When should I schedule my child's first trip to the dentist? Should my 3-year-old be flossing? How do I know if my child needs braces?

Many parents have a tough time judging how much dental care their kids need. They know they want to prevent cavities, but they don't always know the best way to do so.

When Should Dental Care Start?

Proper dental care begins even before a baby's first tooth appears. Remember that just because you can't see the teeth doesn't mean they aren't there. Teeth actually begin to form in the second trimester of pregnancy. At birth your baby has 20 primary teeth, some of which are fully developed in the jaw.

Running a damp washcloth over your baby's gums following feedings can prevent buildup of damaging bacteria. Once your child has a few teeth showing, you can brush them with a soft child's toothbrush or rub them with gauze at the end of the day.

Even babies can have problems with dental decay when parents do not practice good feeding habits. Putting a baby to sleep with a bottle in his or her mouth may be convenient in the short term — but it can harm the baby's teeth.When the sugars from juice or milk remain on a baby's teeth for hours, they may eat away at the enamel, creating a condition known as bottle mouth. Pocked, pitted, or discolored front teeth are signs of bottle mouth. Severe cases result in cavities and the need to pull all the front teeth until the permanent ones grow in.

Parents and childcare providers should help young kids set specific times for drinking each day because sucking on a bottle throughout the day can be equally damaging to young teeth.

Preventing Cavities

The Dental Association recommends that a child's first visit to the dentist take place by the first birthday. At this visit, the dentist will explain proper brushing and flossing techniques (you need to floss once your baby has two teeth that touch) and conduct a modified exam while your baby sits on your lap.

Such visits can help in the early detection of potential problems, and help kids become accustomed to visiting the dentist so they'll have less fear about going as they grow older.

When all primary teeth have come in (usually around age 2 1/2), your dentist may start applying topical fluoride. Fluoride hardens the tooth enamel, helping to ward off the most common childhood oral disease, dental cavities (also called dental caries). Cavities occur when bacteria and food left on the teeth after eating are not brushed away. Acid collects on a tooth, softening its enamel until a hole — or cavity — forms. Regular use of fluoride toughens the enamel, making it more difficult for acid to penetrate.

Discoloration also can occur from prolonged use of antibiotics, and some children's medications that contain a large amount of sugar. Parents should encourage children to brush after they take their medicine, particularly if the prescription will be long-term.

Brushing at least twice a day and routine flossing will help maintain a healthy mouth. Kids as young as age 2 or 3 can begin to use toothpaste when brushing, as long as they're supervised. Kids should not ingest large amounts of toothpaste — a pea-sized amount for toddlers is just right. Parents should always make sure the child spits the toothpaste out instead of swallowing.

As your child's permanent teeth grow in, the dentist can help seal out decay by applying a thin wash of resin to the back teeth, where most chewing occurs. Known as a sealant, this protective coating keeps bacteria from settling in the hard-to-reach crevices of the molars.

If Your Child Has a Problem

If you are prone to tooth decay or gum disease, your kids may be at higher risk as well. Therefore, sometimes even the most diligent brushing and flossing will not prevent a cavity. Be sure to call your dentist if your child complains of tooth pain, which could be a sign of a cavity that needs treatment.

As kids grow, plan on routine dental checkups anywhere from once every 3 months to once a year, depending on the dentist's recommendations. Limiting intake of sugary foods and regular brushing and flossing all contribute to a child's dental health. Your partnership with the dentist will help ensure teeth healthy and a beautiful smile.

Reviewed by: Lisa A. Goss,

RDH, BS