Taking a Bite Out of Tooth Decay

By: Michelle Place, CRNP
As parents you want to do whatever you can to make sure your kids are as healthy as they can be. While you worry about fevers and coughs and whether organic is best, the fact that dental health is a vital part of your child’s overall health is often overlooked.
The truth is that  tooth decay is the most common chronic disease in children older than 5 years. Dental caries are five times more common than asthma and occur seven times more often than hay fever. One in four kids begin kindergarten with a history of dental caries. You may think these teeth do not matter because all they are good for is a few bucks from the tooth fairy, however, children with cavities in their baby teeth are much more likely to develop cavities in their adult teeth. The good news is that unlike a lot of other ailments, tooth decay is a disease that is by and large preventable.
Your mouth is home to billions of bacteria. The main culprit in causing cavities is a bug with the ominous sounding name of mutans streptococci. Oral bacteria are usually transmitted from parent or caregiver to child. This most often happens after the eruption of the first tooth so usually between the ages of 6-31 months, however, these bacteria have been found on the tongues of infants as young as 3 mos of age. The younger the child is when their mouth is colonized by mutans streptococci, the more likely they are to develop dental caries.
We must work together to keep children’s mouths healthy.
What you can do:

  1. Avoid saliva sharing activities

Do not “clean” your child’s pacifier by putting it in your mouth
Do not share food or utensils
Do not put your child’s hand in your mouth
Do not kiss your child on the mouth

  1. Routine Dental Care

Never allow your child to sleep with a bottle in his/her mouth
Make sure water is fluoridated – use to make formula, etc.
Start brushing twice a day at the first sign of a tooth with a smear (size of a grain of rice) of fluoride toothpaste, best right after breakfast and before bedtime
Your child should not be allowed to brush their teeth independently until they are able to tie their own shoes (usually around 7 years of age)
No sugary snacks or drinks/juice between meals
Schedule regular dental visits starting at 1 year of age (see our website for a list of recommended pediatric dentists)
What we can do:
Here at Potomac Pediatrics we have started applying Fluoride Varnish at all well visits for children from 9 mos to 3 years of age. Fluoride is a mineral which strengthens tooth enamel (the outer coating on teeth) and slows down tooth decay. Studies show fluoride helps prevent new cavities from forming and if tooth decay is just starting it can even help repair the tooth! Even if a child receives fluoride from other sources such as through drinking water, the direct topical application of fluoride to the teeth is much more effective in preventing cavities and is recommended by the American Academy of Pediatrics.
I know what you are thinking…
Isn’t this a job for the dentist?
Very young children often do not see a dentist unless there is a problem They do, however, go to their pediatrician’s office for 11 well child visits by the time they are 3 years old. This allows the fluoride treatments to be completed as recommended. All children should continue to visit a dentist starting at their first birthday for routine dental care.
How is it done?
The procedure is quick (less than 2 minutes) and painless (unless the provider gets bitten). While lying in their caregiver’s lap, a small piece of gauze is used to clean and dry the teeth. The bubblegum flavored varnish is painted onto all tooth surfaces using a tiny brush. The varnish forms a sticky covering over the teeth that hardens as soon as saliva touches it. Depending on the brand of varnish used the teeth may temporarily look yellow or dull. Do not worry, your child’s teeth will return to normal after the fluoride varnish is brushed off the following morning. Most children like the taste.
Does it hurt?
It does not hurt when the varnish is applied, however, this does not mean that young children will not cry before or during the procedure. Fortunately, brushing on the varnish only takes a few minutes. Also, crying results in an open mouth which makes getting in there to apply the varnish much easier.
How long will we have to wait to feed the baby?
Your child can drink and eat immediately after the fluoride application but should avoid sticky, hard or hot foods for the rest of the day. You should not brush your child’s teeth until the next morning at which time the varnish will come off leaving the teeth white and shiny.
Is it safe?
Fluoride varnish is safe. Due to the fact that it hardens as soon as it comes in contact with saliva, almost no fluoride is swallowed.  
Oh, great! Another thing I have to pay for?
Good news! Insurance companies are now required by law to cover this procedure. As a result, it ends up being little to no cost for you!
Please call our office at (301 ) 279-6750 or email us at question@potomacpediatrics.com with any other questions or speak to your child’s healthcare provider at their next check-up.