Early Childhood Care

We suggest starting with the use of a circular rotating power toothbrush, which will be similar to our tooth sparkler or polisher. We suggest talking to them about how the dentist will look in their mouth with a mirror and tooth counter. You can practice getting them to open for 20 – 30 seconds at a time and closing how they chew.  You can also introduce them to the dentist with children’s books about visiting the dentist.

This is dependent on the age of your child and how cooperative they are.  For very young children we may get the parent to sit in the chair with them and have a knee to knee visit with the child’s head in the lap of the dentist to get a clear look in their mouth.  A toothbrush often helps get them to open their mouth to count their teeth.  Sometimes all we can do is a happy visit.  This is a show and tell visit.  We show them the mirror, tooth counter, squirt gun, Mr thirsty (suction), the overhead magic light and the magical chair that goes up and down.  When they are older ( 3 – 5 years of age) and very cooperative we will try to scale if needed, polish their teeth, take xrays to detect cavities between their teeth and with your approval paint cavity prevention fluoride varnish on their teeth.

We will encourage your child to brush by themselves but mom and dad have to at least check and finish brushing and flossing until they can tie their shoes on their own when they have proved they have good hand dexterity.

Sometimes it is helpful to have them watch an older sibling or a parent get a cleaning before they have their own as long as neither one is anxious themselves.

Establishing good oral hygiene habits at a young age may be the most effective means of preventing the occurrence of dental problems later in life.  If your young child doesn’t allow you to brush their teeth please contact us so that we can make oral hygiene less frustrating for you and successful at home.

Healthy primary/baby teeth play an important role in your child’s appearance, smile, speech patterns, eating ability, developing jaw and bone growth, saving space for adult replacements, as well as their developing self-confidence. When their teeth are nice and healthy this will avoid pain and infection in the future.  Primary teeth have thinner enamel and problems can quickly develop and progress rapidly once they start.  Baby molars aren’t usually lost until 10 – 12 years of age so we need to keep them healthy until this time.

Very young children may not like getting their teeth brushed, flossed or brushing their own teeth but it is very important that it get done to prevent issues in the future.  Children may even cry when oral hygiene is practiced but persevere and they will get used to it.  When children are young it is very important that parents have the primary role.  As they get older closer to 2 -3 years of age we want parents to encourage a child’s independence and get them to try to do it on their own.  When this starts there needs to be an understanding that the caregiver will finish brushing and flossing to ensure it is done properly and well for 2 minutes until they have proven they have hand dexterity and can tie their shoe laces themselves (usually by age 5 to 7).  It may help to watch someone older than them while they are maintaining their own teeth.  Encourage them to use a timer or play a favourite song that is at least 2 minutes long.  For busy families, especially in the mornings before school, and children older than 5 – 7 years of age that don’t practice oral hygiene well there is a new toothpaste called Plaque HD sold at this office that you may find helpful. This toothpaste or disclosing tablets are helpful to visually see if they have cleaned their teeth properly.  It also teaches them where they need to improve.  If you are still having difficulties at home with oral hygiene for your child please call us and book an appointment today so we can offer some further suggestions.

Early Childhood Caries is the presence of one or more cavities (including white and brown spots that may or may not cause holes in the teeth), missing teeth (due to cavities) or filled tooth surfaces in any primary tooth in a preschool-age child between birth and 6 years of age.  It is a disease process that is preventable and we would like to help families treat it as well as educate them on how to prevent this infectious disease process from occurring or progressing. Cavities form when bacteria that are present in the mouth feed on acids, food that can be converted into sugars or sugars that have been ingested to create acids, which can then weaken or soften enamel. To avoid childhood tooth decay, give your child water at bedtime after cleaning their teeth rather than juice or milk including breast milk. Both juice and milk will allow sugars to constantly bathe and coat their teeth throughout the night and overtime create tooth decay at an early age.  For young infants always clean their teeth or gums after drinking breast milk or formula, especially prior to their longer night time sleep. Limit your child’s access to sweets and encourage him or her to brush after eating to remove oral biofilm and plaque, which harbour bacteria, food and acids.  Brushing with fluoride toothpaste and yearly fluoride treatments can also strengthen teeth and help your child avoid tooth decay.

