Dear Patients, 

Preventing cavities is a topic many parents worry about. This article provides smart guidelines every parent should consider including some age-specific tips for prevent-ing tooth decay.

Dr. Cristina B Georgescu and Dr. Eileen Dano Calamia

A crucial way to help limit cavities—regardless of whether they run in your family—is to diligently brush and floss, which physically pushes bacteria, plaque, and sugar off the teeth. Fluoride is an essential part of dental health because it not only restores calcium to decaying teeth, but also limits the production of corrosive acid. Even though some kids are at a much higher risk of developing cavities, all children can get them. So it's important for everyone to follow this road map for dental health.

Tame a sweet tooth. Limiting sugar—which bacteria need in order to survive—is the number-one way to prevent cavities. It's actually the frequency, not the total quantity of sugar consumption, that matters most, says Dr. Edelstein. For example, eating a chocolate bar all at once is less harmful to the teeth than eating one bite every hour. That's because repeatedly exposing the teeth to sugar prevents saliva, the body's natural tooth cleanser, from doing its job. Candy isn't the only offender: Starchy carbohydrates like crackers and cereal and sticky foods such as raisins can also promote decay.

Avoid sugary drinks. Fruit juice (even diluted), as well as breast milk and formula, bathe the teeth in sugar, says Ronald Kosinski, D.M.D., chief of pediatric dentistry at Schneider Children's Hospital in New Hyde Park, New York. In fact, dentists used to call early dental caries "baby-bottle tooth decay" because it often occurs in children who drink milk or juice during the night, allowing sugar to sit on the teeth for ten or 12 hours. The AAPD advises weaning your child from the bottle by 12 months to prevent decay—but you shouldn't let your toddler walk around all day with a sippy cup either (unless it's filled with water).

Focus on fluoride. If your community's water is not fluoridated (check with your dentist or municipal-water-supply board) or your kids only drink non-fluoridated bottled water, talk to your pediatrician about fluoride supplements. Speak with us during your next visit for a flouoride regimen for your child.

Treat teeth earlier. Dentists can now apply a safe and protective fluoride varnish to young children's teeth. A study found that 1-year-olds who got this treatment twice a year were four times less likely to get cavities in their baby teeth. Also ask your dentist about sealants, or plastic coatings that prevent decay. Some insurance plans will cover these two treatments.

Take care of your own smile. If you have a history of dental problems, avoid sharing utensils or toothbrushes with your baby or toddler—or even letting him stick his fin-gers in your mouth. However, it's possible to reduce levels of mutans in your mouth. Your dentist can prescribe an antibacterial mouthwash that can reduce transmission to young children. Research has also found that chewing sugarless gum containing the sweetener Xylitol (such as Trident, Wrigley's Orbit, or Carefree Koolerz) four times a day significantly lowers a mother's bacteria levels. Good nutrition during pregnancy may also strengthen a baby's tooth enamel. Of course, you should brush and floss well, and get any problems treated promptly. This will also set a good ex-ample for your child and show him that protecting his smile is essential.

Dental Health at Every Age

Here are some age-specific tips for preventing tooth decay.

Babies

• Clean your baby's gums even before her first teeth erupt.
  Wipe them with a damp washcloth after feedings.
• Start brushing as soon as the first tooth appears. Wet a baby toothbrush and gently rub it back and forth on the surface of the tooth and along the gum line.

Toddlers

• Brush your toddler's teeth for at least 30 seconds (ideally a minute) after breakfast and before bed. Lean her head on your lap and place the brush at a 45-degree angle to the teeth
• Start using a pea-size amount of fluoride toothpaste when your child is 3 years old
• Begin flossing your child's teeth when two of their teeth are touching.

Preschoolers

• Brush your own teeth at the same time as your preschooler brushes, and give him lots of positive feedback
• Studies have found that manual toothbrushes are just as effective as powered ones. But if letting your kid use an electric or battery-operated one makes it easier to get her to brush, go for it.

School-Age Kids

• Your child can start brushing and flossing on her own at around age 7. If she can tie her own shoes, chances are she's ready to brush solo. She should now brush for two minutes.
• Look for food and plaque around the gum line of her teeth to see whether she's doing a sufficient job. You can also let her chew gum with Xylitol.

By Rebecca Felsenthal
Parents Magazine