When should I start brushing baby's teeth?
Start at 4 months which is before most babies have teeth. I recommend using an extra soft tooth brush for babies (Oral B has good ones). Gently brush the gums, massaging the gum tissue which feels good! If baby chews on the brush a little, its okay. That's also why I don't recommend the finger tooth brush because baby may chomp on your finger and those little gums hurt!
Incorporate brushing into the daily bath time/ face washing routine. Then, when baby's teeth come in they won't object to brushing because it will already be part of their day. Babies will tend to fuss less if they are used to daily brushing. Even if they do cry, it's okay because then you can really see in their mouth to brush! It is better for baby to cry a little with daily brushing then cry a lot having cavities filled! I find that parents who don't brush because their baby or toddler cries usually will have a child who has several cavities.
Toothpaste: Yes or No?
I personally recommend using the tiniest amount of children's toothpaste possible once baby has a tooth or teeth. Swipe a hint of toothpaste on the brush and then gently brush all surfaces of the tooth/teeth. This amount is so small that it won't be harmful even if it is swallowed. Then baby will be used to the flavor of toothpaste and won't object to it later. I have seen kids fight and refuse tooth brushing when toothpaste is introduced. I used a miniscule amount fluoridated toothpaste on my kids everyday, and they are cavity free. Although fluoride use is considered safe at appropriate doses, it can be very controversial to some. Therefore, use your own discretion about choosing toothpaste.
There are a lot of anecdotal reports about fluoride being harmful. However, the only real documented problem with excess fluoride is dental fluorosis. This is when excess fluoride is taken up into the structure of permanent teeth and causes white or brown spots. Although it may be unsightly, dental fluorosis is not harmful. It can also be treated cosmetically with micro-abrasion, up to having the teeth crowned or capped as an adult.
While it is true that fluoride can be poisonous if an overdose is taken, it is extremely difficult to do.
A fluoride overdose is equal to 5mg/kg or 340 mg for a 150 lb adult. According to the American Dental Association or ADA, there is 192 to 211 mg fluoride in a large (6.4 oz.) tube of toothpaste and 138 to 152 mg fluoride in a small (4.6 oz.) tube of toothpaste. Therefore, one would have to consume at least 2- 3 tubes of toothpaste to overdose. Fortunately we have natural protection against this because excess fluoride combines with stomach acid to make Hydrofluoric acid, which automatically induces vomiting. Thus, there are no known or reported deaths/ overdoses from ingesting too much fluoride.
Yes, baby teeth can get cavities!
Cavities form when the germs that cause cavities take the sugar from the foods you eat or drink, make acid, which then erodes the teeth. Even milk or formula can cause cavities because there is sugar in milk/formula called lactose. Sugar bugs (cavity causing bacteria) can use that sugar to cause cavities.
That is why dentists and pediatricians do NOT recommend putting baby to sleep with a bottle of milk or juice. This can result in severe tooth decay, especially in the front teeth also known as "baby bottle rot". It is best to only give water in bottles at bed time. Also, be sure to brush baby's teeth before putting them down at night. What about night time feeding? Most babies are able to sleep through the night by the time they have several anterior baby teeth.
I used to give my children a bedtime snack once they started on solid food. After snack, I made sure to brush their teeth. This little meal would often hold them until morning without the need to wake up for a bottle. However, if an older baby knows he/she will get a bottle when they cry in the middle of the night, they won't grow out of it. I've seen babies 18 months who still wake up at night for a bottle!
Baby teeth are important! As you may know, baby teeth are instrumental for chewing and talking. They also are involved in the proper growth and development of the jaws. Baby teeth are necessary to save space for un-erupted permanent teeth. A baby tooth usually remains in the child's mouth until a permanent tooth underneath it is ready to erupt through the gums. The roots of the baby tooth dissolve and the tooth becomes loose and falls out. Then the permanent tooth "comes up" a few weeks later. If a child loses a tooth too early--before the permanent tooth is ready to erupt--or if it is accidentally knocked out, or is removed by the dentist because of disease, the space must be saved. A space maintainer can be inserted to hold the place of the "baby tooth" until the permanent tooth is ready to emerge. If not, the permanent tooth could be trapped below the gum and bone and may need surgical and orthodontic intervention to come into proper position.
When should you stop letting baby use a pacifier or suck their fingers/thumb?
This is a touchy subject! I had one child who used a pacifier and one who sucked her fingers. I will say, I preferred the pacifier because they could be disinfected and eventually thrown away! Finger sucking habits can last a LONG time, or indefinitely without intervention. That being said, babies soothe themselves by sucking pacifiers or fingers when they are small and that is a good thing.
I encourage parents to start talking to their toddlers about stopping the pacifier habit at 2.5 years. They may not stop then, but they do understand and often you can reason with them or bribe them to stop. My daughter gave up her pacifier in exchange for a new toy. Mercifully she chose Candy Land! I would definitely try to have them stop using pacifiers/ sucking fingers by 3 years old at the latest. Prolonged use of pacifiers or finger sucking can cause the bones in the upper jaw to malform and anterior teeth to flare. This may require orthodontics or surgery to correct their bite in the future.
I also recommend parents talk to children about finger sucking habits at 2.5-3 years of age. It may require intervention though because as stated earlier, you can't throw fingers away. I recommend using a product called the T-guard. You can view and purchase it online with the link to the left. Here is the description of how it works from the website, "Rather than trying to prevent thumb sucking, its patented technology allows it: but without the suction that creates the pleasure. If you break the suction, you break the habit! With a success rate greater than 95% "
I have parent testimonials who bought this product and found it very effective in stopping a finger sucking habit in their children. I did not have to resort to using a T-guard with my youngest because she started telling us she didn't suck her fingers anymore. When we caught her and pointed it out, she'd get upset so eventually she stopped on her own! As she used to say, "I'm not a baby!"
When should I schedule baby's first visit to the dentist?
According to the American Academy of Pediatric Dentistry, " It is recommended that the child be seen by a pediatric or general dentist at the time the first tooth comes into the mouth, and no later than the child’s first birthday."
This may be ideal, however the reality can be altogether different. I do not discourage parents who want baby to be seen that young. However, parents may be disappointed that their child may not fully cooperate for a dental exam and cleaning at one years old. We try to inspect the teeth as best we can and brush using a soft toothbrush instead of the polisher we usually use. We find that some babies will accept the toothbrush better because it doesn't make noise. Also, hopefully the parents have been brushing at home so it is a not totally new experience for the child. Baby may feel more comfortable sitting in a parent's lap in the dental chair or being examined laying on a parent's knees, laying back toward the dentist as above.
At baby's first dental visit, we also reinforce home care habits such as brushing morning and night. We recommend parents avoid giving babies cavity-causing foods like candy, fruit snacks, sugary drinks (sweet tea, kool aid, sports drinks), and acidic fruit juices such as orange, grapefruit. That often also means having a serious talk about diet with well-meaning, but over-indulgent grandparents.
We strongly advise parents to prepare baby prior their first visit to the dentist by reading books or watching children's movies about going to the dentist. There are many titles starring the latest cartoon characters available at the local library. Also we recommend letting your child watch an older sibling or cousin at a dental visit IF that child is well behaved and calm during their cleaning visit. Watching family members or friends in the dental chair demystifies the visit and young children are often look forward to having "their turn" to get their teeth cleaned.
Hopefully I have touched on most of the major questions parents have about caring for baby teeth. If not, please feel free to contact me with any concerns. I may be reached via email: info@currydentalcenter.com.
Happy Smiling!
