Consultation with the Specialist: Dental Care

Introduction

Dental care for children often is an underrecognized responsibility for new parents. Health care practitioners need to inform parents of the appropriate measures to care for their children’s teeth until the children can clean them effectively. We also should prescribe fluoride for those individuals living outside fluoridated drinking water supplies (Table⇓ ). Fluoride should be supplemented until age 16 years or later if teeth eruption is delayed.

Initial Care by the Parents

Primary teeth start to form in utero, and permanent teeth begin formation shortly after birth. Primary incisors can be present at birth and should be differentiated from natal teeth or keratinized remnants. Parents should begin caring for their child’s teeth simply by watching for tooth eruption. The child should be examined for teeth at each visit, especially at about the 6-month health supervision visit and all examinations thereafter. Usually the lower anterior teeth come in first, followed by the upper opposing teeth. The standard is usually one tooth erupted by 6 months of age and six teeth by 1 year, but the variation from normal can be as great as 12 months. Eruption of teeth generally does not interfere with nursing; children typically learn very quickly not to bite because the breast will be withdrawn.

Early dentition care involves cleaning the mouth and teeth at bath-time with a washcloth prior to washing the rest of the body. Teeth can be cleaned with a washcloth very effectively without disturbing the child. Toothbrushing can begin as soon as the child is ready and depends on the child’s development and ability to tolerate other hygiene activities. Children who are allowed to watch parents and older siblings brushing their teeth are likely to want to emulate …