Oral Health FAQ

When teeth first appear, by 12 months old.

Current guidelines state that children should see a dentist when the first teeth come in and definitely by 12 months old (except that some children don’t get teeth until after 12 months). However, there seems to be a shortage of dentists in our area, even pediatric dentists, who will see children according to their own guidelines. That’s one of the reasons pediatricians are now applying fluoride varnish to kids’ teeth.  Children should definitely go by 3 years of age, and sooner if there are signs of tooth decay (white or dark spots on the teeth).

No true. No recommendation or guideline says that. Not the AAP. Not the AAPD. Not the ADA. Not the CDC.

We hear this all the time. What your family dentist really means and should say is that they don’t see children until 3/4/5 years old or whatever their answer is. Then they should tell you that your child does need to see a dentist, and they should give you a list of pediatric dentists who will see your child.

This does not count!

A dental visit for infants and toddlers includes checking the gums, mouth, jaw, and tongue. It also includes checking the front and back of the teeth for tooth decay, and applying fluoride varnish every 3-6 months. Every pediatric oral health and dental guideline says children need fluoride applied to the teeth at least every 6 months. If your child is not getting these things, then it is not really a dental visit.

We have our list here. You can also go the AAPD and search for a pediatric dentist on their site.

As soon as they appear!

You should brush your child’s teeth twice a day as soon as they come in! You should use toothpaste with fluoride. They still sell toothpaste without fluoride for toddlers and young children, but this is no longer recommended.

For children less than two years old, use a small smear of toothpaste (about the size of a grain of rice). In older toddlers, use a pea-sized amount. It is fine if they swallow it.

Children this age cannot brush their own teeth well enough; you have to brush them. It is good to let them practice before or after you brush them.

You should use toothpaste with fluoride. Even in babies and toddlers. Even if they don’t spit it out yet.

Fluoride toothpaste is now universally recommended. They still sell toothpaste without fluoride for toddlers and young children, but this is no longer recommended.

For children less than two years old, use a small smear of toothpaste (about the size of a grain of rice). In older toddlers, use a pea-sized amount. It is fine if they swallow it.

YES.

It is very important that children drink water that contains fluoride. Almost every county and city water supply has added fluoride. If you use well water or bottled water, it can be tested to see if it has enough fluoride. If you use Nursery Water or similar product, be sure to use one with added fluoride. Children who do not drink water with fluoride should be on fluoride drops, which are a prescription.

NO.

Teething happens… but it does not cause any symptoms other than a little fussiness sometimes. Teething does not cause fever, runny nose, or diarrhea. The best treatment is something cool to chew on. Ibuprofen can be used for more painful cases. Do NOT use teething/oral gel or homeopathic teething tablets; they are both dangerous to children.

NO. No. No.

Homeopathic teething tablets do not help (except that they are made from lactose — milk sugar — as a base, and this calms babies down. But homeopathy means putting very tiny amounts of poison in the tablet or liquid, and some babies have been actually poisoned the past few years. Besides, teething does not usually cause many symptoms, and there are better treatments.

Not usually.

You can control pacifier use; stop using them by age 2. Thumb sucking is harder to stop. If it persists after your child turns three, it can cause problems. See a dentist about an oral appliance.

Yes!

Baby teeth are very important. They are needed for healthy eating and speech. Also, we now know that caries (tooth decay) over time can effect the overall health of your child (this is true in adults as well).