Youth and Teens (12-17y)

Getting a teenager to take care of his/her mouth can be demanding for a parent or caregiver. A transition in personal care and decision-making is beginning, and it is critical that the tween and teen understand that their behaviors and actions can set them on a course for a healthy mouth and pleasant smile in the years ahead. Consumption of sugary foods, sodas, juices and energy drinks all increase the risk of dental decay. Toothbrushing with fluoride toothpaste twice a day and between teeth cleaning at least once a day should become a normal part of daily personal cleanliness. Regular dental visits are important to monitor growth and development and assess the need for preventive treatments such as sealants and fluoride gels or varnishes.
 

Ask

About preventing tooth decay

How to reduce sugar in your teenager’s meals and snacks

About toothbrushing and between teeth cleaning

How frequently to visit the dentist

 

Tell

Your child’s dentist or dental hygienist if:

  • You are worried about your child’s dental health or the color of his/her teeth.
  • Your child is taking fluoride supplements or any prescription medicines, such as antibiotics.
  • Your child is about to start playing contact sports.
 

Do

Make sure your child is using a good, soft toothbrush and fluoride toothpaste, and carries out between-teeth cleaning as recommended by a dental professional.

Take your child for dental check-ups as frequently as your dentist or pediatrician advises.

Make sure your child wears a mouthguard that is well fitting every time he/she plays a contact sport.

 

Remember

Brush twice a day with fluoride toothpaste.

Floss or carry out interdental cleaning at least once per day.

No filling is the best filling.

Regular dental visits are the best way to keep your child’s dental development on track and healthy.

Take extra vigilant care during orthodontic treatment, having check-ups with both the orthodontist and the family dentist or pediatric dentist at the recommended time intervals.

 

 

Click on a question for more Information

What is the best way for me to prevent cavities in my growing children and teenagers?

Cavities or tooth decay are caused by the bacteria in dental plaque feeding on sugar in foods and drinks. Sugar causes the bacteria to produce harmful acids that dissolve minerals, such as calcium, out of the tooth.


There are three key actions you can do:

  • REDUCE SUGAR: Avoid sugary snacks and drinks between meals.
  • TOOTHBRUSHING TWICE A DAY: Teeth should be brushed for at least two minutes twice a day with fluoride toothpaste.
  • BETWEEN-TEETH CLEANING should start once the child’s teeth fit closely alongside one another. Use either interdental brushes, flossers specially designed for children, or dental floss.


Ask your dentist if sealants or topical fluoride treatments may be necessary to protect your child’s teeth from tooth decay.



Figure: Early stage tooth decay may occur either in the grooves on the biting surfaces or just above the gumline, between the teeth and out of sight. The first sign may be white spots near the gum line.



Figure: As decay advances through the tooth, it spreads into dentin and toward the nerve.

How often should I change my family’s toothbrushes?

Most dental professionals recommend that toothbrushes be replaced at least once every three months. It may be necessary to replace the brush more frequently if the bristles begin to look bent or splayed out or the brush-head looks worn.


Toothbrushes should not be shared, and should be rinsed clean of all toothpaste and left in the open air to dry after each use. Some dental professionals recommend that toothbrushes should also be replaced after suffering a cold or flu.



Figure: Note the difference between a new brush and one that is worn and with the bristles splayed out, which should be replaced.

Can teenagers get too much fluoride?

Fluoride is only needed in very small amounts, but it is the single most effective agent to prevent dental decay. After age 12, all the crowns of the permanent teeth are formed, so the risk of the visible effects of fluorosis (common in younger children who use too much fluoride toothpaste as well as other fluoride products) are much smaller. It is now reasonable to increase the amount of toothpaste to a strip of paste no longer than one inch. This will make sure all the fluoride necessary for toothbrushing is available to provide optimum protection from dental decay.


Most municipal water supplies are fluoridated at safe levels. If your water source is an independent well, or if you drink only bottled water, you will have to investigate the level of fluoride that the water contains. Discuss with your dentist, pediatric dentist, or pediatrician the ideal levels and sources of fluoride for your child’s individual circumstances.



Figure: For all those over 6 years of age, apply fluoride toothpaste no longer than a one-inch strip.

What are dental sealants?

Dental sealants are thin plastic coatings that are applied to the chewing surfaces of the back teeth to seal the grooves (fissures and pits on the surface). Most decay in children and teens occurs on these areas of the teeth. Ask your child’s dentist about the need for sealants to prevent decay. Not all children will need them. However, the risk of decay can change as the child grows, and sealants may be needed if the risk of decay increases. Sealants will provide protection for 5–10 years. They do not replace fluoride for cavity protection. Sealants work in those areas of risk where fluoride is not as effective. Their purpose is to keep dental plaque and food particles out of the areas on the biting surfaces, where particles can easily get trapped and not always be removed by toothbrushing.



