Q. What is the latest thinking on children and fluoride?
A. Fluoride is one of dentistry's best preventive measures. It is used in two forms: topical fluorides-the kind in toothpastes, mouth rinses, and fluoride treatments you receive in dental offices-and systemic fluorides-minerals ingested in drinking water or dietary fluoride supplements.Infants and young children who ingest too much fluoride may develop enamel fluorosis, a cosmetic condition characterized by white or brown streaks in the tooth enamel.
The American Dental Association recommends that for infants up to age 12 months who get most of their nutrition from formula, concentrated or powdered formula should be mixed with water that is low in or free of fluoride when possible. The American Academy of Pediatric Dentistry (AAPD) guidelines state that a smear of toothpaste can be used on children younger than age 2. A smear means just the tips of the toothbrush bristles have toothpaste on them and the toothpaste does not penetrate the bristles. Once children reach age 2, a pea-sized dab can be used.
Q. Does a pediatric dentist work with our family dentist? When do parents need a pediatric dentist?
A. Pediatric dentists are trained two or three years beyond dental school to treat infants, children, and persons with special health care needs. These oral health care providers have specialized training in growth and development, psychology, and behavior management that helps them treat children from infancy through adolescence. A family or general dentist may recommend a pediatric dentist for a variety of reasons. The child might need extensive or specialized treatment, or the dentist may find children (especially very young ones) difficult to treat. In any event, children should visit a dentist within six months of the eruption of their first tooth and no later than their first birthday.
Q. At what age do children start to get dental X-rays? Is this safe?
A. Dental X-rays are safe when used according to standard guidelines. They help the dentist diagnose disease, monitor dental and facial development, and check the progress of therapy. Dentists use lead aprons and shields to protect children. There is no specific age for the first dental X-ray exam. The dentist determines the need for X-rays after conducting a dental exam and a thorough health history. The dentist may take X-rays to check for decay if he or she cannot see between the baby teeth. Dental X-rays also may be taken to monitor the development of the permanent teeth buried deeper in the jawbones and to observe growth patterns in facial bones. In general, children need X-rays more often than adults, because their mouths grow and change so rapidly.
"Oral Health Topics: Fluoride Supplements: Facts About Fluoride." American Dental Association. http://www.ada.org/2684.aspx?currentTab=2. Accessed 2013.
"Interim Guidance on Fluoride Intake for Infants and Young Children." American Dental Association. http://www.fairbanksalaska.us/wp-content/uploads/2011/07/20061108ADA-Interim-Guidance-Fluoride-Intake.pdf. Accessed 2013.
"Guideline on Fluoride Therapy." American Academy of Pediatric Dentistry. www.aapd.org/media/Policies_Guidelines/G_FluorideTherapy.pdf. Accessed 2013.
"The Pediatric Dentist." American Academy of Pediatric Dentistry. http://digital.ipcprintservices.com/publication/?m=17254&l=1. Accessed 2013.
"Baby Teeth." Mouth Healthy, American Dental Association. http://www.mouthhealthy.org/en/az-topics/b/baby-teeth. Accessed 2013.
"X-Ray Use and Safety." American Academy of Pediatric Dentistry. http://digital.ipcprintservices.com/publication/?m=17256&l=1. Accessed 2013.