Baby Tooth Care

Baby_teeth“Why do I have to bring my baby to the dentist if he barely has any teeth?”

You bring your healthy infant to the pediatrician multiple times in the first year, but less than 1% of infants see a dentist by the recommended age of 1.  An infant dental screening is about giving parents the correct information on how to care for baby teeth.  Much of the information on baby tooth care found in baby books, the internet and even from the pediatricians is out-dated or incorrect!  Cavities are preventable, but prevention needs to start early with the eruption of the first tooth.  Putting off proper care until a child is 3 or 4 years old is too late, but early prevention can last a lifetime.

At the infant oral screening exam we will cover not only tooth brushing, but also growth & development, medical complications affecting teeth (like ear infections or asthma), feeding issues, dietary practices, speech, trauma, vitamins, toothpaste, and so on.  The mouth requires proper cleaning from the very beginning – its no different than cleaning the rest of the baby’s body!

Did you know that cavities on baby teeth don’t hurt?

If you are waiting for your child to “be ready” to see the dentist, stop waiting!  We make the dentist office fun and care for each child uniquely.  Don’t allow your own fears to stand in your way, most parents are very surprised how much fun children have at the dentist these days. If you are waiting for your child to complain of a toothache – it won’t happen!  Baby teeth do not have the same complex nerve signals that adult teeth do. Unfortunately cavities in baby teeth grow silently and are usually very large by the time they are seen with your eyes.  By the time a child complains of a toothache, its usually too late to save the tooth and it likely needs to be extracted.

Few Children receive Dental Care before Recommended Age of 1 Year:

Research shows that children most susceptible to dental cavities are very unlikely to receive early dental care. The study surveyed 2505 children aged 4 and found that 39% had never visited a dentist. Less than 1% of healthy children visited dental clinics by recommended age of 1 year and less than 2% of them by 2 years of age. The study further found that never being to a dental office was associated with few factors such as younger age, poor economic condition of the family, prolonged bottle feeding, and daily consumption of sweetened drinks such as juice.

Can’t find a dentist who treats infants and toddlers?

Pediatric dentists are specialists devoting to treating children, especially those with complex medical needs.  This extra training requires years beyond dental school and multiple examinations.  You can find a Board-Certified pediatric dentist at ABPD.org.  We are happy to see your child at any age.  Remember, an ounce of prevention is worth a pound of cure!

See you soon~


Anticipatory Guidance

Anticipatory  Guidance refers to all those things I speak to you and your children about at every visit.   Some topikidscs will make sense right away, like nutrition, while others may seem more obscure, like snoring!  As your child’s dentist, I have the privilege of seeing them frequently (usually every 6 months) and watching them grow.  This puts me in a unique situation to address different issues associated with your child’s growth and overall health and well-being.

Topics in your child’s exam may include:

  • feeding issues, muscle tone, drooling
  • speech, tongue thrust, lisps, articulation
  • perioral habits:  thumb/finger sucking, chewing on clothes
  • safety including helmets, seat belts, mouthguards
  • behavioral development or delays including PDD, sensory issues and motor issues
  • counsel for 504s, IEPs and navigating the NYC DOE
  • snoring, apnea, mouth breathing issues
  • growth of the jaw, jaw joint and assessment of bite
  • effects of medications (chronic or seasonal) and alternative treatment options
  • nutrition from infant through teenage years
  • pre-teen guidance, positive self-image building

Each dental exam I perform includes an assessment of your child’s growth, both mental and physical.  Assessments include reactions to lights, sounds, sensations and touch.  Early intervention is essential to your child’s successful growth and we are lucky in New York to have a vibrant early intervention community with world-renowned experts just outside our doorstep!   While it may seem to an outsider that we are simply “playing in the dental chair”, a lot of time and thought goes into each interaction I have with your child.   As the mom of a child with special needs, I also have a unique perspective on therapy, interventions and how to navigate the school system.

Don’t worry, if I have any concerns regarding your child, I will always speak to you right away.

Looking forward to seeing you and your child at their next check up!

Drink Up!

Winter weather may have you drinking less water, but its crucial to good health to drink up.


Here in New York City, the amount of fluoride in our water is adjusted along with the seasons.  Parents of my New Jersey patients are often shocked to learn that Jersey City (and much of the state of NJ) is a non-fluoridated community.  That means your child may be missing out on the valuable benefits of tap water on both the baby teeth that you can see and the permanent teeth that are forming under the gums.

