Every parent wants the very best for their children. At my practice, I love meeting parents who are excited about helping their children achieve outstanding dental health and maintain beautiful, healthy smiles.

But many parents have questions about caring for their kids’ teeth, especially baby teeth. Today, I’ll answer the most common questions I hear and hopefully help all you parents out there!

How old should a child be before visiting the dentist?

The American Academy of Pediatric Dentistry says that children should visit the dentist no more than 6 months after they start teething. This is a good guideline, but parents shouldn’t stress out too much about it. A bit longer than 6 months is usually fine.

When working with a child, my goals are simple:

Check for early signs of dental issues
Show that a trip to the dentist isn’t something to be scared of

Tip: Make the first dentist visit for your child easier by scheduling an appointment for you and your child at the same time.

What causes cavities?

Cavities are caused when the hard, outer layer of a tooth, the enamel, is damaged. Damage to enamel can lead to damage to a tooth’s dentin and eventually the pulp, the inner layers.

Tooth enamel is stronger than steel. It’s the toughest, hardest material in the human body. Unfortunately, despite its strength, enamel can be damaged by acid.

Where does acid come from? You have over 20 billion bacteria in your mouth - some of them are harmless and some of them cause dental problems. All of them just want to eat and make more bacteria. Bacteria can group together, and along with the food you eat can create a sticky substance called plaque that adheres to our teeth.

Bacteria eat sugar, produce acid as a by-product (much like how people breathe in oxygen and exhale carbon dioxide), and reproduce. That’s all they do.

The acid they produce damages tooth enamel. If plaque, bacteria, and acid aren’t removed by brushing, flossing, and regular visits to the dentist, cavities can be the result.

Drinking acidic drinks like soda, fruit juices, and eating foods with acid-filled additives can all damage your tooth enamel as well. The more sugary foods you eat (like candy) the more food it is for the bacteria to eat.

Tip: Make sure your kids enjoy snacks that are healthy and won’t lead to tooth damage!

If your child is eating a healthy diet, you don’t need to blame yourself for cavities. Over 90% of adults and over 40% of children will get a cavity at some point.

Additionally, the bacteria in every person’s mouth is unique, kind of like a fingerprint. Interestingly, people in the same family will usually have similar bacteria, because the bacteria are often passed from parents to children. So, it’s important for parents to take great care of their teeth to help minimize the amount of cavity-causing bacteria they are passing to their child.

How can you help your child minimize his or her risk of cavities and tooth decay?

Visit the dentist for checkups and cleanings every 6 months
Don’t have too many sugar-filled or acidic snacks or drinks
Set a good example for your kids by maintaining good brushing and flossing habits yourself
Make sure your kids are brushing and flossing properly-- your dentist can give lessons and tips to the whole family

How can I tell if my child might have a cavity?

Regular dental checkups are the absolute best way to catch cavities early. The earlier a cavity is found, the easier it is to repair. Cavities are usually painless until they are very large, so just make sure your child is having regular dental visits to catch problems while they are small.

How often should my child brush his or her teeth?

Many parents wonder about the day-to-day care of their child’s teeth.

I recommend brushing with fluoride toothpaste twice a day once a child gets their first tooth. For children who aren’t old enough spit out toothpaste, a grain-of-rice sized amount of toothpaste is all that's needed. Once a child is old enough to spit, a pea-sized amount is OK.

Flossing is not necessary until kids get a little older. However, it's never a bad thing to start getting them used to flossing at a young age!

A fluoride-containing mouth rinse for kids who can spit and who have had a cavity in the past is also a good idea.

Will my child be afraid of the dentist? What can I do to help?

It is pretty normal for younger children to be fearful during their first dental visit. However, I find that once a child visits the dentist a few times and has good experiences, they become more relaxed. A dentist who makes your child feel comfortable and who is sensitive to the needs of young patients will go a long way towards helping your child feel at ease during dental visits.

As a parent, preparing your child for dental visits using positive language is so important. Children are looking to adults for guidance on what to expect at the dentist, so talking about dental visits positively and with reassuring words will help minimize anxiety. Try to avoid scary words like “shot” and “pain.” I know a lot of adults and parents do not love going to the dentist themselves, but many children will never have a bad experience at the dentist, so I encourage parents to project a positive attitude about the dentist so children do not have negative expectations.

It’s just a baby tooth-- does the cavity really need to be fixed?

Yes, it does! Untreated cavities in baby teeth can be dangerous. Not only are they potentially painful, but they can actually cause serious health problems.

An untreated cavity will get larger over time, and can cause life-threatening infection. Dental abscesses can happen in children as well as adults, and can lead to an emergency situation. Infection in a tooth can spread to soft tissues in the face, head, and neck, leading to swelling, pain, and even death.

Taking care of cavities while they are small is also much less expensive - once cavities get larger, more treatment can be necessary.

Do you recommend replacing a child’s amalgam (silver) fillings with composite fillings?

Amalgam (silver) fillings usually have to be replaced at some point. Silver fillings expand and contract causing a tooth to fracture much like an ice cube fractures in a glass of water. If this happens, we will recommend replacing them with composite fillings that will last for decades. Composite fillings prevent further cracking by actually bonding to and strengthening the surrounding tooth structure.

It’s always a good idea to avoid unnecessary dental procedures. Every time a filling is placed, some healthy, natural tooth structure has to be removed. This should be avoided whenever possible. If an amalgam filling is in good condition and isn’t causing any problems it’s probably best to keep a close eye on it and replace it when necessary.

Photo Credits: Brian, Kenneth Lu

Dr. Caitlin Batchelor
Dr. Caitlin Batchelor earned her Doctor of Dental Surgery degree from Virginia Commonwealth University’s Medical College of Virginia. She later completed a 2-year postgraduate General Practice Residency at Wake Forest University Medical Center. Since joining this practice in 2013, Dr. Batchelor has been committed to providing individualized dental care to the specific needs and desires of her patients, taking the whole person and their unique qualities into consideration.

Dental Advice: How To Care For Your Child's Teeth