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Dentists Need to Brush Up on Baby Care

American Dental Association urges parents to schedule child's first checkup by age 1

SATURDAY, Feb. 23, 2002 (HealthDayNews) -- One in five American children is at risk of serious tooth decay -- and their dentists may be partly to blame.

As many as 20 percent of children have cavities by the age of 3, and those cavities might be avoided with early checkups, experts explain.

The American Dental Association recommends children get their first dental exam by their first birthday. Yet many dentists tell parents not to bring children in for their first checkup until age 2 or even 3.

The delay means dentists miss a chance to educate parents on caring for their young children's teeth. And parental education is critical, because children under the age of 5 or 6 lack the physical skills to really do a good job of brushing and flossing on their own.

"We are trying to re-educate our dentists," says Dr. Kimberly Harms, a dentist in Farmington, Minn., and an ADA spokeswoman. "It's a good thing to bring children in for a checkup at one year."

Because of fluoridated water, the majority of kids nowadays have healthy teeth, so many dentists see no urgency in scheduling the first exam. Indeed, Harms, who has been in practice for 20 years, says she also used to tell parents not to bring their kids in until they were 2½ or 3 years old.

"But we've realized that for some children that do develop decay, it is often rampant decay," she says. "And had we been able to catch that at an early age, it would be far less difficult for the children and the parents."

Just ask the Toth family of St. Petersburg, Fla. When their daughter, Charly, was born, their dentist told them to start brushing Charly's teeth at age 1 and to get her first dental checkup at age 2.

But when Charly did visit the dentist, the family got shocking news: Charly had extensive decay that required a root canal and 11 caps on her baby teeth. The cost of the surgery was $5,000.

"It was definitely a shock," says her mother, Darlene Toth. "Your heart just sinks, and your first thought is: 'Oh, I'm a bad mother. What have I done wrong?' "

Toth says both she and her husband had bad teeth as children, and she suspects genetics could be at work. That could be part of the problem, experts agree.

Another likely factor: Throughout her infancy and into her second year, Charly was a restless sleeper who often awoke in the night. Her mother would breast-feed Charly to get her to sleep, then put the child back to bed without brushing her teeth.

Experts warn against putting babies to sleep with a bottle, and the same goes for breast-feeding. Leaving milk on the teeth overnight invites the growth of bacteria that cause tooth decay.

The best way to avoid youthful tooth decay is to start early with good oral hygiene. Even before teeth appear, parents should wipe the infant's gums with a clean cloth after feeding.

"Children need to get used to the stimulation," says Dr. Mary J. Hayes, a pediatric dentist in the Chicago area and a spokeswoman for the American Dental Association. "You're trying to get the baby used to having someone in their mouth."

When teeth appear, the parents should start brushing them with a soft toothbrush twice a day, in the morning and before bed. Since babies can't spit, use infant tooth and gum cleanser without fluoride. If a child swallows too much fluoride, it could cause stains on the permanent teeth.

And brush from the gumline, not just the tips of the teeth.

Flossing should start by age 4 -- or sooner if the teeth have grown close enough to eliminate the spaces between them. Again, the parents will need to take the lead.

"Parents will tell me, 'Oh, my child doesn't want me to brush his teeth,' " says Hayes. "Well, just because they don't like it, doesn't mean the parents are off the hook. There's a lot of things children don't like. But you have to take tooth and dental care seriously."

What To Do: Get answers to frequently asked questions on infant and child dental care from the American Dental Association, or find further information from the National Library of Medicine.

SOURCES: Interviews with Mary J. Hayes, D.D.S., and Kimberly Harms, D.D.S., both spokeswomen for the American Dental Association
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