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Many people think dental fluorosis is a disease, but it’s not; it’s a condition that affects the appearance of your tooth’s enamel, not the function or health of the teeth. These changes may vary from tiny, white, barely noticeable spots to very noticeable staining, discoloration, and brown markings. The spots and stains left by fluorosis are permanent and may darken over time.

Dental fluorosis occurs in children who are excessively exposed to fluoride between 20 and 30 months of age. Only children ages eight years and younger can develop dental fluorosis. Why? That is the period when permanent teeth are still developing under the gums. For kids, fluorosis can cause significant embarrassment and anxiety about the appearance of their teeth. No matter how much they might brush and floss, the fluorosis stains do not go away.

Many well-known sources of fluoride may contribute to overexposure, including:

• Fluoridated mouth rinse, which young children may swallow
• Bottled water which is not tested for fluoride content
• Inappropriate use of fluoride supplements
• Exposure to water that is naturally or unnaturally fluoridated to levels well above the recommended levels

One way to reduce the risk for enamel fluorosis is to teach your children not to swallow topical fluoride products, such as toothpaste that contains fluoride. In fact, kids should use no more than a pea-sized amount of fluoride toothpaste when brushing, and children under the age of two shouldn’t use fluoride toothpaste at all.

Dental fluorosis can be treated with tooth bleaching, microabrasion, and conservative composite restorations or porcelain veneers. Please give us a call at our office to learn more or to schedule an appointment with Dr. Diane Colter.

Unless you work for an insurance company, you probably do not spend a lot of your time studying all the terminology that dental insurance companies use to describe the treatments and services they cover. If it seems pretty confusing, here are some of the most commonly used dental insurance terms and what they mean.

A Basic Glossary

Annual Maximum–The maximum amount your policy will pay per year for care at All About Kids Dentistry. It is often divided into costs per individual, and (if you are on a family plan) per family

Co-payment– An amount the patient pays at the time of service before receiving care, and before the insurance pays for any portion of the care

Covered Services– A list of all the treatments, services, and procedures the insurance policy will cover under your contract

Deductible– A dollar amount that you must pay out of pocket each year before the insurance company will pay for any treatments or procedures

Diagnostic/Preventive Services– A category of treatments or procedures that most insurance will cover before the deductible which may include services like preventive appointments with Dr. Diane Colter, X-rays, and evaluations

In-Network and Out-of-Network– A list of providers that are part of an insurance company’s “network”

• If you visit in-network providers, the insurance company will typically cover a larger portion of the cost of the care you receive. If you visit someone who is not part of the network, known as an out-of-network provider, the insurance company may pay for a portion of the care, but you will pay a significantly larger share from your own pocket.

Lifetime Maximum– The maximum amount that an insurance plan will pay toward care for an individual or family (if you have an applicable family plan)

• This is not a per-year maximum, but rather a maximum that can be paid over the entire life of the patient.

Limitations/Exclusions– A list of all the procedures an insurance policy does not cover

• Coverage may limit the timing or frequency of a specific treatment or procedure (only covering a certain number within a calendar year), or may exclude some treatments entirely. Knowing the limitations and exclusions of a policy is very important.

Member/Insured/Covered Person/Beneficiary/Enrollee– Someone who is eligible to receive benefits under an insurance plan

Provider– Dr. Diane Colter or other oral health specialist who provides treatment

Waiting Period– A specified amount of time that the patient must be enrolled with an insurance plan before it will pay for certain treatments; waiting periods may be waived if you were previously enrolled in another dental insurance plan with a different carrier

There are many different insurance options available, so you need to find out exactly what your insurance covers. It’s important to review your plan with a qualified insurance specialist. Don’t be afraid to ask questions about the policy so you can understand it fully and be confident that you know everything your policy covers the next time you come in for treatment at our Dallas office.

What a milestone! The transition from bottle to sippy cup is one of baby’s first steps toward toddler independence. And like all first journeys, some helpful guideposts come in handy. That’s why Dr. Diane Colter and our team have several recommendations to help you navigate this transition, making sure your baby’s dental health is protected along the way.

Choosing a Sippy Cup

Sippy cups are often a parent’s first choice for this big step in baby’s development. While sippy cups offer a variety of child-safe materials, lively colors, and comfortable handle options, the feature of interest from a dental perspective is lid design.

