Q&A: Tips to improve your child’s oral health Published Jan. 26, 2015 By Capt. (Dr.) Brian Blackwell 92nd Aerospace Medicine Squadron Dental Clinic FAIRCHILD AIR FORCE BASE, Wash. -- February is Children's Dental Health month. Since parents often have questions for dental providers about caring for their child's developing teeth the Fairchild Dental Team would like to raise awareness to help parents establish habits that will ensure their child's oral health. There are often many questions from parents on how and when to start brushing their child's teeth. When should I start brushing my child's teeth? Oral care begins before the first tooth erupts. Initially, it is important to brush or wipe the infants' mouth once daily with a soft infant toothbrush or a damp cloth to help remove built up milk, and formula debris in the mouth, as well as reduce the risk of infection of the oral tissues. As soon as the first tooth erupts, parents should begin brushing the teeth and gums at least twice a day with a soft toothbrush. How much toothpaste should I use for my child? The American Dental Association and American Academy of Pediatric Dentistry recommend brushing with a rice grain size smear of fluoridated toothpaste once the child has erupted teeth and before the age of 3-years-old. From 3 to 6 years old, the ADA and AAPD recommend increasing to a pea-sized smear of fluoridated toothpaste. Parents should continue to assist with brushing through age 6 and beyond if needed. Also make sure the child is spitting out and not swallowing excess toothpaste. Should I be concerned about the spacing between my child's teeth? What about flossing? Once the child's teeth have erupted, parents often have concerns about the spacing between baby teeth. Spacing between baby teeth is actually a good thing and is not a reason to be alarmed. The extra spacing between the smaller baby teeth allows the larger adult teeth to have enough room as they come in later in childhood. If there are areas where spacing between baby teeth is minimal, it will be important to focus on flossing where the teeth are contacting. Flossing helps to remove and physically disrupt any plaque that builds up between the teeth. Removing the debris from between the teeth helps to reduce inflammation in the gums and minimizes the risk for cavities. I've seen other children my child's age with teeth; why doesn't my child have teeth yet? Parents sometimes have questions about delays in the eruption of their child's teeth as well as the possibility of missing teeth. The majority of disruptions in tooth development that severely affect the number of teeth a person develops is syndromic (i.e. associated with other symptoms or medical conditions) and are typically diagnosed before a child's first teeth will erupt. It is important to note that when dentists refer to tooth eruption times, it is often to the average age that teeth are expected to erupt. So a perfectly healthy child may have teeth that come in earlier or later than these averages. The timing of tooth eruption is often familial: so if mom, dad, siblings or cousins did not get teeth until later, there is a good chance the baby will not get his or her teeth until later as well. What do I need to know about teething? Teething is probably the issue of greatest concern to parents. It is a long process that begins in infancy and continues into childhood. Teething generally starts between 4 and 6 months of age. The child begins to salivate more, having red and tender gums in the area of the erupting teeth, and being more irritable. The AAPD recommends using analgesics (Tylenol or other suitable alternative) and chilled teething rings to manage the child's symptoms. Oral anesthetics (such as Orajel) are discouraged due to risk of toxicity in infants. The first teeth to appear are generally the lower central incisors around 6 months of age. The child will have a full set of baby teeth (20 in total) by around 30 months of age. At around 6 years old, the first permanent molars erupt behind the last baby teeth and are therefore the first adult teeth present in the mouth. The first permanent molars do not replace any baby teeth and so these will generally erupt before the child starts losing any of their baby teeth. What can I do to prevent cavities? Finally, the effect of diet on the child's teeth is another concern for parents that can span from infancy to childhood and beyond. Cavities are caused by increased acidity in the mouth which dissolves the outer enamel layer of the tooth. Acidity in the mouth is increased after the consumption of foods with high sugar and carbohydrate content. Bacteria in the mouth processes those sugars and creates acidic byproducts that break down the teeth. Below are a few dietary tips for parents to help reduce cavity risk in their child. - Avoid sugary foods and beverages (for instance, juice or soda); also, minimize foods and beverages that are already very acidic (such as energy drinks and diet sodas). - Do not give the child sippy cups of milk or juice to drink throughout the night; instead give water only. - Try to limit frequent snacking, especially on sugary or high-carbohydrate foods. - Be wary of very sticky foods that are high in sugar and tend to be retained on the teeth such as dried or gummy fruit snacks. The staff of the Fairchild Dental Clinic hope these tips and insights will be helpful in raising awareness and concern for children's oral health amongst Airmen and their families during the month of February. For more information on dental health contact the 92nd Aerospace Medicine Squadron Dental Clinic at (509) 247-2362.