You have questions, we have answers

When should my child have her first dental visit?

Dr. Green recommends that children see a dentist between 12 – 18 months of age. At this early age, a well-check visit would be set to check the eruption of teeth, growth and development of bones and soft tissue; go over diet, nutrition, and early home care; and to catch any possible early decay. If you have any concerns about your child’s teeth, regardless of her age, a visit to a pediatric dentist is warranted.

When will my child start getting teeth or losing teeth?

Teeth begin to form in a baby’s mouth even before birth. All 20 primary teeth, or baby teeth, are present under the gums when your child is born. The lower two front teeth are the first to erupt, and this usually happens around 6 months of age. A parent should not be concerned if a child is a little delayed; there is a definite time variance on eruption. By age 3, however, all primary teeth should be present. Permanent tooth eruption usually begins around age 6 and will follow the same pattern as the primary teeth, starting with the lower front teeth. Permanent eruption ends with the eruption of the third molars, usually between 17 – 21 years of age.

What is the difference in toddler and children’s toothpaste?

Toddler tooth paste does not have any fluoride in it. Children’s toothpaste does contain fluoride. Make sure to read labels. It is recommended that a child use toddler toothpaste until she can spit all of the toothpaste out, usually around 2 – 3 years of age. If there is any concern that your child is swallowing toothpaste, keep her on toddler toothpaste.

What is baby bottle decay?

Decay in infants and toddlers is called baby bottle tooth decay. This is caused by nursing, bottles and sippy cups at nap and bed time. It can destroy teeth; damage most often occurs in the upper front teeth but other teeth may also be affected. Decay occurs when sweetened liquids are given and are left clinging to an infant’s teeth for long periods. Many sweet liquids cause problems, including milk, breast milk, formula and fruit juice. Bacteria in the mouth use these sugars as food. They then produce acids that attack the teeth. Each time your child drinks these liquids, acids attack for 20 minutes or longer. After many attacks, the teeth can decay. It's not just what you put in your child’s bottle that causes decay but how often and for how long a time. Giving your child a bottle of sweetened liquid many times a day isn’t a good idea. Allowing your child to fall asleep with a bottle during naps or at night can also harm her teeth.

Why save baby teeth?

Primary teeth “hold” space for the permanent teeth. Sometimes a primary tooth is lost before the permanent tooth beneath is ready to erupt. If primary teeth are lost too early, teeth nearby can tip or move into the vacant space. When permanent teeth are ready to erupt, there may not be enough room for them.

When is it time to floss?

As soon as you notice that teeth are touching you should start flossing. Decay-causing bacteria still linger between teeth where toothbrush bristles can’t reach. Flossing helps remove plaque and food particles from between the teeth and under the gum line.

Is my child ready to brush on her own?

A child should not be allowed to brush alone until she is 8 years of age. Also, you want to supervise your child, even at 8 years of age or older, to ensure she is using proper brushing techniques.

Do I need a fluoride supplement?

Fluoride is especially important for the development of healthy teeth. Fluoride is available in certain water sources, processed foods and toothpaste, as well as fluoride applications that one receives at the dentist. Let Dr. Amy determine if your child needs any additional fluoride treatments.

What are sealants?

A sealant is a plastic material that is usually applied to the chewing surfaces of the back teeth — premolars and molars. This plastic resin bonds into the depressions and grooves (pits and fissures) of the chewing surfaces of back teeth. The sealant acts as a barrier, protecting enamel from plaque and acids. Thorough brushing and flossing help remove food particles and plaque from smooth surfaces of teeth, but toothbrush bristles cannot reach all the way into the depressions and grooves to extract food and plaque. Sealants protect these vulnerable areas by “sealing out” plaque and food.

My child grinds a lot; should I be worried?

Grinding is normal for small children. This stimulates the jaw bones to continue to grow. If Dr. Amy has any concerns about abnormal wear patterns on your child’s teeth, she will discuss those concerns with you.

What should I do in dental emergencies?

• Bitten lip or tongue: Clean the area gently with a cloth and apply cold compresses to reduce any swelling. If the area is bleeding heavily and doesn’t show signs of stopping, you may want to go to your local urgent-care center or emergency room.

