Additional Information for Parents

Dental decay is a common condition all over the world. One way to help prevent cavities from occurring is through the use of fluoride. Fluoride helps harden the tooth enamel and make it more resistant to tooth decay. A small cavity can be stopped and even reversed by the remineralization process enhanced by fluoride.

Fluoride can be delivered to the teeth in two ways: topically (direct contact on the teeth) and systemically (enters the blood stream).
Systemic Fluoride

Systemic fluoride is delivered to the tooth surface via the bloodstream. Systemic fluoride can be derived from a food source, water source, or dietary supplements (pill, tablet, lozenge, drop). Fluoridated water is an effective way to reduce the problem of dental decay. It has been shown that fluoridated water and dietary supplements can reduce up to 60% of tooth decay.

Some water supplies naturally contain fluoride, but for others fluoride is added to the water supply. If you would like to know if your community’s water supply contains fluoride, call your local water or health department.

Children from birth to 16 years of age will benefit the most from systemic fluoride. Sixteen is currently the age at which the American Dental Association recommends children can discontinue fluoride vitamin supplements. This is because when fluoride is ingested, it circulates through the bloodstream and into developing teeth. The fluoride is then built into the enamel structure of the developing tooth, making the tooth more resistant to acids.
Topical Fluoride

Even though the benefits of fluoride are maximized before the teeth erupt (come in), fluoride is still very beneficial for children and adults after the teeth are fully erupted. Topical fluorides are applied directly to the tooth structure to delay or slow down the tooth decay process.

Topical forms of fluoride include:
Toothpaste – used daily, must have an ADA or CDA Seal of Acceptance on the label.
Professional fluoride application – this is a gel that is applied for 1 to 4 minutes, usually in a tray at the end of a dental appointment. Not everyone is given a professional fluoride application; it depends on your oral health needs.
Fluoridated home mouthrinses – can be purchased over-the-counter and used for children over 6 years of age and adults who are susceptible to cavities.
Home care fluoride gels – applied by trays or by brush, these gels are for those who are highly susceptible to cavities. These people would include:
Adults with a high incidence of root cavities.
Those who experience an extremely dry mouth.
People who wear braces or orthodontic appliances.
Those who have rampant or excessive cavities.
Even though the benefits of fluoride are maximized before the teeth erupt, fluoride is still very beneficial as a daily defense against decay. Fluoride gels can be purchased over-the-counter or by prescription. Ask us for a daily home fluoride program that is individualized for your needs.

Fluoride Safety

Fluoride is very effective in controlling dental decay when used properly. If not used in the proper doses, fluoride toxicity and dental fluorosis can occur.
Fluoride toxicity occurs when large amounts of fluoride are ingested over a short period of time. This can be dangerous to your health.
Symptoms of fluoride toxicity may include nausea, diarrhea, vomiting, abdominal pain, increased salivation or increased thirst.
These symptoms generally begin 30 minutes after ingestion and can last up to 24 hours.
Depending on the amount of the toxic overdose of fluoride, certain emergency procedures should be implemented. If you feel nausea, drink milk or try to induce vomiting and call us or physician. If these symptoms do not subside, or the conditions worsen (difficulty breathing), call an emergency service to transport you to the hospital.
Dental fluorosis is an excess of fluoride intake during the stages of tooth development. Dental fluorosis ranges from mild (white specks on teeth) to severe (brown staining and pitting of enamel).

To ensure your child does not experience any adverse effects from fluoride, follow these basic rules:

Fluoridated products should not be swallowed.
Only a small amount of toothpaste, the size of a small pea, is needed for a child.
Fluoridated products, especially mouthrinses should not be given to a child under 6 years of age, or to anyone who cannot rinse and spit ( those you suspect are swallowing some of the product).
Keep fluoridated products out of reach of children.
Parental supervision is needed for children when brushing or using any fluoridated substances.

Oral Hygiene for Children
baby_toothbrushShould I clean my baby’s teeth?

Definitely! Even before the first tooth appears, use a soft, clean cloth to wipe your baby’s gums and cheeks after feeding. As soon as the first tooth appears, begin using a small, soft bristled toothbrush to clean the tooth after eating. Don’t cover the brush with toothpaste. Young children tend to swallow most of the toothpaste, and swallowing too much fluoridated toothpaste can cause permanent spots on baby teeth called dental fluorosis.
I find brushing my child’s teeth awkward. Do you have any suggestions?

