Parents should take their children to the pediatric dentist every six months for check-ups, beginning with the eruption of the first tooth (around 1 year of age). Then, the dentist can recommend a specific program of brushing, flossing, and other treatments for parents to supervise and teach to their children. Of course a balanced healthy diet limiting sugary snacks and drinks will help give your child a lifetime of healthy habits.

If your child is not on solid foods yet and they have teeth, then do not nurse them to sleep or in the middle of the night. Also, do not put them to bed with a bottle of milk, juice, formula, or sweetened liquid. While they sleep, any un-swallowed liquid bathes their teeth and feeds bacteria which produces acid and causes cavities.

Make sure your child has a balanced diet, including one serving each of: fruits and vegetables, breads and cereals, milk and dairy products, and meat, fish, and eggs. Limiting the servings of sugars (candy, cookies, and soft drinks) and starches (like crackers and goldfish) will also aid in protecting your child’s teeth from decay. Suggested snack foods include: cheese, low-fat yogurt, bananas, oranges, apples, carrots, celery, and hard-boiled eggs. Having your child drink water in between meals is also desired for good oral health.

As you begin to shift your child from bottle feeding or nursing to a training cup, it’s important to consider a few key factors:

• The type of cup you choose

• What goes into the cup

• How often your child drinks from it

• Not allowing your child to carry the cup around all day

The best type of training cup is one without a valve. Many "no-spill" cups have valves under the spout that require your child to suck rather than sip — similar to how they drink from a bottle. This can delay proper oral development and encourage habits that contribute to tooth decay.

Instead, choose a cup with:

• A spout (not a nipple)

• A snap-on or screw-on lid

• Optional handles for easier grip

As your child gets older, introduce cups with straws. Drinking from a straw encourages proper lip and tongue movement and helps direct liquid past the teeth, reducing the risk of cavities from prolonged exposure to sugary drinks.

According to national estimates, 78% of children in the United States have experienced dental decay by the age of 17 years. As much as 90% of decay occurs in pits and fissures on top of the teeth in school-age children. The teeth at highest risk are the permanent first and second molars as they are hard to reach with a toothbrush, and often come in slowly and for a long time can be partially covered by soft tissue.

Sealants work by filling in the pits and fissures on the chewing surfaces of back teeth (molars and premolars). This prevents food particles and plaque from getting caught in the deep grooves of the teeth. The covering is only over the biting surface of the tooth, so areas on the side and between teeth cannot be coated with the sealant. For this reason, good oral hygiene, flossing and a good diet are still very important in preventing decay next to these sealants or in areas unable to be covered.

The American Dental Association (ADA) recognizes that sealants can play an important role in the prevention of tooth decay. When properly applied and maintained, they can successfully protect the chewing surfaces of your child's teeth. A total prevention program includes regular visits to the dentist, the use of fluoride, daily brushing and flossing, and limiting the number of times sugar-rich foods are eaten or drank. If these measures are followed and sealants are used on the child's teeth, the risk of decay can be reduced or may even be eliminated!

The procedure for applying sealants is fast and non-invasive. We compare it to applying nail polish on nails. Following the placement of sealants, your child should refrain from eating ice or hard candy. This tends to fracture the sealant. Normal retention of a properly applied and maintained sealant is four years or longer.

Children do not have the hand coordination to properly and completely brush their teeth until the age of 7 to 8 years when they can easily tie their shoes. Even then, they still need supervision up to the age of 10 to 11. Teeth need to be brushed at least twice a day: in the morning after breakfast, and most importantly at night before bed. After the nighttime brushing, your child should not have anything to eat or drink except for water. The proper technique for brushing includes:

1. angling the toothbrush at a 45-degree angle to the gums;

2. doing 3 circles on every side of every tooth;

3. brushing the chewing surfaces of the teeth;

4. brushing the tongue after the teeth. This should take approximately 2 to 3 minutes (a timer may be used).

You should replace your child’s toothbrush every 3 months. If the bristles are worn, then replace it more often. Make sure your child is not applying too much pressure while brushing because too much pressure may injure the gums.

