Sippy Cup Do’s and Don’ts

Sippy cups provide a natural transition between bottles and regular cups. A good sippy cup can be a wonderful tool to teach your child how to drink independently and transition from sucking to sipping. Sadly, many families misunderstand the purpose of sippy cups and use them less as a teaching device and more as a way to avoid messes. This can result in the formation of bad habits and increased risks of dental problems. Here are a few do’s and don’ts to consider when transitioning your child away from the bottle.

Don’t use a sippy cup with a valve. A sippy cup with a valve will encourage your child to continue to suck, which is exactly the opposite of the reason you are transitioning with a sippy cup in the first place.

Do use a sippy cup with snap-on or screw-on lid. The little plastic extension on the top of the cup teaches children how to sip properly while minimizing mess.

Don’t give your child any beverage other than water in a sippy cup, except at mealtime. Even before children develop teeth, they run the risk of developing cavities if they drink too many sugary or acidic beverages. Teach them that the best solution for thirst is water and that other drinks are only to be consumed at mealtimes.

Do introduce regular cups early. Believe it or not, your child should transition to a normal cup by about 18 months of age. Typically, sippy cups are recommended for children between 12 and 18 months old.

Don’t let your child become dependent on sippy cups. Some parents let their children use sippy cups into kindergarten and beyond. Many children suck on the spout of a sippy cup like a pacifier. And, as children become more mobile, the odds of their running around while sucking their cup, tripping and damaging their teeth increase substantially. This injury is common enough to bear a strong warning.

If you have any questions about your child’s drinking skills, let us know. Limiting how long and under what conditions your child uses a sippy cup can improve your child’s prognosis for a healthy mouth.

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Reduce the Risk for Enamel Fluorosis

Parents are vigilant lest their baby develop any imperfection—especially one that could be avoided. For instance, parents would not want to feed their child with formula that would cause enamel fluorosis in permanent teeth.

Although the name sounds ominous, enamel fluorosis is most often nearly invisible to the naked eye and has no systematic effects. Enamel fluorosis is the excessive whitening of spots on the enamel of permanent teeth. The condition develops only while the teeth are still maturing, invisibly, below the gums, in children 8 years and younger. It’s caused by the intake of too much of the tooth-strengthening mineral fluoride.

When it occurs, enamel fluorosis is almost always mild, with the whitened spots visible almost exclusively to peering dental professionals. Occasionally, fluorosis spots are more visible; very rarely do they cause a potential cosmetic problem.

How would an infant take in excessive fluoride? Theoretically, by consuming too much highly fluoridated water, especially water to which more than 2 mg/liter of fluoride is added. Properly fluoridated water contains about 0.7 mg/liter of fluoride. Fluoridation, usually, is a good thing—it helps prevent tooth decay.

But, often, babies drink not only tap water in their bottles or sippy cups but also powdered or concentrated liquid formula that has been prepared with fluoridated water. The formula itself does not contribute to enamel fluorosis; it is the improperly fluoridated water with which it has been mixed.

If you’re concerned about your tap water, a potential source of enamel fluorosis, consider these choices:

  • Breastfeed your child for at least the first six months of life.
  • If and when you feed your child formula (after consultation with your child’s physician), choose either the ready-to-feed kind or mix the formula with low-fluoride bottled water, usually marked purified, distilled, demineralized or deionized. You can also alternate between fluoridated tap water and bottled water.
  • Wipe your child’s gums with a soft cloth after he or she drinks formula—a good habit to develop, in any case.

If you don’t know how much fluoride is in your tap water, consult your local water utility—or ask us. We’ll have the answer or help you find it. Taking care of your child’s primary teeth can have a big payoff on the health of his or her permanent dentition.

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Varnished Teeth Have Fewer Cavities

More than 10% of all American children suffer from early childhood caries (tooth decay in the primary teeth). Although this condition used to be called “baby bottle tooth decay,” based on the idea that it was caused by frequent consumption of drinks such as juice and soft drinks containing sugar from a baby bottle, dentists now recognize that early childhood caries is caused by multiple factors, including the presence of bacteria that cause caries.

Teeth both lose and gain enamel constantly. One way to encourage tooth remineralization is through the use of fluoride products. We may apply a fluoride varnish to your child’s teeth semiannually or annually during well-care visits.

A recent study reconfirmed that fluoride varnish can help reduce caries in young children. The children received fluoride varnish on all surfaces of their primary teeth at six well-child visits. When the children were 4½ years old, their teeth were checked on all surfaces for evidence of caries. The results were compared to a similar group of children who had not received fluoride varnish.

  • Children who received no fluoride varnish treatments averaged more than 23 tooth surfaces with evidence of early childhood caries.
  • Children who received 1, 2 or 3 treatments had results similar to the children who did not receive any treatments.
  • Children who received 4, 5 or 6 treatments had approximately 35% fewer tooth surfaces with caries
  • These results were consistent regardless of the child’s sex or age when the treatments began.