Figure: The left tooth shows the normal fissure of a tooth before sealing. The right tooth shows the fissure system completely filled with a dental fissure sealant.

My child’s teeth look dark or stained. Can my child’s teeth be whitened?

Not everyone’s teeth are going to be bright white. Most teeth are slightly yellow or gray.

Some experts believe that the color of the teeth should match the shade of the whites of the eye.


Teeth that do not have a natural bright appearance can sometimes be “whitened.” However, success depends on the cause of any discoloration. If you are concerned about the color of your child’s teeth, seek the advice of a dentist. Teeth may become more yellow due to certain prescription medicines or a condition that dissolves away the enamel, allowing the more yellow dentin to show. Teeth may also look yellow if they simply are not being cleaned very frequently.



Figure: Teeth have many different shades and hues, even within the same mouth. Dentists have standard shade guides to assess tooth color.

Are amalgam (silver-mercury) fillings safe?

Yes, but the best dental filling material is no dental filling at all! All commonly used filling materials are safe, and dental amalgam has been in use for over 150 years. Some concerns are raised from time to time over the safety of dental amalgam fillings, as they contain mercury. The mercury added to the mixture of other metals when the filling is prepared forms a safe and stable material. The American Dental Association, the FDA, the Centers for Disease Control and Prevention, and the World Health Organization all agree that, based on all the scientific evidence available, dental amalgam is a safe and effective filling material.

Does my teenager need a cleaning appointment every six months?

Dental cleanings remove deposits and stains that can build up on teeth. Generally, if their oral hygiene regimen is good, few deposits and stains will occur. Your dentist will recommend the frequency with which they should have check-ups, and typically a cleaning will be performed immediately before the check-up so the teeth and gums can be thoroughly examined. Cleanings are not harmful and help keep your mouth looking good. Dental hygienists are the experts in helping everyone clean their mouth most effectively, as well as removing stains and deposits that build up between dental visits. Ask your dental hygienist for advice about cleanings and their frequency.

Are routine dental x-rays necessary?

Dental x-rays (radiographs) are a diagnostic tool and help the dentist detect conditions not always visible to the human eye. They can help detect dental decay and gum disease involving the bone, and they are helpful in monitoring a child’s growth and development. Your dentist will assess the benefit of gaining the additional information the x-rays will provide after reviewing your child’s dental history and examining their mouth, and then will advise whether or not x-rays are needed.


Many x-rays are now digital. Digital x-rays require even smaller levels of radiation and are safer for the environment, as no chemicals are necessary to develop the films.


Dental x-rays require very low levels of radiation exposure, and various protective mechanisms limit exposure to the rest of the body, such as a lead apron and thyroid collar.

Does my child really need to floss their teeth?

Mouth cleaning with a toothbrush alone is not enough. There are many areas between the teeth where the bristles of a toothbrush cannot reach.


Flossing will clean these areas and should be carried out at least once per day. Flossers are small easy-to-grip handles that are pre-loaded with floss, and are ideal for children learning to floss.


Cleaning between the teeth and other hard to reach areas can also be accomplished with interdental or interproximal brushes where space permits. These are generally much easier to use and are as effective.

What is the proper method for flossing?

It’s hard to get into the habit of flossing every day.

Cleaning between the teeth is important. Flossing can be challenging. A wide variety of floss is available in different thicknesses, textures and coatings. Flossers and floss handles are also helpful to position the floss between the teeth. You should seek the advice of your dental hygienist to establish the optimal method for your own situation.


Flossing is not for everyone, and many people find the use of interdental brushes much easier and equally as effective. Both flossing or interdental brushing remove dental plaque from between the teeth – if left undisturbed between the teeth, dental plaque builds up and can lead to cavities and gum disease.

How frequently should a child aged 12–17 years visit the dentist?

Regular frequency of dental visits should be determined in consultation with your dentist or pediatric dentist. Typically, a child in this age group should be seen every six months, but the dentist can advise more accurately based on the child’s growth, development, and risk of developing dental disease, especially new cavities.


A child undergoing any form of orthodontic tooth movement or therapy should visit both the orthodontist and the family dentist on the recommended routines. It is important to develop a schedule with both dental professionals for the overall oral health of the child. During orthodontic tooth movement, a child may be more at risk of developing cavities, or small white spots on their teeth around the orthodontic brackets and clasps—an early form of decay.

What is gingivitis and how can I prevent it?

Gingivitis is a common condition in which the gum margins become inflamed and appear red and swollen. The inflamed gums may bleed easily, especially during and immediately after toothbrushing or flossing. Healthy gums are pale pink and not swollen, forming a knife-edge appearance where they meet the tooth.


