Oral Health by Age/Stage
Should I Be Concerned About Dental Health During Pregnancy? Yes! If you are pregnant or planning to become pregnant, it is important to see your dentist to make sureyour teeth and gums are healthy. Hormonal changes during pregnancy can make your mouth more susceptible to disease. Your gums may bleed and become inflamed, and you may get a cavity or cavities even though you haven’t had one for a while. Proper dental care is especially important at this time because of risks associated with periodontal disease. Periodontal disease can lead to premature and low birth weight births and increase your risk for cardiovascular disease, diabetes and respiratory infection.
If you suffer from morning sickness, make sure to rinse your mouth afterward with water and a teaspoon of baking soda to neutralize the acid. Wait an hour to brush (and use a soft toothbrush) because your enamel is softer from the stomach acid. If you use Tums or chewable antacids, the sugar content can cause cavities, so rinse your mouth afterward. We recommend adding a fluoride rinse to your brushing routine. Fluoride helps protect your tooth enamel from acid. Also, avoid taking any medications not safe for your baby (your provider will give you a list) and discontinue any tooth bleaching products. Quit using alcohol and tobacco products. Quitting smoking is not only healthy for your body and your baby, but secondhand smoke is harmful for children after they’re born as well. Ensure that those in the home quit smoking or don’t smoke around you or your baby.
During the second trimester, continue to maintain a healthy diet with plenty of fruits and vegetables in addition to folic acid, vitamin C, calcium, and vitamin B12—these will help build a healthy baby and healthy teeth. If you have cravings for sugary foods, try to consume them with normal meals and brush afterward to avoid getting cavities. If you have a scheduled dental appointment during this time, let your dentist know so that he or she can take all the necessary precautions for you and your baby. The second trimester is the best time to receive elective dental care if needed. If you have a toothache or gum problems, don’t delay making an appointment with your dentist.
Avoid dental treatments during the last six weeks of your pregnancy, mainly due to the discomfort of lying in the dental chair. Schedule a dental appointment for shortly after your baby is born. Studies show that babies can be infected with bacteria from mothers’ saliva before they even get teeth. Babies who get bacteria from mom sooner also tend to get more cavities. So make sure to maintain excellent at-home brushing and flossing. Keeping your mouth clean can lower the amount of cavity-causing bacteria that can be transferred to your baby (vertical transmission). You can also chew xylitol-containing gum three times a day.
Although babies have the beginnings of their first teeth before they are born, teeth don’t erupt until around 6–8 months. Even though your baby doesn’t have teeth, it is still important to take care of your child’s gums. Use a soft gauze pad or cloth to gently wipe baby’s gums after feeding. When you first see a tooth (usually on the bottom gum), you can start brushing the tooth (and subsequent teeth) with a soft baby-sized toothbrush twice a day. Along with the ADA and AAPD, we recommend using a “smear” (size of a piece of rice) of fluoride-containing toothpaste to strengthen and clean the teeth. This very small amount, even if swallowed, is safe for your baby. Once your child is 3 years of age, you can use a “pea-size” amount of fluoride toothpaste on the toothbrush. Also, NEVER put your baby to sleep with a bottle or allow them to use a bottle or sippy cup throughout the day. The natural sugar from milk, juice, and even breast milk — if left on the teeth for extended periods — can cause severe tooth decay. To discuss these issues and check your child’s teeth, we would like to see your child after the first tooth erupts and no later than their first birthday.
Your Baby's First Visit
Your baby’s first visit is a simple visual exam to evaluate your child’s oral health and determine his/her risk for developing dental disease. A gentle prophy cleaning and fluoride application are performed by our child-friendly dental hygienist if your child is ready to sit in the dental chair. Usually, no radiographs (X-rays) are taken at this appointment. Feel confident about your child’s care as our doctors also look for relatively common and uncommon oral conditions affecting infants that you may not have heard of, such as tongue-tie, missing teeth, abnormal teeth, inclusion cysts (Epstein’s Pearls, Bohn’s Nodules, Dental Lamina Cysts), natal teeth, iron stain and primary herpetic gingival stomatitis.