Sippy cups curb spills because their lids don’t allow liquids to flow out freely, ensuring that drinks make it into baby’s mouth instead of onto furniture or floor. Cup lids might incorporate:

• Built-in straws
• A drinking edge around the rim of the cup which seals when your child isn’t drinking
• Soft spouts
• Hard spouts
• Spouts with valves to prevent liquids from leaking out. (Spouts with valves work like a nipple, which means baby is sucking instead of sipping.)

Which design is best? For short periods, any of these designs can work for you. Over long periods, spouted cups could have the same effects as prolonged thumb-sucking and pacifier use, potentially affecting a child’s tongue positioning, tooth alignment, bite, and speech development. Your dentist will be able to suggest which cups are best for your child’s dental health both short and long term.

What to Put in a Sippy Cup

Once your baby has begun drinking from a cup, it should only hold tooth-friendly drinks.

• Pediatricians generally recommend breast milk and/or formula until your child is 12 months old. You can switch to regular milk (or a healthy milk alternative) once your child is a year old with your doctor’s okay.
• Water can be introduced when your pediatrician thinks your child is ready, usually around the age of six months.
• Because even natural fruit juices have lots of sugar, dentists and pediatricians suggest giving your baby small amounts only—or feed your child fruit instead!
• Skip the sugared drinks, sports drinks, caffeinated drinks, and sodas. They aren’t healthy for little bodies or little teeth.

Help Prevent Tooth Decay

Just like adults, babies can suffer tooth decay, too—and for the same reasons. The bacteria in plaque use the sugars found in our diets to create acids, and acids erode tooth enamel.

When a toddler totes a sippy cup around all day, even filled with healthy drinks, those baby teeth are constantly exposed to the natural sugars found in breast milk, formula, and, for older children, milk. Drinks with more or added sugars, such as juices or sweetened drinks, cause more damage to tooth enamel. Use a sippy cup wisely:

• Offer the cup with meals and snacks, when increased saliva production can help wash away sugars and neutralize the acids which cause cavities.
• Offer water between meals.
• Don’t let your baby take a sippy cup to bed. Some spill-proof cups are designed to be sucked like bottles, and, like bottles, sugary liquids can pool in babies’ mouths as they sleep.
• Get into a tooth-cleaning routine as soon as your child’s teeth start to arrive.

And, while we’re talking about healthy teeth, please don’t let your child toddle around with a sippy cup. A fall while drinking can injure a baby’s mouth and teeth.

Partner with Your Child’s Dentist

The journey from baby to toddler can seem overwhelming sometimes for both you and your child, but you have expert help available! It's a good idea to make a first dental appointment at our Dallas office sometime between the appearance of the first baby tooth and your child’s first birthday. This initial visit is an opportunity for Dr. Diane Colter to:

• Check your child’s overall dental health and development.
• Look for signs of early decay.
• Talk about proactive dental care, including how and when to clean your child’s teeth.
• Answer questions about how you can support your child’s dental health, including the advantages and disadvantages of sippy cups.

Used properly, sippy cups can be a helpful transition on your child’s journey from bottle to cup, and from baby-who-relies-on-you-for-everything to take-charge-toddler. Dr. Diane Colter and our team are an ideal guide as you and your child chart this path together.

Depending on how long the thumb sucking or constant pacifier use continues, and how aggressively the child sucks a thumb or the pacifier, it can indeed be an oral health issue. Generally speaking, most children outgrow these behaviors or are able to be weaned off them successfully sometime between ages two and four. When children wean off the behaviors in this age range, long-term damage is unlikely.

Why Kids Suck Their Thumb or Pacifier

Both of these habits are actually a form of self soothing that your child likely uses when he or she is very upset, or feeling stressed, confused, frustrated, or unable to properly express the emotions. If your son or daughters is a regular thumb sucker, or the child wants to use the pacifier almost constantly, it is best to try to taper off these habits at a young age.

If your child continues to suck a thumb or request a pacifier consistently after leaving toddler-hood, this could be a source of concern, and it should be addressed with Dr. Diane Colter and our staff. We will be able to evaluate your child's mouth to look for any signs of damage such as palate changes or teeth shifting.

Say Goodbye to Old Habits

In the event that your child is quite reluctant to give up a pacifier or thumb-sucking habit, there are a few things you can do to discourage these behaviors.

• When you notice that your child is not using a pacifier or sucking a thumb, offer effusive praise. This type of positive reinforcement can be much more effective than scolding the child.
• Consider instituting a reward system for giving up the habit. If the child goes a certain amount of time without this behavior, award him or her for being such a “big kid.”
• Employ the help of older siblings or relatives that your child admires. When a child’s role model says that he or she stopped sucking thumbs at a certain age, your child is likely to try to emulate that.