Baby's teeth: What you should know

Baby's teeth: What you should know
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Tuesday, May 28, 2013 - 9:45am

ORLANDO (CNN) -- With so many diapers to change and so little sleep, your infant's dental health may not be top of mind -- even after those first baby teeth make an appearance.

But the eruption of that first tooth, between the ages of 3 and 9 months, should be a signal to parents to schedule a child's first dental appointment -- and one should be scheduled no later than age 1, according to the American Academy of Pediatric Dentistry.

"We want (parents) to be aware that a newborn's teeth are already developing," says Dr. Art Nowak, one expert attending the AAPD conference in Orlando last week. "Parents can't see them, but they are there under the gums."

A whopping 97% of parents were unaware of the first-year, first-visit recommendation, according to a 2010 AAPD survey.

But there are compelling reasons for early checkups. Tooth decay is a leading chronic childhood disease -- more common than asthma -- and it's almost entirely preventable, according to the Centers for Disease Control and Prevention.

"I remind parents that this is a very important time," says Dr. Beverly Largent, a pediatric dentist in Paducah, Kentucky. "This baby is 1 year old or younger. They have new teeth. You are starting from the very beginning. And you have all the power in the world to keep your child from ever having a cavity."

During the first visit, pediatric dentists evaluate the child and ward off risks. Before a baby even arrives, pediatric dentists encourage expectant parents to get their own teeth checked. In addition, pediatricians and other health care providers are advised to tell parents the importance of wiping a newborn's mouth clean after each feeding -- something that may not occur to new moms.

Since acid-producting bacteria, called streptococcus mutans, is contagious, pediatric dentists caution parents against blowing on a baby's food or cleaning a pacifier with saliva.

"As soon as the tooth erupts, bacteria start developing plaque," Nowak says. "Whether it's from the mother's milk or formula, activity starts inside that plaque. In no time at all, that activity creates acid and that starts the whole disease process. At 5, 6, 7 months, things are starting to happen."

If you notice a white spot or discoloration on a baby tooth, "that means there could be a problem developing," says Dr. Warren Brill, newly elected AAPD president, and the child should see a dentist right away.

Left untreated, what's termed "early dental caries" -- the first stage of tooth decay -- can destroy tiny teeth and lead to infection, pain, and lifelong consequences. It can even be fatal in rare cases. Several children in recent years have died from abscesses or from surgical sedation to repair decayed teeth, dentists say.

The reality is, "baby teeth" need to stay put well beyond infancy and the toddler years. "In fact, some of those baby teeth are still in place when the child goes to middle school," says Largent. "If not properly cared for, those teeth can cause a lot of trauma. They are important to help your child look good, eat well and speak well."

Some dental health tips for parents:

Establish a routine: Lifting the child's lip, wiping the mouth and inspecting the gums and teeth should be done regularly, dentists say.

"That gives the baby a lot of things -- it gives them the expectation and familiarity of the parent checking inside their mouth," Largent says. "And it gives them the experience of feeling clean."

Begin brushing with the first tooth: And begin flossing daily as teeth line up, doctors say. The child will likely fuss or cry, but don't let that deter you.

"You have to brush their teeth for them," says Dr. Kevin Donly, who practices in San Antonio. "Kids don't have the manual dexterity until they're between 5 and 7 years old. I think a lot of parents really don't realize that. Even when your child thinks they can brush their own teeth, your job is to go back and re-brush for them."

Find a dental home: Having a pediatric dentist means parents know where to go and who to call in an emergency.

"By the time (children) are 12 to 14 months, they're mobile. They are going to fall -- and sometimes they fall forward," says Nowak. "With today's technology, we can tell parents, 'Send me a picture from your smartphone.' If there's something we need to do, we'll have them come in."

Avoid sugary drinks and use water to transition from bottle to cup: "Parents roll their eyes at me when I say, 'You can't put your child to bed with juice,' " Largent says. "Sometimes, when children come in and their mouths are ravaged, I go so far as to say to the parent, 'This has to stop, tonight.' "

Remember that preventative care pays: Costs are 40% lower in the first five years for children who have their first dental visit before age 1, the AAPD estimates.

Pediatric dentists aim to make that first exam as standard as any other medical checkup during the first year of life.

"Those cavity-free visits are marvelous. They're great for parents, there's no stress involved. They're great for kids, there's no stress involved. And, they are great for me because then I'm the best dentist in the world," says Largent.

"When I see a new mom, I want to give her some basic tools: I want her to know that she has to brush his teeth every day. I want her to know she's not being a bad mom if he cries while she's brushing his teeth. My goal is that her child will never have tooth decay." 

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