“Do Pacifiers Cause Braces?” and Other Frequently Asked Questions

Elizabeth Miller DDS Richmond VAKids may not come with a manual, but we can at least give you a guideline on some Frequently Asked Questions about kids dental health.
From pacifiers to dental floss, mom and dentist, Elizabeth C. Miller DDS, MS from Atkins, Maestrello, Miller and Associates Pediatric Dentistry, P.C. answers some frequently asked questions.  We love her tip on getting toddlers to brush their teeth!


Why is dental hygiene important for baby teeth?

This is the best question – and one I get all the time. Parents should baby their child’s baby teeth for many reasons. What many people don’t realize, is that the health of your child’s baby teeth are the gateway to the health of their adult teeth. Some of the adult teeth are growing and developing underneath your child’s baby teeth starting at birth and within their first year of life and continue to develop throughout childhood. So if your child doesn’t take care of their baby teeth, this could cause problems down the road with their permanent teeth. What’s also important to remember is that baby teeth are much smaller than adult teeth, so a cavity can become fairly large very quickly – and cause your child sensitivity, pain, and infection much faster than you would think.

Do pacifiers, bottles and thumb-sucking really cause a need for braces?

Prolonged use of pacifiers and finger habits can cause the change in bone growth and tooth alignment over time, therefore requiring the need for braces down the road. The important thing for parents to remember is that the earlier you can try to nip these habits in the bud, the easier it will be for you in the long run. The longer you wait, the harder it is for the child to get rid of the habit – and therefore, a bigger headache for the parents. I wrote a 3 part series of blog posts on pacifier use on our website.


If baby teeth are still emerging (for example they only have two teeth) do they need to be brushed? Do baby toothbrushes work?

Baby teeth should be brushed as soon as they emerge through the gums! We even recommend wiping your babies gums with a wet washcloth even before the teeth come in. This is especially important for babies who feed at night time. The biggest challenge we face are with babies who either take a bottle of milk to bed or breastfeed at will during the night once their front teeth have come in. We see a very large increase in risk of cavities in these children’s teeth due to the constant sugar exposure to the teeth either from the formula in the bottle, or breastmilk from the mother. For these children, it’s important to wipe or brush their teeth after every feeding so the teeth are not constantly exposed to sugars leading to cavities in their baby teeth.


Atkins, Maestrello and AssociatesTooth brushing is always a struggle in our house, what are some tips to help encourage preschool kids to brush their teeth?

Parents know their child best.  Some children respond best to distraction techniques, others to incentives, and others respond best to positive reinforcement. My son does best with distractions, so when he was young, my husband would change his diaper and I would brush his teeth at the same time while he was laying down – and this distracted him from what we were doing.  One person could also read a book to the child while the other is brushing.  Some children like to brush in the bathtub too! When children get older, they can respond better to things like stickers on their toothpaste bottle when they brush well, or listening to a fun song while they are brushing. Listening to the song also helps them to brush for the appropriate amount of time – 2 minutes.


My toddler’s toothpaste is fluoride free, does it still work? Why and when should we switch for a fluoride toothpaste?

Fluoride free toothpaste is just what it says, it’s a “training toothpaste.” In other words, it gets the child used to using toothpaste but doesn’t provide the protection the child needs from the fluoride in regular children’s toothpaste. So it’s important for parents to use regular children’s toothpaste with fluoride at least once a day with their child (from the time the first tooth erupts), but only use a VERY small amount – a rice kernal size or smaller. This topical exposure of the teeth to fluoride will help strengthen the enamel – and help to prevent cavities in your child’s baby teeth. The very small amount of fluoride the child may ingest after the adult wipes the toothpaste off (if your child can’t spit it out yet) will be negligible and will not hurt your child.

Is there really a difference between an electric toothbrush and a regular tooth brush?

Every person is different when it comes to brushing their teeth. Brushing and flossing is not as easy as you may think, and especially for parents trying to get their adult sized hands in their tiny child’s mouth! An electric toothbrush is a great idea – but usually only for pre-k/kindergarden age children or older. I always tell parents it’s not necessarily the toothbrush you use, but HOW you use it. Parents should be helping to brush their children’s teeth until they are able to write in cursive – usually around 8-9 years old. And that is just a guideline. Some children are still having difficulties brushing their teeth past that age, so parents should always watch their children to make sure they are brushing sufficiently.

At what age should my child start flossing?

This is also a very important question. The most common place I see children get cavities are in-between their back baby molars where they are not flossing. You should start to floss your child’s teeth as soon as you see that two baby teeth are very close together without any space between them. Some children have lots of spacing between their teeth and some have none. Your pediatric dentist can help you identify areas where it is important to floss!

Atkins-Maestrello-Miller & Associates Pediatric DentistryWhen should you make your child’s first dental appointment?

We recommend that children start seeing a pediatric dentist by their first birthday! The American Academy of Pediatric Dentistry recommends seeing a dentist this early for many reasons – but most importantly because of how important your child’s baby teeth are to their overall health.


Atkins, Maestrello, Miller and Associates Pediatric Dentistry, P.C.
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