According to the American Academy of Pediatrics (APP), when children reach their first birthday 90% of them consume fruit juice or fruit snacks. Many parents are unaware that drinking too much juice can contribute to cavities, obesity, diarrhea, stomach pain, and excessive gas.

Fruit juice is very filling and can decrease your child’s appetite for other nutritious foods. Offering juice to infants before introducing them to solid foods can result in the child refusing to take formula or breast milk which is an important source of proteins, fats, vitamins, and minerals. Excessive consumption of juice has been associated with malnutrition along with significant tooth decay.

Juice is very high in natural sugars, even those marketed as “100% natural no sugar -added” fruit juice. The type of sugar in juice acts as a food source for decay-causing bacteria. Prolonged exposure to these sugars results in an “acid attack” on the outer surface or enamel, causing tooth decay.

The AAP recommends parents follow these guidelines:
• Infants under the age of 6 months should not be given fruit juice
• Infants should not be given juice from bottles or sippy cups that allow them to consume the juices easily throughout the day.
• Juice should be limited to 4 – 6 oz per day for children 1 – 6 years of age
• Juice should be limited to 8 – 12 oz per day for children ages 8 – 18 years of age
• Children should be encourages to eat whole fruits

If you have any questions concerning proper nutrition choices for your child, consult your pediatrician. If you have questions concerning these choices and the risk of your child developing tooth decay, consult your dentist.
Paula Ruth, RDH.

What do you do when your little ghost comes home from trick or treating with a bag full of treats? Should you be worried about the effects of all the candy on your child’s teeth?

Tooth decay is not caused by a temporary increased in holiday sweets alone; cavities are formed when your child does not brush or floss daily allowing plaque (sticky film) to form. This plaque will ultimately form cavities over time. Here are some suggestions to make it a fun Halloween for everyone:

1. Decide which Halloween treats you want your child to have:

Avoid sticky candy such as gummy snacks, caramels and taffy which will stick to their teeth for a long time and hard candies, which take longer to dissolve in the mouth and can fracture healthy teeth or teeth weakened by tooth decay.

2. Decide how often and when you will allow your child to have the Halloween treats:

Think moderation – let your child choose one treat at mealtime. Eating a treat along with a healthy meal will lessen the effect of the added sugar.

3. Decide which healthy snacks you can offer in addition to the Halloween treats or substitute other items for the treats:

Offer other items which as yogurt, cheese, fresh fruit, pretzels, or even trade non-food items for their candy, such as Halloween stickers, bubbles, rubber spiders, vampire teeth, etc.

4. Encourage daily brushing and flossing:

Establishing a healthy lifestyle through good nutritional choice and oral hygiene will lessen the effects of this scary time of year!
Paula Ruth, RDH.

Apple juice is one of the most dentally erosive drinks you can give your child because of its combined pH value and sugar level. If you give your child apple juice, only do so with meals and dilute it.

Daily consumption of soft drinks between meals three or more times per day increases the risk of dental decay by 179%

Even though diet sodas do not have sugar they do have acids that are erosive to teeth.

Parents with poor oral health can pass bacteria from their own saliva to their babies through activities like sharing spoons or blowing on hot food. The most vulnerable time for infection is in between 6 and 31 months. If your child uses a pacifier, do not put it in your mouth before giving it to your child.

Fruit snacks are popular with children but high in sugar and stay on the teeth for hours because of their sticky nature. Eliminate or restrict those snacks.

Drinks high in citric acid, like lemonade, Mountain Dew, and lemon-flavored ice tea, have high levels of acid that are destructive to teeth.  Encourage children to rinse with water following consumption of these beverages to neutralize acids.

Flavored waters are acidic drinks and potentially erosive to teeth enamel.

The consequences of untreated dental caries on children's overall health and well-being are substantial. Dental problems result in an estimated 51 million hours lost from school, costly emergency department visits, and hospital-based medical and surgical treatments. Poor oral health has been related to decreased school performance, poor social relationships, and less success later in life.

Children are often unable to verbalize their dental pain. Teachers may notice a child who is having difficulty attending to tasks or who is demonstrating the effects of pain-anxiety, fatigue, irritability, depression, and withdrawal from normal activities - but cannot understand these behaviors if they are not aware that the child has a dental problem.

Early tooth loss caused by dental decay can result in failure to thrive, impaired speech development, absence from and inability to concentrate in school, and reduced self-esteem. Children experiencing oral pain are easily distracted, unable to concentrate on schoolwork, and have problems with schoolwork completion. Children who take a test while they have a toothache are unlikely to score as well as children who are not distracted by pain. School deterioration and altered physical appearance caused by tooth loss or decay cause poor self-esteem.

We encourage you to come back with your child during their initial visit, so that you may meet the staff and put both yourself and your child at ease.

After the first visit, however, we request that parents/guardians remain in the waiting area.  Children generally respond better to the staff without a parental presence and it demonstrates that you have trust in our services; therefore, there is no reason for your child to be anxious. Staff will be out to speak with you regarding all of your child’s dental services provided, as well as, any necessary treatments for the future.

