Teeth are so easy to take for granted. And they’re the only part of your body that doesn’t fix itself! That’s why dental care is so important — we only get two sets, and it’s our job to make sure they last a lifetime. And that work starts when you’re a kid. So how do we teach kids good dental habits from the start? What if they hate brushing?
On this episode of Mayo Clinic Kids, we talk with Dr. Elise Sarvas about baby teeth, cavities, fluoride — and sharks.
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Dr. Angela Mattke: This is “Mayo Clinic Kids,” a podcast from Mayo Clinic where we discuss the latest pediatric research and recommendations to help keep your kids laughing and thriving. I’m Dr. Angela Mattke, a pediatrician with Mayo Clinic in Rochester, Minnesota, and I specialize in helping parents make sense of medical issues. On each episode of our podcast, we talk to different medical experts to help parents with kids of all ages answer the question, “What’s going on with my kid?” This episode: “Little Teeth.”
How should I care for my toddler’s teeth?
[Patient Question]
Jayme: Hey, Dr. Mattke. This is Jayme from Oakland. My daughter’s three. I’m calling because I’m unsure about her tooth care routine. She has been to the dentist twice now. They say she looks fine. I try to brush every morning and every night. When she does brush, she goes pretty quick, like maybe 20 to 30 seconds. She does get all the teeth, generally tops, bottoms in the back, all that good stuff. But mostly I’m concerned about spitting. She’s getting better at it, maybe 10 percent of the time when she brushes. Mostly, I think she’s eating her toothpaste, which is watermelon flavored. I don’t know. I know it says not to swallow it. Is there an issue if she’s eating like two servings of toothpaste with fluoride in it every day? Or is there something we should be doing? Do kids need to be taught how to spit? Is that a thing? Anyway, what’s up with my kid? Okay, thanks. Bye.
Dr. Angela Mattke: Hey Jayme, thanks for the question. There is some good stuff in there, maybe some room for improvement, like most kids. We’ll definitely get to the spitting question later. But overall, it sounds like the two of you are trying your best to form healthy habits, which is great. Let’s talk about teeth—why do we have them, what happens to teeth as we go from kid to adult: what to watch out for, and how to take care of them.
Why is dental care so important for kids?
Teeth are so easy to take for granted. They’re one of the few parts of your body that doesn’t even try to fix itself. Which is why dental care is so important—we only get two sets, and it’s our job to make sure they last a lifetime. The work starts when you’re a kid. Actually, from the moment your first tooth erupts.
Part of the challenge is that dental issues develop gradually. It can be hard to connect our actions (or lack of action) to the effect. But if you don’t take care of your teeth, you’re looking at a mouth full of fillings, root canals, dentures, implants, and more. Better than not having teeth at all, but it’s a lot of hassle, pain —and money. And dental health isn’t just about teeth, and making sure they can chomp. It impacts nutrition. It impacts self-esteem and mental health. And infections in your teeth can spread to other parts of your body.
The good news is most dental issues, especially in kids, are preventable and don’t require anything fancy. The bad news is dental issues are one of the most common chronic health conditions for kids. Access to good dental care is a big part of that. But information can go a long way, too. Whenever I have questions about little teeth, I turn to my friend and colleague, pediatric dentist, Dr. Elise Sarvas. Elise, what did you have for breakfast today?
Dr. Elise Sarvas: I actually had my leftovers from dinner the night before.
Dr. Angela Mattke: The real question is, did you brush your teeth afterwards? Because full disclosure, I did not brush my teeth this morning. And I am feeling so disgusting right now.
Dr. Elise Sarvas: That is totally okay. The nice thing about a toothbrush is you can always kind of come back to it. It’s not like a hundred percent attendance at school or anything like that. I actually brushed my teeth before because I got up and then I didn’t eat breakfast till I came to work really early.
Dr. Angela Mattke: I think that’s what I need to do because I don’t want to brush my teeth in the middle of my coffee drinking because it ruins my coffee flavor.
Dr. Elise Sarvas: It does. It doesn’t taste very good. Or with orange juice.
Dr. Angela Mattke: You’re a pediatric dentist. I’m a pediatrician. We deal a lot with these early teeth that come in. How do teeth typically develop?
