Pediatrics
There can be lots of challenges when it comes to brushing the teeth of infants and toddlers. How can you know if you are brushing enough plaque away? A unique method to do daily or periodically can be filling a small glass jar with water and brushing with no toothpaste. After brushing 25% of the teeth, dip the brush in the water, run your fingers over the bristles, and you will see plumes of white plaque come off into the water. Go back and re-brush this area and repeat the brush in the water until no more plumes come off. Then progress to the next 25% of the mouth. At the end of brushing, apply a rice (infant) or pea (toddler) -sized amount of fluoridated toothpaste to the brush and glide it over the teeth for the tooth-strengthening effect of fluoride. Rinse after 2 minutes of application. If you do not believe in fluoride, this step is not necessary – as the only purpose of toothpaste is fluoride application. Otherwise, brush bristles are strong enough to debride all plaque & residue from the teeth, and anything more is abrasive.
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A “tongue thrust” is an infamous condition characterized by the incorrect function of the tongue during swallowing. Normally with swallowing, the tongue cups food or liquid, presses up to touch the top palate of the mouth, and swallows in a wave motion from front-to-back. With a tongue thrust, one’s tongue pushes forward when swallowing, relying on suction to pull food and liquid back, rather than a cupping motion. This defective habit develops in infant years when the swallowing motion is developed and memorized. A tongue thrust is typically unknown and undetectable except for one particular side effect it causes when a person grows up: splaying of the front teeth. This is because during normal function, the tongue exerts several pounds of contact pressure each time it swallows. Done properly, pressure is applied to the top of the mouth, preventing food from moving forward.
During a tongue thrust, the tongue thrusts forward to allow the suction, pull type of swallowing, and exerts pressure upon the front teeth. All day, every day, amounting to thousands of pounds of pressure over time. The teeth simply can’t withstand this effect, and they splay forward, resulting in improper positioning and flared front teeth. The only solution is to receive speech therapy through a specialist who will try retraining the tongue muscles to swallow. It is a long process spanning months, with tedious home exercises, and an substantially difficult experience, especially for teenagers – since this condition is often discovered by an orthodontist once a teenager visits due to their parents or themselves noticing an improper appearance to their front teeth. What more, treatment for a tongue thrust may never cure the problem – the person may have to conscientiously position their tongue to the top of their mouth every time they swallow, for the rest of their life.
The real solution is to stop the problem before it starts. There are several ways a tongue thrust can develop and they are extremely significant during infancy. A prevailing origin for such a habit is found in artificial methods of feeding or soothing during infancy – such as through bottle feeding, binkies, or thumb sucking. All three of these common practices induce an infant, or toddler, to “suck” to get the food from the bottle, or to achieve calmness through a binkie or their thumb. The result? The tongue begins to habitually thrust forward to pull milk from the bottle, or hold the binkie or thumb. Over time, this completely reprograms the brain in regards to swallowing. Natural breastfeeding avoids this due to the phenomenon of “milk let down”, the natural process where a nursing infant more easily receives flowing milk, which then moves onto the tongue, resulting in a cupping motion, and proper tongue movement to the top of the mouth for swallowing. Mitigating binkies, thumb sucking, and bottle feeding all ensure the risk for developing a tongue thrust is reduced or eliminated.
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Kids get their first adult tooth around age 6 – and many soon after. These adult teeth need to last a lifetime and cavities early on lead to many complications. Consider periodically buying plaque disclosing pink dye tablets and using one after brushing to show missed areas in need of attention. These work very well!
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When is the right age to take your child to a dentist? When the first tooth erupts. This usually happens when an infant is 6-8 months old. At that time, having a general or pediatric dentist trained in this age range will ensure the child develops properly and education is available if you need to learn any home care techniques.
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Many new parents are surprised to learn “baby teeth” still need daily flossing to prevent cavities in their children’s teeth. Most of the time, visible spaces exist between baby teeth, allowing natural cleansing. However, almost always, some teeth will still press against one another enough to get a contact point and trap plaque. You may only find these spaces by flossing and hearing the snap. So ensure all areas of teeth are flossed, even if there is a space present, and identify the areas which will be a greater cavity risk and require diligent flossing. While finger flossing may be too difficult in infants and toddlers, using a handheld floss pick will reach all areas of the mouth and result in a job well done.
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Don’t wait to treat pediatric cavities! One key difference between “Baby teeth” and adult teeth is that baby teeth have larger pulp chambers inside them containing the nerve of the tooth, thus taking up more of the space inside the tooth. The result is less actual tooth structure, and while a small to moderate sized cavity in an adult may be far away from the pulp chamber, even small cavities in baby teeth can reach the pulp chamber with the nerve. The result is the child may require a pediatric root canal or lose the tooth, none of which are simple experiences. So have a routine cleaning and exam schedule established with a dentist competent managing children, and any small cavities can be discovered before they become problems.
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Cavity-causing bacteria are TRANSMISSIBLE, and can be passed on to others. Silverware, cups, kissing… all are vectors for which different oral flora can transfer between people. In fact, one of the ways humans may first become exposed to cavity-causing bacteria is from a parent kissing the child near or on the mouth! As far as science goes, cavity causing bacteria are still not naturally preventable.
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If you or a child ever have a tooth knocked out, as immediately as possible (1) place the tooth under your tongue or in a cup of milk. Do NOT place the tooth in water or almond milk, as the water will cause the living cells on the root of the tooth to swell and die. These cells are needed for the tooth to be successfully placed back in the socket. (2) Travel to your dentist immediately. You have a 1 hour window for the tooth to be put back in place before the body may reject it. You have the best odds for success if done within 30 minutes. Pediatric dentists will be better equipped for age 21 and below.