Flossing removes plaque and food from between the teeth, where a toothbrush cannot reach. You need to floss your child’s teeth for them until age 10 and possibly longer. Flossing should be done every day for prevention of decay development between the teeth as well as gingivitis. When you are flossing make sure you ‘hug’ the tooth with the floss to prevent injuring the gum tissue in between the teeth. Do not force the floss straight down between the teeth. Instead use gentle pressure and work the floss in a C-shape motion until it passes through where the teeth touch each other. Always use a clean piece of floss. You may also use a disposable “floss pick” to help you get in the back of your child’s mouth.

A properly fitted soft mouth guard can protect your child’s teeth, cheeks, lips, gums, and smile. Many experts recommend that a mouth guard be worn for any recreational activity that poses a risk of injury to the mouth. Sports in which a mouth guard should be worn include (but not limited to): basketball, football, baseball, soccer, softball, wrestling, martial arts, hockey, volleyball, skateboarding, lacrosse, boxing, and extreme sports.

There are 3 types of mouth guards:

1. ready-made, or stock, mouth guard you can purchase at a sports store;

2. mouth-formed “boil-and-bite” mouth guard also purchased from a sports store;

3. custom-made mouth guard made by the dentist.

If your child doesn’t have all of their permanent teeth then a ‘boil-and-bite’ mouth guard should be sufficient. However, the most effective mouth guard should be resilient, tear-resistant, and comfortable. It should fit properly, be easy to clean, and not restrict speech or breathing.

The most important thing to do is to remain calm so you can find the tooth. Once you find it, do not hold the root. Rinse it gently in water only without scrubbing or soaping it. Hold the tooth by the crown (the part you see in the mouth) and try to re-insert it into the socket. If it does not go into the socket easily, do not force it, instead place it into a bag or container filled with the child’s saliva, milk or Save-A-Tooth solution. Do not put it in water.

Call your pediatric dentist immediately. In order for the tooth to have a good chance of survival, your child needs to be seen as soon as possible. After 60 minutes of the tooth being out of the mouth, the chances of healing are slim.

The reimplanted tooth will then be splinted by the dentist (an orthodontic wire will be attached to several teeth around the tooth in question to stabilize it and allow the tooth to attach to the bone again). Your child may need to see an endodontist (root canal specialist) soon to initiate root canal treatment in order to prevent resorption of the root.

Rinse their mouth (or irritated area) with warm salt water, brush and floss in between their teeth, and place a cold compress on the face if it is swollen. Give your child either acetaminophen (Tylenol) or ibuprofen (Motrin) for pain if it is needed (following the manufacturer’s directions). Do not place aspirin on their gums because this will cause a chemical burn. Call your dentist as soon as possible. Dr. Theriot might first prescribe an antibiotic and schedule you for an evaluation.

There is very little risk in dental X-rays. Pediatric dentists are especially careful to limit the amount of radiation to which children are exposed. See one of our “Clinical Updates” for more detailed information on prescribing x-rays, frequency, and precautions. We use top of the line digital x-ray technology as well as conservative technique and lead aprons to minimize radiation.

Frequently, especially in the lower front jaw, permanent teeth will erupt without dissolving the baby tooth root. It results in a double row of teeth which we sometimes call "shark" teeth. On occasion, it is just a matter of time for the baby tooth to come out on its own. However, in many cases the baby teeth will need assistance from a dentist to exfoliate.

In our practice we typically give children two weeks from the time that the permanent tooth breaks the gums to work on "wiggling" the tooth out. After that it is important for the dentist to remove the retained baby tooth and make room for the adult tooth to move forward. The good news is that the tongue will usually push the permanent tooth into its correct position after the baby tooth is removed.

Often teeth come in pairs, so if one tooth is not coming in correctly, it's partner on the other side might not either. We might recommend the removal of both "partners" to save patients from visiting our office twice for the same procedure. "Wiggling" of these over-retained teeth is an easy procedure that takes just a few minutes and most children leave excited to have a gift for the tooth fairy.