Compared with the cost of dental work, fluoride varnish is an inexpensive preventive measure. Although it cannot eliminate tooth decay by itself, fluoride varnish can help protect the primary teeth by reducing the amount of early childhood caries. Talk to us about this treatment at your child’s next visit.

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Weighing the Possibility of Developing Dental Cavities

What is the connection between your child’s body mass index (BMI) and the likelihood of dental caries (cavities)? Studies of the relationship have come up with varied answers.

In the United States, some studies have found that children with higher BMI—overweight children—may be more likely to have cavities. This appears to make logical sense: Children can become overweight from excessive consumption of high-sugar and high-carbohydrate foods and drinks such as soda, candy, chips and cookies. If the residue from these types of foods is not brushed away quickly, bacteria can attack teeth, leading to cavities.

Other studies, however, have found no correlation between BMI and cavities. This suggests that a different logic may apply: A child who has a high BMI because he or she eats lots of high-fat, high-sugar food and drink, but who has excellent hygiene habits—brushing twice daily and flossing once—may not necessarily develop cavities any quicker than his or her peers with normal BMI. But a child of any weight who doesn’t get regular professional cleanings or brush often or effectively enough with fluoride toothpaste will be exposed to a higher risk of caries, even if his or her diet consists of mainly healthy foods.

Everyone—parents and children—need to learn the importance for present and future health of maintaining a child’s weight in the normal range, minimizing caries and treating problems promptly when they occur. The key, though, is to make the lessons stick.

When your entire family incorporates lifestyle strategies like eating lots of fresh vegetables and fruit, and cutting back on “junk” food and sugar-laden beverages, your children’s weight and teeth will both benefit. The earlier your child starts eating healthy foods, the better. If you need help, we are always happy to provide suggestions for meals and snacks that will help you make over your menus.

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Your Down Syndrome Child’s Oral Health

Just as they do in the areas of physical, mental and emotional development, children with Down syndrome exhibit both differences from and similarities to other children in oral health maintenance. For instance, children with and without Down syndrome need to learn to brush their teeth independently, visit us for cleanings and avoid the stickiest and most sugary snacks as much as possible.

Children with Down syndrome, however, are at greater risk for periodontal (gum) disease because their immune systems are less able to fight infection. It’s important to keep their mouths free of food residue that can lead to plaque buildup on the teeth, especially near the gumline. This means more frequent rinsing and brushing (even when inflammation is present) and, sometimes, more frequent dental x-rays to check for possible bone damage from gum disease.

In addition, a child with Down syndrome has a greater need for sealants and fluoride treatments to lower the chance of decay formation. After evaluating your child’s oral health, we might also recommend a prescription-strength antimicrobial rinse to further protect him or her against gum disease.

As the parent of a child with Down syndrome, you are in the best position to tell us about your child’s health and capabilities, information that will enable us to best help maintain oral health:

  • Is your child taking any medication?
  • Does your child have heart issues that necessitate taking antibiotics before dental work?
  • Does your child grind his or her teeth or have an especially strong gag reflex?
  • How comfortable is your child at following directions, staying still and tolerating unfamiliar sensations?

Prior to your child’s appointment, we can speak at length with you to discuss these and other issues. Normally, we can take care of this by telephone, but you are certainly welcome to visit our office to discuss your concerns regarding your child’s treatment. We can schedule your child’s visit for the time of day during which he or she will best be able to participate. We will make every effort to ensure that your child feels at home in our office.

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Defense for Your Young Athlete’s Teeth

Did you know that approximately 40% of all dental injuries in teenagers occur while playing sports? If your children are involved in athletics, you need to learn about prevention and treatment of sports-related dental injuries so you can protect your child’s smile. And while you may think that only heavy contact sports such as hockey put your child at high risk for a sports injury, accidents happen anytime there are fast-moving bodies, balls or hard equipment being swung around.

The best way to handle sports-related dental emergencies is to prevent them from happening in the first place. By having your child wear proper protective gear, you’ll reduce his or her chance of sustaining an injury to the face, jaw or teeth.

  • Mouth guards are essential for any contact sport, especially for young athletes playing hockey, football or lacrosse. But even basketball and soccer players can benefit from using mouth guards, which not only protect the teeth but also provide a cushion to protect the jaw’s temporomandibular joint (TMJ) from impact injuries. Mouth guards, which are relatively inexpensive, may also prevent injuries to the lips and gums. We can custom make a perfectly fitting mouth guard for your child, or you can purchase a simple boil-and-mold style mouth guard at a drugstore.
  • Helmets are another way to protect your child’s mouth because they protect the entire skull.
  • Face cages, often used in hockey, prevent anything from striking the face.

Because the most common dental injuries sustained during sports affect the front teeth, the cheeks and the tongue, they have an impact on more than just the appearance of your child’s smile. Dental injuries can also lead to eating, drinking and speech difficulties. That’s why it’s important to see us immediately after a sports accident, especially in the case of a chipped or knocked-out tooth. The sooner you get medical attention, the more likely the tooth can be salvaged.

Before your child’s next sports season begins, be proactive. Talk to us about the best protective gear for his or her particular sport, and avoid having to make an emergency visit in the future!

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