Dentistry has changed drastically in the past couple decades, and this is especially true for children growing up in today’s dental world.  I am routinely asked by parents about the benefits of fluoride and if dental sealants “really work."  Another common question is, "why would I put a filling in a baby tooth if it is only going to fall out?"  All of these are very valid questions and I know that when educated properly, they will make the right decisions for their children.  Obviously, parents want the best for their children, but because things have changed since they were kids, the new recommendations of today are often quite foreign.  My goal in this month’s issue is to educate parents on what they should be providing their children at home, and what kind of services they should expect from their dentist to keep their children’s teeth as healthy as possible.

When I was in dental school it was thought that the most important time to use fluoride was while the teeth were forming. Although systemic fluoride is important in developing strong teeth it is now known to be more important to have topical fluoride on the teeth after they develop to prevent cavities. The greatest benefits can be seen when small amounts of fluoride are constantly maintained in contact with the tooth via saliva. Thus, adults and children benefit from fluoride.  What does this mean for you and your children?  Fluoride treatments that are recommended to you, especially for your children, are extremely important to the overall health of teeth. In our office, we have chosen to utilize fluoride in a varnish form due to its ease of application and little to no taste. The varnish is painted directly onto the teeth and holds the fluoride in close contact with the teeth for many hours. Our patients tend to prefer this method because they can eat and drink immediately following the application.

In my opinion, the simple procedure of dental sealants truly changed dentistry for the better. Dental sealants act as a barrier, protecting the teeth against decay-causing bacteria. The sealants are usually applied to the chewing surfaces of the back teeth where decay occurs most often. We utilize sealants that also release fluoride after being placed, which continues to protect the treated teeth. If sealants were available when I was growing up, I would most likely have avoided the majority of my dental work.  Please consider fluoride and sealants a huge benefit when your dentist offers it, regardless of your insurance plan.  Both procedures cost a fraction of what a filling would cost. This necessary treatment could be the difference in protecting you and your child’s dentition from cavities, and future dental work.

So what happens if your child gets a cavity?  Unfortunately, tooth decay is still the most common disease in children so this is a very regular occurrence in dental offices.  Although common sense would lead us to believe that losing baby teeth would be a solution to tooth decay, this is not the proper approach.  Here are some reasons why:

1.    The baby teeth are placeholders for the permanent teeth. The body naturally loses baby teeth in a certain order to allow enough room for the permanent teeth to come in.  If the teeth fall out earlier or are extracted because of decay, you disrupt this order and there may not be enough room for the permanent teeth.

2.  Cavities in baby teeth can cause infections that can harm your child and damage the developing permanent teeth.  If the baby teeth are damaged, the damage isn’t isolated to the baby teeth.  This disease can spread to the other teeth in the mouth, including the permanent ones.  If a permanent tooth erupts into this diseased environment, it will be subjected this bacteria resulting in a cavity in it as well.  Additionally, when a cavity reaches the pulp (the nerve) inside the tooth, it enters the bloodstream and can cause an infection.  Usually the infection stays around the root of the tooth, but it can spread to other places in the body. 

3.  Baby teeth allow the child to develop good oral hygiene habits. It is much easier to teach a child the right brushing and flossing habits when they are young than it is to retrain an older child who has had bad habits for years.  While I don’t like to consider the baby teeth to be “practice teeth”, I do think parents should use the time before their children’s permanent teeth come in to teach them how to take care of their teeth.  If this is done, there will be fewer problems with the child’s permanent teeth because the child will know how to take care of them.

Home care is obviously just as important in this “battle” against tooth decay. Key ingredients in preventing tooth decay and maintaining a healthy mouth are twice-daily brushing with an ADA-accepted fluoride toothpaste; cleaning between the teeth daily with floss or interdental cleaners; eating a balanced diet and limiting snacks; and visiting your dentist regularly. I also recommend over-the-counter fluoride rinses at night for people who are more prone to cavities.

Hopefully, this sheds some light on why baby teeth are so important and will give parents the right information to make the proper decisions for their children's dental health.