Top 10 questions about children's dental health answered Published Feb. 2, 2007 By Capt. Shawn McMahon 305 DS MCGUIRE AIR FORCE BASE, N.J. -- February marks the start of National Children's Dental Health Month. This national observance began in 1941 as a single-day event and has grown into the month-long celebration sponsored by the American Dental Association. NCDHM messages reach millions of people in communities across the country and at numerous armed service bases abroad. Local observances often include poster, coloring and essay contests, health fairs, free dental screenings, museum exhibits, classroom presentations and dental office visits. In the spirit of this celebration, the 305th Dental Squadron will provide a series of articles concerning children's dental health that they hope are helpful. Below are answers to the Top 10 questions parents have about their child's dental health. When should I first take my child to the dentist? As soon as a baby's first teeth appear, usually by age six months, the child is susceptible to decay. This condition is often referred to as Baby Bottle Tooth Decay or Early Childhood Caries (cavities). In some unfortunate cases, infants and toddlers have experienced severe tooth decay that has resulted in dental restorations or extractions. The good news is that decay is preventable. "First visit by first birthday" is a good guideline, according to both the American Dental Association and the American Academy of Pediatric Dentistry. What if my child is afraid of the dentist? It is normal for children to be nervous about an unfamiliar environment. This is especially true in a place that has sounds of drills and odd-looking tools lying about. Luckily, there are dentists who specialize in treating children. They take things slowly and are very gentle. The idea is to get the child involved and not afraid. Your job as the parent is to discuss the upcoming visit honestly with your child, without using words that might frighten such as "poke, drill or shots." If you can curb your anxiety, the child usually can too. How often should my child be seen by a dentist? Usually every six months. However, this can vary from patient to patient depending upon status and treatment needed. The child's dentist should explain how often and why your child needs to be seen. When should my child start brushing? You can start early by cleaning your child's gums gently with a damp face cloth in order to get them used to the habit. This manner of cleaning works well with the first baby teeth as well. When the first molars come in, usually by the age of 10 months, it's time to start daily brushing. Use a soft-bristled brush and water. Move the brush back and forth gently in short strokes, making sure you reach the front, back and chewing surfaces of all teeth. Be extra careful around the gums. Until your child is old enough to handle a toothbrush on their own -- around age five or six -- you will need to do the actual brushing. When the child turns three, start brushing twice a day, once after breakfast and once before bed. Even when they start brushing their own teeth, children should still have parental supervision until age seven or eight. How much toothpaste should I use? The American Dental Association and the American Academy of Pediatric Dentistry do not recommend using fluoride toothpaste until your child is two years old, and then you should only use a pea-sized amount, making sure your child spits it out and doesn't swallow it. An easy way to make sure you are using the correct amount is to apply the toothpaste crosswise instead of along the entire length of the brush.Does my child have to floss? Yes, but only after adjacent teeth first come into contact with each other. This will definitely take practice, and children under the age of six will need help with this at first. Have patience, wrap the floss around two fingers, carefully glide it between two teeth and gently "rub" the floss up and down each side of every tooth. Make sure to get the floss between the teeth and gums to remove plaque just below the gum line. If baby teeth are going to fall out anyway, why take care of them? For several reasons: First, if the teeth become decayed to the point of infection, it can lead to an abscess and even a whole body infection, not to mention the associated pain and discomfort. Second, just like adults, teeth are esthetic and aid in speech. Third, and perhaps most important, baby teeth serve as place holders for adult teeth. If a child prematurely loses a baby tooth, the remaining teeth can drift and crowd out erupting adult teeth. This can lead to things such as crowding, spacing or cross-bites that may require braces to treat. What do I do if my child knocks out a tooth? If it is a permanent (adult) tooth, act quickly. If the tooth is intact, it can be replaced by any adult within 60 minutes under firm finger pressure. Ensure that the tooth is cleaned off in the child's saliva, milk or a commercial solution such as Hank's, or Tooth Saver. Tap water will work in a pinch, but the other options are more similar to the body's natural fluids. If it can not be replanted for any reason, or the tooth is broken, it is important to save the tooth in a solution that will protect the integrity of the tooth. Commercial solutions can be purchased at local drugstores or can be found in most school nurses' offices. Call your dentist and set up an emergency appointment as soon as possible. If treated within 60 minutes it may be possible to save the tooth. In any case, it is important to bring your child in for an emergency dental appointment to ensure there is no further damage such as broken bones. It is recommended to have a custom-fit mouth guard made for all children participating in contact sports to avoid this situation. At what age should I schedule an appointment for an orthodontic screening? The American Association of Orthodontists recommends an orthodontic screening at age seven. By this age, several permanent teeth in most children have erupted, allowing effective evaluation of the orthodontic condition. This screening can catch potential problems early, and in some cases, treatment can be done that may help your child's teeth erupt into position without braces.What are sealants and how do they help? A dental sealant is a plastic-like material that is put on the chewing surfaces of back teeth to prevent cavities -- no drills required. They provide a physical barrier so that cavity-causing bacteria cannot invade deep pits and grooves on the chewing surfaces of teeth. Approximately 90 percent of the decay in children's teeth occurred in tooth surfaces with deep pits and grooves, and almost two-thirds were found on the chewing surfaces alone. Sealants have been approved for use for many years and are recommended by professional health associations and public health agencies. For more information on dental health, visit the ADA Web site at www.ada.org.