The answer is absolutely! In fact, many sugar-free gums today contain an amazing substance called Xylitol. Xylitol has been shown in studies to actually help decrease tooth decay and acts as a mild antibacterial agent. Some of the brands which contain xylitol are, Orbitz, Koolerz and Trident’s sugar free gum. There are more brands now on the market, so just read the package to see if it is in the gum. Generally, the closer the desired ingredient is to the beginning of the list on the package (in this case xylitol), the more it contains.

In addition, chewing gum stimulates saliva flow which helps to fight further against cavities. Saliva contains many natural anti-cavity substances in it and is just one more hopeful way to protect teeth. So let them chew like crazy!

This is a common concern among parents and has a fairly simple response. In general, your pediatrician will recommend that you plan on discontinuing the use of a bottle by age one. There is, of course, a little flexibility with this so that the child can undergo a relatively smooth transition to the use of a sippy-cup.

Every child is different in their need for that warm bottle of instant comfort. It is indeed an amazing cure-all for infant displeasure, but like all addictions, it isn’t easy to stop. Other children will give it up easily, gladly welcoming the new benefits of becoming a toddler. Most child-rearing books, like the “What to Expect” series, will give you tips and tricks of how to wean both the bottle and the pacifier. My biggest advice would be to start sooner rather than later, especially if you have a strong-willed child.

If you are successful in weaning both the pacifier and the bottle around 12 months, then you have no concern that either one will affect the orthodontic relationship of your child’s teeth. If you go much beyond this time frame, then it is possible that you may have some future orthodontic problems. Again, there is leeway with this, and in general we say that most of the permanent effects occur if the child has not completely stopped by age four. Of course I assume that your four year old is not drinking out of a bottle anymore, so I am speaking particularly about the use of a pacifier. If your four year old is still drinking from a bottle, you are way overdue for a crisis intervention!

The other big concern to be aware of is that, the pacifier can also cause trauma to the child’s gums. This can cause painful ulcers but can also cause the gums to recede from the tooth. This can cause many problems including gum damage for the soon erupting permanent tooth, tooth decay of the baby-tooth or painful root exposure. Your child may experience mild to severe sensitivity to hot and cold foods or even just when the air from speaking passes by the area where the gums have receded. Adults experience this too, but generally it is not caused by the use of a pacifier! There are many causes for adults, but the end result is the same resulting in sensitivity, pain or possible loss of the tooth from becoming loose. So again, stop the habit early, as it will be better for everyone!

Spaces between baby teeth are indeed normal as well as helpful. However, occasionally a child has a much larger than normal space between the upper two front teeth. This large space is what we call a “diastema,” which really just means a large space or gap. They are usually caused by the presence of a little extra muscle tissue between the underside of the top lip. This muscle attaches the lip to the gum tissue between the top two front teeth. We all have this muscle attachment, but occasionally the attachment may be a little excessive or attach a little further down toward/in between the teeth than usual. This slightly different attachment is sometimes just enough to keep the two front teeth from coming together. If not corrected, this attachment can stay present as an adult and may or may not cause other problems.

In general however, this is not something to be overly concerned about until the child is older. Your dentist may choose to have your child evaluated by the orthodontist, as sometimes the space will not close on its own. It is fairly easy to fix, sometimes requiring reshaping and or relocating of the attachment to a better cosmetic place with or without the help of orthodontics. Typically no treatment is performed to fix it until the child has all or almost all of their permanent teeth. If you and your child decide not to fix it, there is usually no problem associated with leaving it other than having the space there permanently. Occasionally if left alone, (this is usually when the problem is on the lower front teeth) the attachment can cause a defect in the bone and gums, causing a host of other problems. So, it is always best to have your dentist evaluate the area regularly during check-ups or if you have concerns about the space.

