The Most Common Dental Health Issues in Kids

Featured Article, Health and Safety

Having healthy pearly whites is as important for children as it is for adults. We asked pediatric dentists to identify common kids’ dental health problems and share suggestions on how to avoid them. Plus real parents shared with us their tips for getting their wee ones to brush without all the fuss. Here’s what they all had to say. Here’s to a healthy smile for a lifetime!

Visit the dentist regularly—and early

It probably comes as no surprise that cavities top the list of dental issues among patients ages 1 to 18, according to Dr. Robert Delarosa, DDS, a pediatric dentist in Baton Rouge, La., and the president-elect of the American Academy of Pediatric Dentistry. Although cavities can cause a lot of problems, most of the time, they’re preventable.

The first line of defense is regular dental visits. Six months is the standard time between visits, but children who are more at risk for cavities—some patients with special needs or children who have a family history of tooth decay or who wear orthodontic appliances, for example—may require more frequent trips.

Dr. Edward Moody, DDS, a pediatric dentist in Morristown, Tenn., and the current president of the AAPD, says that, in general, parents schedule their child’s first dental visit too late—often by several years. The AAPD recommends children see a dentist by their first birthdays, but many parents wait until age 2 or 3 or later.

“That’s just way, way too late,” Moody says. “We’re seeing kids come in the office every week for their first dental visit at 3 or 4—even 2 years old—and already have a mouth full of cavities. We know if we can get them in early, we can educate parents on home care, brushing, diet and all the things you need to be doing to prevent cavities and decay. Parents don’t realize as soon as a tooth comes in, it’s subject to getting a cavity.”

The earlier a child goes to the dentist, the more likely visits are to be easy and uneventful, which is a good thing. On the other hand, repairing toddlers’ cavities often requires sedation or even surgery under anesthesia at a hospital, which can be costly, time-consuming and no fun for kids or parents.

Moody says parents commonly brush off the importance of baby teeth, opting not to care for them as well as they should because they’re just going to fall out anyway. “What parents don’t realize about baby teeth is that the first ones come in around 6 to 9 months and don’t come out until about 6 or 7 years of age,” he says. “The teeth that come in at 2 or 3 years of age don’t come out sometimes until 12 or 13. A small cavity at age 3 or 4 will get bigger. The cavity is an infection, and it’s going to get worse. The tooth starts to hurt. The infection can get all the way into the nerve, the nerve could die, and the tooth could abscess.”

Even the earliest teeth need babying. Wipe them off with a wet washcloth or gauze after babies eat or drink, and then progress to a soft-bristled toothbrush. When teeth start to touch, begin flossing with dental floss or kid-friendly floss picks.

Brush to keep decay away

Parents need to take children’s brushing and flossing into their own hands to ensure good results. The AAPD recommends children (and grown-ups) brush for two minutes twice a day and floss at least once a day. Though toddlers and preschoolers are all about doing tasks independently, dental care should not be one of those things, say both Moody and Delarosa. “For a young child, you’re going to have to brush and floss for them,” says Moody. “They’re not capable of doing a really good job by themselves until about age 7 or 8. They just don’t yet have the motor skills to get the brush where it needs to go.”

How do other parents encourage good brushing habits? Carla Conforto, of Bellingham, Wash., says her dentist recommended she brush her preschooler’s teeth, which she does. Afterward, she gives her daughter the toothbrush to “finish.”

Melissa Foreman, a Pennsylvania mom of four, sang songs to her kids when they were young as she brushed their teeth. Each kid had two toothbrushes, and Foreman let them choose which one they wanted to use when they were resistant to brushing to “give them the feeling they had some control in the situation,” she says.

Brandon Thompson, of Chicago, says his two kids, ages 7 and 5, enjoy the Oral-B Magic Timer iPad app. “It holds their attention and even promotes proper brushing techniques,” he says. Parents can also purchase toothbrushes with built-in lights and timers or go low-tech with an hourglass or kitchen timer to ensure kids do the full two minutes.

Diet matters

Certainly a steady diet of Skittles and soda will create a breeding ground for cavities, but parents should be mindful of all refined carbohydrates their children consume, including kiddo faves like juice, crackers and baked treats. “Things that have a high sugar content and are high refined carbohydrates that can stay on the tooth structure, those are problems for us,” says Delarosa.

Sodas and juices pack a double whammy of sugar and acid, making the teeth extra-vulnerable, but even diet versions of the drinks are highly acidic and bad for teeth enamel. When kids are thirsty, Delarosa says, give them water. The AAPD recommends kids drink no more than 4 to 6 ounces of juice a day, preferably with breakfast and followed by brushing. (Likewise, the American Academy of Pediatrics recommends 4 to 6 ounces of juice per day for kids ages 1 to 6, and 8 to 12 ounces for kids ages 7 to 18.)

Kids, especially toddlers and teenagers, tend to be “grazers,” says Delarosa, meaning they often consume snacks and sugary drinks all day long. He recommends parents establish regular snack and meal times to cut down on all-day munching and curb the constant contact of sugar on the teeth. Avoid sending little kids to bed with bottles or sippy cups of milk or juice. Teens sometimes slack on personal hygiene and may need regular reminders to brush and floss.

Bumps, chips and other tooth-tastrophes

Another common dental problem with kids? Tooth trauma. Wobbly littles often bump their teeth, and school-age kids can chip or lose teeth when playing sports or being on the receiving end of an elbow to the mouth in gym class.

Dentists typically won’t try to replant a baby tooth that gets knocked out, but if it’s a permanent tooth, rinse it with water to clean off any dirt or debris—but don’t scrape or rub it—and put it back in the socket immediately, says Delarosa. Next, call the dentist to schedule an emergency appointment. “The best environment for that tooth is back in that socket,” Delarosa says. “Make sure you make that phone call. That tooth might need to be bonded or held together in place with some orthodontic wire.”

Both Moody and Delarosa recommend kids wear mouth guards when playing sports, but the fact is, dental mishaps are often hard to prevent. If a tooth gets bumped hard enough to cause gum swelling or bleeding, or gets chipped, Moody says, call your dentist’s office or its emergency line. Tiny fractures are difficult to see with an untrained eye, and they could result in more damage or the full loss of a tooth even weeks later. Chips may need to be filed down. When in doubt, snap a picture of the damaged tooth with your cell phone camera and make the call.

Delarosa says, “Here’s what I tell my patients: If you have a concern, call. I never want to miss the opportunity to be able to have done something that would’ve prevented the situation from getting worse.”

To learn more or to find a pediatric dentist, visit the AAPD’s website for parents,

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