Growth, Development, and teething
Your child will be teething from pretty much 6 months to a year, up to age three. The last study that was done on eruption patterns was in the 70s. Most doctors and parents will tell you anecdotally that we see teeth erupting sooner now. Maybe it's better nutrition, maybe it's hormones in the milk, who knows? But the bottom line is, the numbers that I'll give you, if your child's ahead of those, don't worry about it. And if your child's a little behind that, don't worry about it either. Our pediatric dentists in dental school used to say, you know, kids are like flowers in a garden. They erupt, and they come in. The teeth come in when they will.
Around age 6 months to a year, you're usually going to have the bottom front two teeth come in. And when teething starts is a good time to stop breastfeeding because it's going to hurt. But your child's going to teethe pretty much from that through three. And by 3, they're going to have their baby set, which is 10 tops, 10 bottoms.
At that point, there's going to be a pause until they're about six. And about six, they're going to start to get their six-year molars in the back. These are new teeth that come in behind the baby teeth. They are adult teeth that come in. It's super important to protect these with sealants when they come in. The back pits and fissures in the teeth sometimes don't fuse fully, and there's a gap, so sealants can really reduce the risk of cavities on the back molars. That's around six.
But also around six, again, the bottom two teeth will start to come in. It's usually top, bottom, four top, and around six, seven, eight, it's probably going to be the four and the four adult teeth. You do want spaces in your child's teeth when they're younger, when they have their baby teeth. And as your child develops, we don't really have to worry about flossing; there's usually space between the teeth, except around age five, when you might get tightness between the back two molars. I usually say around five, start checking with floss or a floss pick. If it snaps the floss, then the bristles aren't getting between the teeth anymore, and you want to start flossing. If it snaps the floss tight, you want to start flossing. If it's not, then the bristles can clean in there, and you're good.
Around 7 or 8, the four teeth are going to come in. This is when we really check for jaw growth and development. We'll get the dental X-ray that goes around the head, make sure your child's teeth are coming in as they should, make sure there's enough space front and bottom, and check the jaw alignment forward and back. This is the best time for what we call a functional orthodontic appliance, so something to correct jaw growth and development. The ideal time is about in this 6 to 8 range, depending on the child, so that we make sure the jaws are lined up properly. That just saves you a bunch of time and money in ortho.
Ortho won't start until all the adult teeth are in, and that's about 12. Around 7 or 8, the four in the front will come in; you'll have the six-year molars, and then, sometime around 9, 10, 11, the three and three, and then you'll get the 12-year molars in the back. And when those 12-year molars come in, it's a good time to seal those in the back and then look at orthodontics. We offer both clear aligners and traditional braces here at Dulac Dental of Springfield, and if you get jaw growth and development right at 6 to 8, both are options.
We're doing a lot of teen Invisalign now. It's kind of cooler. Kids like it as long as they'll wear it. If your child will wear an appliance that comes in and out, great. If you're worried about that, then we'll do something that's cemented in. I always leave it up to the parent to decide what's best for their child. But we do do all those services here at Dulac Dental of Springfield.
Prevention, Flossing, and Teeth Brushing
Usually, with kids, you don't have to floss their teeth if they have space. If it's snapping the floss, I say check once a week, starting around five. If it's snapping the floss, start flossing those teeth where it snaps. Usually, if kids are going to get cavities, it's between their baby molars in the back. You do sometimes have to floss your kids' teeth if there's not space.
You're going to have to brush after them until they're 8 years old. If you can get a kid a Sonicare for them, my daughter took to it around four or five. My son's five; he can't tolerate it yet. Some kids like the vibration, some kids don't. Once they get a kid Sonicare, you really only have to make sure that they use it. But up until 8, or until they use the Sonicare, you're going to have to brush after them.
If you're worried about how well they're brushing or you want to help them brush, they do make mouth rinses or little disclosing tablets you can get on Amazon that dye the plaque on the teeth pink. If you want to make sure the job's getting done, but you don't want to do it yourself, you can just have them chew that in front of you. It'll turn their teeth all pink, and just tell them, "Hey, go get all the pink off." That's a good way to help train your child in brushing and flossing.