Dr. Elise Sarvas: I think the people who study how teeth develop are saints because that is just a lot of microbiology and histology that I’m glad I don’t have to do. They are now finding different gene-signaling pathways and they’re finding the processes extremely complicated. It’s honestly a miracle we have teeth at all. But humans get two sets of teeth. They’re diphyodonts, which is really fun. Unlike a rodent, who’s a monodon—they get one set of teeth, but they continually grow, so they keep growing and growing and growing. And as they eat it wears down the tooth and then they just kind of grow more kinda like a push pop.
Dr. Angela Mattke: Neverending push pop. That’s every kid’s dream.
When do baby teeth start developing?
Dr. Elise Sarvas: Then, like your other animals like sharks or snakes, they’re multi dots, so they just keep getting teeth all the time. They get a set, they keep ’em for a couple weeks and they just get a new set of teeth. Like A terrifying conveyor belt of teeth. Our baby teeth start developing very, very early. Six to seven weeks in utero, which is astonishingly early.
Dr. Angela Mattke: Yes.
Dr. Elise Sarvas: Our adult teeth even start to develop just a little after that at 14 weeks in utero, but it takes some time for them to develop and calcify and so adult teeth continue to get that hardness to them up until like eight years old. It takes a long time for them to become fully teeth and then takes more time for them to come through the gums, which we call eruption.
Dr. Angela Mattke: Do teeth develop and come in at a particular pattern? And once they come in is that like the first tooth out too? When do they start to lose their primary set of teeth?
What is the typical order of baby teeth eruption?
Dr. Elise Sarvas: Exactly first tooth in, first tooth out. The first teeth we get are usually around age six months to a year. I think that dentist kids always get teeth like later than that six month mark just to give us a little bit extra things to worry about.
But the typical ones to come in are those front little bottom teeth. They’re so cute. They’re really fun. And then we get the top ones in the front and etcetera, all the way to the back. And you’re exactly right, the ones that we lose first are those front bottom ones. We send those to the tooth fairy, and then we subsequently lose teeth.
Dr. Angela Mattke: I have to ask you a question. You brought up the tooth fairy. Is there an official policy among dentists about the Tooth Fairy?
Is there a universal tradition for the Tooth Fairy?
Dr. Elsie Sarvas: That’s a great question. It also depends on where you’re practicing. In North America, the Tooth Fairy is pretty popular, but my South American friends have a ratón which, in my head, was a rat, but my Spanish is terrible. It’s actually a little tooth mouse that comes and takes it.
Other friends in Africa will throw a tooth on the roof of their house for good luck or toward the sun, so it’ll have a bright, shiny smile. So, lots of fun, different things for the Tooth Fairy.
Dr. Angela Mattke: Very cool. So what are teeth? Are they bones? Or something else?
Are teeth bones?
Dr. Elise Sarvas: When I was little I was always told that the teeth are the bones coming out of the head and that’s kind of true, but kind of not. The outer surface of our teeth is actually made from the same germ cell layer. The embryo is from the same layers as skin and hair and nails. Then the inner portion comes from some of the same parts of the body that end up being blood vessels and bones and muscles and things like that. Yes, they’re kind of like bones, but actually they’re much harder than bones.
Dr. Angela Mattke: Are teeth alive?
Dr. Elise Sarvas: Yes and no. The hard outer shell, what you are born with is what you get. If you get a cavity in there, it needs to be repaired. You’re not gonna grow more. But the inside of the tooth, the softer hard part called dentin, and then the nerve and the blood vessels inside of your tooth. Sometimes if you’ve had a root canal, that’s the part that gets infected and needs to be cleaned out.
That part is alive and is really affecting how that tooth develops. If you’ve heard a tooth is dead, it’s because that nerve and pulp tissue are no longer viable. They won’t feel, or they might be infected or you’re not getting a blood supply. Uh, that blood supply is actually really important for the color of our teeth. And so if you don’t have that blood supply anymore, the light will reflect off your tooth differently and cause it to look brown or gray or yellow.
Whereas if you’ve got blood in there and it’s nice and blue and red and happy, it’ll look white when the light reflects back on it.
Dr. Angela Mattke: Do teeth heal themselves? Cuz bones will remodel and heal themselves. Do teeth do that?
Can teeth heal themselves?