Water, water, water…….its the most important drink you give to your child.   Keep in mind,  most bottled water doesn’t contain fluoride, is expensive, and is bad for the environment.  Don’t like the taste of tap water?   Buy a Britta filter to keep tap water ice cold in the fridge without filtering out the fluoride!  Infants under 12 months old may drink water from a baby bottle.  Toddlers and children should be encouraged to use a straw cup or an uncovered cup after their 1st birthday.   Only put water in a sippy cup, straw cup or baby bottle.  Sweetened liquids (including milk) should only placed be in an uncovered cup after 1 year old.  On the go?  Have your child pick out a water bottle to take along or decorate a plain bottle with stickers.

 Please let me know if you have questions on quality and quantity of water necessary for your child.

Communities save $38 in dental expenses for every $1 spent to  fluoridate public drinking water!!

Shark Teeth!

Does your child have shark teeth? (Ectopic eruption)

If your child’s permanent teeth are erupting behind the baby teeth, your child has shark teeth!  Don’t worry, this is a common occurrence and we can help.  If the baby teeth are extremely loose, you can let nature take its course and allow the baby teeth to fall out in a few weeks.

However, once the permanent teeth have erupted 25% (see picture), no amount of wiggling will get those baby teeth out.  It is important to remove the baby teeth as they are an obstacle to the proper growth pattern.

shark teeth

Why did my child’s teeth come in like this?

Ectopic teeth can be caused by genetic factors such as having a narrow jaw, crowded teeth or teeth that are too large for the jaw size.  Other times, it is simply result of where the permanent teeth started developing.

What will happen if I don’t have the baby teeth removed?

The sooner the baby teeth are removed, the quicker the permanent teeth can move into the right spot.  A delay in removing the baby teeth could create a loss of jaw space and create more complex orthodontic (braces) problems in the future.

How quickly will the permanent teeth move in the right spot?

Nature is truly amazing, and the permanent teeth will start moving immediately after the obstacle is out of the way.  Pressure applied naturally from the tongue will guide the new teeth into the right spot within a few weeks.

Will it hurt to take out the baby teeth?

Dr. Gretchen is a Board Certified Pediatric Dentist.   Most children are surprised at the end of the appointment to learn that teeth are out and ready for delivery to the tooth fairy!  Children sense parent fear, so it is important not to worry your children with words like needles or shots.  We encourage you to sit with your child, and we’ll take care of the explanations!



Each time you eat a snack containing sugar or starch (carbohydrates), the resulting acid attack on your teeth can last up to 30 minutes, and a lot of snacks and drinks contain sugar. How much sugar? A single can of pop contains up to 10 teaspoons of sugar, and if you think that natural sugar (like the sugar in juiceraisins or other dried fruit) is better for your teeth it’s not.

Sugar is sugar! Soda, juice, candy, dried fruit…….


Beat the Clock – foods that are eaten during a meal usually pose less of a threat to teeth because of the additional saliva produced during mealtime eating. Saliva helps to wash food particles from your mouth and lessen the damage from acid.  Grazing on snack foods like goldfish, graham crackers, and ‘fruit’ gummies means the mouth is constantly under attack.  Give your mouth a break and drink only water between meals.   Sugarless gum or mints will also return your mouth to a healthy pH.

Brush & floss those teeth – toothbrushing is important, and you should brush twice a day. Did you know that if you don’t floss, you miss cleaning up to 35% of each tooth? Kids need grown ups to help position the floss between molars.  Flossing after brushing at night will push the toothpaste into the right spot!  If you’re not sure how to floss, just ask!


Stock up on Dairy Products – yogurt and cheese, milk and milk products contain things that are good for your teeth. Everything that’s made from milk is a good source of calcium – an essential nutrient for the development of bones and teeth. Some scientific studies have shown that eating cheese actually helps to protect your teeth from cavities by preventing something called demineralization (the loss of important calcium in your teeth).


Pregnancy & Your Baby’s Teeth

Start Motherhood With a Healthy Mouth

Being pregnant affects your oral health. As your body changes during pregnancy, you are more likely to get sore, puffy or red gums. Paying attention to your oral health is especially important at this time. The good news is that by taking care of your mouth during pregnancy, you are not only helping yourself, you are also helping your baby.

