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Interviewer: If you've ever had any questions about baby teeth, are they important? Is it okay if a child has a baby tooth knocked out? Is it a big deal or not? What about when you can start brushing? We're going to cover baby teeth next on The Scope.

Announcer: Medical news and research from University Utah physicians and specialists you can use for a happier and healthier life. You're listening to The Scope.

Interviewer: Dr. James Bekker is with University of Utah's School of Dentistry and he's going to give us some tips and information on baby teeth because you get a lot of questions about baby teeth. First of all, are baby teeth important or are they just that first set of teeth and I don't have to worry about them too much?

Dr. Bekker: Yes. Thanks for the question. That's a good one and we do get that a lot. Parents will often ask or say, "Gee. Why do I need to take care of these baby teeth? Why do I need to go through the expense or the experience of getting them taken care of?"

Interviewer: Or even the hassle of getting your kid to brush, right?

Dr. Bekker: Exactly. Baby teeth are very important because they are connected to where the permanent tooth is developing. So if you have a tooth that gets a cavity and gets infected, that infection can go from where it is in the baby tooth and into the jaw around where the permanent tooth is developing. Permanent teeth can be affected by baby teeth that are neglected.

Now if you lost a baby tooth, that brings up the other reason they're important is they hold space. If you lose a baby tooth early, it's like having bricks in an archway. If you pull out a brick in an arch, all the other bricks fall into that hole. Same thing happens with teeth. Everything else shifts and then your permanent teeth don't come in the right place.

So if you lose a tooth early it's important to hold the space and to maintain that space for the permanent tooth. It's also important to know that you're still losing baby molars when you're 12 years old. You've got some permanent teeth in your mouth when you have baby teeth in your mouth and that caries process or cavities process that happens with baby teeth really can affect the permanent teeth that you have.

Interviewer: So if you get a cavity in the baby tooth, is the effect on the permanent tooth underneath even more drastic than if I'd just got a cavity, like an adult got a cavity in a regular tooth? Does that make sense? Does it go beyond just the cavity in that situation?

Dr. Bekker: It depends on how far that cavity is allowed to go. If you just get a small cavity in a baby tooth and it gets fixed then there's probably no repercussions on the permanent tooth. But if that cavity is allowed to go on to get into the nerve, have the nerve become infected, and that infection travel down through the roots to where the permanent tooth is, it can have an effect on the permanent tooth development.

Interviewer: When should a child go to the dentist for the first time? You're talking about how important it is to take care of these baby teeth. When should you really start being concerned?

Dr. Bekker: We like to have children at the dentist at about a year of age.

Interviewer: Really?

Dr. Bekker: Yes.

Interviewer: That's much younger than I would . . . do most people find that to be younger than they expected?

Dr. Bekker: The American Academy of Pediatrics and the American Dental Association have collaborated on a number of studies and it is shown that if we get in early, you do some prevention of caries with the children. But the key point is you're educating the parents. I have so many children that come in at age three and they have a mouth full of cavities. If we were able to see that child at age one and do a little prevention, cleanings and fluoride treatments, that kind of thing, and educate the parents as to how to take care of those teeth, we could probably prevent a lot of those cavities that we see at three or at five.

Interviewer: Yeah. When should a child a start brushing his teeth? Or when should a parent start brushing a child's teeth? At one?

Dr. Bekker: Yes. As soon as...

Interviewer: When that first tooth comes in, start taking care of it.

Dr. Bekker: That's exactly it. Typically the first teeth are going to come in on the lower arch, the mandible, at around six months. Of course, the little kids aren't going to want to brush their teeth at that age. But we show parents how to hold them in a safe way that allows the parent to be able to brush the teeth while they're holding the child and how to effectively help that child get used to brushing, the taste of the toothpaste, and having the brush in their mouth. It's a process. Parents say, "How old should a child be when I let them brush their teeth on their own?" And I say, "About nine."

Interviewer: Up to that point it is the parent's responsibility.

Dr. Bekker: A lot of times, we say, "Have your child brush their own teeth and then mom or dad just check." And we say "check" with big quotation marks around them. You take that brush and you get in there and you go, "Oh, you did a great job on these. And, oh these over here you did a really good job." Mom and dad check the teeth and in checking they get in and get them really brushed done.

Interviewer: Getting a little brushing done. All the way to nine, huh?

Dr. Bekker: Well, thereabouts.

Announcer: That seems like a long time.

Dr. Bekker: Somewhere along in there, when the child can really understand how to effectively brush and floss.

Interviewer: Got you. Give us one great tip to end this interview. If somebody were going to do something for their child's teeth and do it well, if there was only one thing you could tell them and that's all the time you had, what would it be?

Dr. Bekker: Just take care of the ones you want to keep.

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