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Since children have special dental needs, we felt that it was important to dedicate one page to dental information for each major age group. We would also like to add that our office staff couldn't be more family friendly. We have 15 children among seven different families, ranging in age from 5 to 26.

This is one of the most serious problems faced by infants, yet it is entirely preventable. This condition results when an infant is allowed to take a bottle to bed. When milk or juice is used for the bedtime bottle, the sugar in the beverage pools around the baby teeth and allows decay to form.?This decay can be so severe that the front teeth can be decayed off to the gum line, and can cause serious abscesses.?Correcting this condition and restoring the baby teeth?is complicated and expensive, and may require hospitalization and general anesthesia.

This condition can be prevented simply by never giving a baby a nighttime bottle containing anything other than water.?It is surprising how many people do not know about this danger to babies, so please pass the word to your relatives or friends with infants about the serious consequences of giving a bedtime bottle of milk or juice.

If you are breast feeding, or are using a non fluoridated source of water for your baby (including both well water and bottled water), you need to obtain a prescription for fluoride drops from your pediatrician to strengthen the developing teeth. The dosage for fluoride changes at age one and again at age three, so be sure to keep up to date on the amount your child needs.?Usually by age one the prescription changes from drops to a chewable tablet or measured liquid.?It is very important to keep this medicine locked up, out of your child's reach.

You do need to clean your baby's teeth as soon as they come in.?This is easily accomplished by wiping with a piece of gauze or a clean washcloth. Some baby stores sell special finger cots for this process, which may be helpful.?Do not use any toothpaste before age two.?

After age two, you may brush your child's teeth with a toothbrush, but do not use more than a pea sized about of toothpaste.?It is most effective to lean your child back in your lap for the best access for brushing, and try to make it a fun time. Your child may try to brush by him or herself, but do not consider this as anything other than play.?Until age six, a child simply does not have the dexterity to properly brush teeth.?Be sure to keep toothpaste and any other fluoride products (such as adult fluoride gels) out of reach since ingestion of a large amount of toothpaste can result in an overdose of fluoride.

We generally like to see children in the dental office by age three, earlier if there is any hint of a problem.?If you are brushing your toddler's teeth and notice any unusual spots, or if you recognize any of the diet problems described above, you should have your child checked out even if he or she is younger than three.

This may come as surprise to many parents, but one of the best things you can do to prevent dental decay in your child is to make sure your teeth are free of decay.?Studies have shown that with some children with severe decay, the type of bacteria causing it was identical to the bacteria in the mother's mouth.

Apparently, in casual contact (such as sharing an ice cream cone) the bacteria from a parent's mouth can be transferred to the child's mouth and can cause decay.?When parents say that their child inherited their bad teeth, the truth may be that the child received the bacteria from the parent with decay.?You may also want to make sure that your child care provider is not suffering from dental disease as well.

One habit that causes tooth decay problems is too much snacking, or use of food to keep a child quiet.?Parents often use food to entertain a child, and it is not uncommon even in the dental office to see parents constantly shoving animal crackers, cookies, and cereal at the child to keep him or her occupied.

Snacking can be part of a child's diet, but it should be controlled, and should include more nutritious vegetables and fruits.?Make sure that snacking does not interfere with appetite for meals, and limit the number of times a snack is offered because decay is more likely to happen when there are numerous exposures to sugars. (Even good foods such as fruit or crackers still contain sugars.)

Since it can be difficult to keep a young child's teeth clean, it is especially important to keep sweet, sticky foods to a minimum.?Some of the worst culprits are dried fruits, raisins, or fruit roll ups, or any hard candy that is sucked for a long time.?Gummy candies or plain dark chocolate are less sticky and a better choice if you are going to give candy as a treat.?A good rule of thumb for how bad a food is for your child's teeth is to consider how sticky that food is if it gets ground into the kitchen floor.?

Your child's first permanent teeth, the first molars (also known as the six year molars) erupt at around age six, and often parents don't realize their child has permanent teeth because they come in behind the baby teeth molars, and no baby teeth are lost before they come in.?These molars tend to have deep grooves in the chewing surfaces and are very susceptible to decay.?We generally advise having these teeth sealed to help prevent decay from forming?in the grooves. For more information this procedure, click on?"sealants" in the dental departments area of this web site.

As mentioned above, we will be assessing your child for orthodontics at each visit.?Some problems may require early intervention to correct, and others may wait until more permanent teeth have erupted. If there are any questions, we will advise a consult with an orthodontist.

If your child does begin orthodontic treatment, it is important to remember that braces make oral hygiene even more important since they can trap food particles and cause decay or gum problems.?We recommend increasing dental cleaning visits to three- four month intervals while your child is bracketed to help prevent these problems.

We generally take a set of bitewing x-rays around age six and then every two years after that to keep a check for cavities between your child's teeth.?If your child has problems with decay, oral hygiene, or diet, we may consider him or her at high risk for between teeth cavities and take x-rays of problem areas at more frequent intervals until risk factors are lowered.?

