when they were very little...

So I may have mentioned a time or two that I am a former dental hygienist and that my husband is a dentist.  In the interest of full disclosure, I will admit that we are in a battle for the health of my Sweet Boy’s teeth…he is a super stinky brusher!!!  It is to the great consternation of us both, what with our dental backgrounds and all, that at seven years old, we must watch him like a hawk!  He spends more time chatting with his sister or daydreaming than moving that tooth brush around his mouth and as you can see from the picture above, some things never change.  Some sources say that children can brush, unsupervised, by the age of six or seven – but that is more likely the age that they will stop swallowing toothpaste than the age that they will be excellent brushers.  Manual dexterity, and the pursuit of excellence in toothbrushing, will vary from child to child like anything else.  You will need to check your kids’ brushing technique, and their success at removing plaque from the teeth, until they prove to you that they can do a good job, period.  After that, periodic checks will be helpful in keeping them on track.

Everyone is different.  Sweet Girl is just nine, but she is your typical over-achieving, first-born…an excellent tooth brusher and flosser.  On the other hand, I can recall many grown up patients who could not remove bacterial plaque from their teeth successfully, even after many rounds of instruction!  Funny story, once I made a huge faux pas with a new patient of mine.  He was a Cardiothoracic surgeon, which involves surgeries in the chest cavity – “generally treatment of conditions of the heart and lungs” (thanks wikipedia!).  So, as an ice breaker, when we sat down to discuss the care of his teeth and gums, I said, “Now I am expecting great things from you, what with your surgeon’s hands and all.”  This was what, in English class, you would call foreshadowing.  He was literally the worst case of “bad hands” in dental self-care that I ever saw.  No matter how many times I demonstrated, or explained, or pulled out flip charts, this man could not effectively clean his own teeth.  Maybe I jinxed him?  Seriously, let this be a lesson to parents…check your kiddos teeth, regularly!  You can’t assume they are able to do a good job, no matter their age.

healthy, pink gums and shiny, clean teeth

Bacterial plaque.  Do you know what to look for?  White sticky stuff on the teeth, red gums (as opposed to pink gums), or natural tooth structure that is dull and not shiny, are the things I look for in my two peeps.  Tooth colored fillings are more matte than shiny, so you have to make allowances if they have those.  But healthy clean enamel (the outer covering of the teeth) is shiny like glass when it is dry.  I use a flashlight to really check well.  In the back where it is hard to see plaque sometimes, I look for red rims along the gum line, as this is a tell-tale sign of gingivitis.  Gingivitis is just inflammation (that’s the “-itis” part) of the gingiva (the gums); and that means they are missing plaque, near the red area, when they brush…often enough to cause the gums to get irritated.

Click here for a great video on how to brush – that way you can correct your kids’ technique if you see a problem in the way they brush.  The easiest thing we ever did was get an electric toothbrush for each child.  I am not a paid endorser, but we love the Sonicare!  You can get it on Amazon and it is a little pricey, but it is still cheaper than the price of just one filling.  I was going to tell you how to have them use it but there’s a great video for that too – click here!  As I am sure you know, they need to brush twice a day with a fluoride toothpaste.  The toothbrush removes the plaque and the fluoride strengthens the tooth structure if it has been weakened by the bacteria.  Flossing is important because it removes plaque in areas your toothbrush misses.  Anywhere that the teeth touch each other should be flossed, so usually it is best to start when they begin getting permanent teeth.  Don’t expect them to be able to floss on their own until they are at least 8 or maybe 10 years old…but remember my story about the surgeon!  Flossing correctly takes a lot of practice so they will do it wrong for a little while but that is okay as long as they are moving in the right direction.  Contrary to what you may see on TV, plaque cannot be removed by rinsing with mouthwash, so it is not considered a substitute for flossing and brushing.

Diet is also important to good dental health.  The bacteria in plaque which cause tooth decay (a cavity) get a chance to eat when you eat…but they only use the carbs.  And when they eat, they produce acid as they “digest” the carbs.  A cavity forms when the bacterial plaque produce enough acid to eat a hole in the surface of the tooth (enamel) and enter the inside of the tooth (dentin), which is softer and very vulnerable to the acid.  This happens at a microscopic level so by the time you see it, a lot of damage to the tooth may have occurred.  As I mentioned before, fluoride strengthens the tooth – it does this by adding minerals back into the tooth surface to reverse the decay.  Fluoride’s effect is microscopic so you don’t see all the good that is being done by it on a daily basis.  Once the cavity is formed, only a dental restoration can fix it (a filling or crown).  If the cavity gets too large, the tooth may be unsalvageable.  Early detection is key!  Your mouth’s own saliva (spit) has an important role in washing away the acid produced by plaque, so that your mouth is not bathed in an acid wash for too long.  Since bacterial plaque thrive on carbohydrates, eating sweets or anything high in carbs on a very frequent basis does not allow your mouth enough time to wash away the acid and keep your teeth healthy.  A lot of moms I know are surprised to hear that sipping on just one soda all day or eating an M&M every ten minutes would be much worse than eating a whole chocolate cake in one sitting…worse for your teeth, that is.  The thing to remember is to have your sweet, or carb, and then be done with it.  Rinsing with water after a snack is a great help, as is chewing sugarless gum, which stimulates your mouth’s production of saliva and helps return the mouth to normal.  Grazing snackers are really taking chances with their dental health!  Visiting the dentist twice a year can help catch decay before it is really bad and prevent many other problems.

Though there is so much more to say about children’s dental health, I would only add two more things.  First is you can visit the American Dental Association’s website, by clicking here to read more about other dental health topics.  And second, if your child plays a sport, chances are they would be better off if they had a mouthguard.  Athletes often collide or experience blows to the face in sports that are not considered “contact sports”.  At our last duty station, my husband wrote an article for the Randolph Air Force base newspaper (go Sweetie!) which I am quoting here:

The American Dental Association recommends wearing mouthguards for sports such as acrobatics, basketball, boxing, field hockey, football, gymnastics, ice hockey, lacrosse, martial arts, racquetball, roller hockey, rugby, shot putting, skateboarding, skiing, skydiving, soccer, squash, skiing, volleyball, water polo, weightlifting and wrestling.

Wearing a properly fitted mouthguard can prevent injury to the lips, damage to teeth, avulsion of teeth (when a tooth gets knocked out), and concussion.  This last one is the reason the NCAA requires athletes in contacts sports to wear mouthguards.  For example if your child takes a direct hit on the chin, that force can be transferred through TM joint (where the upper and lower jaws connect) to the brain.  Read more about it here.

So finally, I want to encourage you.  Sometimes it is even hard to keep up with your own dental health!  And there is a lot to learn when you are a mom.  You cannot be the expert of everything, though you may want to be.  Do your best and remember, our goal is to teach them to care for themselves, doing it for them till they can, like everything else in motherhood!  Here is something I tell my little brushers that I learned from a wonderful Periodontist, whom I worked for when I first got out of school.  As you will see, he was witty as well.  He told patients this, “The good news is that you don’t really have to brush all your teeth!”  A long pause here is very effective.  “Just the ones you want to keep!”  Of course, be sure to let the little ones know that when their permanent teeth come in, there are no replacements waiting in the wings – you gotta’ keep those!

JustAgirl…just like you!