Parents often ask us when they should start taking their kids to the dentist. Believe it or not, the current official recommendation now is that your child should have his or her first dental visit by age one.
In California, about one third of preschoolers have dental decay. It is much easier to prevent decay in toddlers' teeth than to fill a cavity in a young child. Tooth decay is the most common chronic childhood disease and it can be prevented.
As parents, we may think, "baby teeth fall out, so we don't need to worry about them." This sounds logical, but unfortunately is not true. Luckily, dental science has found out many new facts about how to prevent dental decay. We now know that bacteria causes tooth decay. This "bad" bacteria can find its way into your babies mouths in many ways. Eating foods high in sugar is one of the most obvious offenders. In order to prevent decay in our adult teeth, baby teeth have to be kept healthy as well.
What can you do to keep your child's teeth healthy right from the start? For the youngest babies with brand new teeth you can wipe them off with a soft piece of gauze or a wet wash cloth. Not only are you cleaning off the teeth, (breast milk does have sugar) but you are getting the baby used to a routine. Training your child from the start that teeth get brushed is a good way to create good dental habits that will last a lifetime.
There are other options besides the standard hand held toothbrush. For very young babies there are little flavored towelettes specially formulated for wiping baby teeth. Spiffies was the first of these that I was familiar with. Now there are several brands available.
You could also consider using a soft finger brush. These fit over your finger and if your baby will let you, they allow you to get in there and do a nice thorough job.
If you use a regular toothbrush, make sure it has soft bristles. Replace the brush when it looks like the bristles are getting worn. It is also a good idea to run all the family toothbrushes through the dishwasher every once in awhile. One extra perk about routine dental care is that you might walk out of the dentist's office with a new toothbrush! Younger children will have an easier time handling a toothbrush with a thicker handle.
Perhaps you can let your child be in charge for one brushing a day and the parent be in charge of the other; that way you know you are doing a more thorough job at least once a day. Some people use a two toothbrush approach. Toddler gets to hold one, but so do you. Both of you can be in there at the same time.
Consider putting a little tune on while you brush. This can act as a timer. Brushing is ideally supposed to last 2 minutes. Do the best you can. A full two minutes might be a goal that is a little unrealistic for many of my patients.
You can sing...but don’t dance!!
I just had a patient who got a fairly serious mouth injury from doing a little rough housing while brushing his teeth. Make sure your child isn’t running around with a toothbrush in the mouth.
The old recommendation was to use non fluoride toothpaste for kids younger than two years. The new suggestion is to actually use a tiny amount (just a little dab) of fluoride toothpaste. It is important to note that too much can be harmful so keep the amount tiny. Once kids get to be over two and can spit it out after brushing, you can use a pea sized amount. Xylitol is another recommended ingredient for dental health. It is found in some toothpastes. This natural sweetener is found to help reduce bacteria and strengthen tooth enamel.
It is important to use a toothpaste that is non abrasive. Most kids brands are specially formulated to be gentle. Some adult ones are fine. Most toothpastes will have the abrasive rating noted on the package. Ideally try to brush twice a day and floss once a day (for teeth that are touching.)
Pay attention to habits that may or may not be good for your teeth. Children who are “grazers” tend to have more cavities than the those who eat less frequently. Saliva neutralizes the acids in the mouth and actually ‘washes’ the teeth, but it needs about 2 hours in between meals to work. If someone is constantly eating, the saliva isn’t getting a chance to do its job.
Foods that are high in carbohydrates and sugar are not healthy for our teeth or general health. A daily intake of 60 grams of carbs or higher more than doubles your chance of getting caries (and all that sugar can lead to type II diabetes in kids!)
FINDING A DENTIST
Find a dentist that treats very young children and bring your child to his or her first appointment when the first teeth erupt - no later than by age one. During the visit, the dentist will check your child for dental decay and talk to you about cleaning your baby's teeth. They might also talk to you about proper nutrition for keeping baby teeth healthy.
