As a parent, you want your child to have the best overall health, including good oral health. Here are some answers to common questions parents have about pediatric dental health:

Common questions parents have about pediatric dental health:

When should babies see the dentist? ‍

The American Academy of Pediatrics recommends that a child should see the dentist for the first time by their first birthday. This allows the dentist to check for any potential problems and provide tips for maintaining good oral health.

What is typically done at these early visits?

You may be wondering why you’d even consider taking your little one in when he or she is still rocking that gummy smile. There are a few reasons! At the first visit, the dentist will examine your child's teeth, gums, and mouth. They may also clean the teeth and apply fluoride to help strengthen the enamel - you can always have a discussion prior with any questions or concerns you may have. The dentist will also discuss oral hygiene habits and check for any signs or symptoms of other underlying conditions. Did you know that early signs of Crohn’s disease and cancers can be spotted in the mouth?

When should a parent start brushing and flossing, and how?

‍You can start cleaning your baby's gums with a soft cloth or gauze after feedings. As soon as the first tooth comes in, you can start brushing with a soft-bristled toothbrush and a small amount of toothpaste. You can begin flossing when your child has two teeth that touch.

Is fluoride okay? What if there is fluoride in drinking water?

Fluoride is a mineral that helps to strengthen tooth enamel and prevent cavities. If your drinking water has fluoride, your child will get enough fluoride through their diet. If your drinking water does not have fluoride, the dentist may recommend using a fluoride toothpaste or supplement. It’s also a topic worth discussing with your pediatrician if you’re concerned

Should my child still use fluoride toothpaste if we have fluoridated water?

Yes. The recommendation is to use fluoride toothpaste as mentioned above. I have some families opt to not because their child is low risk for cavities. The best idea is to make a decision with your child’s dentist in order to make a full-fledged plan that takes diet and behavior into account – not just toothpaste type.

What are risk factors for developing cavities? R

Risk factors for cavities include a diet high in sugar, frequent snacking and constant exposure to sugars and simple carbohydrates (both food and drink), and poor oral hygiene habits. Genetics can also play a role in the development of cavities.

What do you do if a tooth gets knocked out?

‍If a baby tooth falls out, don’t try to put it back in - it can damage the adult tooth bud developing. If a permanent tooth falls out, try to save the tooth and place the tooth in a cup of milk or saliva and get to the dentist as soon as possible. Prognosis of saving that adult tooth is time sensitive!

How can a parent prep their child for a dentist visit?

You can prepare your child for a dentist visit by talking to them about what to expect and why it's important. You can also read books or watch videos about going to the dentist to help ease any fears or anxiety. Your demeanor as a parent matters since children can pick up on your anxiety and fears, so be aware of the language you use regarding the dentist! We want to make the dental visit as fearless as possible, despite there being a lot of new sensations (light, smell, taste, etc.)

How can a parent help the dentist do their job as seamlessly as possible?

‍You can help the dentist by ensuring your child follows good oral hygiene habits, including brushing and flossing regularly. You can also provide the dentist with a complete medical history and list of any medications your child is taking. By working together, you and the dentist can help ensure your child has a healthy and happy smile.

When should we see a dentist?

Six months after the first tooth erupts or at one year—whichever comes first. Many parents wait until their child is older as they feel they have proper dental hygiene and no risk of cavities. Creating a dental home after one is great for dental education and incase of injuries to the mouth. Having a dentist after one can also allow your child to get more comfortable with going to a dentist. Brush up!

In conclusion, taking care of your child's oral health is an important part of their overall health and well-being. By following these tips and working with your child's dentist, you can help your child achieve and maintain good oral health for a lifetime.

Early Preventive Info + “Tips””

1. Teething can start as early as 4 months - This can be confusing since nothing is “in” the mouth yet. Some symptoms may include irritability and drooling. Look for white blanching of the gum, swollen areas that create a “bulge.” The first teeth come in around 6 months and they are the bottom two. All the baby teeth erupt by around 33 months (every child is different and this can range!). All baby teeth are lost by around age 13 years old- so we hang on to them for a while and want to keep them healthy!