But you do want to brush after your child until about 8 years old or until they can get an electric toothbrush. I do recommend Sonicare as the best one. They do have a kids' one. It has a rubber grip and a rubber back head. That way, if they bite on it, it doesn't chatter the opposing teeth. This is a great brush. That's the brush I recommend for all my patients.
Fluoride, Toothpaste, and Other Alternatives
In terms of fluoride, yes, you want to use fluoride. As soon as the first tooth comes in, you want to start brushing it a little, like a little dab, until your child can spit it out. Just a little dab, and wipe it off the bristles. You really don't need much. If you think about it, we have 32 teeth. That's where the two minutes of brushing comes from. Their teeth are much smaller. There are fewer of them. You don't have to brush as long. You only need a very tiny amount of toothpaste. Even adults only need a pea-sized amount. The big Dairy Queen swirl that's just to sell more toothpaste. You don't need that much. And until your child can spit it out, you don't want that much.
If you're really worried about them swallowing toothpaste or something like that, you can dip the bristles in a fluoride-containing mouth rinse and then brush their teeth with that. But fluoride is the only active ingredient in toothpaste. So if you're not using a fluoridated toothpaste, you might as well just not use anything. As soon as the first tooth comes in, brush it. You do want to have some fluoride on there, but not a big glob of it that they can swallow. Just a little tiny bit. And you want to help them brush until they're about eight, and you want to start check-flossing around five, and if it's tight, you can get them those little floss picks. Those work great for kids.
Most kids don't like mint. If your kid will use mint toothpaste, you don't have to buy more toothpaste. Fantastic. Tom's of Maine with fluoride makes a great line of fruit flavors. They've been around for decades. Great brand. The other one that's really good and that my kids really like is Colgate Watermelon. It's kind of soupy, so it's thinner, and you don't get a big glob on there. It's pretty thin. You just put a dab on there. They love the watermelon flavor. Then run it under water, and most of it comes off, but it's enough to get the fluoride on the teeth. A lot of kids don't like mint, but you do want to use a fluoridated toothpaste.
If you don't have fluoride in your water, you can get fluoride test kits from the county. If you're completely fluoride-free, I would recommend supplementation, but in most of this area there's fluoride in the water. I know that's a big thing now. There was just a huge study out of Wisconsin that followed people for like 40 or 50 years and found no difference between fluoridated and unfluoridated water. What fluoride does is make the outer surface of the tooth more resistant to decay until about age 12. Fluoride can also go into the whole tooth structure as it's forming to make the whole tooth more resistant to decay. After 12, it's just topical fluoride, but we can't give one group water to kids under 12 and a different group to everyone else. I know that's a big thing now, but if you're super, super anti-fluoride, I'm probably not going to convince you otherwise.
The only other thing to mineralize teeth is hydroxyapatite or nano hydroxyapatite. Up until about a year ago, it was very expensive, about $23 for a tube of it from GC America. Now the price has come down quite a bit, and there are a lot of other sellers out there. I don't know if they lost their patent or all of a sudden, with the anti-fluoride people, more started getting into it, but it's come down a lot in cost. It is still about twice the cost of regular toothpaste. But if you're truly anti-fluoride, then nano hydroxyapatite is what you want, or calcium hydroxyapatite.
The only other thing for home care would be mouth rinse. The only active ingredient in mouth rinse is fluoride. ACT is a brand that's been around since I was a kid. After you brush and floss, it does help prevent cavities to swish with the mouth rinse. In terms of strength of fluoride, there's the over-the-counter toothpaste, over-the-counter mouth rinse, prescription toothpaste, and what we do in the office.
I do recommend the application when you come in. And if there's any cavity risk, I do recommend either an over-the-counter fluoride rinse or the prescription toothpaste. The prescription toothpaste does come in fruit flavor if your kid doesn't like mint. And the over-the-counter fluoride rinse comes in a bunch of flavors, bubble gum and stuff like that. ACT is a great brand that's been around since I was a kid, but I usually just get the store brand, whatever's the cheapest, Amazon Basics, whatever. It doesn't matter.
