How Much Do You Know About Your Child’s Teeth?

In our interview with biological dentist and SafBaby expert, Dr. Raymond Silkman, you’ll find answers to questions such as, “Should cavities in baby teeth be filled?”, “When should I take my child to the dentist?” and more!

“The health of primary teeth is a definitive reflection of the overall health of a child.”  Dr. Raymond Silkman, D.D.S.

What is Holistic Dentistry?

Holistic or biological dentistry involves looking at the whole body and the reasons why a patient is presenting with the dental issues that they have. It further strives to alter or halt the path of the dental disease present which will result in better overall health in time.

In addition, the effects of the materials and procedures that will be used are heavily considered and custom tailored to each individual. This approach varies from practitioner to practitioner and depends on experience as well as the focus of each practice.

In my practice, my own upbringing enabled me to incorporate a holistic approach from the very beginning. My holistically-oriented family recognized that practices such as herbal medicines and wholesome nutrition benefited the entire human system, and this left an indelible mark on me. This, coupled with studying many of the allied fields of holistic health care and uncovering much of the research that has been buried or forgotten in whole-health approaches, has enabled this practice to be truly whole person-minded.

baby with two teethWhat Do Teeth Tell You About a Child’s Overall Health?

Primary teeth and all teeth in general are indicators of overall health. For example, the timing of when a child’s first teeth erupt, fall out and are replaced by permanent teeth indicates the progress of the body in terms of growth and development as well as emotional and psychological maturation.

We know that a child’s primary teeth eruption occurs around the age of 6 months of age. Many parents don’t realize that those first teeth actually started the process of development in utero! Healthy children with healthy teeth require optimal conditions before conception.

This means that parental health, nutrition, emotional and psychological well-being, and healthy lifestyle choices are all-important in the development and birthing so the child can come into the world with the best chance of being healthy.  This process continues with parents supporting, nurturing and nourishing children through breastfeeding and beyond.

It is the consumption of pure, organic or biodynamic whole foods which, in my opinion, includes raw dairy products, ethically, pasture-raised animal products, animal proteins and animal fats, and organic non-GMO plant-based foods, that will help the child develop healthy teeth and healthy dentition.

The presence of decay, decalcification or tooth and jaw malformations such as crowded or narrow dental arches can offer clues as to the overall health and wellness, diet and nutrition and emotional status of the child.

Having the privilege to practice in a very health-conscious area of Los Angeles, California, I have had the opportunity to evaluate and follow many individuals with very specific diet and nutritional programs. If I were to generalize, I would say that unfortunately, individuals and especially children born to long-term vegan or vegetarian diets tend to have a higher degree of dental problems such as decay, narrow arches, etc.

smile with baby teethThe Cycle of Teeth

Primary teeth come into the mouth at around the age of 6 months. The completion of the eruption cycle of all primary teeth ends at around 2 years of age at which time the child will have 20 primary teeth.

These teeth are then typically lost or exfoliated starting around the age of 6 and that cycle is completed by the age of 12. During this time, 20 primary teeth are lost and replaced and an additional 8 permanent molars are added, resulting in 28 teeth in the adolescent’s mouth.

An additional 4 teeth will erupt later in life around the mid or late-teens or even early 20’s. Those are the 4 additional wisdom teeth which will complete the cycle of having up to 32 permanent teeth.

It is noteworthy that 4% or less of the adult population has all 32 teeth. This is mainly because most dental professionals recommend the removal of wisdom teeth before they fully develop and erupt.  In contrast, holistic dentists advise leaving all 32 teeth intact, avoiding extraction unless absolutely necessary.

When Should a Parent Make Their Child’s First Dental Appointment?

Generally speaking, I recommend the first dental visit take place around the age of 3 ½ to 4. It should include an examination, a cleaning and a discussion of diet and care of the teeth with the child and parents. Although some advice has been circulated in regard to visiting the dentist as soon as the first set of teeth erupt around the age of 6 months, I haven’t found any real benefits for a family to have a dental visit at such an early age when the child can’t really comprehend the reasons and logistics of doing so.

This of course, does not apply if a child has true dental complaints, pain, trauma, etc., or a parent has visually noted an issue such as a darkened area or a broken/decayed tooth which would require a visit as soon as possible, no matter the age of the child.

Before the visit, parents can help the child become comfortable with the idea of going to the dentist by reading books that illustrate a visit to the dentist and by also exploring the dentist’s website where you may find pictures of the dentist and staff. If a child is extremely apprehensive, you might consider calling the office to see if you can stop by so the child is at least comfortable with the surroundings and the idea of a future visit.

When Are X-rays Needed? Are There Other Options Parents Should Consider?

With the advent of low-dose x-rays or radiographs and super fast dental films or digital x-rays, the detection process is pretty simple and accurate with very minimal radiation concerns. Most typically, children can have a dental examination with as few as 2-4 x-rays, even up to the age of 7-8.

There are also very bright light-producing devices that simply illuminate the tooth so that areas of decay which appear dark can be visualized. However, most systems other than the traditional x-ray devices have limited capability in detecting tooth decay in-between the teeth (also known as interproximal decay).

Should Cavities in Baby Teeth be Filled?

Many parents wonder about this! Let’s take the example of a 3-4 year old with dental decay on a tooth that will fall out around the age of 10-12.

