Craig N. Fievet, DMD

Congratulations on the arrival of your baby! Are you prepared for the arrival of your baby's first tooth? Follow these guidelines, and your baby will be on her way to a lifetime of healthy smiles!

Caring for Gums
Even before your baby's first tooth appears (or, in dental jargon, "erupts"), her gums can benefit from your careful attention. After breast- or bottle-feeding, wrap one finger with a clean, damp washcloth or piece of gauze and gently rub it across your baby's gum tissue. This practice both clears your little one's mouth of any fragments of food and begins the process of building a good habit of daily oral care.

Baby's First Tooth
When that first tooth makes an entrance, it's time to upgrade to a baby toothbrush. There are usually two options: a long-handled toothbrush that you and your baby can hold at the same time, and a finger-puppet-like brush that fits over the tip of your pointer finger. In each case the bristles are soft and few. At this stage, toothpaste isn't necessary; just dip the brush in water before brushing. If your little one doesn't react well to the introduction of a toothbrush, don't give up; switch back to a damp washcloth for a few months, then try the toothbrush again. During the teething process your child will want to chew on just about anything – a baby toothbrush with a teether can become a favorite toy during this period.

Brushing with Toothpaste
When a few more teeth appear, you can start using toothpaste with your child's brush. However, for the first three years, be sure to choose toothpaste that does not contain fluoride, because too much fluoride can be dangerous for youngsters. At this stage, use only a tiny amount of toothpaste. From the beginning, have your little one practice spitting the toothpaste out after brushing, to prepare her for fluoride toothpaste, which should not be swallowed at any age.

Avoiding Cavities
Don't give your baby any sort of sweetened liquids such as flavored drinks or soda. Even the sugars present in fruit juice, formula, and milk (this goes for breast milk as well) can cause decay, so regular tooth and gum cleaning is vital. Also, make sure your baby never goes to bed with a bottle – sugary liquids in prolonged contact with her teeth are a guarantee for early-childhood decay, also called baby-bottle caries.

First Visit to the Dentist
It's recommended that you bring your baby in for the first visit around three years of age unless you notice a problem or discoloration with a tooth before that age. Since decay can occur in even the smallest of teeth, the earlier your baby visits us, the more likely she is to avoid problems. We'll look for any signs of early problems with your baby's oral heath, and check in with you about the best way to care for her teeth.

Remember that preparing for each dental visit with a positive attitude goes a long way toward making your child comfortable with regular checkups.

Setting a Good Example
As part of the natural learning process, little ones are expert mimics, and you can take advantage of this talent. Brush and floss daily while your child is watching, and she'll intuit at an early age the importance of your good habits. As soon as she shows interest, give her a toothbrush of her own and encourage her to "brush" with you. (You'll find toothbrushes with chunky, short handles that are easy for her to grip.) Most children don't have the dexterity necessary to thoroughly clean their own teeth until they're about six or seven, so you'll have to do that part of the job for her. Try different tactics to make brushing fun: flavored toothpaste, a toothbrush with a favorite character on it, singing songs about brushing.

The primary goal is to instill healthy oral habits at an early age to set your child up for a lifetime of healthy, cavity-free teeth!

Along with favorite blankets, teddy bears, and nap time, thumb sucking can be one of the most comforting aspects of childhood. According to a recent report, between 75% and 95% of infants suck their thumbs, so chances are there's a thumb sucker (or a former thumb sucker) in your family. Is this cause for worry? In most cases, no. However, it's important to pay attention to your child's habits, in case his behavior has the potential to affect his oral health.

What Is Normal Thumb Sucking Behavior?

The majority of children suck a thumb or a finger from a very young age; most even start inside the womb. Sucking is a natural reflex for an infant, and it serves an important purpose. Sucking often provides a sense of security and contentment for a young one. It can also be relaxing, which is why many children suck their thumbs as they fall asleep.

According to the American Dental Association, most children stop thumb sucking on their own between the ages of two and four. They simply grow out of a habit that is no longer useful to them. However, some children continue sucking beyond the preschool years (although studies show that the older a child gets, the lower his chances of continuing to suck his thumb). If your child is still sucking when his permanent teeth start to erupt, it may be time to take action to break the habit.

What Signs Should I Watch For?