Tip: soak washcloth partially in water, breastmilk, or formula and freeze for about 15 minutes, thaw for a few minutes, and use for a teething toy, visit https://www.yourfirstgrin.com/teething-tips for more ideas

2.  Start brushing the gums when there are no teeth - I know this sounds silly, but it helps down the line. Massaging the gums helps alleviate teething discomfort and desensitizes the mouth, which gets the baby used to the feeling of brushing in the future. 

Tip: Gum massager finger brushes and banana brushes are great introductory instruments to get a baby used to the sensation of brushing.

3. Introduce an open cup at 6 months old- Using a bottle or sippy cup for an extended period of time requires a persistent sucking motion that prevents development of a proper swallowing pattern. The pattern allows liquid to pool around the teeth, which can increase the risk of cavities as well as misalignment of the teeth. Introducing open cups around 6 months promotes proper oral development and fosters hand-eye coordination. Proper oral development is creating balance of the oral muscles to allow the jaw to grow properly. 

Straw cups are socially the norm and they allow proper oral development while also giving parents a more convenient and less messy option. 

Tip: you can introduce an open cup around 6 months or when your baby is sitting unsupported. Once your baby can successfully swallow water from an open rim, you can introduce a straw. Even though the goal is to “introduce” an open or straw cup early, this does not mean your baby is expected to learn it at this early age. It can take a lot of time and patience before your baby develops proper musculature and coordination to be able to drink independently and successfully. 

4. Floss wherever the teeth touch - Flossing isn’t age dependent! Between the teeth is the most common place where kids get cavities, and it’s most often due to lack of flossing. Usually teeth start to touch around 2-3, when the baby molars erupt, but sometimes even earlier. Flossing is not easy - it’s a habit that is hard to implement even for adults. It’s stressful for parents, especially on top of all of the brushing struggles. It is low priority with all of the other challenges of parenthood. Here are some tips:

Tips: Set realistic and achievable goals. Start introducing the concept before the teeth touch, so your child won’t fear flossing once they actually NEED to floss. Let your child play with floss or watch you floss. 

If you can’t floss the entire mouth, focus only on the areas where the teeth touch. Rotate which location you start flossing. Take baby steps to desensitize your child to the concept and sensation of floss. Start with one spot first, then add a second a week later. Even flossing ONE spot a night is a HUGE success in helping your little one build the habit and understand that it is part of they routine. It may be hard for your child to hold a floss pick, so be sure to give them a hand, use a mirror, and always supervise flossing!

5. Snacking frequency - The more frequently we graze or snack (liquids other than water included), the more often the teeth are exposed to acid, which weaken the teeth and increase cavity risk. For example, a juice box in one sitting is healthier than sipping on a juice box for a few hours. If the teeth are exposed to the juice for a few hours, they weaken and are susceptible to cavities. The same goes for any snack: a handful of crackers at once is better for the teeth than a handful of crackers over a few hours since the crunchy foods will sit in the grooves of the teeth undisturbed and increase cavity risk.

Tip: Ideally, after snacks, meals, or juice, complete the meal with a sip of non-carbonated water to help rinse and neutralize the mouth as well as help clean out the grooves of the teeth. This minor act helps the mouth a lot. 

