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Oral Health: Children and Teens

Tooth decay, or cavities, is the most common dental problem among children. Tooth decay can begin as soon as a baby’s first tooth comes in.

Nationally, more than half of children ages 6 to 19 have experienced tooth decay. In NYC, more than one in three third-grade students have untreated tooth decay.

Once tooth decay develops, it must be treated by a dental professional or it will worsen. Signs of tooth decay are white or brown spots on the teeth.

If left untreated, tooth decay can cause a variety of health problems, including:

Pain
Infection
Difficulty eating and speaking
Lower self-esteem

Regular dental check-ups, good oral hygiene, and a balanced diet can help prevent tooth decay and keep smiles healthy.

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Infancy and Early Childhood

Keep Gums and Teeth Clean

Wipe the gums. Before your baby has teeth, wipe his or her gums with a clean washcloth after feedings and at bedtime.

Brush twice a day. As soon as the first tooth appears, start brushing twice a day with a soft child-sized toothbrush.

Use fluoride toothpaste. For children younger than three, use a smear of fluoride toothpaste, the size of a grain of rice. For children ages three to six, use a pea-sized amount of fluoride toothpaste.

Supervise brushing. Make sure to supervise children and help them brush until they can do it well on their own, usually around age seven or eight.

Teach proper brushing technique. Here are the steps they should follow:

Place the toothbrush at a 45-degree angle to the gums.
Gently brush back and forth in short strokes.
Make sure to brush all three surfaces of the teeth: inner, outer, and chewing surfaces.
Brush for two minutes (you can sing the ABCs twice).

Floss. Begin flossing when the teeth start to touch each other.

Make Smart Food and Drink Choices

Sugary foods and drinks, such as cookies, candy and soda can cause tooth decay.

Limit sugary snacks. Limit snacks to three per day and opt for healthier options that are low in sugar, such as cheese, yogurt and fruit.

Avoid sugary drinks. Give your child milk or water, instead of sugary drinks such as soda, juice with added sugar or flavored milk.

Limit fruit juice. If you do offer fruit juice, ensure it’s 100% juice with no added sugar. Limit it to no more than six ounces a day and encourage your child to drink it in one sitting, not sip for a long period.

Do not let your child sleep with a bottle or a sippy cup. Sleeping with a bottle or sippy cup filled with with any drink other than water can cause tooth decay. Formula and milk both contain sugar.

Transition to cups. Help your child drink from a regular cup by age one.

Drink tap water. The fluoride in New York City’s tap water helps prevent tooth decay.

Do Not Share Utensils or Bites of Food

Babies are born without the germs that cause tooth decay. They get these germs from saliva that is passed from the mouths of adults to their mouth.

As soon as germs are in a child’s mouth, the process that causes tooth decay can start, even before the child has teeth.

To avoid transferring cavity-causing germs:

Avoid sharing saliva. Don’t share spoons or food by putting them from your mouth into your child’s mouth. Always use separate utensils. If you need to clean a pacifier, use water instead of saliva.

Take care of your own teeth. Brush, floss and visit the dentist regularly to reduce germs in your mouth.

Visit the Dentist

Take your child to the dentist by their first birthday or within six months after the eruption of their first tooth, whichever comes first.. Your child should then visit a dentist every six months to prevent cavities and treat oral health problems.

Speak to your child’s dentist or doctor about fluoride varnish. Fluoride varnish is a coating that is painted on the teeth to prevent tooth decay.
- Ask about sealants. Speak to your child’s dentist about dental sealants, thin white coatings that are put on the chewing sides of the back teeth to protect them from tooth decay. Sealants are usually placed on the adult molar teeth. The first set of adult molars comes into the mouth around age 6 and the second set erupts around age 12.

Middle Childhood and Adolescence

Take Care of Your Teeth

Brush and floss daily. Brush twice a day with a soft toothbrush and fluoride toothpaste. Floss between the teeth daily.

Limit sugary snacks and drinks. Limit snacks to three per day and opt for healthier options that are low in sugar, such as cheese, yogurt and fruit. Instead of sugary drinks such as soda, juice and sports drinks, drink water or milk.

