Dental Dilemmas


Seeing that first tooth pop through of your baby’s little smile is one of those exciting milestones parents anticipate. But what happens when all of the other babies at playgroup are getting their pearly whites while yours is still all gums? And on the other side of the coin, what if your kiddo is 6 and you’re still waiting for the opposite milestone – the loss of a tooth?

 

As parents we can encourage brushing and good dental hygiene until the cows come home, but there are some aspects of tooth care and progression that remain a mystery. Much like everything else pertaining to kids, no two are exactly alike, and that’s certainly something to keep in mind before you start fretting. So relax, take a deep breath and let the experts address some common dental concerns all parents face.

 

My 1-year-old child still doesn’t have any teeth, should I worry?

 

For some babies, those little chompers start descending around 4 months, but that’s not the case for everyone. Take our own Senior Editor Cheryl Crosby: Each of her daughters had already passed their first birthdays before a tooth pushed through. So what’s the norm and when should you be concerned?

 

“The average age for a baby’s first tooth to appear (or ‘erupt’) is 6 months, but there is certainly much variation on either side of this,” says Dr. Kristine A. Grazioso, D.M.D., of South Shore Children’s Dentistry in Cohasset. “If your baby is a little early or a little late getting that first tooth, please don’t worry! It is recommended that your baby be seen by a pediatric dentist sometime around his first birthday. If his primary teeth have not erupted by this first visit, it is something for you to address with the dentist. Through an exam, she can give you a better idea as to what appears to be developing and if there are any concerns.”

 

My son (6) has friends who’ve all had visits from the tooth fairy, but no lost teeth here yet. Is that normal?

 

Your child has all of his baby teeth – congrats! But now you have a kiddo on your hands who’s about to start kindergarten and herein lies the concern as to why he hasn’t lost any teeth yet. It may feel like the tooth fairy has visited every single one of his friends but continues to skip over your house, what’s the deal?

 

“Most kids lose their teeth between 6 to 7 years of age,” says Dr. Htet Htet, D.M.D., of Kid Care Dental in Stoughton. “If teeth come in late, kids will lose teeth later. Being late does not mean anytime is wrong. There is a genetic part involved as well. If parents lost their teeth late, their kids could lose teeth later. If the child has not lost any teeth by age 8, an orthodontic consult is recommended. There might be some permanent teeth that are missing or erupting in the wrong way.”

 

I’ve heard if a child needs braces, 9 years is the magic age. Is that true?

 

There are a lot of “rules” out there pertaining to a child’s health (dental or otherwise) that have been around for so long it feels like they must be true. But just as getting and losing teeth depends on the kid, so does the need for braces.

 

“Your child is most likely being seen every 6 months by their pediatric dentist – she will let you know how their dentition is developing and when/if an orthodontic consultation is necessary,” says Dr. Grazioso. “Some children really can benefit by early orthodontic intervention, while others have no need.”

 
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Dr. Htet also mentions that in the past, when tooth removal was common in an effort to correct bite and allow for tooth movement, children didn’t begin orthodontic treatment until age 12 or 14. Now interceptive orthodontics is often encouraged and is helpful in that it takes advantage of continuing growth to allow for fewer teeth to be extracted. Still, don’t feel the need to rush.

 

“There is no harm in waiting; one can still get a good end result,” she says. “But you have to be open-minded about teeth removal and longer treatment time.”

 

How do I know if my child needs sealants?

 

Sealants can reduce cavities by up to nearly 80 percent, and up to 60 percent for four years or more.

 

“Sealants are perhaps one of the best weapons to prevent tooth decay on permanent molars,” says Dr. Grazioso. “‘Fissure sealants’ were originally introduced back in the 1960s. They are a protective coating that is placed on the occlusal, or biting, surface of the molars. When placed on clean, cavity-free teeth, sealants form an excellent barrier that prevents these teeth from experiencing tooth decay. Your child’s pediatric dentist will assess if his teeth are candidates to be sealed and make a recommendation accordingly. Although sealants are very effective, a healthy diet low in sugar, tooth brushing at least twice a day and daily flossing are also key in preventing cavities.”

 

Are electric toothbrushes better than manual ones?

 

Just because it makes a cool noise doesn’t necessarily mean an electric toothbrush is better. Dr. Grazioso and Dr. Htet like both.

 

“The goal of a good toothbrush is to remove plaque,” says Dr. Htet. “Both manual and electric toothbrushes are equally effective as long as the brushing technique is correct. Regular toothbrushes are cost effective and easy to travel with. For reluctant brushers, an electric toothbrush can motivate to brush due to their fun perks such as a timer, character theme and sound effect. For kids who lack manual dexterity, an electric toothbrush can be helpful to remove more plaque.”

 

Regardless of which type of brush you choose for your family, Dr. Grazioso suggests that a parent help a child brush her teeth until the age of 10. She also stresses the importance of flossing.

 

“In truth, the majority of the cavities that we see on children are between the teeth because of the difficulty in reaching these areas,” she says. “Floss is your best protection against this ‘interproximal’ decay. We encourage you to work with your child by using either the floss sticks or good, old-fashioned dental floss. The key, again, is consistency – you should help your child floss their teeth at least once a day. We generally recommend that this be done at bedtime. Once your child has brushed and flossed, we recommend that they then have nothing but water before bedtime or during the night.”

 

My kid refuses to use toothpaste because of the texture, no matter which flavor we offer!

 

Ah, the finicky kid who makes tooth brushing a fight – not exactly fun before school or bedtime. But, if this applies to your child, Dr. Grazioso encourages parents not to give up.

 

“As you know, there are a variety of toothpaste brands and flavors on the market – there are even some ‘flavorless’ options out there,” she says. “If nothing seems to appeal to your little one, I would recommend that you build up their tolerance to the taste and consistency. Begin by putting a tiny amount of toothpaste on the brush. Once your child has put the brush in their mouth and brushed for one second, reward them with praise or even something motivating such as a sticker. Each time they brush, increase the amount and time for them to earn your praise or a reward. The trick is to not give up – and to try and build them up!”

 

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21 Jan 2016


By Kelly Bryant
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