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    Dental Care Timeline

    Dental decay (cavities) is the most common chronic disease in young people between the ages of 5 and 17. Dentists from the Pediatric Dental Program at Children's Hospital of Richmond at VCU recommend the following steps for a comprehensive dental care program:

    • Infant Oral Care

    An infant's gums should be wiped with a clean washcloth or gauze at least three times a day, after feedings and always before bedtime. Avoid putting babies or young children to bed with a bottle or a sippy cup containing milk, juice, soda, etc. If you must give your child fluids, it should be water.

    • First Dental Visit

    The American Academy of Pediatric Dentistry recommends a child's first dental visit occur when the first tooth appears, or no later than the child's first birthday.

    • Brushing

    Start using a soft toothbrush as soon as the first tooth appears. For pre-school age children, use a pea-size amount of toothpaste and brush for as long as it takes to reach all surfaces of the teeth and gums. You should brush your child's teeth first, then teach the child how to brush. Use a toddler formula toothpaste without fluoride or, if using fluoride toothpaste, wipe out the excess or watch closely to be sure the child is not swallowing toothpaste.

    • Flossing

    Studies show that as many as 95% of children have gingivitis (a form of gum disease that causes inflammation and bleeding). Flossing helps remove food particles and plaque that can lead to this condition. Floss any teeth that are touching as soon as they come in. Young children may not have the coordination to floss so you need to floss for them. Using hand-held flossers can help.

    • X rays

    In general, the first complete set of X rays is taken between ages 5 and 8, and the second set between ages 11 and 14. However, this varies based on the need for diagnosis, the patient's age and other factors. Complete dental films diagnose extra or missing teeth, jaw defects, poor position of developing teeth and some rare jaw tumors. Other types of X rays include bite-wing X rays -- to detect dental decay that cannot be seen during a visual exam -- and panographs – to show current teeth, developing teeth and cavities.

    • Sealants

    Sealants are thin plastic coatings applied by a dentist or dental assistant to the chewing surfaces of the permanent molars (back teeth) where most tooth decay occurs. Sealants may help prevent decay before it starts. They are recommended for:

    • The first molars, which typically come in around age 6
    • The first and second premolars, which typically come in around age 11
    • The second molars, which typically come in around age 12

    Sealants need to be checked periodically and may need to be replaced. It is best if they are applied soon after the molars come in.

    • The Teen Years:

    As teens become responsible for their own health care needs, it is important they keep up good teeth cleaning habits such as:

    • Brushing teeth for approximately two minutes twice a day
    • Flossing at least once a day
    • Using toothpaste with fluoride
    • Keeping a travel-size toothbrush in a locker or backpack to use as needed
    • Visiting a dentist twice a year.

    For more dental health tips, visit the ?Your Oral Health? section of the American Dental Association website at

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