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HOW-TO: CARE FOR BABY SMILES

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by Dr. Stephanie Strickland

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Many parents would probably consider the word disease a dramatic way to refer to a cavity, but consider the following facts:

• Dental caries (the process by which a cavity, or hole, forms on the tooth) is the most common chronic childhood illness — five times as prevalent as asthma.

• Students miss over 51 million hours of school every year due to dental pain and/or cavities.

• Studies have shown that children with good oral health and sound teeth have better school attendance, are more able to pay attention in class, and show higher participation in school-related activities.


   Dental caries is considered a disease because of the nature of its causes and progression. When you consider how devastating its effects can be on your child, the question is how to prevent the process from occurring. That’s where the pediatric dentist comes in.

   In recent years, the trend of caries has increased in primary (baby) teeth. With the growing understanding and use of preventive pediatric dental techniques like sealants and fluoride, parents have a powerful arsenal of tools to keep their children’s teeth healthy. The earlier your child’s first dental visit, the more comfortable he or she (and you!) will be at the dental office and the greater your assurance will be that you have begun a solid foundation of good oral habits.

   Cavities require four conditions to form: 1) the tooth itself; 2) bacteria; 3) sugars or other carbohydrates; and 4) time. Understanding the interaction of these factors can help prevent the infective decay process.  Prevention is a key word to pediatric dentists, and prevention starts early!  The baby teeth play an important role for your child. They promote nutrition by allowing your child to chew properly; they are involved in proper speech development; and they protect the space that will eventually be held by the permanent teeth. The first dental visit should occur within six months of the eruption of the first tooth or by the first birthday, whichever occurs first. This may seem early, but the pediatric dentist will provide you with invaluable information, including a home care regimen that involves instructions on brushing, flossing, diet, and fluoride; tips for preventing injuries; and facts on growth and development. 

   It is critical that parents of infants and toddlers know not to send their child to bed with a bottle or cup of anything but water.  Liquids with any sugar content (including breast milk provided by nursing mothers as the child goes to sleep) can sit on the teeth overnight and have rapidly destructive effects.  Once your child is old enough to eat solid foods, it becomes important to provide him with a balanced diet that is limited in sugar. This diet should include the major food groups every day: milk and dairy; meat, fish, and eggs; fruit and vegetables; and breads and cereals. Carbohydrates are important to your child’s diet, but sugars and starches should not be overused as they put your child’s teeth at a higher risk of decay. 

   Fluoride prevents decay by becoming incorporated into the dental enamel and making it stronger and more resistant to the bacteria that causes cavities.  Fluoride is included in most non-baby toothpastes and is provided in the drinking water in many areas, but it is important for you to consult with your pediatric dentist to make sure your child is getting enough — and not too much — fluoride.

   One final preventive tool is dental sealants. A sealant is a plastic material painted into the grooves of the back teeth (most often the permanent molars) to help prevent the chewing surfaces from decay.  Sealants placed properly can last several years — through the cavity-prone period for your child.  Brushing, flossing, and diet are still important even when sealants are present, but when all of these techniques are used, sealants are an effective way to prevent cavities in high-risk areas.

   Oral health affects your child’s overall health, and good habits can last a lifetime. With the help of your pediatric dentist, you can help your child’s smile to be protected for life.


Helpful websites:
aapd.org (American Academy of Pediatric Dentistry)
ada.org (American Dental Association)


DR. STEPHANIE STRICKLAND is a pediatric dentist practicing in midtown Manhattan.  She also serves on the faculty of New York University College of Dentistry.


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