Emily Hahn, DDS: Hi, I'm Dr. Emily Hahn. I'm a board-certified pediatric dentist at St. Louis Children's Hospital, and I'm a mom doc.

Melanie Cole, MS (Host): The holiday season includes spending time with family and friends and a lot of food and desserts. Well, we are here to discuss how parents can help keep their kids' teeth healthy during the holiday season and really all year long right here on Mom Docs, the podcast from St. Louis Children's Hospital.

I'm Melanie Cole. And Dr. Hahn, thank you for joining us. Before we get into holiday teeth and desserts and all that, how often should we be taking our kids to the dentist? When is the first time we take them to the dentist? Do we wait until they grow all their teeth? Before we get into all the tooth health, that's not easy to say, tell us when is the first appointment.

Emily Hahn, DDS: The recommendation from the American Academy of Pediatric Dentistry, as well as the AAP, which is the American Academy of Pediatrics, is to visit the dentist at age one. Most kids get their first teeth around six months, but there's a large range with that. The reason we start at one is to start answering those questions for parents. Your kid may only have one tooth, your kid may have more than 12 teeth at that age. But what we like to do is build that relationship with the dental team. The pediatrician has a lot on their plate those first couple of years, and the dental team, particularly pediatric dentists, are here to make sure that those questions about oral health are answered.

Melanie Cole, MS: Well, thank you for that. People might not realize that you bring your kids in so early to start the process young. Now, speaking of the process, flossing, you know, our kids, some of them have big gaps between their teeth as they're growing their baby teeth. And then, they're getting their adult teeth. Do we teach kids to floss? Do we teach them how to do it? Are they supposed to do that?

Emily Hahn, DDS: So until the kids are about eight, we recommend parents to help. And you're right, spacing is super common and actually liked by pediatric dentists. The space allows for our spit to naturally cleanse our teeth, which is a fantastic thing. So for some kids, flossing is just to get in the practice. It's a behavior that we would like to create as a habit. Most kids, and honestly most adults, don't floss correctly. They didn't go to dental school. They didn't go to dental hygiene school. So, I always tell parents, it's okay to use those floss sticks just to clean out in between the teeth. And then as we get older, go to the dentist and ask your hygienist, ask your dentist the best way to actually floss your teeth.

Melanie Cole, MS: That's great advice. We could all learn really, how to floss our teeth properly. And what about brushing their teeth? We start when they're little, because we want to foster, as you say, those really good habits. And I remember those sweet, sweet times of brushing my children's teeth until they finally said, "Let me do it." So, do we let them do it? When? Tell us a little bit about really teaching them how to properly brush their teeth.

Emily Hahn, DDS: So, the first thing is, is that most kids-- like I'm shocked that you have a great memory of your brushing teeth. That's fantastic. I feel like I get complaints most of the time about brushing kids' teeth. So first, I would say morning time is a great time for kids to practice on their own, to have that independence and brush their teeth. And we recommend using a smear of fluoride toothpaste from the get-go. Then, at nighttime, it's really important for parents to check the brushing. So if a child wants to brush their own teeth, then have mom and dad check until a kid is about eight years old, we want to do that. The problem is once we get to be about eight, parents just don't enter the bathroom at all. And what I find is most kids rush through that brushing when their permanent teeth are coming in, those six year molars are coming in. So, being around to just monitor to make sure that kids are brushing for two whole minutes around the age of eight is super important.

Melanie Cole, MS: So now, we're looking at the holidays and again, as we said in the intro, there's so many sweets and desserts and really all-year round. I mean, we got Halloween, we got Thanksgiving and Christmas and there's so many holidays coming up. We don't want to have to come to you and say, "She's got four cavities now." So, what do we do? How can a parent-- because it can be really challenging to say, "Oh no, don't have so many sweets," especially around the holidays, what do we do?

Emily Hahn, DDS: Saying no to sweets is actually not what I would recommend. Everything in moderation. What I have found are the families that say no sweets at all, once they're out of the home, it's over. We're talking crazy town. Moderation is key. So first tip, frequency. We want to make sure that we're not snacking on it constantly. Holidays are known for that. So, making sure that we have a snack time where they're just not readily available. So if you want some cookies and you're baking cookies, have cookies. But we don't need to have cookies for three hours straight. It's important to have that designated snack time where the mouth gets a break so that the acidity level of our mouth neutralizes. This includes adults with drinks and those types of things. Our mouth needs a break. Water is super important.

The other thing is, is that the type and texture of food really matters. Those foods that are super sticky are not great for teeth. And although they're delicious, again, they're not great for teeth. Cookies and chocolates and things like that melt. And when they melt, they don't stick in the grooves, and they're less likely to cause cavities in comparison to some of those other things.

Melanie Cole, MS: When we think of bacteria in the mouth, and even little kids get bad breath, Dr. Hahn, is bacteria something that can develop when the mouth is dry and we're not hydrating? Because I think that's important for the kids too, to try and avoid some of those sugary things drinks and for adults as well, right? And some of those sweeter drinks. Tell us a little bit about how bacteria develops in the mouth and how proper dental hygiene can really help to stave that off.

