Good dental care begins before a baby's first tooth appears. Just because you can't see the teeth doesn't mean they aren't there. Teeth actually begin to form in the second trimester of pregnancy. At birth, your baby has 20 primary teeth, some of which are fully developed in the jaw.

Here's when and how to care for those little choppers:

• Even before your baby starts teething, run a clean, damp washcloth over the gums to clear away harmful bacteria.
• When your baby gets teeth, brush them with an infant toothbrush. Use water and a tiny bit of fluoride toothpaste (about the size of a grain of rice). Use fluoride toothpaste that carries the Canadian Dental Association's (CDA) seal of acceptance. (If you are using baby toothpaste without the fluoride, keep it to the same amount because you still want to minimize any toothpaste that is swallowed.)
• When two of your baby's teeth touch, you can begin flossing between them.
• Around age 2, your child should learn to spit while brushing. Avoid giving your child water to swish and spit because this can make swallowing toothpaste more likely.
• Kids ages 3 and up should use only a pea-sized amount of fluoride toothpaste.
• Always supervise kids younger than 8 while brushing, as they're likely to swallow toothpaste.

Babies Can't Get Cavities, Can They?

Oh yeah, they can!  Putting a baby to sleep with a bottle can harm a baby's teeth. Sugars from juice, formula, or milk that stay on a baby's teeth for hours can eat away at the enamel (the layer of the tooth that protects against tooth decay). This can lead to "bottle mouth" or "baby bottle tooth decay" (see below).  When this happens, the front teeth can get discoloured, pocked, and pitted. Cavities might form and, in severe cases, the decayed teeth might need to be pulled.

When kids are 6 months old, they can switch from a bottle to a sippy cup (with a straw or hard spout). This helps prevent liquid from pooling around a child's teeth. By their first birthday, they'll have the motor skills and coordination to use the cup on their own.

When Should Kids See Us?

Healthy baby teeth help guide the eruption of the adult teeth and obviously help your child eat and speak.  So we need to take care of them.  The CDA recommends that children see a dentist by their first birthday. At this first visit, we will explain proper brushing and flossing techniques and do a modified exam while your baby sits on your lap.

These visits can help find problems early and help kids get used to visiting the dentist so they'll have less fear about going as they get older. We will also know when to refer you to a specialist, such as a paediatric dentist or an orthodontist to correct an overbite or an oral surgeon for jaw realignment.

How Can We Prevent Cavities?

Cavities happen when bacteria and food left on the teeth after eating are not brushed away. Acid collects on a tooth, softening its enamel until a hole — or cavity — forms.

So What Do I Do?

Here's how to keep cavities away:

• Start good oral habits early. Teach kids to brush well at least twice a day with fluoride toothpaste and to floss regularly.
• Get enough fluoride. Regular use of fluoride toughens the enamel, making it harder for acid to penetrate. Although many towns require tap water to be fluoridated, others don't. If your water supply is not fluoridated or if your family uses purified water, ask us about fluoride supplements. Most toothpastes contain fluoride but toothpaste alone will not fully protect a child's teeth. Be careful, however, since too much fluoride can cause tooth discolouration. Check with our office before supplementing.
• Limit or avoid some foods. Sugary foods, juices, candy (especially sticky gummy candy, gummy vitamins, or fruit leather or "roll-ups") can erode enamel and cause cavities. If your kids eat these foods, have them rinse their mouth or brush their teeth after eating to wash away the sugar. The same goes for taking sweetened liquid medicines: always have kids rinse or brush afterward.

As your child's permanent teeth grow in, we can help prevent decay by applying a thin wash of resin (called a sealant) to the back teeth, where most chewing is done. This protective coating keeps bacteria from settling in the hard-to-reach crevices of the molars. But make sure that kids know that sealants aren't a replacement for good brushing and regular flossing.

What Dental Problems Can Happen?

If you are prone to tooth decay or gum disease, your kids might be at higher risk as well. So sometimes even the best brushing and flossing habits can't prevent a cavity. Be sure to call us if your child complains of tooth pain, which could be a sign of a cavity that needs treatment.

New materials mean we have more filling and repair options than ever. A silver-coloured material called amalgam (a special mix of metals) was once the substance of choice for most fillings in permanent teeth. Materials like composite resins are more popular due to dramatic improvements in strength, durability and aesthetics. Resins bond to the teeth so the filling won't pop out, and also can be used to rebuild teeth damaged through injury or conditions like a cleft palate.

But in cases of fracture, extensive decay, or malformation of baby teeth, dentists often opt for stainless steel, resin or ceramic crowns. Crowns maintain the tooth strength and integrity while preventing the decay from spreading.

What About Severely Broken Down Teeth?

In some rare instances, usually when a more complicated dental procedure is to be done, we may recommend using general anaesthesia and referral to a specialist.  We will be able to set up any necessary appointments with appropriate qualified professionals, if needed. Don't be afraid ask us questions.

Regular checkups and good dental hygiene can help prevent the need for this kind of extensive dental work. Also, encourage your kids to use a mouthguard during sports, which can prevent serious dental injuries.

What Is Orthodontics?

As kids get older, their bite and the straightness of their teeth can become an issue. Orthodontic treatment begins earlier now than it used to, and braces have changed too. The embarrassing old gear — a mouth filled with metal wires, headgear and 'train tracks' — is in the past. Kids as young as age 7 now wear corrective appliances, and plastic-based (sometimes clear) materials have replaced metal.

Orthodontists know that manipulation of teeth at a younger age can be easier and more effective in the long run. Younger children's teeth can be positioned with fairly minor orthodontic devices, preventing major treatment later on.

Looking Ahead

As kids grow, plan on routine dental checkups with us anywhere from once every 3 months to once a year, depending on our recommendations. Keeping sugary foods in check, encouraging regular brushing and flossing, and working with us will lead good dental health and healthy teeth!