Dr. Elise Sarvas: I wish, but then that would probably put me out of a job. I had a patient the other day and he had a tooth fracture, fortunately I was able to fix it. But the dad was like, can’t you just put a cast on there and you know, rub some gel on it and it’ll fix itself like a bone. And I was like, “Oh man. If only. That would be amazing.”
Dr. Angela Mattke: Yeah, maybe they’ll develop that someday. Who knows?
Dr. Elise Sarvas: Right? Yeah.
Dr. Angela Mattke: Why do we have teeth at all? And why are they all different shapes?
What are the different types of teeth and their roles?
Dr. Elise Sarvas: We use teeth to help with our general nutrition. We’re not like a jellyfish that kind of goes through the sea and sucks up all the nutrients we actually need to tear off the food and then bring it to the back of our mouths and chew it. We have teeth that are designed to do both things. You can see the teeth in the front of your mouth are sharper. And I like when families are the pointy ones. I’m like the canines. Those are great for tearing off food. Then we bring it to the back of our mouths. Then the technical term is masticate, which sounds really fancy, but it just means chew and grind that tooth into smaller pieces so that we can then digest it.
Dr. Angela Mattke: What shouldn’t we use our teeth for? Obviously food is a thumbs up. What’s a thumbs down?
What should we avoid using our teeth for?
Dr. Elise Sarvas: I like to tell my families that teeth are not tools. In fact, I often tell this to my husband who thinks his teeth are tools to open bags or envelopes or no bottles. I’ve seen him do it in my presence, but he probably knows I’d be very upset.
Dr. Angela Mattke: Teeth do more for us than just chewing and breaking down food. Like you said, there’s like this whole component to like social and psychological and concepts of beauty and other things.
How do teeth affect our overall well-being?
Dr. Elise Sarvas: I mean, we know that teeth in the mouth are like just such integral parts of the body and they support all those functions; the chewing and everything. But it’s such a part of our personal identity. Beyond speaking, it helps us to smile and socialize. It’s really such a social thing that we need.
I think the smile is such a window to the body and such a cultural thing that we use to signal happiness and friendliness. And togetherness.
Dr. Angela Mattke: But honestly, there’s nothing cuter than a baby with no teeth. Just a big gummy smile when they give you that and drool coming out.
Dr. Elise Sarvas: The gummy smile is the best.
Dr. Angela Mattke: It truly is.
Dr. Angela Mattke: We know how teeth develop – we get two sets. They both start forming in the womb. First set pops up when we’re somewhere between six to twelve months old. We know what teeth are – a bundle of nerves and blood vessels, called dentin. That’s covered in a super hard substance called enamel.
We know what they do – they tear food apart and smush it up and help us demonstrate that we’re friendly people with good intentions. Now, what happens if we don’t take care of our baby teeth? If they all fall out anyway, do we just get a free pass or a do-over or does what we do as a child, predict the health of our teeth later?
What happens if we don’t take care of baby teeth?
Dr. Elise Sarvas: The most common predictor of cavities in your adult edition. The teeth that you have as an adult is if you had cavities as a kid. We talk about prevention in so many aspects of medicine and healthcare and for teeth, things don’t get better once they start to go downhill.
If we can get to children early, really establish some good habits, give them the knowledge they need to take care of their mouths, that hopefully they don’t need the extreme versions of dental care that they can maybe need as an adult.
Dr. Angela Mattke: How common are cavities, especially in baby teeth?
How common are cavities in children?
Dr. Elise Sarvas: Cavities in children are extremely common. The most common chronic disease of childhood. More common than asthma, more common than a DHD, more common than autism. We have half of kindergartners starting kindergarten with at least one cavity, which, if this was like broken arms or even diabetes, this would be a public health crisis that everyone would be talking about.
Dr. Angela Mattke: Yeah, absolutely. Is there any hereditary component to people that get more cavities? Cause I feel like I see families that tell me, “Oh, our dentist says it just runs in our family and we don’t have strong enamel.”
Is there a hereditary component to cavities?
