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soon as a baby is born, parents can be active
in preventing dental diseases and promoting
good dental health for their child. Most people
believe we can't do anything about our newborn's
teeth until they have erupted. This is not true.
During the last three months of pregnancy the
20 primary baby teeth are almost completely
formed in the bone. At birth there can be as
many as 12 permanent adult teeth starting
their development.
The American Academy of Pediatric Dentistry
recommends that we start cleaning a baby's mouth
even before the teeth start coming in. Before
teeth come in, use a clean damp washcloth or
a piece of gauze around your index finger and
gently wipe the gum pads in your child's mouth.
This will help reduce the bacteria that form
in the mouth, as well as beginning to form the
healthy habit of routine dental care.
It is also recommended that your child
see a pediatric dentist by 12-18 months of age.
This appointment is for evaluation and education.
At this visit a complete exam is performed and
recommendations are given for home care, diet
choices and correct use of toothbrushes and
fluoride. Many dental diseases can be avoided
or treated more gently if found early. Your
child's first dental visit should be no later
than when all 20 primary baby teeth are
erupted. Following this routine, problems can
be detected and taken care of before they lead
to serious and costly types of treatment.
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Baby Teething |
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Infant teething normally
occurs from about six months to 30 months of
age. Once a baby's first tooth erupts, others
follow in small groups until all 20 primary
baby teeth are in. During teething, many
children become irritable, drool a lot, suck
on their toys, blankets, or fingers, and/or
lose their appetite. While some discomfort is
normal, teething does not cause fever, ear tugging,
diarrhea, and flu-like symptoms. If your baby
is experiencing any of these symptoms during
teething, consult your pediatrician. You can
ease teething discomfort by offering your baby
hard, cool teething toys, or frequent cool drinks
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After the Teeth Erupt - Remember...
- Do not allow sweetened liquids to bathe
teeth for prolonged periods of time. The sugars
in milk (human or cow), formula, fruit juices,
or other sweetened liquids can contribute
substantially to dental decay, so it is important
to minimize the amount of time the bottle
or sippy cup is in the mouth. Also, when sleeping,
we rarely swallow; therefore, if a child falls
asleep with sweet liquid in their mouth the
danger of dental decay is much greater.
- Always hold your baby during feedings. Never
prop a bottle/sippy cup, your child
could choke on the liquid and the milk or
juice can start cavities while in contact
with the new teeth.
- Discontinue nursing or remove the bottle/sippy
cup from your baby's mouth if your baby falls
asleep during a feeding.
- Always put sweet liquids like juice in a
cup.
- Please avoid using a sippy cup whenever
possible. They don't spill but they can start
cavities sooner and may cause the front teeth
to flare out.
- Don't put your baby in bed with a bottle/sippy
cup filled with formula, milk or juice. If
a bottle is needed to help your baby sleep,
fill it with water.
- Replace the bedtime bottle with a special
blanket, stuffed animal, or special bedtime
routine, like singing a song, listening to
a tape, or reading a story.
- Don't allow your child to walk around with
a bottle/sippy cup between meals.
- Schedule a visit with the pediatric dentist
when your baby is about 12-18 months old
After the Teeth Erupt - Remember...
- Chewing food more easily
- Learning to speak
- Providing a nice appearance and smile
- Guide normal growth and development of the
jaws
- Provide healthy conditions for developing
permanent teeth
- Reserve space for the permanent teeth to
fit into the jaws, helping the bite develop
naturally
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- Clean your child's mouth with gauze after feedings and at bedtime.
- Ask your pediatrician, Dr. Duga or Dr. Feeney about fluoride supplements.
- Regulate feeding habits.
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- First tooth usually will appear.
- Time to see the pediatric dentist for a well baby exam.
- Begin to brush teeth after each feeding and at bedtime with small, soft-bristled brush but do not use toothpaste containing fluoride yet.
- Baby begins to walk; be alert to dental injuries.
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- Wean from breast or bottle by 18 months of age
- Begin regular dental visits.
- Follow schedule of exams and cleanings recommended by Dr. Duga and Dr. Feeney.
- Most primary teeth have erupted.
- Start using rice-sized portions of fluoridated toothpaste when child is 24 months old or when their 20 primary baby teeth are in.
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- Continue regular dental visits every 6 months or as recommended by your pediatric dentist
- Monitor snacks and beverage intake
- Use Mouth Guards for sport activities
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Brushing
Tooth brushing is one of the easiest and best ways to prevent cavities. As soon as the first teeth erupt, you can start brushing your baby’s teeth with a soft age-appropriate toothbrush. Young children sometimes will resist tooth brushing.
If you are persistent and consistent with daily tooth brushing they will become comfortable sooner than you think. Be positive and make it fun by singing or counting and the children become distracted and brushing becomes easier. Later, if your toddler wants to try a little tooth brushing – great! But, you will still need to thoroughly clean your child’s teeth twice a day as well.