You’ll receive guidance to help you prevent potential problems and dental disease in your child’s future. Along the way, feel free to ask any questions you may have about your child’s new teeth and oral health. Let your infant become familiarized with the dental office setting in a positive way, before he/she gets bombarded with negative propaganda from older siblings, peers or even dental-phobic parents. Enjoy this primary prevention visit where dentistry is “fun”, and future dental disease can be prevented!
Other helpful tips:
- Breastfeeding. Dr. Foster and Dr. Ziegler are happy to review oral hygiene practices for children who are breastfeeding beyond the eruption of the first tooth to decrease the risk of dental decay.
- Sippy Cup Beverages. Don’t let your child walk around with a sippy cup filled with anything but water for prolonged periods during the day.
- Juice. Don’t allow your child drink more than 4-6 oz. of juice per day.
- Cleaning Infant’s Gums. Wipe your infant’s gums after feedings with a clean damp cloth or baby finger brush even before the first teeth erupt.
- Brushing Teeth for Children up to 2 Years Old. Once teeth appear, brush your child’s teeth with a soft toothbrush twice a day (once after breakfast and again before bedtime). Baby can be placed with head on lap and legs facing outward to facilitate cleaning.
By 3 years of age, all of your baby’s 20 primary (baby) teeth are usually fully erupted. The first permanent tooth to erupt is also usually the lower front incisor and this occurs approximately at 6 years of age. Girls tend to get their teeth slightly quicker than boys. There is not much difference, but those whose teeth erupt later tend to have somewhat higher resistance to dental decay.
What to do about Pacifiers or Thumb sucking? Most children quit their thumb/pacifier sucking by age 3, or at least by school age (due to peer pressure). At this stage, any dental problems (tooth movement, jaw-shape changes) that have resulted from your child’s sucking habit will usually correct on its own. If your child’s thumb sucking or pacifier use continues past 4 years of age (or when permanent teeth arrive), full self-correction is far less likely, and there are possibly other issues that are perpetuating the habit that should be explored. Stress may exacerbate the thumb-sucking problem, thus scolding your child for thumb sucking is not recommended. It is better to use positive reinforcement to motivate your child to quit the habit. Finding and eliminating the source of stress can also be really helpful.
Other helpful tips:
- Brushing Teeth, Ages 2-5. As a preschooler, ages 2 to 5, you should brush your child’s teeth twice a day with fluoride toothpaste; once after breakfast and once at night right before bed. The last thing your child’s teeth should touch before going to bed and for the rest of the night is the toothpaste from their brush. Use only a pea-sized amount of toothpaste and smear it into the bristles with your finger to minimize swallowing toothpaste. Brush your preschooler for at least 1 minute each time. Teach your child to “spit out” the toothpaste after brushing as soon as possible.
- Proper Toothpaste. Dr. Foster and Dr. Ziegler are happy to review the recommendations specific to your child.
- Supervision during Brushing Teeth. Young children should always be supervised while brushing and taught to spit out rather than swallow toothpaste. You should brush your child’s teeth until they are 7 or 8 years old because your child lacks the manual dexterity to do so properly until that age. Brushing should last for 2 minutes. Once you have observed that your child can brush properly on their own, then let your child brush independently.
- Flossing. Flossing should begin when and where teeth are touching. Back molars usually begin touching at age 3 or 4. At this point, food can easily get trapped between the teeth and lead to cavities.
Studies show that greater than 40% of children will have cavities before kindergarten. To prevent cavities in your children, ensure they stop using the bottle and sippy cup by age 1, use fluoride toothpaste, and don’t eat too many between-meal snacks (especially sticky foods like fruit snacks or candy). The AAPD and pediatricians recommend no more than 4–6oz of juice daily. Ensure your child stops sucking habits (pacifier, thumb, etc.) by age 3 if possible to prevent problems with their bite and facial development. Finally, children may want to brush their own teeth at this stage. It’s a good idea to let them try to brush, and then you brush afterward to ensure all the surfaces are clean. Kids will typically need supervision with brushing until they are 10 years old.