When we are first-time parents, we often have many new gadgets and gizmos to figure out how to use. Luckily, taking care of your child’s teeth is fairly devoid of a fancy products needed to complete the task. When your child is in the infant stage, you may want to consider using one of those super-cool finger brushes. You do not want to put toothpaste on them yet. They are made primarily to massage the gums during the teething stage to help the teeth come in more comfortably for the baby. It may also help in getting the child prepared for having a toothbrush at a later time. You could also have the same effect with a wet washcloth-just be sure it is clean before using.

Once the baby has teeth, we usually recommend the child chew on a toothbrush without toothpaste. It is my preference to place the child in a highchair or on your lap where they cannot fall or slip and become injured by the brush. Always supervise the child and no time restrictions are necessary at this point-just watch and enjoy! At around age two to four you can introduce fluoride toothpaste to the brush. They make special toddler toothpaste with tastes that are more appealing to your little tike. You should use a very small, less than pea-sized amount!

As a general rule, I usually tell parents that if your child tries to swallow the paste or is not able to spit, then do not use a fluoridated paste yet, regardless of their age. Fluoride can have toxic effects to the body and to the teeth if taken in larger amounts, so always be sure that you monitor your child while brushing. Rinses are generally not recommended until children reach age six years old and can definitely spit out with no problems. Again, I rely less on the child’s age and more on their ability to spit the rinse out without swallowing it.

Flossing. Let’s face it, we all hate flossing. It takes too much time, we forget, we don’t like it, we don’t have time for it. All valid reasons. However, flossing happens to be one of the most important things you can do for your gums and also for your body. Flossing helps prevent gum disease, which can lead to premature tooth loss, bad breath and a multitude of other dental problems. In recent studies, scientists have also linked gum disease to other health problems such as pre-term labor, heart disease, stroke and diabetic complications. So, though we hate it, we really need to do it (sort of like paying taxes, right?). The earlier we can introduce the habit of flossing to our children, the easier it will be to incorporate as part of their daily routine.

When kids finally have multiple teeth, you can start by demonstrating on yourself and then see if they will let you try it out on them. If you are unsuccessful, continue to show them while you do it and eventually you will find that they might at least try on themselves. You will also find that your child may have spaces in between their teeth and thus not much there to floss. The spaces are actually there for a reason and so just go through the flossing motions for now, and let your child practice. The spaces will likely go away once permanent teeth come in and so they will already be a pro at it! The child may complain that the floss stings a little bit. This is normal and is because the gums are not used to having floss touch them. This will be the same for adults. Be sure that they are gentle when they floss and occasionally a little bleeding will occur at first. This is normal, so reassure your child that flossing will make it go away and the more they floss, the happier their gums and teeth will be! Occasionally, flosses coated with mint flavoring can cause stinging during use. So consider buying flavorless floss.

There are many handy devices to make flossing easier and more appealing. One of my personal favorites is the “floss-pick“. It is a little plastic toothpick with floss attached to it. There are many brands, but I will warn you that cheaper is not better, as the less expensive ones tend to break after the first attempt. If your teeth are very tight, I also recommend Glide brand floss. It is a little more expensive but well worth the price! Also, regular floss is really the best, but if it is too difficult for you or your child to use, then you simply won’t use it. So, the bottom line is, use whatever you will use!

As both a dentist and a mommy, I get many questions about teething both at the office and in my own circle of friends. As a first time parent, many areas of parenting and childcare seem like such a mystery. We struggle our best by trial and error and constantly wonder if the question or problem really requires us to take a trip to the pediatrician. Do we want to shell out a co-pay or “wait it out” and see if the problem resolves on its own?

Well, my hope is that I can provide you with a little relief in this area child-rearing. Babies go through so many changes so quick, baby teething can bring about difficulties that feel like an eternity! Just when your bundle is finally sleeping through the night and you are settling in to the groove of being a new parent, the process throws you a new curve ball. Around 6-7 months, you may find your baby acquires some peculiar behavior and not all of it is enjoyable!