• Knocked out tooth: Hold the tooth by the crown (the white enamel part) and rinse off the root of the tooth in water if it’s dirty. Do not scrub it or remove any attached tissue fragments. If possible, gently insert and hold the tooth in its socket. If that isn’t possible, put the tooth in a cup of milk and call Carolina Pediatric Dentistry — 864-585-8558 — as quickly as possible. If you’re out of town, contact your nearest emergency room. Remember to bring the tooth with you when you come to our office or the emergency room!

• Jaw possibly broken: Apply cold compresses to control swelling. Visit Carolina Pediatric Dentistry or a hospital emergency department immediately.

• Objects caught between teeth: Try to gently remove the object with dental floss; avoid cutting the gums. Never use a sharp instrument to remove any object that is stuck between your teeth. If you can’t dislodge the object using dental floss, contact our office.

• Toothache: Rinse mouth with warm water to clean it out. Gently use dental floss to ensure that there is no food or other debris caught between the teeth. Never put aspirin or any other painkiller against the gums near the aching tooth because it may burn the gum tissue. If the pain persists, contact our office.

What about sports drinks or soft drinks?

Sports drinks and soft drinks have emerged as one of the most significant dietary sources of tooth decay, affecting people of all ages. Acids and acidic sugar byproducts in sports drinks and soft drinks soften tooth enamel, contributing to the formation of cavities. In extreme cases, softer enamel combined with improper brushing, grinding of the teeth, or other conditions can lead to tooth loss. Sugar-free drinks, which account for only 14 percent of all soft drink consumption, are less harmful. However, they are acidic and potentially can still cause problems. It is the way they are taken that is most important; the frequency of exposure is key. If one sips a drink all day, that is very harmful. If consumed all at once after a sports practice or with a meal followed by water, sports drinks are less harmful for your teeth.

What about diet?

Eating patterns and food choices among children and teens are important factors that affect how quickly youngsters may develop tooth decay. When bacteria (plaque) come into contact with sugar in the mouth, acid is produced, which attacks the teeth for 20 minutes or more. This can eventually result in tooth decay. Foods that contain sugars of any kind can contribute to tooth decay. Almost all foods, including milk or vegetables, have some type of sugar. However, they shouldn't be removed from our diets because many of them contain important nutrients and add pleasure to eating. To help control the amount of sugar you consume, read food labels and choose foods and beverages that are low in added sugars. Added sugars often are present in soft drinks, candy, cookies and pastries.

What can I do for canker sores?

An aphthous ulcer or canker sore is a type of mouth ulcer which presents as a painful open sore inside the mouth caused by a break in the mucous membrane. Aphthous ulcers develop in childhood and adolescence, and continue sporadically throughout life. Aphthous ulcers occur exclusively on moveable mucosa, such as buccal (cheeks) and lingual (tongue) mucosa, the floor of the mouth, and the soft palate. It is characterized as a yellow-gray ulcer surrounded by inflammation. They tend to heal without scarring in 7 –10 days. Typical treatment is with topical pain relievers and salt water rinses. The exact cause of aphthous ulcers is unknown. In some cases they are thought to be caused by an overreaction by the body’s own immune system. Factors that appear to provoke them include stress, fatigue, illness, injury from accidental biting, hormonal changes, menstruation, sudden weight loss, food allergies, the foaming agent in toothpaste, and deficiencies in vitamin B12, iron, and folic acid. A well-known cause for ulcers in the mouth is when the skin inside the mouth is opened up; a common cause of this is trauma. Physical trauma, such as toothbrush abrasion, injury from sharp food, accidental biting (this can be particularly common with sharp canine teeth), or orthodontic braces can cause mouth ulcers by breaking the mucous membrane. Other factors, such as chemical irritants or thermal injury, may also lead to the development of ulcers. However, in many cases the cause is unknown.

My child still sucks her thumb; what can I do?

Most children stop sucking habits on their own, but some children need the help of their parents and their pediatric dentist. When your child is old enough to understand the possible results of a sucking habit, your pediatric dentist can encourage your child to stop and talk with him or her about positive reinforcements. If this approach does not work, Dr. Amy may recommend a mouth appliance that blocks sucking habits.