Try having your child lie down. Put your child on your lap or on the floor, keeping his/her head steady with your legs. If your child is standing, have his/her back to you with their head tilted slightly and resting against your body. Have your child hold a mirror while you brush and floss their teeth so your child can see what is being done.

Is it important to brush before bed?

Yes. If you have to miss a brushing, the bedtime one is probably the worst one to miss. If you don’t get rid of the bacteria and sugar that cause cavities, they have all night to do harm. While you are awake, saliva helps keep the mouth clean. When you are asleep, there is less saliva produced to clean the mouth. For this reason it is important to brush before bedtime.
How to brush your child’s teeth:

Every day plaque forms on the inner, outer, and chewing surface of teeth and the gums. Tooth brushing is one of the most effective ways to remove the plaque.
The best kind of toothbrush to use is one with soft, round-tipped bristles.
A child will need a smaller brush than an adult.
Young children do not have the manual dexterity to brush properly. Your child will need your supervision and help brushing until he or she is 8-10 years old to ensure a thorough brushing has been done.
When the bristles become bent or frayed, a new brush is needed.
Start flossing your child’s teeth when the teeth touch each other and you can no longer brush in between them.

Pacifier Information

For babies, sucking is very natural. It is how they nourish and soothe themselves. When a baby is not eating, the pacifier is better to use for soothing than a finger, thumb, or a toy.

Pacifiers are less likely to cause a malocclusion and are usually discontinued at an earlier age than thumbsucking. It is easier to take away a pacifier than to discourage using a finger or thumb. Thumbsuckers typically continue the habit until 3-5 years of age.

Thoughts on Pacifiers

If you notice your child beginning to suck their fingers or thumbs during the first 3 months of life, consider introducing your child to a pacifier.
To avoid any trauma to the gums, it’s important to buy a pacifier with a nipple made of rubber
Do not use the pacifier around the clock, only when necessary
In rare instances, pacifiers may cause complications like abnormal swallowing patterns
Check the pacifier daily for breakage. They do not last forever and should be replaced when wear or damage is noticed. A damaged pacifier can cause choking.
Do not hang the pacifier around your baby’s neck with a string. This practice is dangerous and can cause strangulation.

Choosing a Pacifier

Avoid improper breathing and abnormal molding of the baby’s jaws by choosing a pacifier that resembles the natural nipple and breast.

Pacifier use can cause abnormal development of the jaws and teeth. Some reasons are:

Improperly sized and shaped pacifier
Strength of sucking action
Length of time the pacifier is present within the mouth

Snack Facts
Sugar Snack Facts:

Frequent snacking on foods containing sugar increases a child’s risk of getting cavities.
Each time your child eats sugar, plaque in the mouth combines with sugar to produce acid.
This acid attacks the teeth and over time can destroy the tooth structure.
Your child should eat a variety of foods including grains, milk and milk products, meat, vegetables, and fruits. Avoid establishing a “sweet tooth” by limiting foods high in sugar.

Tips for Good Snacking Habits:

Cut down on high-sugar snacks. Offer your child snacks that are low in sugar, such as vegetables, cheese, or pretzels. These do not promote tooth decay.
Cut down on the number of times per day that your child eats sugar in food and snacks. With frequent snacks, the acidity of the mouth stays high. This exposes the teeth to acid for extended periods. High frequency of sugary snacks increases the risk of developing cavities.
Avoid soft, sticky sweets that lodge on and between tooth surfaces such as toffee, dried fruits, etc. Sticky foods are retained in the mouth longer and as a result, the acid that destroys the tooth is produced for a longer period of time. The consistency of the snacks increases the risk of getting cavities more than the amount eaten.
Natural sugars (found in breast milk, fruit, milk, bananas) have the same effect on your child’s teeth as refined sugars (found in soda pop, ice-cream, cake). Healthy foods should obviously not be avoided and brushing after eating is important in the prevention of tooth decay.
Don’t give your child sugar-rich foods that stay in the mouth and prolong the acid attack, such as gum, hard candies, lollipops, etc.
If you do serve sweets, serve them with meals. Increased saliva flow during meals helps neutralize the effects of sugar on the teeth.
Brushing and flossing after snacks and meals is important for preventing cavities that can form from exposure to sugar.