We will take a panoramic x-ray (which shows the entire mouth and jaw area) around age six to assess your child's tooth development.?This will let us know if there are any?problems that will need to be addressed with orthodontics, and check for any abnormal development.

For more information about our state of the art computerized x ray system and our risk evaluation process, click on "x-rays" in the dental departments area of this web site.

It is easy to become confused with how different forms of fluoride work on your child's teeth, since we may be recommending flouride tablets or gels at home and fluoride treatments in the office. Below is a description of how each type of flouride works.

Fluoride tablets, like fluoride drops or liquids prescribed for infants, are swallowed and are utilized by the body to strengthen teeth that are still developing. Tablets do not do anything for teeth that have already erupted.

Fluoride liquids prescribed?at this office, if swished around in the mouth before swallowing, can strengthen both erupted teeth and developing teeth.?Over the counter fluoride rinses may help erupted teeth, but are not meant to be swallowed and do not affect developing teeth.

The fluoride treatment delivered at the dental office is a strong fluoride gel that helps strengthen teeth that have erupted by delivering fluoride into the tooth structure.?Children's teeth continue to strengthen for a few years after eruption, so fluoride is effective on them.?Fluoride also strengthens areas of teeth that have weakened through the bacterial process that causes decay (decalcified) but have not yet actually decayed. Fluoride gels prescribed for home use are weaker versions of the fluoride used at the office.

The same rules that apply to preschoolers?- limiting snacking, sticky treats, and sugary beverages - also apply to school age children.

It should be noted in addition how important it is for pre teens, especially girls, to obtain enough calcium.?It used to be believed that calcium for developing bones was important in the teen age years, but recent research has found that this buildup of calcium occurs even younger.?Girls around ages ten to twelve should receive four servings of low fat dairy foods each day to help them keep healthy bones throughout life. Attention to diet at this age can help prevent osteoporosis and could be a factor in resistance to periodontal disease as an adult.

While periodontal, or gum, disease is usually considered an adult problem, it can develop in teenagers and if it does it is very serious.?This usually happens when there is a family history of the disease, although both stress and smoking by a teenager can aggravate a periodontal condition.

To help prevent this condition from developing, make sure your teenager has floss readily accessible even at school, and make sure you set a good example by flossing yourself.?Also make sure you do not let your teenager slip by with less frequent dental visits, because the juvenile type of periodontal disease can cause destruction rapidly.?If your child develops red, bleeding, puffy gums, you should make a dental appointment right away for evaluation.

One dental problem that occurs frequently involves the improper development of wisdom teeth, particularly impacted wisdom teeth. We generally take a panoramic x ray around age fifteen or sixteen to evaluate wisdom teeth development, and monitor any problems closely.

We do advise parents that if there are problems that cause us to advise extraction of the wisdom teeth, you do so before your teenager goes away to college.?It is much easier to extract a wisdom tooth in a young adult, and doing so can prevent serious problems later on.?Every year we get calls from frantic parents asking what to do when their college student develops a serious infection (called pericornitis) from impacted wisdom teeth.

Many times younger children will not show decay, but as teen-agers develop serious problems. This can usually be traced to a habit of sweetened beverages, particularly sodas or sports drinks.?We recommend that parents do not buy sodas or sweetened drinks for use at home. Many teenagers will drink flavored bottled water instead. (Read the label to make sure there are no sweeteners added.) In Dr. Kayes' house, beverages are limited to skim milk, water, and orange or grapefruit juice, with sodas or lemonade reserved for picnics and parties.

It should also be noted that failing to floss daily also contributes to between teeth decay since the plaque is not removed if the teeth are not flossed. (Brushing teeth provides very little effect for the spaces between teeth.)?

Watching the way teenagers attack food, it is hard for parents to believe they were once picky eaters. Even though they generally eat plenty of food, it is important to stock the house with nutritious yet good tasting food.?Teenagers are going to get plenty of junk food on their own, so making sure good choices are available at home helps them balance out their diet.?

There are many simple food choices that can help teenagers obtain a balanced diet. Try to find whole grain cereals that are acceptable to them both for breakfast and as snacks, and use bread that has at least some whole grain flour in the ingredient list. Having a fruit basket on the kitchen counter with plenty of citrus fruit makes it easy to get vitamin C, and regularly putting out a plate of raw vegetables in the evening helps with vitamin A. (Some of the easiest choices include peeled baby carrots, sliced peppers, and celery sticks.) Canned soup (especially soups with tomatoes or other vegetables) and frozen microwavable burritos are also really nutritious choices.?

The trick is to provide enough of a variety of good foods to satisfy their appetites so that there isn't such a craving for junk.?Remember that the grocery store is where nutrition decisions are made - if high sugar or high fat foods aren't brought into the house in the first place, you don't have to worry about the kids getting in to it.?And of course, if junk food isn't available for the kids, it isn't there to tempt the adults in the household either.