How to keep one- to three-year-olds cavity free

By Maj. Matthew Eusterman, DDSFebruary 13, 2019

Children's Dental Health Month
My name is Dr. Matthew Eusterman (call me "Dr. E"), and I am your garrison pediatric dentist at Vicenza Dental Clinic. February is Children's Dental Health Month and I want to take this opportunity to give parents critical information to create a cav... (Photo Credit: U.S. Army) VIEW ORIGINAL

VICENZA, Italy (February 13, 2019) -- My name is Dr. Matthew Eusterman (call me "Dr. E"), and I am your garrison pediatric dentist at Vicenza Dental Clinic. February is Children's Dental Health Month and I want to take this opportunity to give parents critical information to create a cavity-free home from the youngest ages.

Here are my top tips for infants and toddlers related to dental health:

Baby bottle cavities

Parents may ask, "Do infants and toddlers get cavities?" and, unfortunately, the answer is a sad "yes." The majority of cases I have had to treat at these younger ages are almost entirely related to bottle usage in the crib.

Well-intentioned parents desiring a sound sleeping baby will put their child to bed with a bottle of milk. During the night the child drinks the milk to stay asleep and, in turn, bathes the teeth in sugar-causing cavities. This can also happen with breast milk when the child nurses throughout the night.

Rule of thumb: Never put your child to bed with anything in the bottle except water.

Cavities are contagious

Yes, you heard me right. Cavities are caused by bacteria, and when your child was born his mouth was bacteria free. During the first years of life, a child acquires bacteria from their surroundings. "Who" is their surroundings these early years? Parents and siblings.

If mom, dad, sister or brother have a history of cavities, this means they have a type of bacteria that can cause cavities. If anyone in the home has active cavities, this is when it is easiest to pass the bacteria to other people through their saliva.

Rule of thumb: Don't share saliva by sharing cups, spoons or anything else, and make sure all untreated cavities in the family are treated promptly.

Not just candy

Many people think that if they avoid sweets, they will avoid cavities. This is only a little bit true. In the second tip, we learned that bacteria cause cavities, but how? Bacteria living in the mouth need food to survive and they rely on your child's diet to flourish. However, they can only eat fermentable carbohydrates (simple carbohydrates or processed carbs), and the most common foods in this category are crackers, breads, pastas, chips, fruits, juices and, yes, candy.

So never eat these kinds of carbs? No. I feed my children these kinds of carbs, but infrequently. In order for the bacteria in a child's mouth to create cavities, they need these carbs frequently throughout the day.

Rule of thumb: Keep the fermentable carbs only at mealtime, brush right after meals, and choose low-carb or carb-free snacking. The best kind of cavity-free snacks are cheese, meats, nuts, natural peanut butter and fibrous veggies like carrots, celery and broccoli. Not only are these snacks healthier, they will also fill your child up and your child will snack less.

Fluoride

Unlike water in the United States, water in Italy is not fluoridated (this includes Caserma Ederle, Caserma Del Din and Villaggio). Fluoride water is available through specific brands of bottled water at the commissary or the large jugs found through the PX Express (just look for red caps or read labels).

Fluoride serves two purposes -- it has an antibacterial effect and it strengthens enamel making it more resistant to acid produced from bacteria. In very small doses (as in fluoridated water or toothpaste) it will not harm the body and help keep your child's mouth cavity free. Fluoride toothpaste is also a great way to defeat cavities at home.

For children 1-3 years old, I recommend using only a very small smear of toothpaste while brushing twice per day. For those older than three who can spit out toothpaste, use a pea-sized amount twice per day.

Rule of thumb: Make sure your child has regular fluoride coating their teeth.

First dental exam

If you are reading this and you have a 1- to 3-year-old who has not been to the dentist yet, now is the time. The major focus of these first appointments is education and prevention. I want to make sure your child has the best start to living a life free of oral health problems.

Rule of thumb: The American Academy of Pediatric Dentistry recommends that a child's first dental visit should take place by the first birthday or within six months of the first tooth.

I hope these tips have been informative and will help you create a healthy dental home for your infant or toddler. For more helpful information regarding your child's dental health, visit the American Academy of Pediatric Dentistry at aapd.org. I hope to see you in the near future.

Your Vicenza Pediatric Dentist,

Maj. Matthew Eusterman, DDS

Editor's note: This article was previously published in the Outlook newspaper and online at www.army.mil. It was updated by Dr. Eusterman in preparation of Children's Dental Health Month.

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