ABERDEEN PROVING GROUND, Md. – From the moment a child is born, parents want to do everything to ensure that the child has a healthy outcome throughout each stage of development. However, many parents are unaware that being healthy includes having good oral health.
A child’s oral health care should begin prior to the eruption of the first primary, or baby, tooth, which occurs around the age of six months.
A widely held belief is that baby teeth are unimportant because they will be replaced by permanent teeth. Previous research has indicated that this belief is associated with adverse health habits and outcomes such as less frequent tooth brushing, lower likelihood of annual dental checkups, and increased likelihood of the child having dental cavities in primary and permanent teeth.
Many are unaware that baby teeth contribute to a child’s physical, emotional and social development. Importantly—
- Healthy baby teeth contribute to healthy dietary habits. Children need a healthy diet in order to grow strong and thrive. Primary teeth are necessary for the development of chewing and swallowing habits needed to absorb nutrition from food. Dental pain from cavities can lead to nutritional deficiencies if the child is unable to chew food properly. Toothaches and cavities make crunchy foods, such as fresh vegetables and fruits, more difficult to consume.
- Dental pain can make it difficult to focus on school work. The Centers for Disease Control and Prevention reports that children with poor oral health are more likely to be absent from school and have lower grades than children with good oral health. Left untreated, large cavities can lead to dental abscesses (pockets of pus and swelling around teeth and gums), which are infections that can potentially spread to other areas of the head and neck and lead to serious medical complications.
- Baby teeth are necessary for proper speech development. The teeth work together with the lips and tongue to form words. Children with missing teeth have difficulty making “th”, “la”, and other sounds. Delayed eruption of baby teeth, premature tooth loss due to cavities or trauma, and teeth crowding can affect one’s speech development and articulation techniques during childhood and beyond.
- Cavities and bad breath can affect a child’s self-esteem. A child may avoid smiling or participating in group activities. Children with decayed, fractured, or crowded teeth may become self-conscious about their appearance as the result of comments from other children. Having a healthy smile can increase the self-confidence a child needs for good social experiences and interactions.
- Baby teeth serve as place holders for properly aligned permanent teeth. Premature loss of the primary teeth can lead to crowding and impaction of permanent teeth. Primary teeth should remain in the mouth until they loosen and are pushed out when it is time for the permanent teeth to emerge into the arch.
- It is normal to have spaces between the front primary teeth. These spacings, referred to as primate spaces, serve as placeholders for permanent teeth. The absence of primate spaces may signal future crowding in permanent teeth. When primary teeth are lost prematurely, a space maintainer may need to be placed in the child’s mouth. If the space is not preserved, remaining teeth can drift towards the space. Failure to maintain spacing could lead to expensive orthodontic and surgical treatment when the permanent teeth emerge.
- Tooth decay is the most common chronic childhood disease. It is also the most preventable disease. Parents should understand the importance of their child’s baby teeth and start the child’s oral health care early to help decrease the occurrence of this disease. This includes daily teeth cleaning habits and regular dentist visits. The CDC recommends parents ensure use of fluoridated water and talk to their dentists about placement of dental sealants during checkups.
As a dentist, I am often asked the following questions by parents—
How do I begin oral health care during infancy?
Dental care should begin prior to the eruption of the first tooth into the mouth. Parents should use a damp gauze or cloth or an infant toothbrush to wipe away milk, juices and baby food from the gums. If the child is teething, consider freezing or refrigerating the cloth for a few minutes before use, as the coolness can soothe irritated gums.
How do I start cleaning my baby’s teeth?
The American Academy of Pediatric Dentistry recommends brushing with a rice grain-sized amount of fluoridated toothpaste and an age-appropriate toothbrush when the teeth begin to emerge. The amount of fluoride is small enough to avoid causing an upset stomach if the toothpaste is swallowed.
Does it matter if an infant/toddler falls asleep with a bottle of milk?
While milk is the main source of nutrition during infancy, it is high in sugar – like juices. Milk contains a sugar called lactose and can cause tooth decay. This is why letting a child fall asleep with a bottle of milk or juice is highly discouraged. When a child sleeps with a bottle in the mouth, the liquid pools around the teeth. The sugar from the milk combines with the bacteria in the mouth to form acids which attack and break down tooth enamel and cause cavities.
If the child insists upon having a bottle to fall asleep, water is the best liquid substitute. If the child loudly protests this change from milk to water, then the substitution can be done gradually by decreasing the amount of milk and increasing the amount of water.
How soon should a child see a dentist?
The AAPD recommends children see a dentist by the age of 1 year. The first appointment is quick, fairly easy, and designed to be an enjoyable experience for the child.
You can learn more about oral health for your child at the CDC website
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