An infectious disease such as dental caries can affect a child’s life from the moment the first tooth appears. Yet few parents know what dental caries is or how to prevent it in those adorable baby teeth.

Dental caries, quite simply, is tooth decay, the infectious disease that leads to cavities. The Elk Grove Village-based American Academy of Pediatrics kicks off its initiative for better dental health this month, an annual event initiated in 1941. The academy collaborates with pediatricians and other medical professionals to help educate families about preventing cavities and other diseases in children’s teeth.

“It’s about how to be more proactive—looking in the mouth and giving appropriate advice to parents about proper dental hygiene,” says Dr. Suzanne Boulter, the head of the academy's Oral Health Initiative.

Boulter and Dr. David Krol, another member of the initiative, agree—caring for a baby's and a young child’s teeth is a shared responsibility of the medical pros and the parents.

“Brush together,” says Krol, who works as a pediatric dentist in Toledo, Ohio. “Make good oral health a family affair. Make it fun and make it a habit.”

Krol and Boulter offer some basic tips for how parents can best monitor their children’s dental health—from the very beginning. 

• Know your caries. Cavities are the end product of caries, an infectious disease that can produce holes in young children’s teeth. The development of dental caries can start even in infancy, with the transmission of bacteria from parent to child during breast-feeding. Food contributes bacteria as well. “When we talk about baby teeth, people think they’ll be gone by age 6,” Boulter says. “Caries in baby teeth are going to carry to adult teeth because the bacteria has taken hold.”

• Set routines. “Routines are very important for children and setting those routines early in life can make a big difference in maintaining those routines later in life,” Krol says. Parents can wipe a baby's teeth at bedtime and can gently brush those teeth as early as six months, dentists say. Krol says that it can also be useful to use a wet cloth or gauze to clean a baby’s gums even before they begin teething.

• Introduce the toothbrush at the first sign of teeth. Krol says that a toothbrush and water are all you need for kids ages two and under, and that swallowing a small amount of toothpaste is far less risky than severe dental decay. He advises to keep the amount limited to a baby fingernail-sized amount to avoid any risk of fluoride in the toothpaste discoloring teeth.

• Make brushing fun. Krol tells his patients to sing a song as they brush, or even time themselves with a timer-rigged toothbrush. “Sometimes, I’ll have the little kids be the police for the family,” Krol said. “They’re my little spies. Parents appreciate that and kids love pointing that out. Make this a life-long habit, something they’ll carry on into adulthood.”

• Fight the dentist boogeyman. Adults and children alike are familiar with the impending sense of doom that can accompany a trip to the dentist. If children visit a dentist by their first birthday (as the Academy and the American Dental Association suggest), they won’t associate the dentist with pain and discomfort later. Cleaning and prevention should start early. “Making the first visit to a dentist one that requires drilling and filling is not a good start,” Krol says, “Don’t just come when you have problems.”

• Get rid of that sippy cup. Natural fruit juice contains lots of nutrients and vitamins but also lots of sugar. A child who carries around a sippy cup all day, drinking juice every 10 minutes or so, is fueling the bacteria that can lead to cavities. The sippy cup brings a constant stream of sugar to the teeth, Boulter says. “It’s generally not a good policy to have any sugar-containing liquid—juice, sports drinks, Kool-Aid, soda.” The academy recommends that babies and young children mainly drink water and milk, especially if they are still using a bottle. Cutting back on sugary foods may also help children avoid obesity, an increasing concern in the U.S

• Look into your local water supply. Nearly all Illinois residents receive fluoridated water at the tap, according to the Centers for Disease Control and Prevention. By comparison, less than half the counties in New Hampshire, where Boulter works, offer fluoridated water. “Fluoride is very important in maintaining the enamel of the teeth and keeping them strong and resistant to decay,” Boulter says. If you live in a house with a well, the well water must also be tested as groundwater can contain high amounts of natural fluoride, according to Boulter. As with toothpaste, too much fluoride from drinking water can lead to "enamel fluorosis," a condition that discolors teeth.

• Know the facts. As with many other illnesses, dental problems tend to be more severe when children don’t have insurance or the means to receive regular denta care, says Boulter. She works in a community health center where many patients are on Medicaid. Only 57 percent of children in Illinois who live under the federal poverty level have received preventative dental care in the last 12 months, according to the National Survey of Children's Health. “We’re getting kids with more disease but less access to care,” Krol says. “We want kids to identify a dentist who takes care of them. If we can connect those two, we’ll all the better for that.”

Click on the map below to learn more about the availability of fluoride in Illinois drinking water. 

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