Visit the dentist regularly. Children and adolescents should see a dentist every six months to prevent cavities and treat oral health problems. Ask about:
- Fluoride treatments Fluoride varnish is a coating that is painted on the teeth to prevent tooth decay, and may be placed by either a medical or dental professional.
- Dental sealants Dental sealants are thin white coatings that are put on the chewing sides of the back teeth to protect them from cavities. Sealants are usually placed on the adult molar teeth, which come into the mouth at around ages 6 and 12. <
- Silver diamine fluoride (SDF) Silver diamine fluoride is a non-invasive treatment that stops cavities from getting worse. SDF is a good option for children who cannot tolerate or do not have access to regular dental treatment.

Utilize School-Based Dental Services

Many NYC schools offer no-cost dental services to students, regardless of their insurance status. These services include examinations, dental sealant application, fluoride treatments, and other preventive and restorative care.

To find out whether your local school offers dental services, contact the school directly.

Consent from a parent or guardian is required to receive care. Look for this form in your child’s back-to-school packets or at other times during the year, and be sure to complete and return the consent form. It can also be requested from the school directly.

Video: School-based Dental Program with NYC Department of Health!

Abstain from Tobacco, Vaping, Alcohol and Recreational Drugs

Tobacco use can cause tooth decay, gum disease, oral cancer, and other harmful conditions.

The effects of vaping may be just as dangerous to the mouth as cigarette smoking.
Protect your teeth, heart, and lungs. For help quitting vaping, text DROPTHEVAPE to 88709. To talk to a quit coach about your smoking or vaping, call 866-NY-Quits (866-697-8487). Find more help at nysmokefree.com and nyc.gov/nycquits. You can also find tobacco treatment programs on the NYC Health Map.

Heavy alcohol use and the misuse of recreational drugs increase the risk for mouth and throat cancer, especially when used in combination with tobacco.

Manage Oral Health Side Effects from Common Medications

Many liquid medications contain sugar, which can create a sticky residue on teeth. Oral inhalers for asthma can lead to fungal infections in the mouth. To protect your oral health:
- Rinse after use. Always rinse your mouth with water after taking liquid medications or using inhalers and be sure to brush your teeth well.
- Stay hydrated. If your medications cause dry mouth, drink plenty of water throughout the day. Avoid sugary beverages.

Be Careful with Oral Piercings

The American Dental Association recommends against oral piercings due to various health risks, including pain, infection, and potential damage to teeth and gums.

If you have an oral piercing, it's essential to keep the area clean. Avoid clicking the jewelry against your teeth. If you experience any pain or signs of infection, consult a dentist or doctor promptly.

Cosmetic Dental Procedure Safety

Safety is key when considering cosmetic dental procedures. To prevent harm:

Consult a qualified professional. Always seek treatment from a licensed, experienced, and if needed, specialized dentist.

Understand the risks. Discuss potential risks and side effects associated with procedures like teeth whitening, braces, or veneers. Make informed decisions.

Get regular check-ups. Schedule regular dental visits to monitor oral health and discuss any concerns.

Take Precautions when Playing Sports

When participating in contact sports, wearing a mouth guard is essential to protect your teeth, jaw, and mouth from injuries.

Types of mouth guards:

Custom: Made by dentists for a perfect fit, offering the best protection and comfort.
Ready-to-wear: Available over the counter and easy to use, but they may not fit as well.
Boil-and-bite: A budget-friendly option that you heat in hot water and bite down to create a fit. They may not provide the same level of protection as custom mouth guards.

Stay up to Date on HPV Vaccination

Human papillomavirus (HPV) is a common virus that can lead to various types of cancer, with oropharyngeal cancer (affecting the mouth and throat) being the most common HPV-related cancer.

The HPV vaccine is safe and effective, preventing about 90% of cancers linked to HPV.

It is recommended that children receive the HPV vaccine alongside other routine immunizations at ages 11-12, although it can be given as early as age 9.

Getting vaccinated is a crucial step in protecting your child’s health and reducing the risk of HPV-related cancers in the future.

You can find providers offering the HPV vaccine on the NYC Health Map.