It’s Tooth Fairy time! Around age 6, your child will begin to lose primary teeth in the front and gain permanent teeth in the front and back. Once the teeth start to touch (could be around ages 3–5 too), you should floss your child’s teeth (flossers work well). Children typically don’t brush along the gum line or the back teeth, so pay special attention to these problem areas. However, almost 90% of cavities in permanent molars occur in the grooves. Dental sealants are a great way to protect the permanent molars and other teeth at risk of getting decay. They are a white coating that is placed over the grooves of the teeth to prevent plaque and food from getting stuck and causing cavities.
Up until your child is 7 years old, you should assist him/her while brushing because children often lack the motor skills to do it right. After that, observe your child’s technique and assist where necessary until he/she can effectively brush without supervision. Brush your teeth at the same time to help teach your child to brush by mimicking you. Although a regular children’s brush is perfectly fine for cleaning teeth, sometimes a children’s electric brush can make the experience more fun for your child, increasing motivation to brush. Once again, tooth brushing should happen twice a day – once in the morning after breakfast and right before bedtime. Brushing after snacks is ideal too. At age 6 and above, brushing should take 2 minutes each time.When brushing your teeth and your child’s teeth, angle the toothbrush at a 45˚ angle towards the gum-line and use small circular strokes. Brush the front of the teeth, behind the teeth and the chewing surfaces. Don’t forget to brush the tongue to remove potential bad breath bacteria and other harmful microorganisms. Take 2 full minutes to brush properly. During these ages and older, children become more active with sports, and dental injuries are very common. Ask our team about mouth guards to protect your child’s teeth during sports.
By 12-13 years of age, all of the baby teeth are usually gone, and all of the permanent “adult” teeth are in except for the 3rd molars (wisdom teeth), which most often arrive by age 21. As teens grow more independent and have further control of their diet and habits, it is common to see an increase in cavities. Soda, candy and a lack of consistent or effective brushing and flossing is typically the culprit. Self –awareness also becomes more prominent and your teen may notice if they have discolored teeth or crooked teeth. Talk with our team regarding options for both braces and whitening.
Additionally, we take a panoramic X-ray of your child’s jaws to check the development of third molars, and when indicated will refer your child to an oral surgeon for removal. Be sure to let our office know if your child is experiencing pain from their wisdom teeth. Unfortunately, substance abuse may begin during this stage (90% of adult smokers began before age 19), so monitor your child for signs of alcohol or tobacco use. Finally, eating disorders are also common, and in addition to many other serious issues, can damage the teeth. Please talk with our office regarding assistance with any of these common issues of adolescence.
During these ages, children become more active with sports, and dental injuries are very common. Ask our team about mouth guards to protect your child’s teeth during sports.
Around ages 12 or 13, most kids have lost all of their baby teeth and have a full set of permanent teeth. There are 28 permanent teeth (not including the 4 wisdom teeth). Adolescence is a time of increasing self-awareness and independence. Cavities are more common in teens than any other time in their life due to increasing freedom leading to poor diet choices (soda and candy) and a lack of brushing. During this stage, children also may notice if they have crooked teeth or if their teeth are discolored. Talk with our team regarding options for both braces and whitening. Additionally, during this stage we take a panoramic X-ray of your child’s jaws to check the development of third molars, and when indicated will refer your child to an oral surgeon for removal. Be sure to let our office know if your child is experiencing pain from their wisdom teeth. Unfortunately, substance abuse may begin during this stage (90% of adult smokers began before age 19), so monitor your child for signs of alcohol or tobacco use. Finally, eating disorders are also common, and in addition to many other serious issues, such disorders can damage the teeth. Please talk with our office regarding assistance with any of these common issues of adolescence.