In general, the process of baby teeth begins at 3-4 months old, despite the fact that a tooth may not appear for several months after this. The baby teeth start their ascent into the mouth during this time and parents may notice some of the following behaviors in their infant: Excessive drooling, crankiness, biting and sticking objects in their mouths, coughing or colds, cheek or ear-pulling and unfortunately, night waking! While all of these can be signs baby teething, they can also be signs of other problems, so when in doubt, don’t be afraid to call your pediatrician-that’s what they are there for!

As these new baby teeth make their way in, they typically cause a lot of pressure and discomfort inside the gums. This process can cause crankiness and irritability and even cause baby to wake up at night in a crabby mood. It isn’t abnormal to have baby wake up crying or whimpering at night, only to attempt a bottle with no success. Sometimes they may even take the bottle only to fall right asleep without drinking much.

Babies often try to relieve this pressure during the day by chewing on any object they can fit in their mouth, including their hands. In addition, this grand appearance of teeth very much stimulates saliva flow, causing baby to drool excessively. All of these habits can cause other issues and strange behavior for baby. Excessive drooling during baby teething can cause a rash on the chin as well as stimulate the coughing and gagging reflex. They may also experience discomfort that is referred to the ears or cheeks.

The rashes are not usually a problem unless you find the rash to be causing pain, has open sores or bleeding. If this occurs, see your pediatrician for medicated creams to help heal the area and make baby comfortable again.

While ear and cheek pulling can be a sign of baby teething, it can also be a sign of an ear infection. My kids have had their fair share of ear infections and they can be such a frustrating experience. I have noticed ear and cheek pulling from baby teething to be pretty infrequent but not impossible. So, my suggestion would be that if you see this behavior, especially if accompanied with a fever, have your child evaluated by the pediatrician. Ear infections can be a very painful experience with possible complications and should not be “waited out.”

The drooling may also cause loose or runny bowel movements, but generally not diarrhea. If your baby has diarrhea lasting more than a day, call your pediatrician. While baby is trying to relieve pressure by putting object and fingers into their mouth, they unfortunately can be introducing unwanted germs into their bodies. So, you may notice and increase in colds or illnesses which may cause mild fevers or diarrhea. Fevers are not believed to be from teething directly, but are thought to be from the “bugs” that babies expose themselves to while going through the baby teething process.

So, how can you help your precious baby through this tough time which can last for months? Baby teething rings and toys or cold foods are a good start. Be sure that they are foods your baby is normally able to eat without choking! You can also gently massage the gums with your own fingers but please be sure to wash your hands first! Baby Orajel can be used, however, as a dentist I can tell you that unless you dry the area of gums completely before applying, it really will not work-you’ll only be providing bad taste and a numb tongue! So, if you can dry the area well, and your pediatrician has given you the recommendation to use it, then see if it works for your baby. Infant Tylenol or acetaminophen is another great option when baby is having a really difficult time during baby teething. However, before giving your baby any kind of medicine, always consult your pediatrician and be sure that you give the proper dosage for your child.

There have been many scientific developments in the field of oral health in the last decade. One of the most important studies has to do with the link between gum disease and several other health conditions. I won’t go into depth here about the other health conditions, as they don’t relate pregnancy but I will briefly mention them due to their extreme importance. There has been a proven relationship of gum disease to diabetic complications, stroke and heart disease. The oral bacteria which causes gum disease (which is different from those causing cavities) has been found in the heart and brain tissue of those who have had a fatal encounter with a stroke or heart attack. Diabetics with gum disease also experience more uncontrolled blood sugars. I would suggest a Google search the internet if you are interested in finding out more on the details of this relationship.

