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Healthy Teeth -- Year by Year

These tips from the American Academy of Pediatric Dentistry (AAPD) and the American Dental Association (ADA) will help you get your child's teeth off to a great start:

Infants

Use only water in your baby's bedtime bottle to prevent bottle decay, which occurs when milk or other liquids stay in contact with the teeth for long periods. And after every feeding, wipe your baby's gums with a damp washcloth or gauze pad to remove plaque.

Start brushing, with a soft infant toothbrush, after the first tooth erupts.

If your baby is teething and uncomfortable, try rubbing her gums with a clean finger, a wet gauze pad or a teething ring. If the discomfort persists, call your pediatrician or dentist.

Contrary to common belief, fever is not normal for a teething baby, says the AAPD. If your infant has a fever while teething, call your pediatrician.

Schedule your child's first dental visit by her first birthday, and talk with your dentist about fluoride supplements (which may be needed if your baby doesn't drink fluoridated water).

Ages 1 Through 5

Thumb sucking usually declines after age 2. If continued past age 4, 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 2 1/2. 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 4 or 5, 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 5 and 6. 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 6. Instruct your child on how to use such rinses and supervise when necessary.

By age 7, your child should be able to brush alone. Flossing is more difficult, but by age 8, 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 6 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."

Braces -- The Straight Facts

At around age 7 -- when permanent teeth have arrived -- your child should receive an orthodontic evaluation from a dentist or an orthodontist, says the American Association of Orthodontists (AAO).

Braces have changed in recent years, says Pam Paladin, communications coordinator for the AAO. "Today, the brackets are bonded directly to the front of each tooth with a special fluoride-releasing adhesive," she explains. A thin, nickel-titanium wire is then attached to each bracket with tiny rubber bands. "Many orthodontists offer colored rubber bands, and kids ask for their school colors, red and green for Christmas or orange for Halloween."

The average age for getting braces is age 10, says Paladin. Treatment usually takes between 12 and 36 months, with checkups scheduled every four to six weeks.

The cost ranges from $1,800 to $4,500 or more. The good news? "Most orthodontists offer 24- or 36-month payment plans," she says, adding that more than 50 percent of all orthodontic patients now have dental coverage for at least part of the cost.

For a free, eight-minute video explaining orthodontic treatment, call the American Association of Orthodontists at 1-800-STRAIGHT.





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