Body Wise

How to Reduce Cavities, from Tots to Teens

by Kathy Sena

Tasty toothpastes, kid-friendly fluoride rinses and even dinosaur-shaped “flossers” line grocery and pharmacy shelves these days. Yet early-childhood cavities are on the rise.

Cavities are preventable. Fighting them requires parents to start teaching good dental habits early — and to stay vigilant as kids get older. Here’s what you can do.

Do Kid Brushes Help?

While the novelty of using an inexpensive “kiddie” toothbrush might make brushing more fun, studies have shown these brushes are no more effective than an old-fashioned toothbrush — though a little fun might get kids to brush more often.
From Mom To Baby

Researchers have found that mothers with active cavities in their own mouths can transmit cavity-causing bacteria to their infants through kissing, eating from the same spoon or the baby puttng fingers in mom’s mouth and then his own.
So brush twice a day with flouride toothpast and maintain good dental health.

Toddlers with Cavities
Dentists are now seeing cavities in children as young as 15 to 18 months. “The use of the bottle as a pacifier and while sleeping is the number-one culprit,” says Stephen D. Cohen, DDS, of Children’s Dental Associates, with offices in Elkins Park, PA and Philadelphia.

When a child is allowed to have a bottle of formula or juice throughout the day, she will tend to use it as a pacifier. The teeth are bathed in sugars for long periods, increasing the likelihood of tooth decay. That’s also why a baby or toddler should never be put to bed with a bottle, Dr. Cohen says.

Breast milk contains lactose, a sugar. A baby falling asleep at the breast uses it as a pacifier. The American Academy of Pediatric Dentistry (AAPD) suggests avoiding nursing children to sleep and putting only water in their bedtime bottle. Even if you use a bottle at regular feedings, try to switch to a sippy cup by your child’s first birthday and don’t let him sleep with it, Dr. Cohen advises.

The First Dental Visit
The AAPD recommends scheduling a first dental visit when the first tooth erupts or no later than your child’s first birthday. The dentist will check to make sure the teeth are well formed and that the enamel is not defective. You can ask questions about caring for your child’s teeth, and if something sounds confusing, ask for a demonstration from the dentist or hygienist.

Start Habits Early
Even before a baby cuts her first tooth, parents should wipe her gums clean with a bit of moistened gauze wrapped around the finger or just a moistened, clean baby washcloth. When the teeth begin to erupt, continue this wiping process after meals and before bed.

The AAPD says introduce fluoridated toothpaste when a child is 2 to 3 years old. Before that, clean the child’s teeth with water and a soft-bristled toothbrush. When toothpaste is introduced, supervise brushing and make sure that the child uses no more than a pea-sized amount on the brush. Children should spit out and not swallow excess toothpaste after brushing.

Dr. Cohen notes that fluoride is potentially harmful in large amounts. Toothpaste should not be left where kids can reach it. Parents should monitor tooth brushing at this age. Swallowing too much toothpaste can lead to fluorosis, a condition in which the teeth can become damaged and discolored due to too much fluoride being ingested.

Up to ages 6 or 7, children need supervision when brushing, especially to help with blind spots, Dr. Cohen says. He recommends using “disclosing tablets,” food dye tablets available over-the-counter at pharmacies, as part of an occasional random check to show the child where her brushing is missing.

Flossing for Kids
Dr. Cohen recommends flossing between your child’s teeth daily as soon as the baby teeth come together — at about age 21⁄2. Aggressive flossing isn’t necessary. “You just want to disrupt the bacterial flora between the teeth,” he says.

By kindergarten or 1st grade, you can start to teach kids how to floss on their own. “I say start when a child can tie his shoes,” says Dr. Cohen. Any earlier than that and a child may hurt the gums. Pharmacies stock over-the-counter flossing aids for kids.
It can take five to six training sessions for a child to learn how to floss. Ask your dentist or hygienist for a lesson (for both you and your child) on how to floss your child’s teeth.

Dental Sealants
Sealants fill in the crevasses on the chewing surfaces of teeth, shutting out food particles that can get caught and cause cavities. The application is fast and comfortable and can effectively protect teeth for many years, according to the AAPD.

Dr. Cohen recommends sealants, which cost about $50 per tooth, for the biting surfaces of high-risk permanent molars — four at age 6 and four at age 12 when each set of molars comes in.

Orthodontic Checkup
Gordon C. Honig, DMD, a Newark, DE, orthodontist, recommends an orthodontic checkup at age 7. About half of all kids have narrow upper jaws. “This not only creates overcrowding (when permanent teeth come in), but also it can affect the bite and the ability to breathe through the nose,” he says.

To widen the jaws, Dr. Honig installs a non-removable retainer that a child wears for less than six months. “It creates more space for the teeth, so they can erupt better and be straighter on their own, helps to improve their bite and also increases the width of the maxillary sinus, which allows them to breathe more easily through their nose,” he says.

About 10 percent of kids are at risk of needing to have permanent teeth removed because they have insufficient room to grow in straight. For these kids, Dr. Honing installs a second retainer that corrects the condition.

For More Info

American Academy of Pediatric Dentistry,
(click: Parent Resource Center)

American Dental Association
(click: Oral Health Topics A to Z)

Older Kids: Cut Down on Soda and Snacks
One can of soda contains about 10 teaspoons of sugar. And many older kids super-size their sugar consumption with extra-large drinks that can contain up to a whopping 25 teaspoons of sugar. They tend to sip these drinks over long periods of time, so the sugar is in contact with the teeth even longer.

Kids’ frequent snacking, too, can promote cavities. It takes about 45 minutes of “oral clearance time” for the acid balance in the mouth to return to normal after eating. Frequent snacking doesn’t allow that natural process to happen.

Braces can make fighting cavities even more challenging. Kids with braces can often benefit from using fluoride gels or rinses, which can reach areas where brushing sometimes can’t.

Kathy Sena is a freelance writer and frequent contributor to MetroKids.