Dental Care For Children

Pediatrics for Parents, July, 1999 by Tammy Darling

Fear No More

"Love and hugs, lots of love and hugs." That's the answer to helping children overcome a fear of the dentist, says Dr. Kayron Dube, a pediatric dentist and spokesperson for the American Academy of Pediatric Dentistry (AAPD). "Fear is the biggest obstacle, but it's the little things that make a difference," says Dr. Dube. "Kids respond to a warm, friendly environment. Simple diversions, such as an aquarium and play area, do a lot to alleviate fears."

My own fear is exactly what's holding me back from taking my two-year-old daughter to the dentist. I grew up with a tremendous fear of the dentist and am hesitant to take my own daughter.

"A 1996 AAPD survey shows only 7% of parents take their children to the dentist at the recommended age of one or younger," says Karen Fox, communications coordinator of the AAPD. Jann Ingmire of the ADA says they also recommend parents take their children to the dentist "before their first birthday."

According to Dr. Dube, "99% of dental decay can be prevented, but early dental prevention is the key. Tooth decay doesn't happen immediately, it occurs over an 18 month period." Wean your child from the bottle by age one since letting milk or juice pool in the mouth causes decay. "Parents can use a wet washcloth or gauze pad to gently wipe their baby's gums after each feeding," says Dr. Dube. And when it comes to pacifiers or thumbs, the AAPD votes for pacifiers because the habit is easier to break at an earlier age.

The Big Two

Dr. Dube believes fluoride and diet play the biggest roles in preventive dentistry. According to the AAPD, over 40% of children do not have access to fluoridated water. Your dentist can assist you in getting an analysis of your water's fluoride content, and if it slow he/she will recommend a fluoride supplement. However, more is not better. Too much fluoride can result in a condition called enamel fluorosis, which causes discoloration.

A recent study presented at the 1996 ADA World Dental Congress showed that eating too much and too often causes more dental damage than does the sugar content of the foods being consumed. "Sugar content has nothing to do with it," says Dr. Dube, "it s how often the person eats and how long the food lays there. When we eat or drink anything (except water), minerals are lost. There should be 2-3 hours between eating or drinking, with the exception of water, to allow teeth to re-mineralize."

Dr. Monica Cipes, a pediatric dentist in West Hartford, Connecticut, says the best way parents can get their young children to cooperate while brushing their teeth is to keep it fun. "Don't make it a battle of the wills; choose a time when your child is happy and pleasant." Brush right along with your child or have her brush to the tune of a song. According to Dr. Cipes, "It s the loving interaction that makes it fun for a child."

"Parents can start using a toothbrush on their child when the first tooth arrives," says Dr. Cipes. "Choose a soft, toddler-size toothbrush, but never let your youngster walk around with a toothbrush in his mouth to let him get used to it. Doing this is far s too dangerous." How long and how often a child should brush is flexible. "The important thing is to cover all tooth surfaces, and while brushing after every meal is preferable, it s not always feasible," says Dr. Cipes. According to Dr. Cipes, children under age six should have their parents brush their teeth at least once a day. "The most important time is before bed," says Dr. Cipes, "but the other times the child can help do it himself." Children six and up can usually do it without any help. "A child can brush his own teeth when he can tie his own shoes," says Dr. Cipes. "Both tasks require about the same manual dexterity." Encourage your kids to brush for the length of time it takes for their favorite song to play.

New Advancements

Sealants reduce cavities in children by 80%. A study from the March 1996 JADA reported that less than 20% of the nations school-aged children have them on their permanent molars. Sealants are made of clear or shaded plastic and are usually put on the six-year and 12-year molars soon after they come in. (Despite their name, they can appear before age six or 12).

Lasers are now being used with great benefit to children. They simplify some procedures, save time in others, and enhance the outcomes in still others.

Tooth-colored fillings are similar in color and texture to natural teeth. Kids and parents love them because they're less noticeable, and much more attractive, than other types of fillings. The're also compatible with dental sealants, and the procedures can be done at the same time. However, they do cost a bit more because they take longer to place.

Regular or Pediatric Dentist?

The benefits of using a pediatric dentist far outweigh any cons since pediatric dentists have had an additional 2-3 years of schooling learning how to deal with children. Tina Tharp, mother of seven-year-old Stuart, sings the praises of her pediatric dentist. "I used to take Stuart to a regular dentist until the dentist himself suggested I take him to a pediatric dentist. Now Stuart enjoys playing video games at the office, and he doesn't need gas for treatments anymore." (For a free brochure "The Pediatric Dentist," send a SASE to: AAPD, 211 E. Chicago Ave., Suite 700, Chicago, IL 60611-2616).