First, take note of how your child sucks his thumb. If he sucks passively, with his thumb gently resting inside his mouth, he is less likely to cause damage. If, on the other hand, he is an aggressive thumb sucker, placing pressure on his mouth or teeth, the habit may cause problems with tooth alignment and proper mouth growth. Extended sucking affects both the teeth and the shape of the face and may lead to a need for orthodontic treatment in the future.

If at any time you suspect your child's thumb sucking may be affecting his oral health, please give us a call or bring him in for a visit. We can help you assess the situation.

How Can I Help My Child Quit Thumb Sucking?

Should you need to help your child end his habit, follow these guidelines:

1. Always be supportive and positive. Instead of punishing your child for thumb sucking, give praise when he doesn't suck.
2. Put a band-aid on his thumb or a sock over his hand at night. Let him know that this is not a punishment, just a way to help him remember to avoid sucking.
3. Start a progress chart and let him put a sticker up every day that he doesn't suck his thumb. If he makes it through a week without sucking, he gets to choose a prize (trip to the zoo, new set of blocks, etc.) When he has filled up a whole month reward him with something great (a ball glove or new video game); by then the habit should be over. Making your child an active participant in his treatment will increase his willingness to break the habit.
4. If you notice your child sucking when he's anxious, work on alleviating his anxiety rather than focusing on the thumb sucking.
5. Take note of the times your child tends to suck (long car rides, while watching movies) and create diversions during these occasions.
6. Explain clearly what might happen to his teeth if he keeps sucking his thumb.

Whatever your method, always remember that your child needs your support and understanding during the process of breaking the thumb sucking habit.

Adopting Healthy Oral Hygiene Habits
As new teeth erupt, examine them every two weeks for lines and discoloration caused by decay. Remember that sugary foods and liquids can attack a new tooth, so take care that your child brushes his teeth after feeding or eating. We recommend brushing four times a day for optimal oral hygiene: after breakfast, after lunch, after dinner, and at bedtime.

Brushing can be fun, and your child should brush as soon as the first tooth arrives. When a baby's tooth erupts, parents should brush the tooth with a soft-bristled toothbrush and a pea-sized amount of non-fluoride toothpaste. We suggest reviewing proper tooth-brushing procedures with your child.

Flossing is also a part of good oral hygiene habits, and your doctor will discuss with you the right time to start flossing.

Preventing Tooth Decay
Tooth decay is preventable. Tooth decay is caused by sugars left in your mouth that turn into an acid which can break down your teeth. Children are at high risk for tooth decay for a simple reason - many children and adolescents tend to be lax in their oral hygiene habits. Proper brushing and flossing routines combined with regular dental visits help keep tooth decay away. A low-sugar diet also helps keep tooth decay at bay.

Your child should visit the dentist every 6 months for regular dental cleanings and checkups. We recommend fluoride treatments twice a year along with cleanings to keep teeth their strongest. Tooth sealants are also recommended because they "seal" the deep grooves in your child's teeth, preventing decay from forming in these hard-to-reach areas. Sealants last for several years, but will be monitored at your regular checkups.

Sometimes brushing is not enough. Everyone has hard-to-reach spots in their mouth, and brushing doesn't always fully clean those difficult places. When that happens, you are at risk of tooth decay. Using sealants on your teeth gives you an extra line of defense against tooth decay.

Dental sealant is a plastic resin that bonds to the deep grooves in your tooth's chewing surface. When sealing a tooth, the grooves of your teeth are filled and the tooth surface becomes smoother – and less likely to harbor plaque. With sealants, tooth brushing becomes easier and more effective against tooth decay.

Sealants are usually applied to children's teeth as a preventive measure during the years of most likely tooth decay. However, adults' teeth can also be sealed. It is more common to seal "permanent" teeth rather than "baby" teeth, but every person has unique needs. Your dentist will recommend sealants on a case-by-case basis.

Sealants generally last from 3 to 5 years. However, it is fairly common to see adults with sealants still intact from their childhood. A dental sealant only provides protection when it is fully intact, so if your sealant comes off you must let your dentist know.

There are no major differences in the delivery of general preventative care for a child in a pediatric dental office versus a family practice like ours. Our professional hygienists can take care of all members of your family in one convenient office. Preventative dental care for children is more about matching the personality of the child to a caring hygienist.

Pediatric dentists have up to two additional years of study in children's oral health and development; therefore, if you have a family history of soft teeth or your child's pediatrician recommends a pediatric dentist, then we encourage you to evaluate recommendations thoroughly and find a provider with whom you are comfortable.

Significant restorative work on young children may be referred to a pediatric dentist.