The Children’s Smile Center’s staff encourages this independence and appreciates your understanding.

Children start to get their teeth between 6 and 10 months of age. The first teeth to come in are the lower front teeth; then followed by the upper front teeth. Children should have all their baby teeth in between the age of 2 and 3.

Teething can cause toddlers to be very uncomfortable. The symptoms of teething can include:

• increased irritability
• increased drooling
• tender and swollen gums
• restlessness
• pacing objects or fingers in the mouth and chewing on them
• ear pulling – which may also be a sign of ear infection
• a slight fever or mild diarrhea
• If you child has a fever, diarrhea or pulls at their ears, consult your pediatrician; these symptoms may be unrelated to teething.

What can I do to help my child get through the teething phase?

• massage your child’s gums with a clean finger
• allow them to bite down on a chilled teething ring (not frozen, this may damage their gums). Keep the teething ring as clean as possible.
• try an over-the-counter teething ointment recommended by your pediatrician
• allow then to chew on a cold, wet cloth

Teething biscuits or cookies are not recommended as they can promote tooth decay and may be a choking hazard. If your child is uncomfortable when teething, consult your pediatrician for their recommendations. Paula Ruth, RDH

Tooth decay comes from bacteria or germs in our mouth. Babies are not born with these bacteria; they get it from caregivers, primarily their mother.  It is very important to start cleaning their mouths even before their teeth erupt to reduce the risk of the child developing cavities when they get older.

It does not matter if your baby is formula or breastfed, because both sources contain ingredients that can cause the bacteria to grow. Lay the baby in your lap with their head close to your chest, and gently but firmly rub a clean gauze or washcloth along both the upper and lower gums. Do this after each feeding or at least twice a day. When the baby’s first tooth erupts at around 6 months of age, you can continue to use a damp washcloth, gauze, or a soft infant tooth brush.

Fluoride toothpaste is not recommended for children younger than two. You can purchase baby “training” toothpaste which has no fluoride in it. If possible purchase a brand that has xylitol as an active ingredient. This will help decrease the amount of bacteria in your child’s mouth. With proper cleaning, you are controlling the amount of bacteria which can cause tooth decay as your baby gets older.

If you suspect your child may have cavities or if you have questions about how to properly care for their teeth, contact your dentist or call a dental office that specializes in pediatric dental care.  It is important to always plan for regular dental visits as a normal part of your child’s overall health.

Paula Ruth, RDH

You should take your child for their first dental visit around their first birthday. You will be asked to fill out medical and dental history. For children between age one and three, the dental visit will be educational with a discussion of the following topics:

• How often you are brushing and flossing your child’s teeth
• Use of fluoridated water for drinking or formula preparation, fluoride toothpaste or supplements
• Use of bottle or sippy cup
• Use of pacifier or thumb sucking behaviors
• Any injuries to the teeth or mouth
• Any illnesses or medication your child is taking
• Oral conditions of parents/caregivers
• How cavities can be prevented through appropriate nutrition choices
• The best way to clean your child’s teeth
• Children from age one to two years of age will receive a “lap” exam. The dentist will ask you to lay your child down so that his/her head is on your lap. Most children are fine with this position which will enable the dentist to quickly look at all surfaces of the teeth.

Children from the age of two to three years of age will be introduced to the dental chair and a quick cleaning will be attempted. More mature children may cooperate well enough for a panoramic x-ray. This is very easy for the child and will let the dentist know how well their permanent teeth are developing.

Bringing your child in for regular checkups at an early age will help them be more comfortable with the staff, as well as reinforce the importance of dental health.

Paula Ruth, RDH

The American Dental Association recommends that parents take their toddlers to a dentist when the first tooth appears, which is around the age of 6 months. However, most dental offices will not see children until they are three or older. Pediatric dentists suggest parents find a “dental home” for their child by their first birthday. A dental home is an office that provides an opportunity for parents to bring their children in for routine check-ups and dental care in a family-oriented and child-friendly manner. 

By the age of 12 months, your child should have 2–4 teeth on the top and 2-4 teeth on the bottom. As you brush your child’s teeth, look for any signs of early tooth decay: white or brown spots, or narrow white lines on the front of the teeth close to the gums. These signs are an indication of too much sugar in their diet and/or lack of proper brushing. The dentist will be able to tell just by looking at your child’s teeth how those areas should be treated. 

In addition to your child receiving an exam by the dentist, your first dental visit should also include instruction on proper brushing, flossing, and choices of food/drinks that will influence how cavity-prone your child may be.

Introducing your child early to a dental office that specializes in care for children will greatly influence their willingness to continue good oral health throughout their lives. Paula Ruth, RDH.

Tooth Talk is provided by dental staff at the Children’s Smile Center. The Children’s Smile Center provides free dental care to Medicaid-eligible children residing in Stone, Christian, Lawrence and Barry Counties.  For more information call 582-5439.