbf: Have you seen an increase in the number of kids with cavities over the past decade, a decrease, or has the number largely remained unchanged?

Dr. Cowley: The number of kids with cavities has decreased dramatically over the past 20 to 30 years. This can be attributed to community water fluoridation programs and an emphasis on prevention by dentists and dental associations. Water fluoridation is beneficial because fluoride can be absorbed into the teeth through the drinking water, enabling the teeth to be stronger and more resistant to dental decay.

nbf: What age should parents start brushing their children’s teeth? And how often should they be brushing them?

Dr. Donaldson: Cleaning needs to begin with the eruption of the first baby tooth. This can be done with a washcloth or finger brush for the front teeth only. A toothbrush should be used once the first molars erupt. Parents should clean the teeth twice a day, but the nighttime brushing is the most important because cavity bugs are active while we sleep.

nbf: Is fluoride toothpaste okay for little kids, or is the non-fluoride type specifically marketed for tots better?

Dr. Donaldson: The American Academy of Pediatric Dentistry recommends that every child have fluoridated toothpaste. We recommend a “smear” of toothpaste for children under two, and a pea-sized amount for children aged two to six.

nbf: Do you recommend over-the-counter fluoride rinses for older children?

Dr. Donaldson: Any product sold over the counter is mandated to contain a minimal amount of fluoride. If a child is high-risk for decay and over the age of six, we recommend a prescription-strength fluoride rinse or gel instead of over-the-counter products.

nbf: I’ve heard of sealants to help guard against cavities. What are they?

Dr. Cowley: [They’re] a white plastic material that can be applied to the teeth to act as a barrier, protecting the teeth from dental decay. They are applied to the chewing surfaces of the back teeth which is the area of the tooth that is the most prone to decay.

nbf: Is flossing necessary for kids who still have all their baby teeth? It seems their teeth are spaced so far apart.

Dr. Donaldson: Flossing should begin when the first contact of teeth occurs. This is different for every child. Many children have crowded mouths from a young age. If the adjacent surfaces cannot be cleansed with a toothbrush, it’s time for floss. Children generally do not have the manual dexterity to floss their own teeth until age eight or nine.

nbf: if you had just one tip for parents for keeping their children’s teeth healthy, what would it be?

Dr. Cowley: Consistently brush your toddler’s teeth twice a day! The parent technique for brushing is to stand behind the child and have the child facing in the same direction. Use the left hand to support the chin and the right to gently brush the teeth. It is also important to allow the child the opportunity to brush so he or she can develop the dexterity to eventually brush independently.

Dr. Donaldson: If I can educate a parent about the dangers of the bottle and sippy cup, and the dangers of juices or other acidic drinks at early age, the chances of early childhood decay are minimal.