How to Care for Baby Teeth 

There are many “firsts” in a baby’s life, and one of the most exciting is getting a first tooth. Parents may think that because primary (baby) teeth fall out, it is not as critical to care for them as permanent teeth. But strong, healthy primary teeth are important for speech development and for allowing children to chew their food properly. A healthy smile helps a child feel confident. Tooth decay, on the other hand, can be embarrassing for children, as well as painful and costly.

Dental caries is the disease that causes tooth decay or cavities. Although there has been a decrease in the United States in tooth decay over the last 30 years, the American Academy of Pediatric Dentistry (AAPD) cautions that dental caries is still a big problem for many children, and that more than half of all children have dental caries by the second grade. Many factors play a role in the prevention of caries, including dental hygiene and diet.

Babies & caries
Babies are born without caries, but parents and caregivers can inadvertently transmit caries to a baby. Bound Brook pediatric dentist Dr. Yasmi Crystal, trustee for the AAPD and past president of the New Jersey Academy of Pediatric Dentistry (NJAPD), explains that, “Bacteria can be transferred from a caregiver to a child through saliva. This transfer of bacteria can occur if a caregiver uses her own spit to clean a pacifier, or shares a spoon with a child, or even blows on a child’s food before giving it to her.” In the past, it was thought that babies did not get cavity germs until they had their primary teeth, but new research shows that even a baby without teeth can harbor harmful bacteria in her mouth.

Nutrition also plays a key role in developing caries. Tooth decay can occur when a baby drinks sweet liquids such as formula, milk, and juices from a bottle or training cup, and the liquids are left to cling to the infant’s teeth for a long period of time. Even natural sugars like those found in breast milk can cause tooth decay. This is an especially big problem at night, because the flow of saliva decreases during sleep, and sugary liquids remain in the mouth longer, increasing the risk of caries. Somerset dentist Dr. Daniel B. Krantz, former president of the New Jersey Dental Association, says, “If your child must have a bottle before bedtime, fill it with water.”

Caring for baby teeth
Before a baby’s teeth erupt, parents should wipe a child’s gums with a soft, clean, moist cloth or gauze pad every day. When a tooth becomes visible, brush the tooth with a small, soft-bristle toothbrush at least twice a day. AAPD guidelines state that a “smear” of fluoride toothpaste should be used to brush the teeth of a child who is younger than 2 years old, and children ages 2–5 years old should use a “pea-size” amount of toothpaste. “Starting a non-negotiable routine of good oral hygiene at an early age is the key to preventing tooth decay,” says Dr. Krantz.

Take your child to visit the dentist by his first birthday. If you see white spots developing on your child’s teeth, take her to the dentist immediately, as this is often the first sign of a cavity. For a list of pediatric dentists in New Jersey, go the website njapd.org and click on the Directory link.

Do bad teeth run in the family? Dr. Crystal says, “Some parents think having bad teeth is hereditary. They assume because they have a lot of cavities, their child will too, and that there is nothing they can do about it.” Dental science does suggest that the bacteria in some people’s mouths are more aggressive than others, and that children whose parents have had dental caries are more likely to have these aggressive bacteria as well. However, Dr. Crystal says, “Rather than accept that their children will have bad teeth, parents with dental caries need to be more diligent both in how they care for their child’s teeth and also how they take care of their own oral health. Dental caries is a preventable disease.”

For more information about your child’s teeth, go the website of the American Academy of Pediatric Dentistry, aapd.org.

Dental facts

• Tooth decay will affect more than 40–50 percent of children before the age of 5.
• Dental caries is the number one chronic childhood disease in America, and is largely preventable.
• While 9 million children in this nation do not have medical insurance, more than twice that number—about 23 million—do not have dental insurance.
• According to the May 2000 Surgeon General’s report, Oral Health in America, more than 51 million school hours are lost each year due to dental-related conditions.
• New Jersey ranks 49th of the 50 states in the number of people who have access to fluoridated community water supplies.

Sources: aapd.org and njda.org.

Give Kids a Smile
Give Kids A Smile (GKAS) Day is an annual national program on the first Friday in February (February 5, 2010) when volunteers in the dental community give their time and services to deliver free screenings and treatment to needy children up to age 12. In New Jersey, nearly 4,000 children each year take part in the program at more than 80 locations (by appointment only) around the state.

NJ school nurses notified parents about this event in December and January, and provided a list of participating dental offices. Information is also available online at njda.org/gkas, or via the program’s hotline at 877/576-9278.

Give Kids a Smile is organized through the University of Medicine and Dentistry of New Jersey, the New Jersey Dental Hygienists’ Association, and the New Jersey Dental Assistants’ Association.

Randi Mazzella is a freelance writer from Short Hills, NJ; she has three children.

February 2010