Enamel is very thin on baby teeth compared to their adult replacements.  It doesn’t take long for the thin wall of enamel especially between the teeth where flossing isn’t regularily done to get penetrated with acid attack.  Any food or drink that is an acid or it can used by bacteria in the mouth to make an acid can cause damage to your child’s teeth. If any of these are consumed with high frequency in your child’s diet they will be at risk of decay: pop, juice, gummie vitamins, candies, sweets, chocolate, syrups, dried fruits, fruit leather, and junk food.  It is helpful to write a daily food consumption diary and record everything to help the dentist determine risks and what the root of the problem is so it can be dealt with as well as the cavities.  Apples and cheese are the best finishing snack to help clean teeth if and when a toothbrush isn’t available.

Yes it can be used but the best option is to remove the cavity or decay and place a filling.  Silver diamine requires multiple applications within weeks of each other for the initial treatment and every 6 months thereafter to make it the most effective.  It turns decay permanently black, which in some areas becomes unaesthetic.  This is a good option for children we feel cannot handle a visit with freezing, general anaesthesia or you as the parent want to monitor the tooth and leave the cavity untreated and allow the tooth to naturally fall out on it’s own but stop the decay process from progressing further.

Southbrook Dental Group is a family practice and we are willing to treat children.  When we first meet children we access how we feel they will do with treatment in our office.  Often we start with treatment that is easier for the child to see how they do such as an exam, cleaning, sealants or smaller cavities before we treat larger areas of concern. This allows us to get your child familiar with what we use to help repair their damaged teeth or tooth.  If we feel that either your child has issues staying still, has issues wanting to assist us or they have a lot of treatment in their mouth we may suggest that they receive help from a specialist called a pediatric dentist who may or may not use sedation to treat your child.

At Southbrook Dental we monitor the growth of your child especially their jaw and bite relationships.  If your child has a crossbite or an improper bite the dentists at Southbrook will refer them to an orthodontist.  The orthodontist will monitor their growth and treat their case when they can work with their growth rather than wait until it is too late after their growth spurt and one of the only options is to do surgery.

Most orthodontics start when they have all of their adult teeth at around 10 – 13 years of age dependent on the child but there are some circumstances when it should start earlier and we want to ensure that their parent and the specialist make that decision.

Baby teeth

If the tooth is a baby front tooth and the chip is small go and see your dentist to evaluate the tooth and their mouth as soon as you can to ensure that everything is ok. Your dentist may want to smooth the tooth to make it look nicer in their smile and/or to prevent it from cutting their lip or tongue.

If the fracture is large bring in the piece of tooth to the dental office (if you can find it) to evaluate their mouth and the tooth.  It is very important we see what it looks like early on and take photos so we have something to compare to. These teeth will likely need treatment especially if they are sensitive.  These teeth will also need more long term monitoring.

Adult teeth

If the tooth is an adult tooth and it chipped slightly go the dentist to have it evaluated and form a baseline as this tooth needs to be monitored closely to ensure that it heals well after its trauma. Your dentist may want to smooth the tooth to make it look nicer in their smile and/or to prevent it from cutting their lip or tongue.

If the fracture is large try to find the piece of tooth (if you can) especially if it is in 1 piece.  Bring the piece with you and go to visit the dentist to evaluate the tooth and the area.  This tooth will also have to be monitored closely to ensure that it heals well after its trauma.

If after reading this you don’t know what to do, phone the office for an appointment and we will let you know what to do and the dentist will evaluate your child’s tooth and their mouth.

Baby front tooth

If the tooth is a baby front tooth do not place it back in the socket, hold onto the tooth and go and see a dentist immediately to ensure that there is no other damage.  Ensure that the tooth is taken with you so the dentist can access if the whole tooth and root came out.  We want to ensure that the root is not fractured and left in the socket.

Adult front tooth

If the tooth is an adult front tooth pick it up with care not to touch the root of the tooth.  If it was found in a dirty area rinse it immediately with milk, saline solution or water.  (Do not wrap it in a tissue.)  Place it immediately with care not to touch the root of the tooth in Hank’s balanced salt solution or saline solution if it is available.  If it isn’t place it in milk or in saliva in the cheek of the individual or parent of the child.  If you are ok placing it back in the mouth for your child put it back into position making sure that it is rotated the right way.  It is important to keep it wet so if nothing else is available place it in water.  You now need to get to a dentist or hospital immediately to place the tooth back in the mouth no later than 60 minutes from the time the incident happened.  If you can let the office know that you are coming and the time the incident happened so that they are prepared and make arrangements to treat your child as soon as you arrive. Regardless of how you are able to treat your child on your own you need to see a dentist or go to the hospital as they will need to place an orthodontic wire to stabilize the tooth and it will need to be monitored very closely for a few years to ensure that it is healing well.

