Over the years I have seen a lot of kids with tooth decay. For kids to be healthy eaters, they need a healthy mouth and teeth! One of my goals, when I started my own practice, was to emphasize oral hygiene and prevention of tooth decay. I educate HEAVILY about oral health, give every 6 month-old a bright green toothbrush, focus on establishing healthy eating habits, and refer everyone to the dentist at one year. Many years later I have a practice full of kids with healthy teeth. In fact, of all of the kids who have started with me as newborns, there is an extremely low rate of tooth decay. When kids come in for well visits, and tell me proudly that they have no cavities, I’m happy to give them a sticker for “Dr. Yum’s No Cavity Club!”
I thought I would share my recipe for a healthy mouth. Tooth decay in kids is largely preventable, so join Dr. Yum’s No Cavity Club using these tips:
1. No juice in the home: Recent American Academy of Pediatrics guidelines recommend no juice under a year and offer some limits on daily consumption of juice for kids over one year of age. Kids are persuasive and because juice is sweet and tasty it can be difficult to limit. I recommend that parents NOT purchase juice or have it as an option in the home, even if it’s diluted. For better oral health, milk and plain water should be the choices at home. Whole fruit is a better option for kids and will provide less sugar and more fiber, which is so important for their gut health. Read more HERE about why skipping the juice may be better for your child’s health.
2. Brushing twice a day with fluoride toothpaste starting at 6 months or at the first tooth eruption: The American Academy of Pediatrics recommends using a rice grain-sized amount of fluoride toothpaste to help avoid tooth decay. I recommend pressing the toothpaste down into the bristles of the brush to avoid babies swallowing excess toothpaste. At bedtime make sure that teeth are brushed AFTER the last serving of food and milk for the day. My co-author Melanie Potock suggests that if your child dislikes toothbrushing, sing one verse of “This is the way we brush our teeth” and brush. Each day, slow down the tempo of the song so that you can brush more teeth during one verse. Always, without fail, end the brushing when the verse ends. This assures your child that you will stop and that he can tolerate the brushing until then.
3. 1st birthday = 1st dental visit: Early and regular visits to the dentist help to identify tooth decay before it becomes advanced and makes regular dentist visits a habit from a young age. If your family dentist is not comfortable treating babies or toddlers, ask your pediatrician to refer you to a pediatric dentist. Some family dentists may recommend starting visits later than one. This simply is not in line with recommendations from the AAP or the American Academy of Pediatric Dentistry. Visits starting at the first birthday can help babies get used to going to the dentist, set the stage for a healthy mouth for life, and help avoid early tooth decay.
4. Avoid a “grazing style” of eating and drinking during the day and night: Once children have new teeth, they should have periods of time when they eat and drink, then periods of time when they do not eat or drink anything besides water. They should give their teeth a break from foods like carbohydrates which lowers the pH in the mouth, can soften the tooth enamel, and cause decay. During their breaks from eating, kids can be encouraged to drink plain water to stay hydrated. These breaks also allow the teeth to remineralize or harden between meals. Frequent nursing or bottle-feeding at night after teeth have erupted can also put teeth at risk for decay. It's important to wean all bottles by 1 year and switch all drinking to a straw cup which helps strengthen muscles needed to eat and speak.
5. Reduce sugar and increase whole foods: Kids over 2 should have no more than 6 teaspoons (or 24 grams) of added sugar per day according to the American Heart Association. When kids are offered a diet high in added sugar, especially when there is constant exposure in a grazing style of eating, their teeth are at a higher risk of decay.
6. Wean pacifiers: By 6 months before a child is crawling and walking, make sure they are only using a pacifier in safe places where they will not fall, like in crib for sleep or in the carseat. This will avoid injury to the teeth and lips. By 12 months parents should wean a pacifier completely, meaning both day and nighttime use, to prevent molding of the palate.
Follow my six tips and hopefully, your family can join “Dr. Yum’s No Cavity Club” too!