Tooth Truths: Answers to the Most Common Dental Questions

QUESTION #1
At what age should my child be scheduled for their first dental visit?

ANSWER: The American Academy of Pediatric Dentistry (AAPD) recommends the first dental visit be at first tooth eruption or at approximately age one. This first visit is equivalent to a “well baby visit”. A clinical exam is important, but parental guidance is crucial (anticipatory guidance). Topics discussed include: teething, habits, trauma, home care, fluoride, nutrition, bottle use, and strep mutans transmission.

Pediatric DentistQUESTION #2
My child is 12 months old and still has no signs of any teeth. Should I be concerned?

ANSWER: No. Sequencing is much more important than timing. Early radiographs can put parent’s mind at ease but often are only partially diagnostic. Begin to be concerned if no signs of teeth being present at 15 months. There are numerous systemic and congenital factors that may contribute to delayed eruption, ie. Down Syndrome.

QUESTION #3
Both parents have had a lot of cavities. Can our child inherit cavities from us?

ANSWER: Inherit = NO, Transmissible = YES! Dental caries is a disease process. Transmission of strep mutans can occur from caregiver to child. The window of infectivity is 11-36 months (emergence of colonizing surfaces). Risk factors for Early Childhood Caries (ECC): frequency of feeding (bottle, breast, sippy-cup, grazing), medications, enamel quality, colonizing units of strep mutans, oral hygiene.

QUESTION #4
I worry about fluoride. Should my child take fluoride supplements? Can he/she get too much?

ANSWER: Systemic fluoride intake an be achieved by drinking fluoridated water, ingestion of select foods, and prescribed supplementation. Systemic fluoride helps to strengthen the developing permanent teeth. Central Oregon does not have a fluoridated water supply, therefore fluoride supplements are recommended until about age 13. Like any “drug”, too little fluoride results in increase disease potential and too much fluoride results in potential complications, ie. fluorosis.

QUESTION #5
My son/ daughter still sucks his/her thumb and he is almost three-years-old. Should I try and make him stop?

ANSWER: Although it may cause alterations in the occlusion depending on which digit is being used, these changes are reversible in the primary dentition. Most children will emotionally mature and show signs stopping between ages 4-6. Intervention is possible once permanent teeth erupt.

QUESTION #6
At what age should I take my son’s/daughter’s pacifier away?

ANSWER: Ideally between the ages of 18 months and 2 years. The pacifier habit is easier to control than the thumb habit, however, waiting longer results in a true “habit”. Potential complications with prolonged use: include anterior open bite and speech issues. Tips for stopping use: cold turkey, gradual, ceremonies and rewards

Dark ToothQUESTION #7
My child’s tooth has turned dark. What does that mean? What should I do?

ANSWER: There are two types of discolorations in teeth. Extrinsic= food stain, iron staining, Intrinsic= trauma related. A common childhood injury, is a pulpal bleed or bruise of the tooth due to trauma. This does not necessarily mean that the tooth is non-vital. An evaluation by a dentist is recommended for a definitive diagnosis.

QUESTION #8
And Finally… Is there really  a Tooth Fairy, and if so, what is the going rate per tooth these days?

ANSWER: Yes – Those who believe shall receive. Pennies, nickels, dimes and quarters are out, and dollars are in (especially silver dollars). Highest quote ever heard $20.00/tooth!

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