Childs First Visit To The Dentist
Unless a problem is suspected, we would like to see your child after his/her primary teeth erupt into the mouth [24-36 months]. The most important goals of this first visit are to introduce your child to the office surroundings and to develop a trust in the dentist and our staff. We view this visit as an icebreaker. If your child is too frightened, uncomfortable or uncooperative, we may have to re-schedule several short visits. You will be charged a reasonable fee for the time. Please do not try to explain the first visit yourself. Do not use phrases like "Be brave!" or "Don’t be afraid". Don’t offer them a bribe with special treats to get them to the office. Rather be positive and reassuring that the visit will be fun and one in which to look forward.
The appointment should be 15-30 minutes and may include necessary x-rays, a gentle, comprehensive examination of the teeth, gums, jaws, bite and oral tissues. This is both to observe any problems and to establish a baseline so we can monitor your child’s growth and development. Depending on your child’s age and cooperation, we may also clean and polish their teeth and apply a topical fluoride. Please bring to this first appointment any of your child’s medical records. We will try to discuss and answer any questions you may have at that time. Our objective is to be gentle and patient so your child develops a positive attitude towards the dental office and their own oral health. Our long-term goal is prevention and minimizing and dental problems for him/her as they mature.
Dental Health From Birth To Age 3
• Baby Bottle Nipples
Usually, we like to see your child for their first check-up at about age 2 - 3 years, when all their primary [deciduous] teeth have erupted. However, there are many measures that you as parents can take before this time to insure good oral health. To begin, if mom is not going to breast feed, the type of nipple used on the bottle can have a definite effect on the growth of the jaws and development of muscles and swallowing patterns. The NUK nipple has an optimal shape that fits the anatomy of your babys mouth. Upon first sight, many parents assume that its funny shape and size will cause the baby to reject it, and thus, shy away from using it. Try the NUK nipple for a few days. Most babies will accept it readily. Using the NUK will lessen the chance of your baby developing a colicky stomach and may prevent certain orthodontic conditions that wont become evident until your child is much older.
Perhaps, the most predictable and consistent preventive measure in dentistry is the ingestion of systemic [enters the blood stream] fluoride up to about age 14. The incorporation of fluoride into the tooth enamel allows the tooth to be more resistant to demineralization by acid and ensuing tooth decay. If your water district doesnt add fluoride to the water supply, your baby should be receiving fluoride drops of a fluoride/vitamin combination as soon as possible after birth. The first permanent molars are already calcifying by age 3 months. It is in this formative stage that the tooth will incorporate the greatest amount of fluoride. Studies have shown that fluoride will not cross the placental barrier, so pregnant woman no longer receive fluoride preparations. Systemic fluoride [at 1 part per million] is a safe and effective way to dramatically reduce dental decay, along with the cost of dental treatment. Please call our office to learn if your water is fluoridated, and if not, we will be able to prescribe the proper dosage.
On the average a baby will start to get their first teeth at about six months. Teething [tooth eruption] can cause discomfort for your baby, as well as many sleepless nights for you. During teething periods, your baby may exhibit excess drooling, runny noses, low-grade temperature and/or overall crankiness. To help this situation, you may purchase some 2 by 2 inch gauze pads at your pharmacy and lightly rub your babys gums with them several times a day. This will remove a thin layer of plaque that forms on their gums, thus lessening eruption pain. Most babies will find this massaging very soothing, and some will derive pleasure from sucking on the gauze or your finger. A clean teeth ring to chew on may also be helpful. Teething gels or ointments that will temporarily numb your babys gums and reduce discomfort are available at your pharmacist.
• Nursing Bottle Syndrome
Many parents give their babies a bottle in bed to pacify him/her and enable them to fall asleep. Most people fill the bottle with milk, formula, fruit juice or water mixed with a sweetening agent such as Kayro syrup or honey. Unfortunately, as your baby falls asleep, the tongue and nipple on the bottle pool the liquid around certain teeth. The acidic and/or sugar content of these liquids can cause severe tooth decay. This is called nursing bottle or baby bottle syndrome. Dont allow your baby to become a dental cripple before his/her first check-up. If you must give them a bottle in bed, be sure to fill it only with plain water.
Infants have a natural instinct to suck as a way of nourishing and soothing themselves. Often, this leads to the child sucking on their fingers, a blanket, a stuffed animal or their thumb. Usually, this habit is given up by age 4. If it continues, it can be extremely detrimental to the development of their teeth and jaws causing crooked teeth, an incorrect bite, speech problems and/or open-mouth breathing. This habit may result in psychological trauma if it continues into school age when the other children tease them.
What should a parent do? If possible, try to switch them to a properly designed pacifier that fits the shape of the mouth. Pacifiers are less likely to create the same developmental problems [by distributing forces over greater area], are usually discarded by the child at an earlier age and are easier to hide than a thumb. If the thumb sucking is during the day, discuss the problem with them to discourage the habit. Placing a band-aid on their thumb as a reminder may help. Be positive and praise them when they remember. And reward them for their success.
It is more difficult to control thumb sucking when the child is asleep, because the child is unaware of this involuntary action. So, try this habit-breaking technique that is usually successful within two weeks. Before your child goes to bed, wrap a 2-inch wide ace bandage lightly around their fully extended arm [straight]. Start about 3 inches from their armpit and continue down past the elbow. This will not prevent your child from putting their thumb into their mouth. However, as soon as they fall asleep, the tension created by bending the elbow will pull the thumb from their mouth.
If your child is still sucking on their thumb or anything else by the time their permanent teeth erupt [around age 6], please call it to the attention of our office.
Sippy Cup: Friend Or Foe?
The sippy cup is a spill proof, lid-covered drinking cup designed to help parents teach their toddlers how to drink without spilling. Children can toss it, drop it and turn it upside down, but they can't spill its contents. That's thanks to a valve in the top that releases liquid only when a child puts his lips around the tip and sucks. Day after day countless parents reach for that sippy cup their toddlers love so well, proud that the bottle is a thing of the past, and thrilled that their car seats and living room carpets will be spared! These parents though, should think twice before resorting to extended use of the sippy cup.
Many parents operate under the mistaken impression that the sippy cup is better than allowing the child to sleep with a bottle. The damage done by the bedtime bottle is fueled by the fact that no saliva flows during sleep to clear liquids from the mouth or dilute them. Liquids bathe the teeth all night. The sippy cup filled with sweetened liquids can cause the same damaging effects. The child's teeth are immersed in the liquid during drinking and many parents allow unlimited access to the sippy cup.
The American Academy of Pediatric Dentistry recommends that children be weaned from the bottle by 12-14 months of age and be encouraged to drink from a cup. Parents are cautioned however that the repetitive consumption of liquids that contain fermentable carbohydrates (milk, juice, soft drinks etc.) from a bottle or sippy cup should be avoided.
• Be very selective about the liquids that you give your child from the sippy cup. Avoid milk, juice, and soft drinks. Try water or sugar free beverages instead.
• Use the sippy cup only as a transition to a regular cup or adult drinking glass with no lid.
• Consider cup design carefully. A pop-up straw reduces the amount of time the liquid is in contact with the teeth.
• Some speech pathologists have expressed concern about over use of the sippy cup and liken its use to a thumb-sucking habit, the effects of which are well documented.