We chatted with pediatric dentist Emanuela Corielli from Bright Healthy Smiles about when you should send your kiddie to the dentist for the first time, her tips on getting rid of thumbsucking, and the truth about whether fluoride toothpaste is safe.
CK: When is the ideal age to send my child to the dentist for the first time?
EC: Pediatric dentistry is heavily based on prevention so the American Academy of Pediatric Dentistry recommends the first dental visit at age 1 or 6 months after the eruption of the first baby tooth. A dental visit at this young age allows the pediatric dentist to establish a relationship with families and the child, to detect habits that might create future problems, and to create a comfortable “dental home” to insure good prevention and care. Positive experiences early in life help to create a foundation of trust and healthy dental habits for the future.
CK: Do kids with no teeth need to start brushing just to get into the habit?
EC: While it is not possible to brush a mouth without teeth, it is very important to teach parents and caretaker that using a wet gauze or wipe to clean the mouth before the eruption of the first primary tooth is very important. After the bottle or breastfeeding, a swipe through an infant’s mouth will not only keep his or her mouth clean, but also familiarize them with having their mouth touched. This will make it easier to brush later on.
CK: How bad is the pacifier to the development of mouth and teeth? What about thumb sucking?
EC: Pacifier, straw cups, bottles, and thumb sucking all have the potential to change the shape of the mouth and especially the maxilla. Baby’s bones are soft and malleable and the pressure of, let’s say the pacifier, can potentially push the maxillary anterior teeth forward and restrict the palate. However, sucking is important for infants as well young children for psychological reasons and for self-soothing so great care should be taken in balancing the psychological needs with the development of the mouth.
There are different opinions as to when it is the best time to stop any habit. I like children to stop all habits by age 4 because the pressure from the lip can correct, for the most part, any unwanted changes to the maxilla. I favor gentle and supportive methods and positive reinforcements. Charts with stickers and prices go a long way to change behavior.
CK: Any tips on getting rid of the pacifier? And thumbsucking?
EC: The pacifier is typically an easier habit to break than thumb sucking. I suggest at first concentrating on stopping the habit during the day and leaving the pacifier in the crib. As a second step, parents can have a big party to give the pacifiers to the pacifier fairy. Once this is done, the parents need to be strong and not give back the pacifier. My suggestion is to spend more time in the child’s bedroom before leaving at night to give her more comfort.
For children that are sucking their thumb, the situation is more complicated. Typically they stop the habit during the day once they go to school. At nighttime, cotton gloves might help. A thumb hugger or thumb guard can also be useful. However, during this process is very important to always be supportive and not punitive. Rewards and encouragements are key. Cutting the tip of the pacifier or wrapping the thumb with a Band Aid during the night can be dangerous and I do not recommend it.
CK: My toddler refuses to let me brush his teeth. What should I do?
EC: Toddlers do not want to have their teeth brushed. It is almost universal. Our little ones like to brush by themselves but tend to scream or cry when their parents or caretaker brush for them. As always, be as positive as you can. By keeping a regular brushing routine (morning after breakfast and nighttime before going to sleep ), home care will become part of the routine and eventually accepted by the child. Children who do not have their teeth brushed are at higher risk of developing tooth decay.
CK: Should I be using fluoride toothpaste with my child? I’ve heard mixed things about whether it is safe.
EC: The American Academy of Pediatric Dentistry suggests to start using fluoride toothpaste at age 1. However the amount used is crucial — no more than the size of a small grain of rice.
Starting at age 3, the amount of fluoride toothpaste can be increased to the size of a small pea. However =, it is important to keep in mind that it must be used only two times a day when an adult is brushing. If the child likes to brush alone before or after the parent, he or she should not use fluoride toothpaste.
Fluoride has a key role in remineralizing the enamel of the teeth. However, like everything else, too much fluoride is not a good thing and, in very high quantity can be dangerous. Parental supervision is essential. Never leave the tube of fluoride toothpaste where children can reach it.
CK: How do I make my child’s diet safe for his teeth?
EC: I believe that nutrition is an integral part of dental health and the overall health of a child. In general, foods that are good for the body are also good for teeth and vice-versa. Great attention should be given to snacks. Frequency of eating is as important as the quality of the food. Always try to make sure that water follows any meal. Try to avoid sugary and sticky foods, especially as a snack. Always read the ingredient of what you buy for your child’s snack and do not be fool by the word “organic” in the label. Yogurt, fresh vegetables, fruits and cheeses are better snacks.
Pediatric dentist Dr. Emanuela Corielli is the founder and owner of Bright Healthy Smiles, which has locations on the Upper East Side and SoHo. The practice offers pediatric dentistry, orthodontics, and nutrition and oral care.