The St. Louis American contacted St. Louis area dentists, with basic questions regarding children’s oral health. All agree that care of children’s teeth, from that first break through of a baby tooth – is crucial to proper development of strong, healthy teeth and gums, which should last a lifetime.
Providing insight: Kim Butler Perry, DDS, dental director for Affinia Healthcare and associate vice president of strategic partnerships for A.T. Still University; Duane Dilworth, DDS, a dentist at St. Louis County Department of Public Health; Kelli D. Dorsey, DDS, a dentist at Affinia Healthcare; Karen Richardson, DDS, chief dental director at Betty Jean Kerr People’s Health Centers; and Candace Wakefield, Children’s Dental Zone!
These dentists are just a few of the health professionals that address excellent oral health checkups of patients, as well as tooth decay, fillings, extractions and painful oral health problems of children and adults. The answers they provide are practical advice for positive, informed decisions to support good oral health care for children. It starts at infancy – and leaves passed down fears and apprehension behind.
How early should dental care start?
Butler Perry: Starting at birth, clean your child’s gums with a soft infant toothbrush or cloth and water. Once a child begins to develop a few of their baby teeth, the caregiver can wipe off their teeth with gauze and as they develop more teeth, they can brush them with a soft toothbrush. A toothbrush will remove plaque bacteria that can lead to decay. Any soft-bristled toothbrush with a small head, preferably one designed specifically for infants, should be used at least once a day at bedtime.
Dilworth: Dental care should start when the first teeth erupt. Milk bottle caries can occur when parents leave a bottle of milk in the mouth of a baby while the baby is asleep.
Dorsey: As early as the eruption of the child’s first tooth or at the age of 1 year. At that time they can get introduced to a dentist and get familiar with the instruments that may be used on them.
Richardson: The American Pediatric dental association recommends that children should see a dentist no later than six months after the eruption of their first tooth and or no later than twelve months of age. The six-month visit is to establish a “dental home” for the child so that the child is allowed to get acclimated to the dental office, the dentist and the dental staff. At the six-month visit, parents learn how to care of their child’s teeth, what to anticipate as the dentition erupts, and how to maintain good oral health as the child grows.
Early education and exposure to the dental arena is important because it has been reported by the Centers for Disease Control and Prevention that dental caries (tooth decay) is the most prevalent infectious disease for our nation’s children. More than 40 percent of children are affected by dental caries by the time they reach kindergarten. Therefore, it is imperative that we start prevention of this disease as early as possible.
Wakefield: The American Academy of Pediatric Dentistry recommends that children should have their first dental appointment by the age of one or six months after the first tooth erupts, whichever comes first.
What are the typical services for young children, and why?
Perry: After that initial visit, a check-up every six months is recommended in order prevent cavities and other dental problems. However, your pediatric dentist can tell you when and how often your child should visit based on their personal oral health. Services usually provided are:
Exams – allow the dentist to determine the status of your child’s oral health and see if there are problems that need to be addressed
Cleanings– allow for the removal of bacteria which causes cavities and the loss of teeth
Sealants – are placed on the biting surfaces of the back teeth to help prevent cavities. They are usually first placed at the age of 6 in children on the child’s first molars and later premolars and other molars as determined by a child’s risk of developing cavities and the dentist’s recommendations.
In more severe cases, children may need, fillings, baby root canals, baby crowns and extractions as needed as a direct result of untreated dental cavities.
Dilworth: Children should have Oral examinations, dental prophylaxis (cleanings) and fluoride treatments as preventive measures every six months. Children should have sealants placed on permanent molars when the molars erupt and dental x-rays when needed.
Dorsey: Typically, we will perform lap or comprehensive exams for children as young as 1 year. We will examine the mouth, check the eruption pattern of teeth, give at home oral health instructions and show them how fun, as well as, important brushing your teeth can be. There are some incidences where children around the age of 3 – 4 that will need restorative treatment such as fillings or pulp therapy (sometimes called baby root canals) or stainless steel crowns. Kids that young can receive nitrous prior to treatment, or even be sedated if there is extensive treatment needed.
Richardson: A typical dental visit for a child involves introduction to the dental environment, where the dentist gathers medical and dental information, performs a caries risk assessment and conducts a comprehensive examination that includes an oral cancer screening and evaluation of the oral cavity.
Kids will have their teeth polished to remove plaque and proper hygiene practices are taught to parents and are reinforced by the dental staff.
Based on the child’s caries risk factor, a fluoride varnish application may be given. This serves as an adjunct to help prevent tooth decay to individuals who are at the greatest risk.
Nutritional counseling and dental education is given to parents so that they can be armed with information and resources necessary to prevent dental disease such as tooth decay and periodontal disease.
Wakefield: It is important to note that tooth decay is not based on the age of the child, but whether or not the child has teeth. The services we provide for children are based on preventive procedures (clinical exam, radiographs were appropriate, dental prophylaxis, fluoride applications) as well as educating and gaining information from the parent on topics such dietary choices, medical conditions, craniofacial syndromes, growth and development milestones, speech aberrations and the presence of any developmental dental anomalies or congenitally missing teeth.
Next week, the dental experts will discuss invasive procedures and the care of baby teeth.
