Publication: Montana Woman’s Magazine
Pediatric Dentistry is an important aspect of general family practice. The Flathead valley has only one specialist that I know of, so most offices welcome children patients. Their care differs in many ways from adult dentistry with many special considerations. In fact, there are so many, that I could never fit them on this page, so I will hit some of the important ones this month.
Teeth begin forming in the fetus around 5 months in utero. They become visible in the mouth between 6-8 months of age. This happens to also be the time when the adult teeth begin to develop inside the jaws. This is the reason fluoride vitamins are prescribed at this age, so that this enamel strengthening mineral is incorporated into the developing teeth. Most dentists begin seeing children at 2 ½ -3 years for their first visit. We hope that no problems are present at this age, because it is challenging to treat such young patients and we want them to have a positive experience. Many kids look forward to their trips to the dentist, because we give them cool prizes for good behavior!
Prevention actually can occur before birth, and I think pre-natal advice is very beneficial. Since decay bacteria can pass between individuals, the mother can use the dentist to reduce this risk. Simple measures such as chewing Xylitol gum, treating tooth decay, improving diet, and brushing and flossing, reduce bacteria significantly. Look online for the benefits of xylitol in reducing decay and promoting tooth remineralization.
I frequently have entire families rinse with a prescription chlorhexidine mouthwash to reduce germ transmission.
After the teeth begin erupting, it is the parent who is responsible for the oral health of their child. Clean their teeth with a washcloth or a small brush at first, using little or no paste. Never put a child to bed with a bottle, unless it is only water. Decreased saliva at night lets the bugs breed like crazy. When the back teeth start to erupt, floss between every touching tooth. A healthy mouth is not sore and those little flossholders work well. Dental infections increase the other infections kids get, like ear infections. Breastfeeding is best for natural oral development. Pacifiers increase the need for braces, even though some, like the Nuk pacifiers, are orthopedically designed. Try to minimize their use, and get rid of them after a year is up! Good luck with this one.
When your child is about seven, and the front teeth are mostly in, your dentist can screen for orthodontic problems. Developmental issues can be identified early and if your child has congenitally missing adult teeth, you will have a heads up to begin planning how to deal with that. If thumbsucking habits aren’t gone by now, the teeth will be pushed and pulled out of position by the unnatural muscular tension. Minor crookedness isn’t a big deal; it is more about the shape of the arches and the palate. Orthodontics works best on growing bodies, so growth can be directed by gentle pressure. This is also a good age to begin sealing the permanent molars soon after they erupt.
We can never prevent all the injuries and abscesses that children endure. It is important to know that primary teeth guide the eruption of the permanent ones and it is best to keep the tooth or hold the space, especially in the back. It is worth the effort to prevent the need for extensive dental treatment in kids. Recently, a young girl died in California, during treatment, from over sedation. The risks associated with dental neglect can be high! Even though I think the Dr. was negligent in that case, the condition necessitating treatment was more than likely, preventable!
Between the ages of 9-13, most kids finish losing the rest of those baby teeth and erupt another set of permanent molars. Now they are dental adults. The jaws will grow a bit more until the wisdom teeth start showing up, but there will be no more second chances! These are the only teeth remaining for the rest of their lives! These teeth are the best they will ever be, and the goal is to keep them as pristine as possible. The future of your health may depend on it!
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