Dental disease is caused by bad bacteria (germs) that can be easily transmitted from mom to infant through saliva by sharing food or utensils. Getting dental care during pregnancy is safe and strongly recommended. By getting your own teeth treated prior to the birth of your baby, less bacteria will be transmitted to your baby and your child will be at less risk for developing cavities.

Parents who keep their own mouths healthy will help prevent problems for their child.

How Do You Keep Your Mouth healthy?

  • Brush with fluoridated toothpaste twice daily (especially important before bed time) and floss every day.
  • Chew gum with xylitol (a natural sweetener that reduces the cavity-causing germs in the mouth) four to five times a day, especially after eating.
  • Limit sweet and high-carbohydrate snacks, such as soda, candy, crackers and chips. These foods feed the germs that live in the mouth and cause cavities. When you do eat these foods, brush afterwards. If brushing is not possible, rinse your mouth with water.
  • Continue to get regular dental care while pregnant. This includes preventive care, along with fillings and emergency dental services as needed. Receiving dental care while pregnant is safe and recommended. Once you have a newborn baby, it will be hard to find the time to get to the dentist, so do it now.
  • If you have nausea and vomiting, it is important to reduce the acid in your mouth (it can damage your teeth). Eat small amounts of nutritious snacks during the day. If you vomit, rinse your mouth. Put 1 teaspoon of baking soda in a cup of water and use this to rinse. Be sure to spit after rinsing. Do not brush right after vomiting; this can damage the surface of your teeth.


Dental Sealants

Did you know?


One of the best ways to protect a child’s teeth from tooth decay is with dental sealants

Dental sealants protect the teeth through the cavity-prone years, ages six to 14, when back teeth are first susceptible to decay. Sealants provide extra protection on childrens teeth until they learn how to do a better job of brushing and flossing.

Sealants act as barriers, protecting the teeth against decay-causing bacteria. The sealants are usually applied to the chewing surfaces of the back teeth (premolars and molars) where decay occurs most often.

Applying dental sealants is a simple, painless procedure that’s also inexpensive compared to filling a cavity.


Just the facts

  • Dental Sealants are a clear plastic material, professionally applied to the back teeth to prevent cavities.
  • 90% of children’s tooth decay occurs on tooth surfaces with pits and fissures. Sealants do a great job of preventing tooth decay on those kinds of surfaces.
  • Your child can benefit from sealants applied around six years of age, when first permanent molars erupt.

Questions and Answers

What are sealants?

Sealants are made of a white or clear resin material. They help shield bacteria which causes decay on the surface of the back teeth.

How can sealants prevent decay?

The sealant material bonds to the chewing surface of the back teeth, forming a protective barrier covering the depressions and grooves (pits and fissures) of the molars.

Sealants prevent bacteria from nestling into the grooves of the teeth AND they seal out any food sources from the deep pits and fissures of molar teeth.

Why are sealants necessary?

Because the depressions and grooves (pits and fissures) on the back teeth are impossible to keep clean. The tooth brush bristles cannot reach deep into them. These depressions and grooves are snug places for food and plaque to hide. By coating the grooves with a thick covering of sealant material, plaque and food is kept out, decereasing the chances of decay.

Which teeth are suitable for sealants?

First and second molars are most likely to benefit from sealant applications. It is best to seal these molars right after they have just erupted catching them before decay sets in. First molars generally appear at around six years of age and second molars at about 12 years of age. Children between the ages of six and 14 benefit most from sealants.

How are sealants applied?

After an examination, it is determined which teeth can be sealed. Applying sealants is very simple and painless. First, the teeth are cleaned. Then in preparation for the sealant material, the teeth are dabbed with a very mild solution similar in strength to vinegar or lemon juice. This will roughen the tooth surface slightly so the sealant will bond properly to the tooth and ensure a clean tooth surface. After the tooth has been prepared, the resin sealant material is painted onto the tooth. It will flow into the grooves of the tooth and hardens in about 30 seconds. Afterwards, the bacteria cannot reach the pits and grooves.

Have sealants been thoroughly tested?

Yes. Children around the world have had their teeth sealed in clinical studies. These studies have proven sealants to be effective, easy to apply, inexpensive and nontoxic.

Are sealants covered by dental insurance?

Yes!  Most dental insurance plans offer coverage for up to 100% of the cost of placing a dental sealant.  For information specific to your dental insurance plan, please speak with a member of my staff or your dental insurance company.

How long will dental sealants last?