Preschoolers can brush their own teeth first, if their parents follow up with a thorough brushing. By age 6-7 children can usually brush their teeth but continue to require parental/adult supervision and monitoring.
Brushing, as with other aspects of life, can be a good habit started young and everyone appreciates the reward of having no cavities. Two-minute timers, or a toothbrush with a built-in timer, are helpful to children in developing good brushing habits. The bristles of the toothbrush can wear out break off making them weak, so you should change the toothbrushes every three months with a new one.
New toothbrushes clean teeth much better. Brushing can be a fun and rewarding time between you and your child. Use these few minutes each day to help create a positive self-image, healthy mouth, and a bright future for keeping their teeth shining and their smile dazzling.
Fluoride
Fluoride is very important for preventing tooth
decay. Be sure to tell Dr. Duga or Dr. Feeney
and your pediatrician whether or not your family
has fluoridated water at home or if your family
drinks a lot of non-fluoridated bottled water.
Whether your baby, child, or teen attends preschool,
daycare or elementary to high school it is important
to find out whether or not the facility has
fluoridated water. Hillsborough county and Tampa
city water is adequately fluoridated. If you
are not sure whether you have fluoridated water,
call your water company - then call us if you
have any questions. Also, there is a simple
water test to detect if there is the safe level
of fluoride in you water. If your water is deficient
in fluoride there are methods to supplement
the fluoride your child receives to protect
their teeth. We can discuss your child's fluoride
needs and offer options so that your child can
have the correct amount of fluoride.
Juices
All sugar beverages have the potential to
cause cavities because the bacteria in our
mouths use the
sugar to produce acid that can break down
the teeth over time. Even 100% fruit juice
has high sugar content. The American Academy
of Pediatrics recommends no more than one
cup of juice per day.
Even more important for the teeth than the
amount of juice is the frequency of exposure
to these
sugar beverages. We recommend limiting juice
and other sweets to mealtime or snack time
and
using water in between those times.
Habits
Many children suck their thumbs/fingers or a pacifier
for short periods during infancy or early childhood.
In fact, sucking on fingers, pacifiers or other
objects is completely normal for babies and children.
It gives them a sense of security, comforts them
and gives them a way to contact and learn about
the world around them. Whether the pacifier, fingers,
or thumb all sucking may cause problems with growth
and development of the mouth and teeth. Most children
sback to top during the preschool years but some
continue into the teenage or adult years. The
effect of a sucking habit on the bones of the
face and the way the teeth bite and fit together
depends on several factors, including the frequency
and duration of habit, bone development, genetic
development and the child's state of health. The
average age most children sback to top their sucking
habit is 3-4 years. Long-term studies suggest
that if the habit is sback to topped before 6
years the negative affects their bite are usually
reversible.
The best suggestions to help
sback to top prolonged sucking habit are positive
support during non-sucking times, and indirect
measures such as providing adequate rest and
play outlets for the child. A variety of books
may also be helpful. Many times when your child
is old enough to understand the negative affects
of their sucking habit this is enough motivation
to sback to top. If your child sucks their fingers/thumbs
for comfort during stressful or insecure times
in their life, it may be helpful to deal with
the anxiety producing situations. If these tips
aren't effective, other reminder type products
may be used like a mouth appliance, thumb guard,
bandaging the thumb/fingers, or putting a sock
on the hand at night. A bitter medication can
also be used to coat the thumb. Dr Duga and
Dr Feeney will be instrumental in providing
these explanations to children and parents as
well as work with you to provide the best alternatives
to help sback to top this habit.
Flossing
 While tooth brushing removes much of the bacteria
on your child's teeth, decay causing bacteria
still remain between the teeth where toothbrush
bristles cannot reach. Flossing removes plaque
(responsible for tooth decay and gum disease)
and food particles from between teeth and under
the gum line. Parents should begin to floss there
children's teeth when the two year old molars
are in. They should continue to floss their children's
teeth until 6-7 years of age. Small children can
injure the gum tissue easily and this can cause
problems later in their tooth development. When
it is time for children to start flossing their
own teeth they should be properly instructed on
good flossing technique by Dr. Duga, Dr. Feeney,
the dental assistant or a child dental health
educator. Floss attached to a plastic handle is
usually easier for small hands than regular dental
floss. These floss holders are available in fun
shapes and will often encourage good flossing
habits that will last a lifetime.
Bruxism (Grinding)
Often children grind their teeth. Usually they
will grind their teeth when they sleep (nocturnal
bruxism) and the parents will hear the noise
it makes. Some research relates pressure in
the inner ear at night to the grinding pattern.