Emily Hahn, DDS: So, everyone has bacteria in their mouth. That's not necessarily something that we can change. And maybe dentistry in the future will alter how we treat cavities, because cavities ultimately are caused by different forms of bacteria. The things that we can change are the amount of time that that bacteria sits on the tooth, and really it's not the bacteria itself, it's the waste products of that bacteria and the plaque that sits there. So, we may not be able to change the bacteria. However, we can change the environment so it's not a great place for that bacteria to live. That means we want to make the mouth less acidic. And by doing that, water is key. Juices and sugary drinks that you mentioned are perfect for that bacteria and they will flourish. That's not what we want. Water and break time is huge. So just think, you don't want to feed the bacteria. It's there. We know that brushing off the remnant is the most important part.

Melanie Cole, MS: Well, it certainly is. This is a lot of good advice. And now as a parent myself, of course, my kids are in their 20s, but I would like some advice for fun dental gifts, because I think this is a really great idea. And I remember back in, well, many years ago, dentists, if you went to their house on Halloween, they would give out toothbrushes, sugar-free candy or something, a penny or something. Oh, I'm dating myself there, but I'm wondering about gifts now. What are some cool things that we can give little kids, our littler kiddos, and even our teenagers that they're going to go, "Wow, that's really cool. I'm so glad I got that"?

Emily Hahn, DDS: So, the first thing is many of the major brands now have apps that go with the toothbrushes. And what's really cool is that something that goes on the toothbrush, there's both manual and electric ones. And the camera from either your tablet or your phone, you can watch the little spots on the toothbrush to make sure you're hitting those points.

Melanie Cole, MS: Cool.

Emily Hahn, DDS: Yeah, it's really cool. And so as you brush those teeth, you can like you attack basically monsters and you earn points and you earn hats and you take selfies with it. So, it's really fun and I've tried it with my own kids and they get a kick out of it. So, that is one gift that I would look into. And like I said, many of the major brands do it.

Another thing is to look into different types of toothpaste. It's not only mint toothpaste now and I always tell parents they don't have to use mint. Mint is for your breath. it's not necessarily to benefit the tooth. Peppermint is not beneficial to teeth. I'm sure there's some benefit and someone will find it. But really, it's the fluoride toothpaste that matters and how you brush your teeth that matters. So, if you want to get your kid a strawberry toothpaste, a chocolate toothpaste, a vanilla toothpaste, those all exist. As far as teenagers, I think talking and working with them to just make sure that they have a timer that goes the whole time. And so, we all need to brush our teeth for two whole minutes. So, there's some sort of timer, some sort of music thing, that's what I would do. But as far as like super cool dental gifts for a teenager, that's tough.

Melanie Cole, MS: Well, actually, you gave that app idea where we can see the pictures of it. And I think any teenager would kind of find that really cool as well because you're actually seeing what's going on.

Emily Hahn, DDS: Exactly.

Melanie Cole, MS: That's very good advice. Now while I've got you and because you're a dentist, fluoride treatments, are we supposed to be giving those when we see our dentist? Do you give our children these fluoride treatments? And what about Sealants? When do those come into the picture?

Emily Hahn, DDS: So, fluoride is something that we recommend placing two times a year. Everyone has different cavity risks. So, if you have the anatomy of teeth and you don't get cavities in your family, it's something that you should discuss with your dentist, the risk factors that you and your children have for getting cavities. My own children get two fluoride treatments a year. I get two fluoride treatments a year. And quite frankly, some people would benefit from more frequency than that.

But as far as sealants, we recommend placing those in the grooves of the 6-year molars and the 12-year molars, whenever those teeth first erupt. Now, it depends on the anatomy of your teeth. I explain teeth as having mountains and valleys, and some people's valleys in their teeth on those back molars are really deep, and actually toothbrushes can't clean out everything, unfortunately. And that's where what we do is we fill that valley up with a sealant material, which is similar to a filling material. I recommend discussing with your dentist what's in that material, because everyone uses a little bit different product. But what that does is it allows for food to naturally get out of those grooves, because it's not as deep of a valley. Some kids benefit from getting their baby teeth sealed. The problem is, is that not all kids, my own almost six-year-old himself, has a pretty strong gag reflex. And so, we want to make sure that pushing for a preventive service doesn't cause them to dislike the dentist in the future. And that's where the balance always plays.

Melanie Cole, MS: Well, that is a great place for us to start your summary and wrap up, because we don't want our children to not like the dentist. I am one of those people that loves to get my teeth cleaned and I don't even care if they do a deep cleaning. I love the way that it feels and I love the way that it feels after I'm done getting my teeth cleaned.

So Dr. Hahn, please wrap it up with your best advice as a pediatric dentist. What you want us to know about the upcoming holidays, all the sweets, and the sugar, and the things our kids are going to eat. I mean, we can't get away from that, as you say. What do you want us to know about fostering those excellent dental habits that will last them a lifetime.

Emily Hahn, DDS: The first thing, and if there's anything that people remember, the last thing that should touch your mouth at nighttime is a toothbrush with fluoride toothpaste. We want to rinse off those delicious foods and make sure that that bacteria doesn't also have a sweet treat. So if there's anything everyone wants to remember, it would be make sure we brush our teeth right before we go to bed so that the holidays can remain enjoyable and everyone can have a great time.

Melanie Cole, MS: Great advice. Dr. Hahn, you're an excellent guest as always. Thank you so much for sharing your expertise with parents today. And for more advice and articles, check out the Mom Docs website at childrensmd.Org. That concludes another episode of Mom Docs with St. Louis Children's Hospital. Please always remember to subscribe, rate and review this podcast and all the other St. Louis Children's Mom Docs podcasts. I'm Melanie Cole. Thanks so much for joining us today.