How important is baby tooth care?

Toddler Tooth Care
Toddler Tooth Care

Toddler Tooth Care

Pediatric tooth care may be the most important, cost effective, prevention-oriented dentistry obtainable in one’s lifetime.  When parents or caregivers mistakenly say, “They are only baby teeth, they are going to fall out anyway” they are missing a great deal of information to accurately assess the importance of pediatric care.

The age one dental visit actually sets the tone for that child and the family, particularly if this happens to be that family’s first child.  The baby (primary) teeth serve as the guides for the permanent teeth and are important to the health and function of the permanent teeth.
The baby (primary) teeth are supposed to last through most of childhood – children don’t usually begin losing them until about age six, and the last primary teeth aren’t lost until around age twelve. Premature loss of baby teeth can cause the need for orthodontic treatment as the child develops. It’s just as important to care for primary teeth as it is for the permanent teeth that come later.  Perhaps the most important consideration is to start a program of care based on prevention of disease. Prevention means stopping an anticipated problem before it starts.  Tooth decay is preventable.
The importance of baby (primary) teeth and learning as a family how to have a lifetime of good oral health are the main reasons why parents should bring their children to see a dentist preferably before their first birthday.  In addition, these early appointments set the tone emotionally for the child, having the opportunity to have positive experiences that will eliminate the fear factor from dental care.
In what ways can parents prevent tooth decay in toddlers?

Parents, especially first time parents, will benefit from “Family Oral Health Education” provided by their dentist or pediatric dentist.  It includes a risk assessment evaluation for tooth decay and nutritional counseling unique to each family. This is very important because families have different levels of knowledge regarding these matters. Also, depending upon where you live, fluoride recommendations need to be individualized based on your child’s needs.  We all know that fluoride prevents tooth decay, but we need counseling to make sure that it is being used safely and effectively.  Once all of these factors are assessed properly, and your dentist has determined the level of risk that your child has for tooth decay, the important follow-up appointments for monitoring will be established based on your child’s needs.
Oral hygiene is extremely important and the child’s first visit can teach parents how to effectively clean a child’s teeth, a procedure that usually takes less than two minutes with a very small child’s toothbrush or by simply wiping the teeth off with a wet cloth.
Also, nutrition counseling is often overlooked and can change the balance of health in the oral cavity. Dental professionals can provide important information on the types of foods  to avoid and how the frequency of snacking between meals can influence a child’s oral health. At first glance, many foods like cereals and granola bars may seem healthy and good for a child to have throughout the day. They aren’t – and neither are raisins or fruit juices, even though they contain natural sugars and are full of vitamins and minerals. Carbohydrates in cereals, crackers, and granola bars will stick to the teeth where bacteria can easily interact with them over extended periods of time. And, regardless of whether the food contains processed or naturally-occurring sugars, bacteria metabolize both and form acid.
Parents are advised to avoid giving their children sugary foods, especially in high frequency, that have any form of sugar listed as the first or second ingredient.  So the key factor is not that they can’t have these foods, but to have them in moderation and not between meals because they influence the body’s natural defense mechanism, saliva. Saliva neutralizes acid and supplies calcium and fluoride to protect and even reverse early decay. But it takes time – about two hours to neutralize the effects of acid. A snack every hour – which promotes the continual presence of acid in the mouth – won’t give saliva the opportunity to work effectively.  So, let’s confine any sweet foods to the main meals and substitute carrots, nuts or cheeses between meals if snacks must occur.
Everything in life seems to require balance

The same can be said of tooth decay.You might wonder why some people get cavities and others don’t.  We need to identify what is out of balance and how it affects health. The factors causing tooth decay include large amounts of specific acid producing bacteria, the loss of the neutralizing effect of healthy salivary function, and poor dietary habits.  The protective factors preventing tooth decay include healthy salivary function that is not compromised because of between meal snacks, sealants (to seal the areas most likely to decay), the use of anti-microbial mouthwashes, topical fluoride and a healthy diet.
Sealants – using special resins with fluoride to seal the places where decay primarily occurs in the tiny pits and fissures of the teeth, will help prevent decay especially in children whose enamel is much more susceptible than adults.

Are sippy cups and pacifiers really bad for children’s teeth?

They can be, it all depends on how they are used, the frequency of use and for how many years they are used. One of the reasons for the Age One Visit is to examine the child for a number of forms of tooth decay that can affect babies and small children. For many years, healthcare professionals have recognized a specific pattern of decay, known as Baby Bottle Tooth Decay (BBTD). BBTD was primarily associated with the use of a sleep-time bottle containing a liquid with natural or added sugars such as formula or juice and occurred between twelve to eighteen months of age.

In the past few years, similar cases of early and severe tooth decay have been found in children who do not fit the classic BBTD pattern of bottle use. The term Early Childhood Caries (ECC) is now being used to more accurately express this concept of tooth decay in infants and young children. ECC includes cavities associated with many causative factors, mostly sugars. These include continuous use of a “Sippy-cup,” at-will breast-feeding throughout the night, and the use of a sweetened pacifier.
ECC can develop rapidly and can occur in six months or less. The extent and severity of ECC can vary depending on the child’s culture, genetic makeup and socio-economic factors. On the other hand, ECC is really much like any other type of tooth decay, dependent on the presence of three conditions I mentioned earlier: specific bacteria in dental plaque on the teeth, unprotected teeth (lack of sealants and fluoride or the neutralizing effects of saliva) and the right mix of carbohydrates from food and drinks, such as natural or refined sugars.
Here are some other important facts to keep in mind:

  • Baby bottles or sippy cups are frequently used by parents at sleep time to stop fussing or crying. Round-the-clock feeding promotes the constant production of acid in the mouth, so the use of baby bottles or sippy cups should be limited to meal-times.
  • Pacifiers dipped throughout the day in a variety of different sweeteners, including jam, corn syrup or sugar, results in frequent exposure of the teeth to higher acid levels in the mouth.

When should parents consider no longer using a pacifier?

According to research studies, a child’s sucking needs are strongest the first three months of life, but decreases about the seventh month when sucking needs are considered less important.  We can start decreasing the pacifier dependency at the eighth month and discontinue completely between the second and third year of life. Sucking habits that last longer than three years cause malocclusions and some arch form changes that are not beneficial.  Parents should purchase pacifiers that are labeled “physiologic” that more closely resemble the anatomy of a woman’s breast.  Obviously, the longer a child uses a pacifier, the more harm a child can do to the development of his teeth and jaws. Please see your dentist to evaluate if any changes have occurred because of the pacifier sucking habit which may or may not be strong enough or be long enough in duration to create changes that are harmful to your child.

By Dr. Vilardi, President and Publisher of Dear Doctor-Dentistry and Oral Health.

Dear Doctor – Dentistry & Oral Health is a consumer publication written exclusively by dental health care professionals for the education and well-being of the general public.  For more information, please visit 

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