Another thought is that the grinding is associated
with growth and development. Most childhood
grinding does not require any treatment and
is more irritating to parents since they hear
the grinding noise than the children. Children
usually just outgrow this grinding practice.
Usually they start to grind less when the first
permanent teeth start to erupt around the ages
6-9 years and by about 12 years old most children
will sback to top grinding. If they continue
to grind after this time a grinding mouth guard
may be needed to protect the permanent teeth. |
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When a child
is still growing, research has proven that
many of the more serious orthodontic problems
can be corrected through early orthodontic
intervention. Traditionally, orthodontics
is not started until the permanent teeth
are all erupted (grown in). At that age,
much of our face and jaw growth is close
to maturity. By starting to address and
treat the serious malocclusions (bite problems)
early we can have our natural growth assist
us in correcting these more severe problems.
This earlier
set of braces is called Phase I or Interceptive
Orthodontics and is usually treated
at 6-11 years old. The treatment goals include:
- Treat without
extracting permanent teeth
- Treat more quickly - usually in 12-14 months
- Treat with lower risk of your child needing
surgery to correct jaw mal-alignment
- Treat with increased stability when the
braces are completed
- Treat at a lower cost
Guidelines
regarding Phase I or Interceptive Orthodontics
Braces are usually not placed on baby
(primary) teeth. Most often the permanent
front teeth (incisors) and permanent back
teeth (6-year molars) have braces or appliances
attached to them. This will provide your
child with the following benefits:
- Their bite be normalized.
- Sufficient room for permanent teeth
be made.
Once the jaws and teeth segments are aligned,
the rest of the permanent teeth can come
into position as they would in a person
who was not treated with braces. When treated
interceptively with Phase I Orthodontics,
normal growth and eruption can resume on
schedule for your child.
The goal for Phase I Interceptive Orthodontics
is to establish healthy symmetrical jaw
and facial growth. Many children that are
treated with Phase I Interceptive Orthodontics
will need Phase II Full Orthodontics to
complete their correction after the rest
of their permanent teeth have erupted. However
the Phase II following a previous Phase
I treatment is usually easier, shorter time
and the resulting occlusion is more stable. |
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Life
is hectic for the teen as they balance social
and school responsibilities. Though the time
it takes to complete daily dental hygiene may
seem too time consuming for them, it is absolutely
important that they continue with the healthy
habits that were started when they were young.
Good prevention practices - including brushing,
flossing and regular dental visits - are important
care practices that don't sback to top as we
grow. Dental disease is not outgrown and in
fact, may become more of a problem for this
age group. As children become teenagers, their
attitude toward dental care may change. Cleaning,
fluoride treatments, and sealants continue to
be important preventive measures, as well as
monitoring facial and jaw changes during routine
dental visits.
 Appearance,
fresh breath, and straight teeth may become
significant to them. Decayed or poorly positioned
teeth make them very self-conscious. Smiling
and speaking with confidence can be a high priority.
Corrective measures regarding their bite, crooked
or chipped teeth and grayness and be reviewed
at this tim
Teens also eat frequently and often snack foods
and sports drinks tend to become a major part
of their diet. Help guide your teen to fresh
fruits, vegetables and cheese as healthy snack
alternatives.
Drinking water rather than sport drinks or
soft drinks also helps decrease the high level
of sugars that can be present in the teenage
diet. Water is also a great quick way to rinse
their mouth.
Safety continues to remain a concern for the
teens, especially since the driving age has
begun. Buckle up in the car not only saves lives,
it also saves your teeth. A seat belt with a
shoulder strap can keep your teen's face from
hitting the dashboard or steering wheel during
minor fender benders.
Mouth guards should be worn and are now part
of the standard equipment for many sport activities
where contact with others, equipment or where
a risk of a fall may occur. Don't forget to
protect those teeth and jaws!!
Dentistry for teens is a part
of the advanced education of the pediatric dentist.
Our doctors have been trained to deal with behavior,
to restore and guide teeth, and to teach preventive
dental health care with your teen in mind. When
they have followed your child from early youth
into the teen years, they will also change the
approach to your child's own special needs in
a sensitive, caring, and professional manner.
Our office environment is designed with the
teen in mind. As well as popular video games,
teens may choose age-appropriate movies, listen
to music with headphones, sit and read in a
quiet area, hook up online or just hang out
in a comfortable chair.
Sports
Drinks/Soft Drinks
Although tasty, soft drinks and sports drinks
can be harmful to the teeth. In addition to
the high sugar content these beverages may also
be acidic and/or carbonated. The bacteria in
our mouth use the sugars to produce acid that
over time can cause cavities. Even diet soft
drinks, while low in sugar, have a high acid
content. The acid can erode the outer layer
of the tooth. While it is okay to enjoy these
beverages, usually it is best to limit the frequency
of sports drinks and soft drinks. The best option
is to completely finish these drinks in one
sitting and drink water the rest of the day.