Dr. Elise Sarvas: I grew up in an area of Appalachia where everyone talks about having soft teeth. We thought for a long time that genetics played about a 5 percent role if you were going to get cavities, but now we think it’s probably a little bit higher, like 12 to 15 percent, which is still small. It’s probably not the enamel that is causing it. It makes it easier to get a cavity. The genetic conditions that really destroy enamel and cause a soft enamel are very rare—but rather, how your saliva works. Do you get enough saliva to wash off the bacteria, to wash off the food, to neutralize the acid? There’s some genetic component and it does run in families. What I see more and what probably explains that family hypothesis is that the family’s all eating the same diet.
They’re eating a lot of things that the bacteria that cause cavities thrive off of. They’re eating it frequently throughout the day. It doesn’t give the bacteria a chance to wash off, or the body a chance to buffer that out.
Dr. Angela Mattke: What actually causes cavities? What are they?
What causes cavities in teeth?
Dr. Elise Sarvas: Cavities form on teeth. They form holes in teeth. What this all comes from is that our mouths are full of bacteria. Some are really good bacteria, some are bacteria that cause a little bit more damage to teeth. Those bacteria take fermentable carbohydrates, which is a really fancy word for sugars, and it doesn’t have to be sugars like sweet sugars. It could be sugars found in other carbohydrates like goldfish crackers, and they ingest those and then they excrete acid.
When I’m telling a kid I really need them to brush their teeth, I say, “All those bacteria, they poop acid in your mouth, man!” Those eyes light up and they’re like getting the toothbrush. I have to say. “No, no, no, you can brush it at home.” Those acids start to eat away the enamel. And a lot of times our body can buffer that out so it can neutralize it. But if you’re constantly getting attacks on that enamel, (which is the hardest substance of the body, harder than bone. I used to tell people that they’re gonna find your little enamel 65 million years from now), that acid will wear that down and once it wears it into the inner surface of the tooth, that next layer is called dentin. You then have a cavity and that needs to be fixed, because if it keeps going, it’ll then get into the nerve of the tooth and cause pain and maybe swelling and other types of infection.
Dr. Angela Mattke: The bacteria aren’t actually just eating away at the teeth.
Dr. Elise Sarvas: No, no. They don’t have little tiny mouths that they also have to brush.
Dr. Angela Mattke: Okay. Sounds good.
Dr. Elise Sarvas: Acid on the teeth.
Dr. Angela Mattke: Do we know if baby teeth are more susceptible to cavities compared to adult teeth?
Are baby teeth more susceptible to cavities?
Dr. Elise Sarvas: Yes, baby teeth are smaller. You don’t have to be a dentist for me to tell you that. Their outer surface of enamel is much, much thinner. It’s about a third of the size of adult enamel. That enamel is a hard outer shell that’s protecting teeth. You can imagine if the bacteria start to excrete acid there and start to form a small hole, that hole is gonna move into the soft part of the tooth, the dentin, much, much faster than adult teeth.
That’s why we definitely wanna see children early and if they’re getting any cavity so that we can help prevent that process. I’ve seen kids who went to bed the night before, they were totally fine and the next morning woke up with a big facial swelling because an infection moved so quickly in their teeth. Definitely faster in baby teeth.
Dr. Angela Mattke: What age range do you see cavities typically starting in?
At what age do cavities start appearing in children?
Dr. Elise Sarvas: Unfortunately I start to see them really young as a pediatric dentist, so it does take some time for a cavity to form. But I’ve seen two year olds with a cavity in every single tooth, and that’s before they even get all of their baby teeth. They have baby teeth ready to erupt and their other teeth that have been there for six months have cavities.
Dr. Angela Mattke: That’s really sad. Are there symptoms that come with a cavity? A parent could be like a trigger to look for or is this something that’s primarily picked up on a routine dental screening?
How do you identify a cavity in young children?
Dr. Elise Sarvas: It just depends on how large that cavity is. If it’s really, really small, a dentist will be able to see it and then offer some preventative options for that cavity. You might not even have to drill and fill it at that stage, but you can stop it in its tracks. But if the cavity gets bigger, then a non-dental person might be able to see it. And what we really don’t want to happen is that it gets so big, it starts to cause the child pain and they can’t eat or sleep or concentrate in school.
