School Age Children
Sealants
Your child's first permanent teeth, the first molars (also known as the six year molars) erupt at around age six, and often parents don't realize their child has permanent teeth because they come in behind the baby teeth molars, and no baby teeth are lost before they come in. These molars tend to have deep grooves in the chewing surfaces and are very susceptible to decay. We generally advise having these teeth sealed to help prevent decay from forming in the grooves.
Dental x-rays – bitewings and panorex
We generally take a set of bitewing x-rays around age six and then every two years after that to keep a check for cavities between your child's teeth. If your child has problems with decay, oral hygiene, or diet, we may consider him or her at high risk for between teeth cavities and take x-rays of problem areas at more frequent intervals until risk factors are lowered. We use digital x-rays, which have one-tenth of the radiation dose of traditional x-rays.
We will take a panoramic x-ray (which shows the entire mouth and jaw area) around age six to assess your child's tooth development. This will let us know if there are any problems that will need to be addressed with orthodontics, and check for any abnormal development.
Orthodontics
As mentioned above, we will be assessing your child for orthodontics at each visit. Some problems may require early intervention to correct, and others may wait until more permanent teeth have erupted. If there are any questions, we will advise a consult with an orthodontist.
If your child does begin orthodontic treatment, it is important to remember that braces make oral hygiene even more important since they can trap food particles and cause decay or gum problems. We recommend increasing dental cleaning visits to three- four month intervals while your child is bracketed to help prevent these problems.
Contact sports and mouth protection
It is important to provide mouth protection for children playing contact sports. We see too many young injured athletes with chipped or knocked out teeth, and these problems can be prevented with a custom mouth guard. We can fabricate them at the office, or alternatively they can be purchased at a sports store.
Cavities Between teeth
Many times younger children will not show decay, but as teen-agers develop serious problems. This can usually be traced to a habit of sweetened beverages, particularly sodas or sports drinks. We recommend that parents do not buy sodas or sweetened drinks for use at home. Many teenagers will drink flavored bottled water instead. (Read the label to make sure there are no sweeteners added.) Ideally, beverages readily available at home should be limited to skim milk, water, and fruit juice (to be consumed in limited amounts) with sodas or lemonade reserved for picnics and parties.
It should also be noted that failing to floss daily also contributes to between teeth decay since the plaque is not removed if the teeth are not flossed. (Brushing teeth provides very little effect for the spaces between teeth.)
Nutrition Concerns/snacking
The same rules that apply to preschoolers - limiting snacking, sticky treats, and sugary beverages - also apply to school age children.
It should be noted in addition how important it is for pre-teens to obtain enough calcium. It used to be believed that calcium for developing bones was important in the teenage years, but recent research has found that this buildup of calcium occurs even younger. Girls around ages ten to twelve should receive four servings of low fat dairy foods each day to help them keep healthy bones throughout life. Attention to diet at this age can help prevent osteoporosis and could be a factor in resistance to periodontal disease as an adult.
Fluoride treatment
It is easy to become confused with how different forms of fluoride work on your child's teeth, since we may be recommending flouride tablets or gels at home and fluoride treatments in the office. Below is a description of how each type of flouride works.
Fluoride tablets, like fluoride drops or liquids prescribed for infants, are swallowed and are utilized by the body to strengthen teeth that are still developing. Tablets do not do anything for teeth that have already erupted, although systemic fluoride is present in saliva, which may have some effect on erupted teeth.
Fluoride liquids prescribed at this office, if swished around in the mouth before swallowing, can strengthen both erupted teeth and developing teeth. Over the counter fluoride rinses may help erupted teeth, but are not meant to be swallowed and do not affect developing teeth.
The fluoride treatment delivered at the dental office is a strong fluoride gel that helps strengthen teeth that have erupted by delivering fluoride into the tooth structure. Children's teeth continue to strengthen for a few years after eruption, so fluoride is effective on them. Fluoride also strengthens areas of teeth that have weakened through the bacterial process that causes decay (decalcified) but have not yet actually decayed. Fluoride gels prescribed for home use are weaker versions of the fluoride used at the office.
