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Teeth and Bite Q&A for Parents

By Jason Gonzalez, DDS & Stephen Tanner, DDS

As parents, we have questions about everything, including oral health. When should I schedule my child’s first trip to the dentist? Should my 3-year-old be flossing? How do I know if my child needs braces?

Many parents struggle to judge how much dental care their kids need. They know they want to prevent cavities but do not always know the best way to do so. According to the CDC, more than half of children aged 6 to 8 have had a cavity in at least one of their baby (primary) teeth, and more than half of adolescents aged 12 to 19 have had a cavity in at least one of their permanent teeth.

Unlike sharks that continually shed their teeth (some Carcharhiniformes shed approximately 35,000 teeth in a lifetime, replacing those that fall out), we humans only get so many teeth! We know that parents want to keep their kids’ teeth healthy as they grow, so we asked the experts to answer some common questions parents have about oral health.

Q: How should I clean my baby’s teeth?

A: A toothbrush with soft bristles and a small head, especially one designed for infants, is the best choice for babies. Brushing at least once a day, at bedtime, will remove plaque bacteria that can lead to decay.

​Q: What is baby bottle tooth decay, and how can I prevent it?

A: Baby bottle tooth decay is a pattern of rapid decay associated with prolonged nursing. It happens when a child falls asleep while breastfeeding or bottle-feeding. During sleep, the flow of saliva is reduced, and the natural self-cleansing action of the mouth is diminished. Avoid nursing children to sleep or putting anything other than water in their bedtime bottles.

Q: When should I schedule my child’s first trip to the dentist?

A: The American Academy of Pediatric Dentistry gives the following recommendation: To prevent dental problems, your child should see a pediatric dentist when their first tooth appears or no later than their first birthday. Cavities can start very early, and it is best to have the dentist catch them before they begin to hurt or compromise the structure of the teeth. Also, the sooner infants are introduced to dental cleanings, the more comfortable they will be as it becomes a part of a semi-annual routine.

Q: Should my 3-year-old be flossing?
A: This depends on when and where you see your child’s first teeth touch. The first teeth to touch might be your child’s baby molars or their first two front teeth. Generally, the back teeth start touching at the age of 3. Use your judgment, but as with brushing, it is important to start young to develop a flossing habit.

Q: I am worried about all the spacing between my 5-year-old’s front baby teeth. Is there a problem?

A: Great news! Adult teeth are larger than baby teeth, sometimes significantly larger, so extra space is a good sign for successful future eruption. You should worry when baby teeth are perfectly lined up with no visual space between them.

Q: I cannot get my kid to brush their teeth for very long. What can I do to keep them brushing?

A: It is common for kids not to brush their teeth long enough. Try singing a song, setting a timer, or coming up with another creative way to keep your child engaged in brushing for the recommended two minutes (or at least for long enough that your combined efforts leave their teeth clean).

Q: Is it okay for my 7-year-old daughter to suck her thumb? It allows her to relax and fall asleep at night.

A: It may be comforting for your child, but ongoing sucking habits cause damage to the palatal vault and teeth. The longer the habit persists, the greater the changes and the more difficult it is to correct the damage. Ideally, sucking habits should stop before the eruption of the adult incisors.

Q: I am not concerned about the crowding in my 10-year-old daughter’s mouth. She is still growing, and her jaws will get bigger. She will grow into her teeth, right?

A: The truth is that our jaws are 80% of their adult width by age 6 and nearly 100% by age 10. Without early intervention, crowding will worsen as the remaining permanent teeth erupt between the ages of 10 and 12.

Q: How do I know if my child needs braces?

A: Typically, one can diagnose crowding or an overbite in a child’s mouth without a dental degree. Bringing this up with the dentist at your child’s cleaning appointment can give you answers about the ideal time to get braces. The answer might be “now” or “we should wait and see if losing more baby teeth creates more room.” Sometimes the dentist will use diagnostic tools to answer this question, like X-rays to determine if teeth are impacted or missing. With a complete picture, the dentist can recommend braces or orthodontic treatment to prevent any developmental problems in the future.

Q: My child’s teeth have always been slow to erupt. Should I be worried if my 14-year-old son does not have his adult canine teeth?

A: There may or may not be a problem; delayed eruption aside, impacted canines are common and can be avoided by taking early steps to encourage their eruption. X-rays of the unerupted teeth may be warranted to see if there is an underlying issue.

Q: My daughter is so excited; she wore her retainers for two years! Is she done with her orthodontic treatment?

A: Unfortunately, no! Wearing retainers and keeping your teeth straight is a lifelong commitment. If you stop wearing your retainers, your teeth can potentially shift back to their original position. Keep wearing them at night to maintain that beautiful smile!

Q: My child plays sports. How should I protect their teeth?

A: A mouth guard should be a top priority on your child’s list of sports equipment. Athletic mouth protectors, or mouth guards, are made of soft plastic and fit comfortably to the shape of the upper teeth. They protect a child’s teeth, lips, cheeks, and gums from sports-related injuries. Any mouth guard works better than no mouth guard, but a custom-fitted mouth guard created by a dentist is your child’s best protection against sports-related injuries.

Q: What should I do if my child knocks out a permanent tooth?

A: First of all, remain calm. Find the tooth, if you can, and pick it up by the crown (top) rather than the root. Try to replace the tooth in the socket and hold it in place with clean gauze or a washcloth. If you cannot put the tooth in the socket, place it in a clean container with milk or water. Take your child and the tooth to the pediatric dentist immediately. Time is essential, so the faster you act, the better your chances of saving the tooth.

As kids grow, plan on routine dental checkups anywhere from once every three months to once a year, depending on your dentist’s recommendations. You can encourage good dental health by keeping sugary foods and sodas in check, encouraging regular brushing and flossing, and working with your dentist. If you are looking for more dental educational activities, the American Dental Association has free resources like activity sheets, coloring pages, and holiday crafts at mouthhealthy.org.

Jason Gonzalez, DDS: Dr. Jason is a pediatric dentist who loves living in Santa Fe. He is also a magician, loves his family, and enjoys woodworking.

Stephen Tanner, DDS: Dr. Steve is an orthodontist who loves animals and being outdoors. You will often find him traveling to each coast to visit his two daughters.