Oral Piercing
Teenagers are always looking for ways to make
a fashion statement. Those who want to look
cool with oral piercing may want to consider
the alarming side effects of mouth jewelry.
Common symptoms after oral piercing include
pain, swelling, infection, an increased flow
of saliva and injuries to the gum tissue. Speaking
in a clear manner may also be limited. Some
people may drool. If a blood vessel was in the
path of the needle during the piercing, severe
and difficult to control bleeding can result.
Many may be subject to chipped or cracked teeth,
blood poisoning or even blood clots can occur.
For most people the swelling of the tongue is
a common side effect, though in extreme cases,
a severely swollen tongue can actually close
off the airway and prevent breathing. |
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 Cavities
have no regard for age. Tooth decay can still
be a problem for teenagers and adults, since plaque
constantly forms on your teeth. When you eat or
drink foods containing sugars or starches, the
bacteria in plaque produce acids that attack tooth
enamel. The stickiness of the plaque keeps these
acids in contact with your teeth. After many such
acid attacks, the enamel can break down and a
cavity forms. Gum disease is also a dental health
risk.
Gum disease causes red swollen gums, bleeding
of the gums tissues and bad breath. It is especially
important for teenagers to brush twice a day with
a fluoride toothpaste, floss at least once per
day, eat a balanced diet, limit between meal snacks
and visit us regularly for cleanings and check-ups.
Based on information from the 2001 American Dental
Association annual meeting, dentists report that
in some studies oral bacteria have been associated
with heart disease, stroke, diabetes and pre-term,
low-birth weight babies. |
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Wisdom
teeth are valuable to your mouth when they are
healthy and properly positioned. However, they
often develop problems that require their removal.
Our doctors will monitor their development and,
should the wisdom teeth become impacted (unable
to come in or misaligned), only partially erupt
or might damage adjacent teeth, they will refer
you to an
oral surgeon for further evaluation.
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 Dental injuries are the most common type
of injury to the face and half of all dental
injuries can be prevented. In the United States,
5 million teeth are knocked out each year,
mainly the front teeth! About one of every
three dental injuries each year is due to
sports-related accidents when athletes are
not wearing mouth protection. By encouraging
the use of mouth guard correctly and consistently,
tooth damage and loss can be decreased and
prevented. Amazingly, mouth guards also protect
the lips, cheeks and tongue. They can also
assist in protecting children from head and
neck injuries such as concussions and jaw
fractures.
Use
a mouth guard during any activity with a risk
of falls, head contact with other players
or head contact with equipment necessitate
the use of a mouth guard. In sports like football,
ice and roller hockey, basketball, baseball,
it is easy to remember mouth guards. However,
don't forget that we need mouth guard protection
for other sport activities like gymnastics,
Lacrosse, racquetball, soccer, field hockey,
skateboarding, roller blading, martial arts,
boxing, wrestling, and volleyball. Mouth guards
minimize the risk of broken teeth and injuries
to the soft tissues of your mouth. Children
should wear mouth guards during practices
as well as games. Athletes, parents, coaches
need to realize that players at any level
of competition can be injured. Parental support
and encouragement are needed to make dental
injury prevention a success. The cost of repairing
a broken/missing tooth is more expensive than
a mouth guard. If you lose a permanent tooth,
it is gone forever. Talk to Dr. Duga or Dr.
Feeney if you participate in any activities
that might put you at risk of such injuries,
and they can suggest what type of mouth guard
will offer you the best protection for your
smile.
Quick Mouth Guard Overview/Choosing a Mouth Guard
Any mouth guard is better than none at all.
Choose a mouth guard that your child will
wear. A mouth guard should be flexible, comfortable,
fit properly, be easy to clean, odorless and
tasteless, durable, and not tear.
Three types of Mouth Guards are available
- Stock Mouth Guards: These
are sold in sporting goods stores and come
in sizes small, medium, and large. They are
held in place in your child's mouth by biting
down on them during use.
- Boil and Bite Mouth Guards:
These are sold in sporting goods stores. The
mouth guard material is softened in boiling
water and then formed to fit in your child's
mouth.
- Custom Made Mouth Guard:
These mouth guards are made by your dentist
to fit exactly in your mouth. An impression
is taken of your child's mouth and then a
thin custom mouth guard is make which is held
in place by natural suction.
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An orthodontic
problem is called a malocclusion - meaning
bad bite . Most malocclusions are
inherited, although some can be caused by
accidents, early or late loss of baby teeth,
or sucking of the thumb or fingers for a
prolonged period of time. Dr. Duga or Dr.
Feeney can evaluate whether or not braces
are right for you, and whether you might
possibly be a candidate for Invisalign®,
or invisible braces . |
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