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Making it a positive experience is key

November 23, 2010
By CHRISTOPHER DIEM Journal Staff Writer

MARQUETTE - Joshua Fifield came out of his dental checkup at Marquette Pediatric Dentistry with more than just clean teeth. He got a rub-on Spiderman tattoo, stickers, lip balm and a new pencil and notepad set - a pretty good haul for a 3-year-old.

Positive reinforcement, plenty of prizes and a comfortable, homey atmosphere are essential elements of childhood dental health, according to Dr. Erika Tyler of Marquette Pediatric Dentistry.

The dentistry, on Third Street in Marquette, treats children from birth to 12. Tyler said one of her primary goals is to make sure it's a fun experience for children. She doesn't use words like shot, pull or pain but explains what's she's doing in kid-friendly words and terms. She said she doesn't want to enforce any negative preconceptions of dentist check-ups.

Article Photos

Joshua Fifield, 3, of Iron River gets his teeth checked by Dr. Erika Tyler at Marquette Pediatric Dentistry on Third Street in Marquette. (Journal photo by Christopher Diem)

"It's not a dental office environment. We're trying to create a dental home. So it's supposed to be very, very homey and friendly. I feel like parents should not project their own worries and their own nervousness, because if a parent had a bad experience as a child then they might be nervous and use scary words and threatening language."

Babies' teeth usually start to appear at 6 months. The American Academy of Pediatric Dentistry and American Academy of Pediatrics recommends infants have their teeth checked no later than age 1.

Parents should begin cleaning their baby's mouth the first few days after birth. After every feeding the baby's gums should be wiped with a clean gauze pad, removing plaque and residual food.

When teeth start to come in, some babies may have sore gums. The pain can be soothed by rubbing the baby's gums with a clean finger, cool spoon or a wet gauze pad. A clean teething ring can also help. Fever is not normal for a teething baby and if exhibited parents should call a physician.

One cause of decay in baby teeth is frequent and prolonged exposure to liquids containing sugar, such as fruit juice and potentially milk, breast milk and formula. Infants should not be allowed to fall asleep with a bottle. Neither should they carry around a sippy cup with sugary liquids. According to the AAPD, infants can drink liquids with sugar during meals but if they are thirsty between meals, they should be given water.

"I like bottles, pacifiers and sippy cups to all be gone by 18 months," Tyler said.

Parents should start brushing their baby's teeth with water and a soft-bristled, child-size brush as soon as the first tooth appears.

Tyler said baby teeth are important not only for their function but also aesthetics.

"We have a lot of kids that have very sore teeth and they can be malnourished because their teeth hurt, they don't want to chew with them. So function is very, very important. But also aesthetics. Kids are very mean in school and they tease and if you have ugly teeth then it can affect their self-esteem," she said.

Baby teeth are also place-holders for adult teeth so if baby teeth come out too soon then the adult teeth can shift around and move.

Cavities are the result of a bacterial infection called streptococcus mutans, Tyler said.

"It's passed person to person through spit. So if parents share a water bottle or check the baby cereal on the spoon to see if it's too hot, then they pass on their bug to their kids ... so if parents have a lot of cavities their kids tend to have a lot of cavities and the earlier you get the bug the more cavities you tend to have throughout your life," Tyler said.

She said studies have shown that most humans on the planet are exposed to the bacteria between 6 and 22 months.

Tyler said all food can cause cavities, not just candy. She said giving kids candy is fine, as long as its done in moderation.

"To me it's not really what kids are eating, it's how often," she said. "So kids that carry around a sippy cup or a little bowl of goldfish crackers all day long and snack on them, they're going to be way more prone to getting cavities because their teeth never get a chance to rest."

She said it's normal for kids to go through stages when they don't want their teeth brushed but parents have to be firm.

"It's one of those things you have to do as a parent. You have to brush their teeth for them. Most kids don't have that fine motor skill to do it yet - until they can tie their shoes or write cursive," she said. "Before bedtime is most important so that the food you eat all day long doesn't stay on your teeth and make cavities while you're sleeping."

Permanent teeth start coming in at age 6, Tyler said, and kids should be encouraged to wiggle loose teeth so they come out quickly. If there's an adult tooth trying to grow in while the baby tooth is still there, the adult tooth may come in crooked.

"A lot of kids that leave them there too long, they don't want to brush because they get sore so then they get gingivitis - red, swollen gums," she said.

Parents also need to be aware of how much fluoride their child is exposed to. For instance, someone whose home uses well water may not have fluoride in their water. But if they go to school in Marquette, they are exposed to fluoride in city water. Parents should also watch to make sure kids are not eating toothpaste.

"If they are eating toothpaste, taking a fluoride vitamin and have fluoridated water they'll get what's called fluorosis, which is too much fluoride," Tyler said.

She said children who can't spit should use a fluoride free toothpaste.

Tyler said Marquette Pediatric Dentistry is the only pediatric dentistry in the area. Some of the next closest are in Green Bay and Traverse City, so many people often drive long distances to see Tyler.

Joshua's mother, Barbara Fifield, drove him to his appointment in Marquette from Iron River. When she took him to her dentist in Iron River she was told Joshua was too young and the dentist referred her to Tyler.

"I think they're very, very wonderful with the kids. They really make the kids feel comfortable and at home," she said.

Christopher Diem can be reached at 906-228-2500, ext. 242. His e-mail address is



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