Kids’ Dental Care is Not Only More Effective These Days — It’s a Lot More Fun

by Kathy Sena

Half of all American school-age children today have never had even one cavity in their permanent teeth, according to the American Academy of Pediatric Dentistry (AAPD).

That’s an amazing statistic for those of us parents who grew up in an era when getting a few cavities as a kid was just expected. Remember that Crest commercial on T.V.? “Dad, Dad! I only had one cavity!”

Improved dental care, fluoride and advances such as sealants can give our kids an edge — but only if we get them started on the right track.

Choosing Your Child’s Dentist

Family dentists have traditionally taken care of the entire family’s teeth. But pediatric dentists, who have two to three years of additional training in working with children (including child psychology and behavior management), are becoming increasingly popular with kids and their parents.

I’m not surprised: On my then-two-year-old son’s first visit to a pediatric dentist, he enjoyed a toy-filled waiting room, an exam room featuring a purple “Barney” dentist chair, Disney videos, grape-flavored dental floss and bubblegum-flavored toothpaste.

His biggest concern about visiting the dentist? “When can we come back, Mom?”

In addition to providing a less-intimidating environment for their pint-sized patients, pediatric dentists are trained to provide, when necessary, sedation for cavity filling and other procedures.

Pediatric dentists and family dentists charge roughly the same fees, according to the AAPD. However, pediatric dentists are more prevalent in major cities. Family dentists often are easier to locate, especially in smaller towns. “Also, most generalists don’t want to see patients before age three,” notes Mark Smilack, D.D.S., a family dentist in Columbus, Ohio. After that age, however, “A good family dentist certainly has the experience to treat the entire family,” he says.

Easing Dental Anxiety

Both the AAPD and the American Dental Association (ADA) recommend a first dental visit by the first birthday. But some parents may be reluctant to bring their child to the dentist because they may have had a less-than-wonderful dental experience as a child.

“Young children can pick up on a parent’s anxiety very easily,” says Smilack, who recommends talking to your child about her first dental visit in positive, matter-of-fact tones. Also, never use a trip to the dentist as a threat when trying to get them to brush their teeth, Smilack stressed.

Knowing exactly what will happen during a dental visit can ease kids’ — and parents’ — fears, says Ruth Becker, D.D.S., M.S., a pediatric dentist in Torrance, Calif. Becker, known to her patients as “Dr. Ruth the Tooth,” helps ease dental jitters by offering “tooth parties” for ages two through seven. Dressed in a tooth costume, Becker introduces kids to her dental-office friends, “Mr. Squirty” (the water/air syringe) and “Mr. Thirsty” (the straw-like device that removes saliva). She shows videos featuring tooth-brushing dinosaurs and takes giggling kids for a ride in her dental chairs. As parents see their kids enjoying themselves, it helps ease their own anxiety, Becker says, noting that many pediatric dentists offer such educational programs, either in their office or through local schools.

Ages 1 Through 5

Thumb sucking usually declines after age two. If continued past age four, it may hinder dental development, so you’ll want to talk with your dentist.

Help your child learn to choose sensible snacks that don’t promote tooth decay.

Flossing (done by the parent) should begin when all the primary teeth have erupted, usually by age two and a half. If your child wants to “help,” tie the floss into a loop to make it easier for little hands to hold, suggests Becker. Talking about “scooping the goop with the loop” adds to the fun, she notes.

Toddlers and preschoolers need help with tooth brushing. (Singing a silly song, such as “Sugar Bugs, Sugar Bugs, Go Away!” makes the task more fun.) By age four or five, your child may be able to brush his teeth under your watchful eye. Make sure he uses only pea-sized amounts of toothpaste, and that he learns to spit, not swallow.

Ages 6 Through 12

The first permanent molars usually erupt between ages five and six. Because they don’t replace any primary teeth, they are often mistaken for primary teeth. But they are permanent teeth that must last a lifetime. They also help determine the shape of the lower part of the face. Teach your child to take good care of them.

Your dentist may recommend that your child use an over-the-counter fluoride mouth rinse daily after age six. Instruct your child on how to use such rinses, and supervise when necessary.

By age seven, your child should be able to brush alone. Flossing is more difficult, but by age eight, she should be able to floss with supervision.

The American Dental Hygienist’s Association recommends applying a dental sealant — a clear plastic coating that is applied to the chewing surface of molars with deep grooves and pits — at age six and again at around age 12. An application lasts several years and can be examined during check-ups. After cleaning the teeth, the dentist or hygienist applies the sealant with a dropper or brush. The sealant fills the pits and grooves and protects the tooth from cavity-causing bacteria. Sealants cost between $25 and $35 per tooth, says the AAPD — about half the cost of fillings. They usually aren’t covered by dental insurance.

What’s new at the dentist’s office?

What if, despite all that brushing, flossing and sealing, your child still gets a cavity or two? While our experts didn’t recommend laser-dentistry techniques for children, some improvements in dental care are tailor-made for kids, including microabrasion, in which an air stream containing aluminum-oxide particles “sand blasts” small areas of decay. The procedure requires no anesthetic, says Smilack.

After the decay is removed, many dentists are now using tooth-colored composite resins for fillings instead of silver-mercury fillings. “In addition to looking more attractive,” he explains, “they bond to the tooth structure and actually strengthen the tooth.”