Karen D. Foster, DDS

Diplomate of the American Board of Pediatric Dentistry

Almost everything I read begins with infants; instead, let’s mix it up a bit. Let’s work our way from the teen years back to prenatal for a different perspective.

Keys for dental care in the teen years include maintaining routine check-ups every six months. Your teen may want to continue seeing a pediatric dentist or prefer to transition to a general dentist. If your teen feels the pediatric dental office is too childish, your pediatric dentist can help with the transfer. Just let the office know your teen will be going to an adult dentist so the team can help by providing your teen’s dental records. If you don’t have a dentist in mind, plan to share the list of providers allowed by your insurance at the next appointment. The pediatric dental team can indicate with whom the office works. “Wisdom teeth”, third molars, tend to be a big concern in the teen years. Generally, your teen will be referred to an oral surgeon for a consultation. A large panoramic x-ray will be taken so it can be shared with the dentist, the orthodontist and the oral surgeon for the third molars to be evaluated for removal. Then surgery will be scheduled at a second appointment. Having a bag of frozen peas available for aftercare is a good idea to help keep any swelling down!

Let’s consider pre-teens and orthodontics next. According to AAO (American Association of Orthodontists,) all children should be screened by an orthodontist by age 7. Any treatment needed will commence sometime between the ages of 7 and 14. Children with specific problems such as crossbite, when the top teeth are tucked inside the bottom teeth, or severe crowding may start treatment very early. They will need a second set of braces once all of the permanent teeth erupt. Directing growth with early interception can often minimize the time braces are needed. Early intervention may also avoid jaw surgery or removing permanent teeth to make space.

For the younger ones, accidents and trauma bring kids to the office in addition to their routine care. I highly recommend mouth guards at any age for all sports activity. If your child takes a spill and there is no sign of a concussion that would require a trip to urgent or emergency care, then call the dentist. Team members will be able to advise you about appropriate care. Injuries to the mouth commonly bleed freely. Knowing what to do for a knocked out tooth and having an ice pack handy is very important.

Now the toddlers; establishing good preventive care for life by following a few guidelines at this age is key. Bear in mind cavities occur because we have teeth, we have bacteria that cause cavities, and time for those elements to work together. By limiting the frequency of sugar exposure we can avoid cavities. Anything other than water, even if nutritious, has natural sugar. Brushing twice a day for two minutes each time with a small amount of fluoridated toothpaste should begin as soon as teeth are noticeable in the mouth. Flossing once a day becomes important when teeth are close together and the toothbrush bristles are not able to clean between them. The first dental checkup should occur by age one or six months after the first tooth appears whichever is earliest

An adult should floss a child’s teeth until the age of 8 or 9. After that, supervision will still be necessary. Consider a reward calendar to help establish good routine home care.  Print out a blank calendar; post it on the bathroom mirror or refrigerator door. The parent should make a mark for brushing two times a day and one for flossing. At the end of the week, if every day has 100% of checkmarks, then reward the child with an extra fifteen minutes of play before bed, allow the child to pick the vegetable for dinner or have one on one reading time. My patients have found Plaque HD toothpaste to be a good brushing motivator. Remember the red tablets you chewed as a child that dyed your gums? Plaque HD works similarly, it just has green, not red, dye incorporated into the toothpaste requiring you to brush until the green dye has been removed. The reward calendar can also be used to encourage stopping of any habits such as pacifier or thumb sucking. There is debate regarding optimal timing to stop these habits but everyone agrees preschool age is the best time.

Now back to the earliest oral health care. During pregnancy, it is important for Mother to have good dental care. This ensures your baby will enjoy a lifetime of good oral health. Remember that bacteria cause cavities? Babies are not born with it in the mouth; it is transmitted from caregiver to child. Anytime we test the temperature of food in our mouth before giving it to baby or share a utensil, we transfer our bacteria to baby. By maintaining good oral health for ourselves, we have a lower bacteria count in our saliva and our baby benefits.

I hope you have found this helpful and I wish you and your child a lifetime of good oral health.

Article originally appeared in the Colorado Dental Association Journal