So, what does this have to do with pregnancy? Well, let me first give you a quick lesson on gum disease, since most of the population really doesn’t understand what it is. What it typically means to most people is the dreaded “you have to floss more” lecture from your dental hygienist. Basically, flossing your gums (notice I did not say teeth here) allows you to clean out the debris below the surface of your gums-in the area where popcorn kernels get caught. If that debris is not removed, it can turn into a concrete-like, bodily substance called “tartar” or “calculus” from the minerals in your saliva. This tartar can then become strongly adhered to the tooth root beneath the gums, causing inflammation which may be called gingivitis or gum disease.

Once tartar is present, it is not possible to be removed by flossing any longer. It will only come off with those dreaded scrapers we all hate at your dental cleaning appointment. Everyone gets tartar, but some people get it more abundantly than others either due to genetics, nutritional habits and/or mineral composition of saliva. This is why a dental cleaning or “prophylaxis” is needed every six months. It takes about six months for the body to develop enough tartar to elicit the start of the gum disease process.

If you don’t have your teeth cleaned, the tartar stays on the tooth root and allows more tartar to continue building on top of the existing tartar layer. This causes an even more inflammation of the gums. Eventually, the body “sees” this tartar layer as a “foreign object” and tries to get rid of through chemical and biologic means. So, this is good, right? Well, I have only told you part of the story. While the body is trying to help, it also releases special mediators that unfortunately destroy the bone around the teeth in an effort to get rid of the tartar.

If left untreated, the cycle of tartar deposited and more bone destroyed continues, causing the teeth to become loose. I always use the analogy of a “For Sale” sign in the yard-if you keep taking away the dirt around the big wooden post, eventually it becomes loose and falls out. Teeth are really as simple as that analogy. Eventually the teeth either fall out on their own, or have to be pulled because they cause a choking hazard.

In addition to this, pregnancy causes a huge hormonal shift which causes a lot more than tears, weight gain and cravings. An increase in the hormone progesterone during this time causes the gums to become more sensitive and prone to gum disease if plaque and tartar are not controlled. Signs of gum disease may be as follows: Sore, sensitive, swollen, red gums which may bleed spontaneously or especially while brushing or flossing. You may notice a black, yellow or brown, rough-appearing, grainy-looking substance along the gum-line of your teeth. You may also notice an increase in bad breath or a bad taste in your mouth.

You may hear your dentist call this process “gum disease” or “periodontal disease” (they mean the same thing) and they may tell you that you have “pockets” around your gums. These “pockets” are the popcorn-kernel-catching areas I was referring to earlier and get deeper with the deposition of more tartar over time. Certain ethnicities, such as African Americans and Hispanics are more genetically prone to getting gum disease. If you are of either of these descents, I strongly encourage you to see a dentist regularly and be sure that they are actually checking your gums every 6 months. Especially if your gums bleed when you floss or are highly sensitive.

So, of course we can see that one implication of gum disease as it relates to pregnancy would be the loss of teeth and therefore inadequate nutrition due to the inability to chew. While this is a huge concern, the primary concern is actually systemic in nature. Scientists have linked the presence of gum disease to increased incidence of pre-term delivery and low birth weight.

As mentioned earlier, the body’s attempts to resolve gum disease result in the release of bodily chemicals. These chemicals can cause the early onset of contractions, leading to pre-mature birth. Premature birth can cause a myriad of problems for the baby including, breathing difficulties (due to immature lung development), seizures and bleeding in the brain, difficulties in feeding and thus slow weight gain and poor nutrition. There are many other problems which can arise from pre-term labor and if you have concerns regarding this link with gum disease, talk to your physician and dentist. The best protection against this is to brush and floss regularly and to see your dentist regularly for a check-up and cleaning before, during and after pregnancy.

I know most people hate flossing (myself included) and despise going to the dentist. I know too that food is one of life’s greatest pleasures, especially during pregnancy. However, as parents, something in us changes and causes us to care for our children (event the unborn ones) and allows us to do the best for our children. Modification of routines and following a few simple guidelines will only eliminate one more thing to have to worry about during pregnancy. They are factors which we can control when so many other things during this amazing time are out of our control.