First Visit from the Tooth Fairy

A couple of weeks ago my daughter, Lilah (5 ½ years old), was eating a cracker and told me her bottom tooth was hurting. I took a look and realized that she had her first loose tooth. Over the last couple of weeks I’ve noticed her playing with the tooth more and more. She’s had a difficult time eating things like corn on the cob so I have been cutting it off for her. When I picked Lilah up from school last night the tooth was moving all over the place. I cringed every time I saw it move, but she thought it was the greatest thing. I stepped out into the yard for a few minutes, and when I returned she told me she had pulled out her tooth, and that it “didn’t hurt but there was some blood.” EEWW!

Last night she eagerly placed her tooth in a baggy under her pillow and awaited the gift mom promised from the Tooth Fairy. This morning she ran down the stairs pleased as punch with a five dollar bill. I used the opportunity to reminder her about proper dental care. I explained that she needed to be extra careful to keep her mouth clean so that the new hole from her missing tooth would not get an infection. We have also been discussing that when she gets her new teeth they will have to last her a lifetime.

I’ve included some information below about the baby-to-adult teeth process. I hope this helps ease any fears you may have and equips you with information to prepare your child for this milestone.

When will my child’s baby teeth start falling out and which ones?
Alan Carr, D.M.D. a prosthodonist with the Mayo Clinic said, “A child’s baby teeth (primary teeth) begin to loosen and fall out on their own to make room for permanent teeth at about age 6. Timing can vary, though, and girls generally lose baby teeth earlier than do boys. The last baby teeth typically fall out by age 12 or 13.

Baby teeth usually fall out in the order in which they erupted — first the two bottom front teeth (lower central incisors), followed by the two top front teeth (upper central incisors), the lateral incisors, first molars, canines and second molars. If a child loses a baby tooth early as a result of tooth decay or an accident, a permanent tooth may erupt early and potentially come in crooked due to limited space.”

What if my child in nervous about the process and wants you to take it out?
If your child wants you to pull out a loose tooth, grasp it firmly with a tissue or piece of gauze and remove it with a quick twist. If the tooth is resistant, wait a few days and try again. If you’re concerned about a baby tooth that doesn’t seem to loosen sufficiently on its own, check with your child’s dentist. He or she may recommend a wait-and-see approach or an extraction in the dental office.

When your child starts to lose his or her baby teeth, reinforce the importance of proper dental care. For example:

• Remind your child to brush his or her teeth at least twice a day. Supervise and help as needed.
• Help your child floss his or her teeth at bedtime.
• Limit eating and drinking between meals and at bedtime — especially sugary treats and drinks, such as candy and soda.
• Schedule regular dental visits for your child, either with your family dentist or a pediatric dentist.
• Ask the dentist about use of fluoride treatments and dental sealants to help prevent tooth decay.

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Wow, I wish I was a kid again

Well, maybe not all the time but I must admit I was a bit envious of Lilah’s first pediatric dentist visit. When I was a kid I was lucky to get a Highlights or Ranger Rick magazine in the waiting room. When we walked into her new dentist office there were trains and toys galore along with all the kid’s magazines. I checked Lilah in for her appointment with the super chipper staff, and we were shortly ushered to their quiet consultation room. They walked me through the dental appointment process and procedures and were patient when Lilah was too shy to answer any questions.

All new patients get a keepsake of their visit.

I was amazed when they brought us in to the patient room. It was heaven. They had the patients’ tables with TV screens above (and headsets) for the kids to watch cartoons on, there were video games in the corner (real arcade types) for the kids who were waiting for their siblings or had just finished up their own appointment, and at least 4-5 staff members were talking to the kids, cleaning teeth and taking photos of each patient with the dentist. After giving Lilah a sticker of her choice (Dora and Boots), the dentist and his assistant both walked Lilah and I through the steps of how to brush properly, which teeth needed to be flossed (only the ones that were close together where plaque can collect), and choosing proper nutrition and drink options for the best possible dental health. I was incredibly proud of my girl when she fully cooperated and even smiled for her photo. Just like when I was a kid, Lilah was given the opportunity to take a small toy from a basket as a prize (though she declined).

After all was said and done, she convinced me to stay for an additional 15 minutes to play with the trains. She did not want to leave and exclaimed that she had “so much fun.” I’m thrilled that her first experience at the dentist was a positive one. Shortly after arriving home, Lilah pulled out her goody bag and showed me her stash of 4 toothbrushes, a flossing tool, a SpongeBob sticker and some other random items. That evening she couldn’t wait to show me how well she could brush her teeth. Yay!!!

Less than a week after her visit Lilah received a colorful handwritten postcard (with stars and hearts) thanking her for being an amazing patient. I couldn’t be happier. I would suggest that anyone considering whether to take their kids to their dentist or a pediatric dentist should go with the latter. I’m sure this experience will set her up for a more positive outlook towards her dental health.

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Kids and their Dental Hygiene

Lilah's assortment of toothbrushes

While cleaning our bathroom counter the other day, I was overwhelmed with the number of toothbrushes my daughter has collected. Okay, so maybe I don’t have to buy so many for her, but I’ll do whatever it takes to get her to brush her teeth! When I was pregnant, my husband and I would discuss parenting techniques. We agreed that we would not negotiate or bribe her to get her to do what was normally expected of a child, but reality has set in, and I’m finding it almost impossible not to. I now subscribe to Mary Poppins’ philosophy, if buying a few extra toothbrushes and some fun toothpaste can “move the job along” than so be it. I recently learned that it’s recommended that children go for a dental check up before their first birthday. (No way! I ‘m way behind on this!)  Here are some other tidbits I learned.

What is the difference between a pediatric dentist and a family dentist?
Pediatric dentists are the pediatricians of dentistry. They receive two to three additional years of training beyond dental school, and are trained in child psychology, behavior control, growth and development and the latest techniques in introducing and providing dental care to children. Pediatric dentists limit their practice to primary and specialty oral care for infants and children through adolescence, including those with special health needs. 

Recommended Care by Age:
*This is a simplified version and IS NOT a complete list. 

6-12 months 

• Complete exam
• Provide oral hygiene counseling for parents
• Clean stains or deposits
• Assess the child’s systemic/topical fluoride status and provide counseling regarding fluoride
• Assess feeding practices and provide dietary counseling in regards to oral health
• Provide counseling for nonnutritive oral habits (pacifiers, thumb sucking)
• Complete Caries risk assessment
• Determine child’s interval for periodic evaluation

12-24 months 

• Repeat 6-12 month procedures every 6 months or as indicated by child’s risk status
• Provide topical fluoride treatments every 6 months or as indicated by patient’s needs

2-6 years 

• Repeat 12-24 month procedure every 6 months or as needed based on child’s risk status
• Scale and clean teeth every 6 months or based on child’s risk
• Provide pit and fissure sealants for caries-susceptible primary molars and permanent molars, premolars, and anterior teeth
• Assess and provide treatment for oral health as needed

I did it! I just scheduled her appointment. If it’s time for your child to see a pediatric dentist and you need help finding one in your area, here is the American Academy of Pediatric Dentistry’s national dentist locator. 

SMILE!

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