Dr. Angela Mattke: Alright, so there you go. If we don’t brush those little teeth, bacteria will poop acid all over them and form holes, a.k.a, cavities, which can be painful and are unfortunately super common. There’s a 50/50 chance your kid will get one by the time they hit elementary school. Genetics can make it more or less likely for you to get a cavity. But, the food your family eats and the brushing habits they do or don’t help you form will have the biggest impact. So what can we do about it?
Dr. Angela Mattke: In the past hundred years, even the past 50 years, there’s been huge advances in dental health and paralelled advances that we’ve seen in the medical field as well. Can you talk a little bit about how that relates to the recommendations for prevention and treatment in pediatric dental health?
Dr. Elise Sarvas: The history of dentistry is so fascinating to me and the reason we have twice a year dental visits isn’t because of any scientific recommendation. It actually comes from the United States government and specifically the United States military. In World War II GIs who were going off to fight overseas, the most common reason they were pulled off the front lines was not because of a bullet wound. It wasn’t because of a trench foot—it was because they had a toothache. They had a dental infection. The military started recruiting dentists and getting them to brush their teeth and see the dentist and take care of problems before it became a bigger issue. When GIs came back, everyone started going to the dentist twice a year.
What role does fluoride play in dental health?
Around that same time, in the forties and fifties, we discovered community water fluoridation. This is a program where fluoride is placed into water in Minnesota. That means every municipality has fluoride in their water. But you can go on the CDC website and check if your particular municipality has water fluoridation. This has lowered the rate of cavities in half. It’s one of the greatest public health measures of the 20th century, right up there with seat belts, vaccines, and all those other amazing accomplishments. Fluoride in the water has been really helpful in reducing the cavity load.
Dr. Angela Mattke: Ok, let’s do an at-home cavity prevention lightning round. Everyone knows that you should brush your teeth, but at what age should parents start brushing their child’s teeth? Like the very first eruption of the little tiny tooth or like when it’s all the way in?
How can parents help prevent cavities at home?
Dr. Elise Sarvas: Right when that tooth starts to come in. And that’s for a couple of reasons. One, it does remove the bacteria. It’s also gonna feel good on the gums of the infant to just move. Remove any epithelium or skin that’s kind of sloughing off in that eruption process. It also gets that child used to having someone in their mouth. That, I think, is the biggest thing. Just making sure that they’re not really terrified of having that toothbrush every time it comes out, that they’re gonna be traumatized.
Dr. Angela Mattke: When can kids start brushing independently?
At what age should children start brushing independently?
Dr. Elise Sarvas: That’s a great question. I like for parents to keep brushing their kids’ teeth until that child can tie their own shoes. It takes a lot of manual dexterity to be able to get into all those little nooks and crannies and around the teeth, and it really is just hard to get all the way back there and make sure you’re getting off all that plaque and bacteria that blends into the tooth surface. I also encourage parents to spot check. Kids are very independent, especially two-year-olds and three-year-olds; they want do it themselves. Let them do it themselves and then have the adult in the home go back and check. And by check, I mean actually do it.
Dr. Angela Mattke: There’s still a big market for training toothpaste and the majority of the toothpaste that most adults use has fluoride in it. What are the recommendations for children?
Dr. Elise Sarvas: They can actually use a fluoridated toothpaste from that first tooth. But you wanna treat it like a medicine, it has fluoride in it. You don’t want that child to swallow a whole tube of toothpaste and some kid toothpastes taste really good now. I say to families, “Treat it like a medicine.” Keep it out of reach, but have that parent use about the size of a grain of rice. If there’s only one tooth, maybe half the size of a grain of rice. That tube is gonna last you a really long time. Then, as the child is able to grow and develop the ability to spit, then you can start to do a pea size amount, which is about the size that everyone should be using.
Dr. Angela Mattke: What’s a typical age in a typically developing child that they should be able to spit out? Because I feel like one of my kids was way different than the other.
Dr. Elise Sarvas: We say around age three.
Dr. Angela Mattke: How long should kids brush their teeth?
Dr. Elise Sarvas: Two minutes, twice a day.
Dr. Angela Mattke: No way is that happening.
Dr. Elise Sarvas: That two minutes is a long time. You’re not alone. That two minutes is just to help get all those nooks and crannies. That removes the bacteria, but the other part of brushing allows fluoride to be in the mouth and it takes a long time for that fluoride to soak into teeth and cause that chemical reaction to make them stronger.
