Dr. Joye Warr, the experienced pediatric dentist from Warr Pediatric Dental Associates, hosts a live Q&A via Facebook Live twice a month. In these sessions, she has addressed a wide range of dental care topics with her characteristic bubbly personality. Her answers are always frank, to-the-point, and empowering.

We have compiled Dr. Warr’s top tips on how to best treat and prevent tooth decay in infants and children here. Watch the videos for a taste of Dr. Warr’s infectious smile or read the summaries below the videos for the highlights.

Why do we fill baby [primary] teeth?

There are three critical things that determine whether to fill a baby tooth or not:

  1. The age of the child. Not all baby teeth come out at the same time. So, if you have a four-year-old, and you’re talking about a tooth that’s not going to come out until your child is between 10 and 12 years old, then you probably should have that to get filled. Another important part of this is that not all four-year old’s or five-year-old’s lose teeth at the exact same time. Every child is different.
  2. The extent of the decay. Every tooth has three layers. On the outside is the enamel. The middle part is dentin. Then on the very inside is the nerve (the pulp) of that tooth. If the decay has reached the nerve, it’s probably going to be painful and will probably abscess. Therefore, you will want to do treatment on that tooth.
  3. How soon the underlying adult tooth will erupt. In other words, if it’s a tooth that probably doesn’t have that much root structure left on it, and it’s going to erupt in another year or so, then perhaps you don’t have to fill it. However, remember that it’s always easier to fill a small cavity than it is to wait until the cavity gets big. If that tooth is going to be there for a little while, it’s easier to fill it when it’s small.

The thing about tooth decay is that it keeps going. It’s not like when you get a cut on your skin. Cavities don’t get better on their own.

Why are baby [primary] teeth important?

There are three reasons why baby teeth are important:

  1. Function. It may seem simple, but if your child doesn’t have teeth, how are they going to chew? Baby teeth are important because they’re the first part of the digestive process.
  2. Bone development. Teeth help your child grow. The teeth oppose the jaws, and so it helps the jaws to grow into form. Without teeth, your child’s head, neck, and face won’t develop normally.
  3. Aesthetics. We like smiling with our teeth!

How do we handle teething?

Babies tend to begin teething anywhere from two to six months and continue to teeth until they’re between 2.5 to 3.5 years old.

There are many ways that children react to the teething process. One of the ways is that they get cranky. It’s also not unusual for kids to have almost like an allergic response with runny noses, loose stools, or diarrhea. Sometimes they can drool a lot. Some kids just have a little pain or a low grade fever. And then some kids may have nothing! The point is that every child is different.

There are many treatments or modalities to help your child with their teething:

  • A teething ring. We recommend that you do not put those in the freezer. You can put them in a refrigerator.
  • A warm cloth. Some kids like cold stuff. If your child doesn’t like that, try something warm that won’t tear or break.
  • Over the counter medication. Some kids respond to Ibuprofen, baby Tylenol, or baby Advil. Some kids respond to homeopathic teething tablets.

WARNING: We do NOT recommend teething biscuits. Now, they do take the child’s mind off whatever is going on because they provide a little bit of texture. But they have sugar in them!

Finally, one last caution. Do not give your child their toothbrush to chew on. Now, I know when your child brushes their teeth, they do two things, they suck on the toothbrush, suck all the toothpaste off, and then they chew on the brush. That’s fine for them when they brush. But make sure that you don’t give your child that toothbrush instead of a teething ring or a teething toothbrush.

Unfortunately, there’s no cure for teething. It’s something, it’s a stage that they got to go through. And it’s a stage that as soon as it comes, it’ll be over. So, go with the flow because it’ll be over soon.

How to brush your child’s teeth

  • Use the size that is smallest so it will fit into your child’s mouth. You don’t want to use a toothbrush that’s too big because then that defeats the purpose.
  • Use the proper toothpaste.  It’s recommended that until your child can spit out all the toothpaste that you use a toothpaste safe to swallow. For children under 2, you want to make sure it is a fluoride-free toothpaste.
  • Floss too! Don’t forget that any teeth that touch, you should floss them.

Note: fluoride is good, especially when children get a bit older, but too much fluoride is just as bad as not enough.

Real Talk about Pacifiers

I know pacifiers and thumb-sucking are comforting for your child. However, both the American Academy of Pediatrics and the American Academy of Pediatric Dentistry all recommend that you discontinue the pacifier habit at the age of one.

Studies show that when you stop using pacifiers that it helps your child to grow more uniformly. It also chases away what we call malocclusions or a bad bite.

Thumbs are connected. We get it. It’s not much you can do about thumb-sucking. But if your child is still doing the pacifier, or sucking their blanket or something like that, for comfort, around the age of 12 months, it’s time to begin to wean them from that habit.

Now, I know a lot of parents are like, well, how do I do that?

Well, there are a couple things that I’ve heard that parents do, especially with the pacifier. The first thing is the Binky fairy, just like the tooth fairy, and this works especially well. The second thing that I’ve heard that works well is if you cut off the tip of the pacifier, now, cutting off the tip, it relieves the suction that gives them satisfaction. So, while it sounds a little bit mean, it serves the purpose of helping your child to say, you know what, I don’t think I want to do this anymore.

Healthy Snacks for Teeth

When we talk about snacks, it is important to remember that the lower the pH of your child’s mouth, the more prone they are to cavities. So the frequency that your child snacks is just as important as when or what they snack on. You must make sure that you space snacks out.

There are some snacks that are better, that raise the pH of your child’s mouth, like cheese or chips don’t affect the pH as negatively as most sweet snacks. And so, chips or pretzels are always a better choice.

The other thing we have to talk about is juice consumption. Now I know you’ve probably heard this from your pediatrician, but we stand by what the AAP says the American Association of Pediatrics: your child should consume no more than four to six ounces of juice per day.

A recent study shows that the highest sugar content in foods that we give to our children are in juice, even 100% juice and yogurt. So, yogurt and juice have a higher sugar content than you think.

What to do when your baby falls and damages a tooth in High Point, NC

When a baby tooth is traumatized, the first thing you should do is of course, call your pediatric dentist, Most pediatric dentists have an emergency line.

One of the things we caution about is to make sure that you do not go to the emergency room. Most of them do not have dentists on staff. Certainly, go there, if you think that your child has sustained a head or neck injury, or you think that they’re not acting dizzy, or if they need stitches, certainly seek out your pediatrician and your emergency room.

The very first thing we do after you call is check to see if your child is crying. When they fall into something, crying is a proper response to the discomfort. It’s when they don’t cry that we get a little bit worried and wonder if there’s been head or neck trauma or something that we should be concerned about. So crying is the correct response.

Then we start to assess whether the teeth are okay or whether they can be saved or not. Now, when children’s teeth when baby teeth are traumatized, it can be anything from a small chip to chopping the tooth off to the tooth coming all the way out. And each one of those traumatic scenarios we treat differently.

If your child traumatizes a baby tooth, we always want to take an X-ray, to make sure that the adult tooth above the baby tooth is okay. Nine times out of 10, if there’s minor trauma to a baby tooth, the best thing to do is to leave it alone and let it heal. We often wait six weeks before we do anything, just to make sure that tooth is okay.

Having an established dental home for your little one will set them up for a lifetime of healthy dental hygiene habits.

Give us a call at 336-887-9277 to discuss how we can best support your child and to set up an appointment. And, if your child is 2 or under, don’t forget you get a FREE first visit with us!