Sealants will chip or break off if you regularly chew on ice or hand candies (you can also break a tooth doing that!) Sealant application can last for as long as you are careful not to bite into things that are not foods.   They should be checked regularly and reapplied when the appear to have worn off.  My goal is to send your child off to college cavity free and with intact sealants to protect their teeth into the future!

Cough Syrup Cavities

Cough syrup and cavities

cough syrup

It’s that time of year when coughs, colds and flu can make your life miserable. And like most people, you’ll probably reach for an over-the-counter medication to ease your symptoms. But did you know that spoonful of medicine could add tooth decay to your list of side effects?

Many cough drops and liquid medications contain a variety of ingredients that make your teeth more susceptible to decay:

  • Ingredients such as high fructose corn syrup and sucrose contribute to decay when the bacteria in your mouth feed on the sugars, breaking them down and forming acids that attack the enamel of your teeth.
  • Ingredients such as citric acid can wear down the enamel of your teeth. In addition, some antihistamine syrups contain low pH levels and high acidity, which can be a dangerous combination for your teeth.
  • The addition of alcohol in some popular cold and cough syrups also has a drying effect on the mouth. Saliva helps to naturally rinse the sugars and acids away from your teeth – so with less saliva present, the sugars and acids remain in the mouth even longer, leading to greater risk for decay.

These risks can be magnified if medication is taken before bedtime. The effects of taking liquid medication before bedtime aren’t much different than drinking juice or soda before bedtime – because you produce less saliva while you sleep, sugar and acids remain in contact with the teeth longer, increasing your risk for decay.

What’s the remedy?

There are things you can do to lessen the effects of the sugars and acids in liquid medication.

  • Take liquid medication at meal times instead of bedtime so that more saliva is produced to rinse away the sugars and acids.
  • Brush your teeth with fluoride toothpaste after taking medication.
  • Rinse your mouth well with water or chew sugar-free gum after taking liquid medication.

Baby Bottle Tooth Decay

whitespotsBaby Bottle Tooth Decay

Even though they are temporary, your child’s baby teeth are important, and are still susceptible to cavities. Tooth decay in infants and toddlers is often referred to as Baby Bottle Tooth Decay, or Early Childhood Caries. Children need strong, healthy teeth to chew their food, speak and have a good-looking smile. Their first teeth also help make sure their adult teeth come in correctly. It’s important to start infants off with good oral care to help protect their teeth for decades to come.


What causes Baby Bottle Tooth Decay?

Baby Bottle Tooth Decay most often occurs in the upper front teeth, but other teeth may also be affected.

There are many factors which can cause tooth decay. One common cause is the frequent, prolonged exposure of the baby’s teeth to drinks that contain sugar (yes, that means milk!). Tooth decay can occur when the baby is put to bed with a bottle, or when a bottle is used as a pacifier for a fussy baby.

Tooth decay is a disease that can begin with cavity-causing bacteria being passed from the mother (or primary caregiver) to the infant. These bacteria are passed through the saliva. When the mother puts the baby’s feeding spoon in her mouth, or cleans a pacifier in her mouth, the bacteria can be passed to the baby.

If your infant or toddler does not receive an adequate amount of fluoride, they may also have an increased risk for tooth decay. The good news is that decay is preventable.


Preventing Baby Bottle Tooth Decay

  • Try not to share saliva with the baby through common use of feeding spoons or licking pacifiers. After each feeding, wipe your child’s gums with a clean, damp gauze pad or washcloth.
  • When your child’s teeth come in, brush them gently with a child-size toothbrush and water or a toothbrush dipped in fluoride rinse.
  • Brush the teeth with a smear amount of FLUORIDE toothpaste from the ages of 2 to 6.
  • Supervise brushing until your child can be counted on to brush every surface – usually not before he or she is 7 or 8!
  • Place only formula, milk or breastmilk in bottles, NEVER with liquids such as sugar water, juice, coconut water or soft drinks.
  • Infants should finish their bedtime and naptime bottles before going to bed.
  • If your child uses a pacifier, provide one that is clean—don’t dip it in sugar or honey.
  • Encourage your child to drink from a cup by his/her first birthday.
  • Encourage healthy eating habits.

When your child’s first tooth appears and no later than their 1st birthday, schedule the first well-check visit with a pediatric dentist. Treat the first dental visit as you would a well-baby checkup with the child’s physician. Remember: starting early is the key to a lifetime of good dental health.