They have really great timers, they’re wonderful apps. Now I say, find your favorite song that’s around two minutes long. That could be helpful. It really just gives you enough time to get into all those little places and get it all.
Dr. Angela Mattke: How do you actually, pragmatically speaking, get your kid to brush for two minutes?
Dr. Elise Sarvas: It takes so long. I have an almost one-year-old and she hates when I brush her teeth, and I’m like, you know who your mother is? We have to do this.
Dr. Angela Mattke: She’s making it extra tough for you, probably.
Dr. Elise Sarvas: It’s been purgatory now for all the times I’ve told families, “Oh, it’s so easy. It’s totally fine.” I think what motivates your kids the best is just developing that habit and really that’s the hard part for all of parenting.
Wash your hands after using the restroom, put your toys away and things like that. I’ve seen some families be really successful with a sticker chart in that if you’re consistently doing it, they’re also fancy toothbrushes that will connect to an app that will chart it for you, but if they’re able to do that for a consistent amount of time, like say a month, then they get something that they really want. Maybe it’s Roblox money or like a toy that they really wanted and things like that. It’s really trying to figure out what motivates them.
Dr. Angela Mattke: I’m all about the bribe. I always tell my patients that we wouldn’t go to work if we didn’t get paid either. We got to make sure the kids want to get paid in things that we ask them to do as well.
Dr. Elise Sarvas: You probably don’t want to bribe them with candy.
Dr. Angela Mattke: No, I would never do that. Never. Okay. What about flossing? Because that’s another battle that I fight on the regular with my children. What age do we start flossing our kids’ teeth?
When should kids start flossing?
Dr. Elise Sarvas: We do that right when the teeth start to touch together. For some kids, this could be when they first come in. Of course my child, her front two teeth are touching and we need to hold her down and floss that area. And by we, I mean my husband and I. You’re the dentist, that’s your job. But in the back, they can start touching really early or they might have really nice spacing. And so it really just depends on the kid.
I also say if you’re not able to do it every single night, aim for weeknights. Full disclosure, I only floss on weeknights. I don’t floss on the weekends cuz like, I need a break too. And I do it after stringy foods like chicken or celery or other things that stick between your teeth and can hold bacteria there.
Dr. Angela Mattke: Those little flossing picks that have the little floss in between them. Are those good for kids to use or should we just use straight old floss that comes out of the little roller container?
Dr. Elise Sarvas: I’d use anything that is easiest for you.
Dr. Angela Mattke: Okay. Just use it.
Dr. Elise Sarvas: Just use it. I use the little floss picks for my kid because it’s their favorite. Their mouths are tiny and you got to get your big old fingers back there. Floss picks are great and they make them in fun flavors for kids now, so they’re not all minty and spicy. Now there’s fruit flavors and lots of fun ones.
Dr. Angela Mattke: Electric toothbrush or regular toothbrush, which one is better?
Is an electric toothbrush better for kids?
Dr. Elise Sarvas: This is the great debate in our hygiene world. It really kind of comes down to are you using it properly and are you using it for two minutes a day? And then it really doesn’t matter whatever one you want to use. Some kids really like that vibration, but it can be really intense for other kids. See which one they want to use. We just like one with really soft bristles so it can just gently scrub the teeth and it doesn’t scrub the gum away as well as. A smaller head so it can get back into those little grooves a little bit easier.
Dr. Angela Mattke: Lightening round for at-home care complete. Now, to the dentist! When should kids see the dentist for the first time?
When should a child first visit the dentist?
Dr. Elise Sarvas: First tooth or first birthday. And the reason for that, it seems really early and it seems like it’s just gonna be a very loud visit for everyone involved. And that’s true and they’re my favorite types of visits. One, if the kid is loud, I can see everything. And two, I wanna talk to that family before they go down the pathway of developing cavities.
If we can do that, all the important prevention you talked about, that visit’s going to be a lot of counseling, a lot of talking about diet, especially in those early ages when everyone is sleep deprived. You’re the smartest help as a human or as a parent. And we’re gonna talk about things like not going to bed with a bottle and letting that formula or milk wash over those teeth all night.
