Dental Care Primer

From Toddler Molars To Teen Braces, Here Are Answers To Common Parent Concerns

By Dr. Brian Quo

Dental CareTeeth are integral to good health and self-esteem, and parents can help instill a lifetime of good habits with regular dental care, beginning no later than a child’s fi rst birthday.

That first visit is all about education – for the parents.

Dentists will talk about how to prevent cavities and answer questions, such as when to start brushing (not until the teeth erupt) and other important issues. Here are some of the most oft en-asked questions.

What can I do to help relieve pain when my child’s molars start coming out?

Teething pain is very common, but not all children exhibit discomfort. If your child has discomfort, it is always best to give him or her something to chew on, whether it be a rubbery teething ring, a cold wash cloth or even a toothbrush. In fact, I prefer a toothbrush since it will accomplish both cleansing and pain relief.

If teething is still too painful, you can use a little Tylenol or Motrin. Baby Orajel can relieve discomfort as well.

Are dental X-rays necessary for healthy toddlers and preschoolers with good diets and good brushing practices? Are we putting our kids at unnecessary risk by exposing them to extra radiation at such an early age? Their teeth are baby teeth and are going to fall out anyway in a few years.

The baby teeth will certainly fall out; it is more a matter of “how.” Teeth normally fall out between ages 6 and 8 for the incisors and ages 9 and13 for canines and primary molars. Sometimes, though, children lose teeth early because of cavities, infection or abscess.

An X-ray is one very important method of detecting cavities or decay. Most offices use digital X-rays or a faster speed of X-ray that diminishes the amount of radiation your child receives. There is more radiation flying in an airplane from Los Angeles to Boston than there is in a fullmouth set of X-rays for an adult.

My daughter is 7 and so far has lost three baby teeth. She has not had any cavities. Her dentist mentioned that we could put a sealant on her teeth.

Sealants are an insurance policy against cavities. It depends on the anatomy of your child’s teeth. If there are a lot of pits and fissures in the teeth, then sealing them will help prevent decay.

Remember, the permanent teeth have to last a lifetime and some locations can be very difficult to clean. If your child has not had a cavity in the past, but her new teeth are relatively groovy, it may be inevitable that she get small cavities somewhere on the biting surface of the tooth.

My child fell hard and bumped his mouth. He didn’t bleed, but one of his baby teeth chipped and seemed to be displaced. What do I do about this kind of trauma?

If the tooth in question is chipped or displaced, usually the proper line of treatment is to do nothing and let the body heal itself. The tooth will oft en appear mobile and will take up to two weeks to firm up. If displaced so that it interferes with normal biting and chewing, this will often lead to extraction. If the tooth is excessively mobile to where there is a risk of your child swallowing or aspirating the tooth into the lungs, then it needs to be extracted.

A traumatized baby tooth often turns a darker shade, which alone is not a bad thing. Look for two signs: pain or abscess. If either occurs, it means that the body has begun to reject the tooth and it needs to be extracted.

My child sucks her thumb when she is tired, bored and sleeping. Th e suction is so strong that I can’t even pry her thumb from her mouth when she is sleeping. Th is habit is impacting her front teeth and causing an overbite. I have tried applying bitt er polish on her thumbnail and have used the thumb guard; neither works. What can I do to help her break this habit?

All attempts to stop thumb sucking earlier than age 3 will be very difficult because your child will not understand why or how to stop. It is my belief that some children need their thumb to comfort themselves, and we do not want to deprive them of this ability.

When your child reaches an age where she can understand, usually around 3, try to explain the importance of stopping this habit. If she resists, then she may not be ready emotionally.

Start with little steps. Try to have her only suck her thumb at bedtime or naptime. Try to avoid the “bored” thumb sucking and, of course, give her a lot of rewards – whether it be praise or a prize – when she accomplishes this fi rst step. Then, proceed gradually until the habit is only at nighttime, and then eventually gone altogether.

When do children start with orthodontia nowadays? It seems that kids are wearing braces earlier than when we were kids. How do we know if we should be considering orthodontia for our kids? Will our pediatric dentist refer us if it’s needed?

Although most problems are eff ectively treated when all the permanent teeth are in (at about age 12 or 13), some problems require earlier treatment.

Orthodontia should only be started early if your child exhibits a growth discrepancy – meaning they are in mixed dentition with both adult and baby teeth. This can start as early as 6 or 7 years of age.

Braces at this age are started because the orthodontist is planning for the future so that adult teeth may not need to be extracted. Your pediatric dentist should advise you of the need for braces and should monitor the growth of your child’s jaws at each of their six-month check-ups.

By Dr. Brian Quo is a pediatric dentist who practices in Palo Alto, CA.


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