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Good habits make for healthy teeth

Start early for lasting care

Recommendations for healthy teeth from babyhood through adolescence

A young patient shows off her ‘Cavity Free Rockstar” certificate with dentist, Neesha Duggal of Wurtsboro Dental, in Wurtsboro, Orange County.  

When Julie Jones' 14-year- old daughter spent an overnight at a friend's house, she forgot her toothbrush. As soon as she got home, she told her mom that she needed to brush teeth right away.

Not every teen might have had that reaction, but there's a reason this one did.

"It all goes back to habits," said Jones, of a cornerstone of good dental health that she's incorporated into her daughter's care. "It's routine and habits."

As a mother of three in Kingston who works with Family of Woodstock Inc. that provides services for families in need, Jones is well-aware of the challenges many parents may face in getting good dental care.

"I believe it's always a parent's intention to do their best, but sometimes all the other pieces are missing," she said, of obstacles that may keep kids out of the dental chair, such as transportation, childcare issues, or budgetary constraints. 

But there are other cases, Jones said, where adults who don't pay attention to their dental health, don't see the value of why it's important for their child. A pivotal moment for Jones was when a dentist told her that people only get one set of teeth.

 "When my girls were young, we were all in (the bathroom) brushing together," she said. "It was a moment we could spend together and there was a lot of laughter," along with a brushing routine.

For the little ones, Jones suggested that parents brush their child's gums or gently massage them when their teeth start to come in. Then, by pre-school, a children's book on dental care or a model of the teeth can help get kids invested in about caring for their own.

A pediatrician and dental visits also play important roles, said Jones, since getting a toothbrush kit can put a smile on kids' faces.

Dentist has key role. Dentist, Neesha Duggal, of Orange County and a graduate of Goshen High School grew up shadowing her father, Paul Duggal a dentist and head of a long-time dental practice in Middletown. Duggal, the mother of a three-year-old son, now runs her own practice, Wurtsboro Dental, in Wurtsboro.

Early on, Duggal said, children's pediatricians typically start kids on supplemental fluoride drops. But by the time children are two and their baby teeth have grown in, kids should begin dental visits.

"This is a quick exam and the child can sit on Mom or Dad's lap and be comfortable," said Duggal. "They may learn a little about the toothbrush and mirror the hygienist or dentist will use, but the main objective here is to begin a relationship with the dentist's office and to prevent dental phobia. There may be a little exam or cleaning."

Duggal said these early, easy interactions help form a trust and comfort level that will make future care a positive experience, even if more involved treatment is needed.

"Mom and Dad are the most crucial part in all of this," Duggal said. "They can be part of a routine visit and take tools home to use."

Fluoride, said Duggal, can help slow the rate of decay. The chronic disease occurs in one-in-four children who do not have access to fluoridated water or other readily available sources of fluoride.

"They can miss school, have speech delays and poor nutrition because dental health is preventing them from eating," Duggal said. "It's all intertwined." 

READ MORE: Find a dentist for your family

With February being National Children's Dental Health Month, Duggal plans to go into local schools and daycares, including her son's preschool, with an educational program on dental care. She's also working with the Monticello school district to provide programs for middle- and high school-aged students.

"Middle school students are not getting enough education on dental health," she said. "They still need reminders. Parents may think their kids know at this point, but they don't, or they need a reminder."

Healthy dental habits come down to a long-standing relationship with your dentist, said Duggal, including dental hygiene practices that become a part of kids' routines.

"You want the child to have trust in their dentists and not be traumatized," she said. "If you don't come back for two to three years, that's when problems can arise."

And, for those teens that don't have good dental habits or a positive relationship with a dentist, Duggal re-introduces them to the right way to brush their teeth and reminds them that their teeth are the only set they're going to have.

Important, said Duggal, are brushing twice a day, seeing the dentist twice a year, and getting the appropriate amount of sodium fluoride to help prevent cavities and support enamel formation.

"We'll talk about juice and candy and other sweets," she said of the relevance of diet. "For instance, an apple is better than apple juice."

Hygienist tips. Greenville resident, Liz Brown, a hygienist at Wurtsboro Dental and mother of two grown children said when it comes to getting up to speed on dental care, it's about education.

"When I started out, I didn't always realize the right way to do things," said Brown, talking about raising her children before she worked in the field of dentistry. 

Nowadays, she's seeing more parental concern about their child's teeth and dental health. For instance, making time for a six-month check-up and cleaning that includes removing tartar (dental calculus) which can trap bacteria helps prevent gums from getting inflamed.

As well, children's floss picks are available and, if needed, parents can help with their child with flossing.

"As regular floss can be awkward, (electric water flossers like) Waterpik are another good tool, as is an electric toothbrush," said Brown, adding that they can bring efficiency and fun technology to the process.

READ MORE: Honoring the tooth fairy

For young children that don't have the coordination to brush properly, Brown said parents can start them on the brushing process, then let the child finish for a sense of accomplishment.

Also important is fluoride's part in dental care, with fluoridation in most counties in the Hudson Valley specific to a town or area, such as a housing development (find out if your water district is fluoridated at

Dentists, said Brown, will look at how much fluoride a child is getting from available sources and proceed from there, possibly prescribing fluoride vitamins.

"It's important to start at a young age with drops or chewable vitamins," she said. "Fluoride toothpaste isn't swallowed and isn't enough. Vitamins with fluoride will help protect the baby teeth but it also goes into the adult teeth that are being formed so it's a dual purpose."

The back teeth (pre-molars) maintain the space for adult teeth that come in around ten years old and the front baby teeth do the same for permanent teeth come in between five and seven years old.  

Many dental teams offer nutritional counseling, including brushing after eating sweets. For example, products such as fruit roll ups and gummy vitamins stick to the teeth, said Brown, leaving troublesome residue on them if they're not brushed after enjoying the treats.  

She also advised against using a bottle with milk or sweet substances with the child overnight. "That causes problems," Brown said, since long exposure to the sugars in these products allows them to pool around teeth and increase the incidence of tooth decay.

Olivia L. Lawrence is an editor for a news organization. She likes to spend her free time outside gardening or otherwise enjoying nature.