Ages, stages and recommended care for children’s dental health

Leslie Penkunas//February 21, 2019

Ages, stages and recommended care for children’s dental health

Leslie Penkunas//February 21, 2019

In honor of National Children’s Dental Health Month, we take a look at how to take proper care of those important, albeit temporary, baby teeth.

0-6 months: Cleaning and teething

To build a foundation for healthy habits and to help keep bad bacteria at bay, dentists advise swabbing an infant’s gums with a clean, damp washcloth or gauze pad at least twice daily. It’s even better if you swab the gums after each feeding. When your infant starts teething — typically accompanied by swollen gums and drooling — you can rub the gums with your clean fingers or the cool, wet gauze. You can also use a teether.

Teething can make babies miserable, and may cause a slightly elevated temperature; however, if your baby is fussing and has a fever, contact your pediatrician to make sure nothing else is the cause. Up until six months ago, parents had the option of using over-the-counter, medicated teething gels to help relieve their children’s teething pain. But products that contained benzocaine — like Orajel’s medicated teething gel and swabs — were pulled from the shelves in Summer 2018 after the U.S. Food and Drug Administration (FDA) warned that the ingredient can cause methemoglobinemia, a condition that can result in death. If you have any of those medicated teething gels or ointments remaining in your medicine cabinet, do not use them on your child.

After your baby’s first tooth emerges, you can begin brushing with a toothbrush specifically designed for babies and toddlers: one with a soft, small head and a large handle. The American Dental Association (ADA) recommends using just a “smear” of fluorinated toothpaste — about the size of a grain of rice. Brush both the front and back of the tooth or teeth twice a day; this preventative care is essential as dental decay can begin as soon as a tooth breaks through the gums.

7-12 months: First check up and fluoride concerns
Cavities are one of the most common chronic diseases of childhood, and many children have them before age 1. To help minimize your child’s risk, continue to brush their teeth twice daily with a smear of fluorinated toothpaste. The American Academy of Pediatric Dentists (AAPD) also recommends that you take your child to a pediatric dentist once the first tooth appears, or no later than 12 months of age.

In addition to evaluating the health of your baby’s teeth, the dentist will discuss with you the fluoride level of your child’s primary source of drinking water. Fluoride — a mineral found in all natural water sources — can prevent and control cavities. It can be delivered topically by fluorinated toothpaste or a prescription-strength gel the dentist applies; or systematically, by drinking fluorinated water. According to an interactive tool provided by the Centers for Disease Control and Prevention (CDC), only 23 of Central Pennsylvania’s 244 water systems contain fluoride. Well water has naturally occurring fluoride, but the concentration may be too weak, or too strong. Additionally, if you use a water filter, it may filter out the fluoride in your water.

Ingesting too much fluoride while the teeth are forming can cause fluorosis, which can result in white spots as well as stained, pitted enamel. If your child is not getting enough fluoride through water (especially if the fluoride level is deficient or if your child drinks bottled water without fluoride), they are more at risk of developing cavities; your dentist may recommend fluoride tablets. In January 2019, the Children’s Health Defense called for the U.S. to end water fluoridation; however, the ADA and the American Academy of Pediatrics both state that optimally fluorinated water protects teeth without posing health risks.

1-5 years old: Flossing and brushing
As more of your child’s permanent teeth come in, it’s essential to continue brushing their teeth twice a day with a smear of fluorinated toothpaste. If their teeth are touching each other, you should also floss their teeth once daily. And you should take your child to the dentist every six months for a professional cleaning, topical fluoride treatments, and an evaluation of their dental health, including teeth and jaws, as well as to discuss any concerns you may have.

According to the ADA, you can increase the amount of fluorinated toothpaste you put on your child’s toothbrush to a pea-sized portion when they reach 3 years old. Supervise their brushing to make sure they are reaching all of their teeth and are not swallowing the toothpaste.
6+ years old: Sealants and rinses
When your child’s adult molars begin to emerge — typically around age 6 — ask your dentist about sealants, which are thin, protective barriers that fill in the chewing surfaces of the back teeth, protecting them from tooth decay.  According to the CDC, sealants reduce the risk of decay by nearly 80 percent in molars. Sealants should last at least two years, and some last much longer than that. At your child’s regularly scheduled dental appointments, ask the dentist how the sealants are holding up, and if there are any new teeth that should be sealed.

While your child should continue to brush with fluorinated toothpaste twice a day and floss regularly, they also may now add to their dental health regimen by start using over-the-counter fluoride rinses; their dentist should be able to recommend one.