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Dental Care through the Stages

How to care for your kids’ teeth, from teething to wisdom teeth.

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Still putting off your family’s dental visits in order to prioritize “more important” medical appointments? A new study might make you rethink how you view dental care.

In 2016, the Mayo Clinic released a short report highlighting the important role of oral health as a window into your overall health. The healthier your mouth is, the healthier your body typically is, and good oral health habits need to start early.

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“Almost all tooth decay can be avoided with proper care and preventative measures,” says Molly Pereira, associate executive director of the Colorado Dental Association. She’s an advocate of educating parents early so they can get a jumpstart on forming healthy dental habits for their kids. As a parent, this means it’s important to keep yourself educated on good oral care throughout the many ages and stages of your child’s life.

Infants and Babies

When you have an infant, “establishing good preventive care for life by following a few guidelines at this age is key,” says Dr. Karen Foster, a pediatric dentist at Saddle Rock Pediatric Dentistry in Aurora. Start this by washing babies” mouths and gums with a soft cloth and water when they do not have teeth. Dr. Jack Emmons, a family dentist with a practice in Lafayette, says that this simple practice will do wonders at keeping some of the bacteria away.

Both the American Academy of Pediatric Dentistry and the American Academy of Pediatrics agree that the best time for a child’s first dental visit is six to 12 months after the child’s first tooth comes in. After this initial visit, seeing the dentist every six months is appropriate for most children.

Emmons and Foster warn against a few common mistakes that parents make. Don’t leave a bottle of milk in the crib to soothe your child. Prolonged sipping—even on milk—contributes to a bacterial build-up in the mouth. And never put soda in the bottle. Ever. And if you lick or taste things before you give them to your baby, stop that, too. This transmits the bacteria from your mouth to the baby’s mouth. Since babies are born with little to no bacteria in their mouth, the less of ours we transmit, the better. It’s the total amount of bacteria in a mouth that counts, so you want to keep that to a minimum.

Toddlers

Once a child cuts some teeth, it is OK to use regular toothpaste, but just a tiny smear on the very ends of the bristles. During these toddler years, the parent should do most of the work of oral care. Include the child, of course, and let them brush for themselves, but then always follow up and make sure to get the areas they don’t. Aim for two minutes of brushing, twice a day. Flossing once a day should become part of the routine once there are a few teeth close together in the child’s mouth.

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Early Elementary

Around age six, children should be encouraged to brush entirely on their own, but with your supervision. Touch up any areas that they miss brushing. Foster suggests helping them floss at least until age eight or nine. Flossing becomes more critical during this stage since your child has a mouthful of teeth that are close neighbors. The goal should be to get your child to engage in healthy habits on his or her own. Be warned, however, that this is also the stage at which many kids will try to push the limits. “One common manifestation of this is that kids will wet their toothbrush and tell you they brushed,” Emmons says. Supervising is key!

The Tooth Fairy also typically shows up during the elementary years. Children start losing baby teeth and getting their first adult teeth. This creates a great opportunity for parents to impress upon kids the importance of healthy oral habits. Molars will also start to come in behind the existing molars. Emmons says to be vigilant about looking out for the new molars “because they are new, and often do not get brushed at all until there is a cavity.” He also recommends fluoride varnish on the child’s teeth during regular check-ups. This varnish helps prevent cavities thereby helping keep teeth healthier.

An orthodontic consultation should also happen around age seven, according to the American Association of Orthodontists. Dr. Hilary Baskin, a founding partner of All About Braces in Lakewood, says that even if your dentist doesn’t refer your child to an orthodontist, you should take your child in. Most reputable practices offer initial consultations free of charge and Baskin is quick to note that taking your child in certainly won’t mean they need braces or other treatment. However, a visit at this time allows the orthodontist to determine whether or not there might be some growth guidance necessary at this stage. Even with straight teeth, there may be hidden crowding, blockage, or teeth that don’t meet correctly. “These sorts of growth guidance issues are the ones that orthodontists like to address at an early age,” says Baskin.

If any initial phase of orthodontic treatment is needed, it works to create a better environment for permanent teeth. “Aligned teeth make oral health easier all the way around,” says Baskin.

Tweens

If necessary, a second round of orthodontic treatment would start during the tween or early teen years. A second phase typically addresses improvement or correction to complete the tooth and jaw alignment that was started in phase one. This typically happens once all of the permanent teeth have erupted.

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The good news for any tweens surly about getting braces is that thanks to early intervention in the elementary years, the time in braces should be shortened. This also may help prevent jaw surgery or removing permanent teeth to make space.

In the event that your child has braces, Baskin and Emmons both point out that keeping teeth clean is critical. In addition to regular brushing and flossing, you might consider investing in a water flosser, many of which have attachments especially for braces.

Teens

With or without braces, Emmons warns that teenagers are notorious for being the worst group of brushers out there. “They just don’t do it, and someone’s wallet and their teeth usually suffer in their twenties, so be sure to continue to monitor and encourage their brushing and flossing,” he says. Foster says it’s also critical to maintain routine checkups every six months during these years.

Third molars, often called “wisdom teeth,” also come up during the teen years. They erupt anywhere from age 15 to 65, but most commonly around age 18.

“They are considered by most to be somewhat of a vestigial organ,” says Emmons, “much like the appendix, tonsils, or tailbone, that are not needed, but may have played a role in ancient humans.” With the eruption of first molars around age six, there is not much room for additional teeth. When third molars come in, chronic or acute infections can arise, that can be very dangerous. “The long term cost (of leaving the wisdom teeth in) is significantly higher than the cost of early removal, even in (the case of) perfectly erupted third molars, which is rare,” Emmons says.

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He advises that the best way to determine whether or not your teen’s wisdom teeth should be removed is to see your dentist regularly. Generally, teens will be referred to an oral surgeon for a consultation. A large panoramic X-ray will be taken in order to evaluate whether or not removal is needed. In the event of surgical removal, remember that it is a very routine procedure—a bag of frozen peas can work wonders for any swelling.

As your child enters the later teen years into early adulthood, continue to remind them about the importance of good oral care. As with so much you do as a parent, Emmons says that the example you set is critical: “Parents with healthy mouths have children with healthy mouths.”

Courtney Messenbaugh is a freelance writer based in the Boulder area. She is married with three children and a big dog.

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Helpful Hints and Best Practices

In order to encourage consistent and good dental self-care, experts offer the following tips and tricks.

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Visit mouthhealthy.org, a site run by the American Dental Association, for more tips on oral health.

Braces: What You Can Eat

So often when children get braces, they fixate on all the things they can’t eat. But there are lots of delicious foods a child with braces can eat. Here is a starter list, courtesy of All About Braces.

For more orthodontic-friendly foods, check out The Braces Cookbook: Recipes You (and Your Orthodontist) Will Love.

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