In this situation, the decay can definitely pose problems over the next 6 to 8 years if it gets larger and reaches the internal structures of the tooth (also known as the dental pulp) where the nerves, blood vessels and lymphatic vessels exist.  If dental decay reaches into the pulp chamber and pulpal structures of the tooth, then tremendous inflammation along with a potential infection can cause pain, swelling and extreme discomfort.

Therefore, the decision to treat or not treat a cavity in a primary tooth really depends on considering the age of the child, the typical age at which that tooth may be lost or replaced with a permanent tooth, and the extent of the decay. This should be discussed and thought through on an individual basis with the child’s dentist.

child and dentist How Do You Help a Child Gain Comfort Around Getting a Cavity Filled?

It is at the initial visit where a rapport of caring and trust should be established. At that time, there should be a comprehensive evaluation and diagnosis of what needs to be done and prioritized. Once the dentist, parents and child feel like they can proceed, a treatment appointment should be made. Ideally, this should be separate from the initial examination.

At the treatment appointment, the dentist can discuss the way in which the procedure will take place. I believe in using language that replaces fear-provoking words such as “drilling or shots or suctioning of saliva” with visually/conceptually gentler words such as “the little motor that takes the decay or soft part of the tooth out” or “sleepy juice that helps the tooth go to sleep” or “the thirsty straw that gets the water out.”

I don’t recommend over-explaining any of it, or sharing any of your own past experiences or having siblings try to explain the process to a child that has not gone through it themselves. Unfortunately, many people have had unpleasant dental experiences during their childhood and children can pick up on the fears that may be harbored within the parents or siblings.

The use of music that the child likes via headphones or dental video glasses and monitors can provide a gentle distraction to all that is going on and is an excellent adjunct to a successful, pain-free experience for all children and even adults.

I would recommend minimizing or avoiding the use of sedation medications such as nitrous oxide (laughing gas), if possible. The effects of sedation on the nervous system, the brain and the long-term effects in the individual child may be difficult to assess. Although it is great that we have these resources, ideally, if we can avoid them, it would be best.

Is There a Way To Stop a Cavity From Getting Larger?

If the cavity does exist, but is small, the decay can be stopped using treatments that help the body replenish the lost mineral content of the tooth structure. This is called remineralization. Under normal and healthy conditions, it occurs naturally and is ongoing. However, the process can be helped by having the child consume a nutrient rich diet, applying certain clay or mineral containing packs or poultices to exposed areas of teeth and by removing environmental toxicity and easing emotional discomfort.

Typically, in order to stop the decay process by way of medications and chemical interventions, the tooth structure has to be made unusable or toxic to microbial life. To do this, fluoride and ozone may be suggested, but both are highly toxic. There may be benefits to doing this in specific circumstances but this really needs to be assessed on an individual basis.

What Material is the Safest for Filling a Cavity?

The types of materials used for dental treatment of children’s teeth are typically amalgam (mercury-containing fillings), composites, glass ionomers and pedodontic crowns made of stainless steel, composite, acrylic or even zirconia type materials.

The consensus among holistic dental professionals as well as health conscious practitioners in the fields of dentistry, medicine and allied fields here and internationally, is that mercury-containing amalgams are toxic and should not be used in children or adults.

Ideally, materials with the least toxic and most bio-compatible components are best. Even though the teeth may be exfoliated at some point during the child’s life, the effects of these materials will stay long after the primary teeth are lost. Composites and glass ionomers, having a more biocompatible footprint, are a better alternative.

A material’s biocompatible footprint refers to how favorably its ingredients affect the body. Heavy metal and non-precious metal dental restorative materials, such as mercury fillings, base metal-containing crowns, high aluminum and aluminum-oxide materials and zirconium restorations have a poor biocompatible footprint.

Also, procedures such as pulpotomies and pulpectomies (baby tooth root canal-like procedures) that use toxic Formocreosol or Formalin/Formaldehyde-containing medicaments followed by stainless steel metal crowns is strongly discouraged.

There are many healthy and alternative ways to provide these treatments if they are needed for a child. A Holistic/Biological dentist should be consulted.

How to Find Holistic/Biological Dentists

To find such practitioners you can consult with the following organizations:

D.A.M.S. Dental Amalgam Mercury Solutions is the oldest nonprofit group educating the public on this issue, with a vast library of books and scientific papers documenting the hazards of mercury and amalgam fillings.

IAOMT has taken the lead in educating dentists and allied professionals in the methods of safely dealing with amalgam fillings, and safely disposing the waste. It has also led the way in developing more biocompatible approaches in other areas of dentistry, including endodontics, periodontics and disease prevention.

About SafBaby’s Expert in Dental and Oral Care:
Biological Dentist Dr. Raymond Silkman 

dr. silkmanDr. Raymond Silkman has been providing holistic dental care to families for 25 years. His approach considers the interrelationships and influences of body structures, organs and systems as well as the overall nutritional and emotional health of each patient. These typically reveal the underlying causes of dental issues such as decay, periodontal disease, dental crowding and more. His incorporation of alternative health modalities has helped patients bring about profound changes in their well-being.

Dr. Silkman’s protocols also include safe removal and detoxification of toxic dental materials, conservative approaches to restorations, functional jaw orthopedics for proper jaw development and care for TMJ and orofacial pain.

Through nationwide lectures and his writings, Dr. Silkman educates about how prevention far outweighs the cure. He especially encourages mothers to be aware of the critical importance of nutrition during preconception and pregnancy which is when the foundation is laid for a child’s entire lifetime.

Dr. Silkman’s practice is based in Brentwood, California.