We’re going to talk about how much toothpaste to use for a kid who only has like four teeth. We’re gonna talk about strategies for brushing, cuz I’m gonna ask how brushing is going at home. I fully expect that answer to be terrible. We’ll talk about strategies there too. We’ll also talk about what to do if a kid gets injured and who you should call.
In 2000 is when we first made that recommendation for children to come to the dentist on their first tooth or first birthday, and that’s because pediatricians and dentists were seeing kids at three with all of their teeth had cavities and it was just too late for them at that point.
Dr. Angela Mattke: That probably speaks to the importance of why prevention is so critical, but so not accessible sometimes to other people to get routine dental care. Do we know how many kids are actually getting dental care during their pediatric years?
How has pediatric dental care evolved?
Dr. Elise Sarvas: Yes. Only about half of people in the United States. Children are able to access a dentist each year. Dental care in the United States is separate from medical care. In other countries, they’re together and it all has to do with the medical folks who kicked us out of a university in the 1800s and the dentists have had a chip on their shoulders since then.
In the U.S. the pathway diverged in the 1800s because of some egos, but it makes it really hard for people to access dental care. Dental insurance is really tough to get. It might come with your medical insurance and the Affordable Care Act made it so that pediatric oral health coverage was included in essential plans, but not adult. In the state of Minnesota, we’ve been fighting to get more adult coverage because we know that when adults are covered for their teeth, they’re more often to bring their children in even if they’re covered.
Dr. Angela Mattke: That makes complete sense. They’re going in for routine care, so they’ll schedule it for their child at the same time.
Dr. Elise Sarvas: Exactly. Kids in different areas get cavities at different rates. We see that the disease that causes dental cavities is what we call socially patterned. If you have a kid from a family with a low socioeconomic status or who lives in a rural area, or who might be a family of color, they have less access to the dentist because of issues like systemic racism and they have higher rates of cavities.
And so really we see that about 20 percent of the kids in the U.S. have 8 percent of the cavities. Making sure we get a dentist for all those children can be really challenging. Something we’re definitely working on. The American Academy of Pediatric Dentistry works with all pediatric dentists and as well as general dentists who see children.
Their big motive this year is access to care. And every year, but this year is a big highlight just to make sure that kids are able to get the help that they need.
Dr. Angela Mattke: Excellent. Elise, this was great to talk to you. I’ll probably need your cell phone number so I can call you when my son will not brush his teeth for two minutes.
Dr. Angela Sarvas: Oh, my pleasure. Happy to chat with him at any time. I’m happy to show him some really gross pictures of what happens when you don’t brush your teeth, and I find that’s really motivating, especially for younger boys.
Dr. Angela Mattke: It’s motivating for adults too. I might need to see that.
Dr. Elise Sarvas: In full disclosure, I definitely show them pictures of meth mouth. Not that that’s what’s gonna happen.
Dr. Angela Mattke: Do you show that to the kids?
Dr. Elise Sarvas: Oh, yeah, I pulled that out.
Dr. Angela Mattke: Side note. Also, do meth.
Dr. Elise Sarvas: Also, don’t do drugs.
Dr. Elise Mattke: Ok Jayme, we didn’t forget about you! First, keep up the great work. Habits take a long time to form, stick with it.
As far as improvements go, try to get her brushing for as close to 2 minutes as you can. But also remember your daughter’s teeth probably won’t fall out if you don’t hit that target every night. Just keep trying.
As for the amount of toothpaste, yeah, maybe try reducing that pea to a grain of rice, at least until she’s spitting out the toothpaste reliably. But again, if she eats two peas of fluoride toothpaste a day, she’ll be fine. Just don’t leave her alone, unsupervised, with a whole tube of it. I bet the watermelon stuff tastes good!
For everyone else, remember, bacteria are pooping acid on your kid’s teeth! Start brushing as soon as that first tooth pokes out. And schedule that first dentist appointment on their first birthday or with that first tooth. And fluoride — whether it’s in your water or your toothpaste — it’s crucial.
That’s all we got for little teeth and cavities. But if you have a question or a topic suggestion, you can leave us a voicemail at 507-538-6272 and we might even feature your voice on the show. You could also send us an email at whatsupwithmykid@mayo.edu. Thanks for listening!
Please remember, this podcast cannot provide individual medical advice and the discussion presented here cannot replace a one-on-one consultation with a medical professional.
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