Dr. Norman Tinanoff

Dr. Norman Tinanoff (Kenneth K. Lam, Baltimore Sun / March 14, 2014)

Tooth decay has become a major problem among young children, and pediatric dentists are urging parents to take steps such as limiting sugary snacks and drinks. They also now advise brushing with a small amount of fluoride toothpaste and having a wellness exam at age 1, according to Dr. Norman Tinanoff, chief of the division of pediatric dentistry at the University of Maryland School of Dentistry.

How big a problem are cavities in children?

Tooth decay in children under age 6 is called early childhood caries by health professionals. As early as age 1, some children have signs of tooth decay. National figures show that 60 percent of children have decay by age 5. In Maryland, 12 percent of Head Start children are reported to have tooth pain from dental cavities. The repair treatment that dentists must do is difficult and expensive because many children in this age range need specialty care, which may include sedation or hospitalization, to fix their teeth.

How can I tell if my child has tooth decay?

Current guidelines state that children should be examined for signs of tooth decay by age 1. At this age, dentists perform "well baby" visits with the help of the parent holding the child's hands. Many pediatricians in Maryland also have been trained to examine the child for signs of dental decay and refer to dentists when necessary. Tooth decay in children is not hard to see, even for parents. Children's teeth should be white all over. If there are black or brown spots the child may have decay and should be seen by a dentist. If a child has tooth pain, he or she needs to be seen right away by a dentist.

What can parents do to prevent their children from having tooth decay?

Most importantly, children's teeth should be brushed twice a day with toothpaste that contains fluoride. Children also should not frequently eat or drink sugar-containing foods.

So with brushing, when should I start? How can I do it? What if my child refuses?

Tooth-brushing by the parent with fluoride toothpaste should start when the child first gets teeth. It is important to use the correct amount of toothpaste. For children under age 3, a "smear" or "grain size" amount of tooth paste should be put on the brush. For children 3 to 6, a "pea size" should be used. This amount of toothpaste is important because young children are not able to spit out the tooth paste. Parents should continue to be the brusher until the child is 7 or 8. If this routine of brushing twice a day is started early, there should be little objection by the child. However, parents should not let the child "get away" by refusing. Just remember, any measure that prevents a child from having dental cavities is certainly worth the effort.

What about sugar?

The bacteria on the child's teeth "eat" sugar from the child's diet, producing acid. If sugar is eaten frequently by the child, the acid is constant and the teeth will lose minerals. Therefore, reducing between meal snacks and reducing foods or drinks that are eaten slowly, such as lollipops, will do much to starve the bacteria that are making acid.

What procedures does the dentist perform to prevent tooth decay?

On routine dental visits, the dentist will evaluate your child's risk for tooth decay. If it is thought the child is at risk, the dentist can apply concentrated fluoride on the child's teeth. Most often, this is in the form of fluoride varnish. If you live in an area that does not contain fluoridated drinking water, the dentist may consider fluoride supplemental tablets. Additionally, when you child's permanent molars come in, around age 6-8, the dentist may suggest that applying pit and fissure sealants will prevent tooth decay in those teeth.

meredith.cohn@baltsun.com