6. Pacifier weaning - Pacifiers are a useful soothing tooth in the newborn and infant years, but extended use during times of play, vocalization, jaw development, etc. can impact speech development/articulation as your child gets older. From a developmental perspective, it’s a great soothing mechanism, but our older toddlers can be taught other coping skills where a pacifier will no longer be necessary 

Tip: The goal is to wean the pacifier by 3 years of age. Some approaches include:

• cold turkey - throwing it away, having them throw it away
• the child may happily give it up, or it may involve some tears for a few days, so make sure to reassure them, get down to their level when they are sad, redirect them to other activities, verbally applaud their bravery, and teach breathing exercises when they are calm)
• planting the pacifier in a garden - this was a popular method
• plant the pacifier with them and tell them something exciting will be there in the morning. After they go to sleep, put flowers or balloons where the pacifier used to be. Watch them get excited seeing how their pacifier turned into magic!
• use the “Pacifier Fairy”
• have them put the pacifier underneath their pillow or in their crib. In the middle of the night, replace it with a new loving item
• throw a “bye-bye pacifier” party
• celebrate them being a big kid now and have a celebration to remind them of how proud they should be of themselves for no longer needing the pacifier

Remember, removal of a pacifier in the toddler years is NOT a bad thing. There may be tears, so consider options that work for you and your child. If there are tears, remember that these tears are not harmful and can be met with compassion, understanding, and redirection. Be patient, consistent, and persistent with whichever method you choose!

Fluoride Info For Parents

Fluoride: A Guide to Understanding Your Child's Dental Needs

When it comes to your child's dental health, it can be difficult to navigate through the various opinions and information available on fluoride. What is it? Is it necessary? What are the benefits? To help you understand the facts, let's take a closer look at the role of fluoride in your child's dental care.

What is Fluoride?

Fluoride is a naturally occurring mineral that can be found in water, soil, and air. Fluoride is added to many public water supplies in America to help protect teeth from damage and reduce the risk of cavities. When the bacteria in the mouth combine with sugars, it creates acid that can harm the outer layer of the teeth (enamel). Fluoride helps protect the enamel and makes it stronger, reducing the risk of tooth decay.

Fluoride Supplements and Fluoride Varnish

If your community water supply is fluoridated, you generally do not need fluoride supplements unless prescribed by a dentist or pediatrician. Fluoride varnish, which is applied by a pediatrician or dentist, helps prevent or slow down tooth decay. It is painted on the top and sides of each tooth and hardens quickly, and it is recommended that children have varnish applied 2 to 4 times per year until they are 5 years old.

Fluoride for Babies Under 6 Months

Breastfed and formula-fed babies under 6 months old do not need fluoridated water or fluoride supplements, as there is a risk of developing fluorosis (streaks on the teeth from fluoride). You can use bottled or purified water that does not have fluoride or ready-to-feed formula instead of fluoridated water for formula.

Fluoride Toothpaste for Children

For children who are at high risk of cavities, it is important to use fluoride toothpaste. The amount of fluoride in a small amount of toothpaste is not harmful to children and helps make the tooth enamel stronger, reducing the risk of tooth decay. Children who are at high risk for cavities should consider using fluoride toothpaste, including those who:

• Have a primary caregiver who is at high risk for cavities
• Consume more than three sugar-containing snacks or beverages a day
• Go to bed with a bottle
• Have a history of cavities
• Follow a diet high in sugars and starches
• Live in a community with limited or no fluoride in the water supply

When Should We Start Brushing?

For children under 3 years old who cannot spit, caregivers should start brushing their teeth as soon as they begin to come into the mouth using a rice sized amount of fluoride toothpaste. For children aged 3 to 6 years old, a pea-sized amount of fluoride toothpaste is recommended. If you prefer to use fluoride-free toothpaste, keep in mind that it will help clean teeth, but it will not protect teeth from tooth decay. The goal should be to brush twice a day by one year (or sooner if possible!)

About FirstGrin

Dr. Ashley Lerman started working at an extremely busy dental practice where she quickly recognized the amount of misinformation and lack of personalized information provided to parents for their babies on oral health, which inspired her to start Firstgrin (www.yourfirstgrin.com). Firstgrin helps improve the lives of caregivers and children by eliminating the surplus of information (and misinformation) about oral health care online by creating a central hub for education, products, and access. They send age and developmentally appropriate products to pregnant, peri-partum, and postpartum parents along with preventive oral health education, which are normally not covered in-office or in the pediatric medical setting.