If you have any concerns about the manner in which the teeth are erupting, having a dentist who is familiar with your child will be very useful.
Another important thing to think about is that having a dentist can come in very handy if you happen to have any dental emergencies. Kids have accidents! It is not unusual for me to get calls about chipped or loose teeth after a fall. I usually suggest that they contact their dentist on those occasions, and the folks that already have one are way ahead of the game. If there is a dental emergency, early intervention can be the difference between saving the tooth or losing it.
Some parents avoid taking children to the dentist to save money, yet studies show that the dental costs for children who have their first dental visit before the age of one are 40 percent lower in the first five years of life than for those who do not see a dentist before their first birthday. Consider this when deciding whether or not to add your child to your dental plan (if you are lucky enough to have one.)
We are fortunate to have lots of excellent choices in our city. Below is a partial list of dentists who we send patients to. If someone is conveniently located or is on your insurance plan that is certainly worth consideration.
If you have a favorite dentist who you think should be included on my list, let me know!
David Rothman 415-333-6811 is over on Ocean avenue near Stonestown. He was my kids' dentist and they loved him. He is an excellent dentist with a wonderful sense of humor. His office is able to do procedures under general anesthesiology in the office if needed.He remains my "go to" guy if I have any tooth related questions.
Bergen James, Doris Lin-Song and Jennifer Yu 415-668-3500 They are located on Parker Street near Laurel Village. Love dogs? They have a couple in the office! Dr. Kaplan uses this office for her son and gives them two thumbs way up.
Claudia Masouredis 415-753-2777 is fairly close to our office, just up the hill on Portola. Nurse Jen brings her kids here and they adore her. Dr Masouredis can also do procedures in her office that require sedation.
Dorothy Pang 415-681-8500 is on Taraval and 18th in the Sunset. Dr. Pang is affiliated with the UCSF dental school. If someone needs a dental procedure under anesthesiology she can do this at UCSF rather than in the office.
Raymond Katz 415-751-7900 This practice is at 5233 Geary. We have plenty of patients who have been using these folks and only have nice things to say about them. Dr Schwanke used to take his girls over there when they were young.
Han Pediatric Dentistry 415-681-3220 Dr. James Han’s office is at 1530 Noriega Street. Dr Han is also on staff at CPMC and attends any dental emergencies at the ER there. He can perform general anesthesia cases in the OR there as well. www.
Dr. Charles Spitz and Dr. Tyler Davis 650-375-8300
Peninsula Pediatric Dentistry and Orthodontics. If you are looking for a practice down on the peninsula, this great practice is located in San Mateo. Dr. Davis works with Dr. Spitz, who used to have a practice in the Mission. They are located in the Mills Medical Arts building on the corner of South San Mateo Drive and 2nd Avenue in downtown San Mateo.
"We are a preventative practice first and foremost. We believe the best dental care is personalized to meet the individual needs and preferences of each child we see. We work hard to get to know our patients and their families. We're always willing to listen, to discuss options and to answer your questions."
Help your child keep their shining healthy smile! If you need assistance in finding a dentist, or low-cost children's health insurance in San Francisco, please call the Women and Children's Health Referral Line @ 1-800-300-9950.
RECAP: Tips for Healthy Teeth
- Take your child to a dentist twice a year; starting by age one
- Brush your child's teeth everyday; as soon as they come in
- Make those snacks healthy ones
- Take care of your own teeth; adults can spread cavity-causing bacteria to children
- Never let your baby have a bottle or cup in bed that has anything other than water
Daddy Adam sent me this tip:
He used a kids bluetooth sonicare toothbrush, which has a corresponding app on the iPad. It gives you a little creature that you need to take care of, and you not only clean the critter's teeth when you brush yours, but you also get food and treats to feed it. His daughter Millie loved it, and it made brushing super easy. They no longer use the app very frequently anymore, but the brushing routine is ingrained.