What to Expect at Your Child’s Dentist Visit
Up until about age three, we just go over all this stuff: home care, prevention, how to prevent cavities, growth, and development. Around age three, we'll typically start polishing the teeth. Around age five, we'll start trying to get dental X-rays to see between the teeth. And at age six, the X-ray that goes around the head.
For the first couple of years, it's just kind of acclimating your child to the office, starting the cleaning. Some kids do get tartar. It's not common, but some kids do get tartar. If there's tartar on the teeth, we'll start cleaning it off for sure. A lot of kids don't get tartar, but once their six-year, 6- to 8-year baby teeth come in, or adult teeth come in on the bottom, there's usually tartar to clean off. Adult teeth tend to develop a lot of tartar buildup; that's what we're scraping off during the visit. The kids usually don't get it as much, but if your child does, we'll obviously clean it off.
What Causes Cavities and Safe Snacks
Let's transition into something that's almost always forgotten and is super important. What causes cavities? It's not the amount of sugar in your diet, it's the frequency of it. The bacteria that we have in our mouth, when it gets sugar, it makes acid. The acid dissolves the tooth and makes a cavity. It makes acid from the second it gets it until 20 minutes after. So you can eat or drink, or your kid can drink, whatever they want, three or four times a day. It's snacking between meals and sipping on things with sugar, like juice, between meals that's going to get you.
No juice in a sippy cup. Juice is like crack for kids. Keep it to mealtimes. Keep it to special occasions. No juice in the sippy cup. Even Juicy Juice, 100% juice, it's just sugar water, just leave it out.
Healthy snacks would be snacks your child can have anytime and snack freely on without causing cavities: cheese, most kids like cheese; meat snacks; whole fruit, the sugar's bound up in too much fiber for it to be an issue; veggies with ranch, check the ranch, some ranch has sugar in it now, it's crazy; or popcorn. Most kids like either cheese or popcorn. As long as it's not caramel corn or something with sugar on it, like butter and salt, that's fine.
Those are the safe anytime snacks: popcorn, meat snacks, cheese, whole fruit, and veggies. Make sure the ranch doesn't have sugar. And whole fruit, it can't be like a fruit cup processed with a bunch of sugar in it. It's got to be like fresh fruit.
Those are the safe anytime snacks. Everyone thinks about fruit snacks, fruit roll-ups, and stuff like that as having sugar in them. What gets easily overlooked are pretzels and crackers. I haven't met a kid who doesn't like pretzels and crackers. They're actually worse for causing cavities than caramels. The pretzels and the crackers stick in the pits and grooves of the tooth for a really long time. So, pretzels and crackers, just keep them to mealtimes.
Yogurt's one of those ones, too; you've got to be careful about sugar. Some yogurt is sugar-free. That would be fine. If it's yogurt with sugar, I would keep it just to mealtime. So pretty much they can have whatever they want three or four times a day, but between meals, water only, soda water, popcorn, meat snacks, cheese, fruit, and veggies. Those are the safe snacks to have anytime.
Avoiding Dental Problems and Orthodontics
If you do those things and get the sealants at six and bring your child in once a year, once every six months for cleanings and checkups, you're going to avoid 99% of dental problems. Kids don't get oral cancer. They don't have jaw issues, they don't have gum disease. It's basically just cavity prevention and growth and development to save you money in ortho when they get to be like 12.
Around 6 to 8, if we get the jaws lined up right, that saves money around 12. Straighter teeth are easier to keep clean. I do recommend orthodontics for anyone with crowding, rotation, or a non-functional bite. There are a lot of benefits beyond cosmetic benefits to orthodontics. And if we catch it early, it's great.
Really, we're just focusing on cavities, the home care, the fluoride, prevention, minimizing the sugar, and checking the jaw growth and development.
Serving Your Entire Family’s Dental Needs at Dulac Dental of Springfield
Building positive dental habits at a young age can support a lifetime of healthy smiles. Contact our team at (703) 451-4500 or email [email protected] to schedule your child’s visit.