If you are unsure if the tooth is a baby tooth or an adult tooth read the adult portion and treat the tooth like an adult tooth but don’t place it in the socket until the dentist looks at it.

Sealants are coatings placed in plaque trapping deep grooves on the chewing surfaces of back teeth.  Sealants help you and your child keep their teeth clean and prevent future decay in these highly susceptible areas.

Occasionally baby teeth don’t fall out when the adult teeth come in.  This happens when the adult tooth doesn’t come up right underneath the baby tooth.  If your child can’t wiggle the tooth out on their own you will need to bring them in for the dentist to help wiggle the tooth out for them to allow the adult tooth to come in properly.  This will most often then allow your child’s tongue and lip to guide the adult tooth into a better position.

Breastfeeding is very helpful with oral development.  It is a great facial muscle work out for your baby.  It requires the baby to co-ordinate their muscles to form a vacuum to allow milk to be released from the breast.  Their tongue will mould the upper jaw and work as a natural palate expander.  As your baby continues to feed their tongue moves forward and stimulates the forward growth of the upper jaw.  The lower jaw also grows forward with the movement of it back and forth and in turn helps open their airway as well.

Breastfeeding is the most recommended form of nourishment for a baby for the first year of their life, but as every baby is different so is every mother.  You should stop breastfeeding when you feel it is best for you and your baby.  If you are having a hard time breastfeeding don’t despair it doesn’t always mean their jaw doesn’t form properly and orthodontics can be a future solution if it is and it may have had to be done anyways.  If your little one is having a hard time feeding it could be a frenum or lip attachment that is making it difficult for them to suck or latch properly. This may need to be assessed if you doctor hasn’t already looked at it.

If you are still breastfeeding when your child teeths ensure that you are wiping and brushing their teeth after feedings to ensure that they don’t have issues with decay.

Naturally children want to suck as it is a comfort to them.    If they don’t discover their hands parents often offer them a soother to keep them happy.  Certain soothers are fine if your child is eating enough and under a certain age.

There are many soothers that can be purchased but the ones labeled orthodontists recommended are the soothers we would recommend.  They allow the roof of the mouth to develop better and don’t alter the position of their teeth too much if it is removed at a certain age.

• Speech can be delayed if they constantly have it in their mouth
• They will have very spaced teeth and a very broad arch
• Their front teeth may not touch each other to accommodate their soother
• Their front teeth tip forward and become crowded
• Their tongue won’t have the proper posture at rest as it is always accommodating the pacifier and this will alter it’s movement and position

It is recommended that the soother be eliminated as soon as possible and at very latest before their adult teeth erupt around age 6.

• Explain to your child what can happen if they continue to suck a soother (see above question)
• Limit where they can suck their soother: for example, only at naptime or bedtime
• Don’t allow complete access to the soother, put it up high away from their reach
• Notice and offer praise when they don’t suck their soother, positive reinforcement is powerful, let them know you would rather see their beautiful smile and face than the soother
• Cut the tip off of the soother and let them know it is broken
• Put a package together to let your child know that it is for babies and you will give it to a baby
• Place it in a stuffed teddy bear that they can now sleep with that will be special to them, the bear now has a very special heart
• Throw away as many as you can so there are less available

Thumb sucking is fairly common in infants and children up to about age 5, but it can cause problems if it continues after front permanent teeth begin to erupt usually at age 6.

This habit can:

• Flare teeth to the lips
• Push teeth out of alignment
• Cause an open bite in the front or their teeth don’t touch
• Constrict or limit the growth of their upper jaw
• Affect the position of your child’s lower and upper jaw
• Affect your child’s speech
• Affect your child’s airway

Thumb sucking is a comfort behaviour developed when they are young infants sometimes even in the womb.  It will take some time to break this habit and sometimes they cannot do it on their own.  We should have this habit stopped at the latest by the time they have adult teeth starting to erupt usually age 6.

• Explain to your child what can happen if they continue to suck their thumb (see above question)
• Limit where they can suck their thumb: for example, only at naptime or bedtime
• Remind your child when they are thumb sucking as they may not notice
• Notice and offer praise when they don’t suck their thumb, positive reinforcement is powerful
• Wear a sock on the hand they suck or sew a sock or mitt to some pajamas for bedtime wear
• If none of the above help there are appliances that can be made to deter their habit

If thumb sucking continues to be a problem, schedule a consultation with one of our dentists. We will be happy to help!