Oral Health for Kids

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We all know that feeling: Uh-oh, my child has a cavity. Was it too much candy? Not enough time spent brushing? Should we have come in sooner for a checkup?

Preventive care is always the goal with any dental visit, but many questions abound. What age should my child first come to the dentist? What measures can I take to ensure that first visit doesn’t have any unfriendly surprises?

We polled dental professionals from across the mid-Atlantic region to address common questions in pediatric oral care.

Dr. Michael Virts, DDS
Mount Airy Children’s Dental Associates
Frederick County, Maryland

What causes cavities in children’s baby teeth?

Bacteria causes cavities. The bacteria eat the sugar that is left on the teeth after eating or drinking, then create acid, and the acid erodes the teeth, making a cavity. Cavities are caused by a combination of bacteria and a carbohydrate source.

If the bacteria were left on the teeth by not properly brushing or flossing, cavities can develop. And a proper diet low in carbohydrates is almost just as important as brushing and flossing to prevent cavities as well as seeing the dentist by the time your baby is 12 months old.

When should children get their first oral health exam?

Children should see a dentist no later than 12 months of age or when the first tooth appears in the mouth — whatever comes first. For example, if a 6-month-old baby gets a tooth in, then it’s time to see the dentist. Unfortunately, many children end up seeing a dentist for cavities for their first visit instead of seeing a dentist preventively at any early age. Cavities are a very preventable but common disease of childhood. Dental illness accounts for millions of school hours lost each year.

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Dr. Maria Cordero-Ricardo, DMD, MS, MPH
Philadelphia Pediatric Dentistry
Philadelphia, Pennsylvania

When are children old enough to brush their teeth on their own?

I use a helpful benchmark of when children can tie their shoes or cut food with a fork and a knife. That’s a good benchmark of manual dexterity. Until then, it’s great to let them practice by doing it first and having a grown-up go over it (with them). Some kids are ready around age 6. Some kids need a little more help until age 8 because we all develop at different rates.

What’s the best way to encourage children to brush their teeth correctly and regularly?

Children learn best from modeling of behaviors. Make sure to include them in your own family’s routines and rhythms. The little children see you brushing, the older children in the house — or if you have just one child — brushing side by side and making it part of a happy routine before bed and sometime in the morning after breakfast is ideal. But I like making it part of family routines because children learn from what the grown-ups do.

Dr. David R. Ross, DDS, MS
Orthodontist
Baltimore County, Maryland

When should parents consider orthodontic treatment for their children?

The best time to take your child to an orthodontist for an evaluation is when they’re around 7 years old. Why 7? Well, by the time your kiddo is 7, they’ll have lost several baby teeth already and an orthodontist can look at their smile and see if any potential issues may be popping up. Not only that, the American Association of Orthodontists recommends that all children see an orthodontist by the time they’re 7.

During your child’s first visit, most children find out that they don’t need early intervention and are monitored every few months to make sure their teeth are coming in correctly. If it turns out that your child does need early intervention, this allows an orthodontist to guide your child’s teeth and jaw development while their mouth is still growing, greatly reducing the need for tooth extractions or surgery later. David Ross Orthodontics offers free orthodontic evaluations for children ages 7 and older.

Dr. Tracy Bowden, DDS
Kids First Pediatric Dentistry
Baltimore County, Maryland

What’s the best way for children to protect their teeth from injury due to sports and injuries?

Many parents bring their children in with mouth injuries for sports, so custom mouthguards or mouthguards that you can buy over the counter are pretty good. That’s probably one of the best ways to not have mouth injuries, of course, and also to prevent concussions. Sixty percent of concussions are supposedly from that fall where you hit your chin.

(Also it’s) just wearing mouthguards in sports where children normally don’t. Kids in soccer don’t usually wear mouthguards. They don’t wear them in basketball, and that’s where we see all the injuries.

Dr. Peter Markov, DMD
VK Pediatric Dentistry
Arlington, Virginia

How effective is toothpaste containing fluoride for kids?

Fluoride in kids’ toothpaste is one of the most effective and important ingredients to look for! In general, as soon as a child has teeth, we want to make sure there’s fluoride in their toothpaste.

Fluoride helps in a variety of ways, but most importantly, fluoride helps strengthen the teeth so they are more resistant to cavities. This (fluoride) is especially important for kids as their teeth, and their hygiene habits, are still developing. For kiddos who can’t spit out the toothpaste yet, aim for a grain-of-rice-sized smear of toothpaste on the brush. For older kiddos, a pea-sized amount is adequate for protection.

At what age should parents consider sealants for their children’s teeth?

Sealants are very effective at preventing cavities on the smooth biting surface of teeth. Although some children receive sealants on baby teeth, typically the first teeth to be sealed are the permanent molars which start coming in around age 6.

Permanent molars have deep grooves that can be difficult to fully clean, even for the most diligent of brushers. Adding a sealant to these teeth is a relatively easy process and can go a long way to protect the teeth and prevent cavities in the future. Some studies show up to a 50% reduction in cavities on sealed teeth! A benefit of a sealant compared to a filling is that it requires no drilling or numbing and is a very conservative option that offers great protection.