Category Archives: Dr. Maria Meliton Archives

What are your thoughts on giving a baby a pacifier? What age should it be taken from the child?

The choice of giving your baby a pacifier is really up to you. It is natural for babies to have a strong sucking reflex. Some even suck their thumbs and fingers before they’re born. Pacifier use has many advantages in helping to soothe a fussy baby and to help in lulling a baby to sleep. Researchers have also found an association between pacifier use during sleep and a reduced risk of SIDS.

Given the choice of a baby sucking his or her fingers or thumb versus the use of a pacifier, I prefer the latter. I find that it is easier to wean a child from this habit when it’s time. Also, a parent can control how often the child has access to the pacifier. It is preferable to give the baby the pacifier only for nap times and bed times and not to have it accessible at all times. A thumbsucking habit is harder to break for this very reason. The thumb is always accessible!

Hi Dr. Meliton,
My 5-yr-old daughter is grinding her teeth at night. She has complained about her mouth hurting in the morning, and it wasn’t until I heard her grinding that I realized what it is. Should she go to our dentist or an orthodontist? I ground my teeth when little as well and it resulted in a problem of a tight/locked jaw at times. Is this hereditary? Thanks

What your daughter is experiencing is called nocturnal bruxism or clenching and grinding of the teeth during sleep. The cause of this sleep-related problem is unclear. Many articles on bruxism state that 30% of all children clench or grind their teeth at night. It has been linked to stress, occlusal disorders (problems with the way teeth come together or align), allergies and sleep positioning. In addition, a few studies have cited that type A personality behavior combined with stress is more predictive of bruxism. I describe this as an exuberant, active child during the day who continues to show activity even in their sleep involving restless sleep patterns and teeth grinding. There is no definitive position on whether or not this habit is hereditary.

My 4 year old already has 2 cavities. I feel terrible about it. He is very good about brushing twice a day. Is this a sign that he will have problems with his adult teeth. I dread taking him to the dentist for fear that he will have another cavity. Any suggestions? Thank you

Early childhood caries is a syndrome characterized by severe decay in the teeth of infants and young children. It is a very common bacterial infection and its prevalence is epidemic.

According to the U.S. Surgeon General’s report, tooth decay is the single most common chronic childhood disease — 5 times more common than asthma, and 7 times more common than hay fever. Over 50% of 5-9 year olds have at least one cavity. This increases to 78% among 17 year olds. What many people do not realize is that your child’s baby teeth are at risk for decay as soon as they first appear in the mouth around the age of 6 months. This early decay is most often seen with the upper anterior teeth but can also affect other teeth. The good news is dental decay is completely preventable.

My 8 year old niece has a loose tooth that she has been wiggling for a few weeks. The problem is that her new tooth is already growing in and pushing the loose tooth almost horizontal in her gums. It is still loose but not ready to be pulled out. Should she see a dentist to get the tooth pulled? Is this normal?

In the normal course of events, the root of the baby tooth dissolves as the permanent tooth erupts. With the root missing, the remaining portion of the baby tooth becomes loose and naturally falls out. The permanent tooth now has the space available to erupt properly. However, it doesn’t always work out this way.

From what you described, it sounds like your niece has what is referred to as an over-retained baby tooth. The tooth is loose but is wedged in position by the erupting permanent tooth. Often, the child avoids touching the tooth because he/she is afraid of the tooth falling out or that it will cause discomfort and bleeding. Over time, this over-retained baby tooth takes on a skewed position as the permanent tooth erupts further.

My 4 and 6 year old know not to swallow the toothpaste when brushing. Is there any need to keep buying the kids brands? Also, what brand of toothpaste is best?

Very young children just learning how to brush their teeth have not mastered the sequence of brushing, swishing/rinsing and spitting. Often times, a good amount of toothpaste will be swallowed. Ingesting too much fluoride in the form of toothpastes or fluoride supplements and rinses during tooth development can lead to a health condition called fluorosis. Fluorosis, in its mildest form, appears as faint white streaks or specks that are often unnoticeable. These spots are permanent and can darken over time. A more severe form of fluorosis has the appearance of mottled enamel which presents as brown and black stains as well as a pitting of the dental enamel. The undesirable cosmetic appearance of this more severe form of fluorosis often results in many years of dental treatment to correct the problem.

The critical period of exposure is between the ages of one and four years old. This is why non-fluoridated training toothpastes are recommended for use until the child clearly understands that the toothpaste should not be swallowed. Fluoride-free training toothpastes have become more popular in recent years and several brands are available on the market.

My five-year-old still sucks her thumb at night. It’s not throughout sleep; just when she has her blankie in-hand. Is it true that thumb-sucking will lead to braces? Should we try to work towards ending it?

Thumb-sucking is normal in babies and young children. This can become a prolonged habit when it is used to comfort or soothe children when they feel hungry, sleepy, anxious, restless or bored. Thumb-sucking can lead to dental problems, one of which being malocclusion or improperly aligned teeth. Thumb-sucking can push the anterior teeth outward (commonly known as ‘buck teeth’) and also cause a change to the shape of the roof of the mouth or upper palate. Also, thumb-sucking can lead to what is known as an “open bite”, wherein the posterior teeth or molars touch when biting down but the front teeth or incisors do not. If the habit is stopped before permanent teeth erupt, there is often a great chance of the malocclusion correcting itself. If the thumb-sucking continues, there is a greater chance that orthodontic treatment will be needed to correct the dental problems.

What age should a child begin seeing a dentist? A friend told me that by a child’s 2nd birthday they should be seen but that seems too young!

This is one of the most common questions we are asked. As a
pediatric dentist, our guidelines follow those provided by the
American Academy of Pediatric Dentistry. “First visit by first
birthday” sums it up. Your child should first visit a pediatric
dentist when the first tooth comes in which is usually between 6 and
12 months of age. The most important reason for this early visit is
to begin a thorough prevention program. Dental problems can begin
very early. A big concern is early childhood caries or baby bottle
tooth decay. Early visits can detect potential problems or habits
that can leave a child susceptible to decay. The earlier a problem is
diagnosed, the earlier we are able to intervene with preventive
measures. Additionally, this first visit is a perfect opportunity for
parents to learn how to properly clean their child’s teeth and to get
advice about supplemental fluoride if needed. Other issues that can
be addressed are thumbsucking/fingersucking habits, pacifier use, and
how it can affect your child’s bite. I have found in my years of
practice that these early visits foster a positive attitude towards
going to the dentist. The child gets used to seeing the same dentist
and becomes familiar with having his or her mouth examined. Dental
fear or anxiety is essentially avoided. My last piece of advice is to
choose a pediatric dentist who has a good preventive-based infant oral
health care program within their practice. This will establish a very
competent dental home for your child wherein early examinations and
preventive care will protect your child’s smile now and in the future.