Snack Facts
Sugar Snack Facts:

sugary_snacksFrequent snacking on foods containing sugar increases a child’s risk of getting cavities.
Each time your child eats sugar, plaque in the mouth combines with sugar to produce acid.
This acid attacks the teeth and over time can destroy the tooth structure.
Your child should eat a variety of foods including grains, milk and milk products, meat, vegetables, and fruits. Avoid establishing a “sweet tooth” by limiting foods high in sugar.

Tips for Good Snacking Habits:

Cut down on high-sugar snacks. Offer your child snacks that are low in sugar, such as vegetables, cheese, or pretzels. These do not promote tooth decay.
Cut down on the number of times per day that your child eats sugar in food and snacks. With frequent snacks, the acidity of the mouth stays high. This exposes the teeth to acid for extended periods. High frequency of sugary snacks increases the risk of developing cavities.
Avoid soft, sticky sweets that lodge on and between tooth surfaces such as toffee, dried fruits, etc. Sticky foods are retained in the mouth longer and as a result, the acid that destroys the tooth is produced for a longer period of time. The consistency of the snacks increases the risk of getting cavities more than the amount eaten.
Natural sugars (found in breast milk, fruit, milk, bananas) have the same effect on your child’s teeth as refined sugars (found in soda pop, ice-cream, cake). Healthy foods should obviously not be avoided and brushing after eating is important in the prevention of tooth decay.
Don’t give your child sugar-rich foods that stay in the mouth and prolong the acid attack, such as gum, hard candies, lollipops, etc.
If you do serve sweets, serve them with meals. Increased saliva flow during meals helps neutralize the effects of sugar on the teeth.
Brushing and flossing after snacks and meals is important for preventing cavities that can form from exposure to sugar.

Teething Information

Teething BabyTeething may make your baby restless and irritable. If fever, vomiting, or diarrhea occurs do not dismiss this automatically as due to teething, as it is not generally the cause of these conditions. These symptoms should be discussed with your pediatrician.

Some signs that your baby may be teething:

red cheeks or rash on cheeks
increased saliva/drooling
restlessness
irritability
loss of appetite

What to do?

Let your child chew on a cold, hard object, such as a teething ring. The coldness helps ease the discomfort and the hardness will speed up the eruption of the tooth.

Massaging your child’s gums with a clean finger can help reduce pain and discomfort during teething.
Teething gels or ointments (ask your pharmacist for a brand name) are used to numb the gums and reduce the discomfort.

Teething cookies or biscuits are not a good choice as they contain sugar and may lead to tooth decay.

Thumb-sucking Information

Little girl sucking thumb hugging toy dogThumb-sucking or finger-sucking is a habit that forms in many infants. Your child will usually give it up naturally by the age of four. If the sucking habit continues beyond the time when permanent teeth start to erupt, your child may develop crooked teeth and a malformed palate (roof of the mouth). This results from pressure applied by the thumb on the teeth and roof of the mouth. The severity of the problem depends on frequency, intensity, duration and also the position in which the thumb is placed in the mouth. The relationship between the upper and lower jaws may also be affected. Speech defects can occur from misaligned teeth resulting from thumb-sucking and/or finger-sucking.
Treatment:

encourage-pacifierThe best prevention is to get your newborn to take up the pacifier instead of thumb-sucking or finger-sucking. Although prolonged use of the pacifier can lead to similar problems, it is not attached to the child and can be more easily discouraged.
Children should be helped to give up the habit before they enter school to prevent teasing.
Timing of treatment is important. Your child should be willing to give up thumb-sucking or finger-sucking. If your child is not willing to stop, therapy is not usually indicated. Pressure to stop may only lead to resistance and lack of cooperation. Try again at a later time.
Give your child attention and understanding and gently discourage the habit. Reminders such as a band-aid on the thumb can help.
Offer rewards (star on chart, dimes, extra story) for days when your child is successful. Praise your child when successful.

After daytime sucking is controlled:

Take one step at a time. Encourage your child not to suck during one daytime activity, like story time or television watching. Gradually add another activity until daytime sucking is controlled.
Help your child to give up the sucking habit during sleep. This is usually an involuntary process and a glove, sock, or thumb/finger guard can help stop the habit.
If these considerations are not successful, let us know. By the time your child’s permanent teeth begin to erupt (at around 6 years of age), it should be brought to our attention. We may suggest other options such as a reminder bar that is placed in the upper arch.

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