Raising Healthy Smiles
Motherhood. What do I know about it, right? Very little I'm mare, but I've had some great examples in my life. Naturally my own mother has had a major influerice thus far, and more recently my wife as she is approaching the maternal 7 year mark. My wife of course is a woman, so we discum everything that is on her mind. This happens most nights as we lie in bed gleaning every second of the only quiet moment we get to spend together. From these conversations, I have gathered insight enough to describe the 6 of a Mother as a Shakespearian roller coaster.
Tragedy, comedy, future imaginary neighbor boys who are off limits...our daughter is only 6 Some readers are laughing to themselves right now. "Six years old? This guy better buckle up!" These readers are on a whole different ride that my wife and I would not meet the height requirement for...not that we'd want to ride quite yet anyway. What I'm getting at is raising children, along with life in general, is a Comedy of Errors.
According to an old African proverb, it takes a village to raise a child. This village consists of relatives, neighbors, school teachers, coaches, employers, etc. We all know this is true, and you'll find yourself thinking of your unique individual villages this very moment. I think of the villagers that I make time to call upon when I have the chance to return to my hometown. The Dental Office was part of my village, and you will be doing yourself and your children a great favor in making the Dentist a consistent component of your family village. The remainder of this column will address contemporary dental care for children, and the responsibility we have as parent's in maintaining the oral health of our kids.
Newborns
Babies are born devoid of the oral bacteria which cause tooth decay, Streptococcus mutans and Lactobacillus. This bacteria can be transferred from mother to infant (Vertical Transmission), or even from sibling to infant (Horizontal Transmission). To prevent this transmission for as long as possible, make sure all items placed in the baby's mouth are clean. This is especially important if the mother is prone to tooth decay and/or has active gum disease (a.k.a. periodontal disease). To be honest with the readers of 406, I'm terrible at this. My family and I share ice cream cones, straws, etc., but I try my best. Ultimately, colonization of these oral bacteria, at some level or another, is inevitable. Therefore, it is my opinion that you will wage a better fight by taking the approach that the best offense is a killer defense.
Infants on average are toothless for the first six months of their life. Their gums should still be cleansed with a soft toothbrush or a wipe of some sort. This functions to not only clean junior's mouth but to also initiate "healthy-habit" development. In addition, make sure the little one is present when you take care of your own mouth; make it a family event. Maxwell, my youngest, watched me brush and floss Nayvee and Banksy's teeth every night. The result was a stubborn urge to have a toothbrush in his own, toothless mouth. Now, just days passed his 1st birthday, he offers no resistance to my brushing of his 6 front teeth. In fact, he is upset when I'm done.
Baby Teeth Stage (1 to 6)
Somewhere between 6 months and 1 year, a baby's first tooth appears. Nature has provided us with this wonderful dress rehearsal that lasts until approximately 6 years of age. This is our chance as caregivers, to miss cues, jumble lines, and ultimately polish our technique and perfect our delivery. It is recommended that children be seen in the dental office at approximately one year. This initial appointment is important for the new mother to be educated in infant oral health care and again to aid in the child's healthy habits. During these visits the child's teeth are not my main concern. We want to introduce a welcoming and comfortable atmosphere to the child. This typically involves chair rides, balloons, and a prize. If the child will allow me to look at the few teeth. they might have, great! However, I do not force the issue if the child is not cooperative. Keeping this first visit a positive and fun experience is my main priority.
At this appointment the mom will be instructed to brush their child's teeth twice a day. In the morning after breakfast for two minutes, and immediately before bed for two minutes. In addition to brushing at night, flossing should be performed. As soon as the child is able to rinse without swallowing, a fluoride rinse should also be performed at night. As kids become more independent, they will want to brush their own teeth. While this should be encouraged, no teeth brushing session should conclude without an adult performing a proper brushing.
Mom will also learn that the most common cause of childhood tooth decay is putting the child to bed with a bottle of milk or juice. If the child needs the comfort of the bottle, try and only use warm water. Also, if a snack is needed during the night, cheddar cheese has been shown to actually reduce tooth decay.
Mixed Dentitions Stage (6 to 13)
Your child's 6th birthday is fast approaching, and they mention that their gums hurt behind their teeth. You inspect and find the gums slightly inflamed with the pearly glisten of a perfectly healthy 1st molar starting to poke through. The curtain has dropped; the lights are blinding. This is what you have been training for and because you are prepared you shall not fear. Mixed Den- tition refers to the period where baby teeth and permanent teeth are both present in the mouth.
The biggest mistake made at this point is not brushing these new teeth adequately. They are so far back and hard to reach, but they are the most important teeth in the mouth. It breaks my heart to see a 7 year old with extensive decay on these 1st molars; and I see this often. This kid will likely lose these teeth early in life setting the stage for a sad ending.
During this mixed dentition stage, and throughout the remainder of their life, regular 6 month dental check-ups are of paramount importance. These exams will allow the Doctor to inform you of areas that need improvement, to reinforce proper technique, to evaluate bite and alignment of teeth, to place sealants on permanent molars and premolars, and provide cleanings and fluoride treatments for your child that will strengthen their teeth. If the Doctor gets his/her eyes on your child's teeth every six months, they can catch problems early. Tooth decay and gum disease are for the most part slow processes that can be managed before any major damage is done.
I recommend that parents remain an active participant in care of their children's teeth until their child's 8th birthday. At that point it is important to let them fly solo under your supervision of course. If your family is like mine, brushing/flossing/rinsing is a family event (clean bedrooms, pajamas, teeth brushing, story, prayers, lights out) so it will be easy to monitor children's brushing.
Post Mixed Dentition (13 on)
During this interval between 13 and adulthood, the above instruction remains the same, but you will likely encounter your child's need for orthodontics (braces) and wisdom tooth removal. In my experience, 9 out of 10 mouths will benefit enough from orthodontics to make it worth the investment, and if a wisdom tooth is there, I recommend removal a majority of the time, with few exceptions.
By this point your child has developed the healthy habits mentioned in this article:
Brushing twice a day for 2 minutes each time with proper technique.
Flossing every night with proper technique.
Rinsing with a fluoride rinse at night.
Having regular 6-month dental cleanings and check-ups.
Conclusion
I treat children and adults with serious dental problems accompanied with exquisite dental pain on a daily basis. I try my hardest to empathize with them, but I personally have never experienced dental discomfort of any significant nature. There was a dentist in my village that my Mother took me to every 6 months. I do not hesitate to smile because I love my smile, a smile I owe to my Mother.
Look at your children. You want nothing but the best for them. Raising kids is the challenge of your life. Create for them a village that promotes: health, creativity, imagination, charity, adventure and love of life.
Finally I want to wish a Happy Mother's Day to my wife Juli Miller, my mother Linda Miller, and to all the readers who have the honor of that title. There is no greater job and responsibility. Thank You!
This article only scratches the surface of pediatric dental care. I would encourage you to visit the website of the American Academy of Pediatric Dentistry (www.aapd.org/publications/brochures/) for additional information.
Read Raising Healthy Smiles and other Smile Montana articles by Dr. John F. Miller, DDS, in 406 Woman magazines.