Gingivitis is caused by the build-up of dental plaque. Dental plaque is a biofilm of bacteria that causes the body to react by defending itself against the bacteria and their harmful byproducts. If dental plaque is not frequently and completely removed, it becomes harmful and the gums react to it through the process of inflammation.


If the dental plaque is removed by using correctly designed cleaning aids and a technique recommended by your dentist or dental hygienist, the gingivitis will subside and the gums return to their normal healthy state.


Gingivitis is reversible for most people. However, for some individuals, the build-up of dental plaque may lead to a much more serious condition known as periodontitis.


Thorough and regular removal of dental plaque is the best way to prevent it.



Figure: Healthy gums are pale pink and form a knife-edge at the gum margin where they give way to the crown of the tooth.



Figure: In early stage gingivitis, the gum margin begins to change from pink to red, especially between the teeth.



Figure: In moderate stage gingivitis, the gums become redder over a larger area, and look swollen and puffy.



Figure: In advanced stage gingivitis, the gums are very red, puffy, and swollen, and bleed very easily. There will generally be obvious deposits of plaque and calculus.

What is puberty gingivitis? My child is going through puberty and their gums look very red and bleed easily. Could this be puberty gingivitis?

Many changes occur in the body during puberty, and body systems that have worked normally may easily be disturbed during the process of puberty. One such disturbance is in the mouth when the gums may react much more aggressively to the presence of dental plaque.


The change in hormone levels in the blood stream affects both the gum tissues themselves and some of the bacteria in the dental plaque, as the hormones can pass through the gums and into the mouth itself, where the bacteria absorb them.


The effect on the gum tissues is to make them more reactive to the presence of the bacteria in the dental plaque. An effect on the bacteria is to release more harmful byproducts. Both of those effects are apparent by red and swollen gums that bleed easily.


Though unpleasant, the condition will pass with the conclusion of puberty. However, while the condition exists, it is important that the child work extra diligently to remove plaque on a daily basis, using their normal oral hygiene techniques and aids. Dental advice should be sought to assess the situation, and if needed, provide a prophylaxis to remove any build-up of plaque. Use of an anti-plaque rinse may be recommended depending upon the severity of the condition.



Figure: In puberty gingivitis, the changes in hormones result in an increased reaction of the body to the dental plaque. Note the redness of the gum tissue, a key sign of inflammation.

My child’s breath has an odor. I fear she/he may have bad breath.

Bad breath, sometimes referred to as oral malodor or halitosis, is a fairly common condition and, for most people, very transient. For others it can be more a permanent issue.


It is very normal to wake up in the morning with bad breath. The mouth can get dry at night as both the flow of saliva that normally keeps the mouth clean and fresh decreases and many people start to breathe through their mouth and/or snore, which further dry the mouth. Bacteria can grow and it is these bacteria, together with their waste products, that cause an odor. Early morning breath can be reduced by good oral hygiene before sleeping and then again early in the morning. Mild odor is fairly normal and nothing to worry about.


An odor that lasts throughout the day and is persistent over several days may be the sign of something more serious, such as an infection in the mouth, nose, or throat. Some malodor may also come from the stomach, especially if spicy or pungent foods are regularly eaten. Again, good oral hygiene will help, but it is wise to seek the advice of a dentist to check for oral conditions in the mouth such as gum disease and dental decay, or a physician to check for causes in the nasal passage and throat, as well as the stomach.


Experts believe most oral malodor originates on the surface of the tongue. Good oral hygiene should include tongue cleaning.

How can my teenager clean his/her tongue?

One of the most common sources of bad breath is the surface of the tongue. The surface of the tongue is made up of numerous grooves and ridges that trap bacteria and food debris.


Regular cleaning of the tongue should be part of good oral hygiene. Cleaning the tongue can be a challenge, as it is very sensitive or ticklish. The simplest way to clean the tongue is to brush its surface with your toothbrush as you finish brushing all your teeth. Many people find this difficult, as the surface is very soft and spongy. Specially designed tongue-cleaners are shaped in accordance with the contours of the tongue, and they easily lift off the bacterial biofilm, food debris, and dead cells, which together produce bad-smelling compounds and gases – the most common causes of bad breath, also known as oral malodor or halitosis.


Your dental hygienist can help you in determining the most effective way to clean your tongue. If you believe you have bad breath, or people tell you that your breath odor is unpleasant, consult your dentist or dental hygienist so they can investigate the source and help you overcome it.



Figure: The surface of the tongue is made up of numerous grooves and ridges that trap bacteria and food debris.

Is Xylitol Chewing Gum good for my oral health?

Chewing sugar-free gum has been shown to promote good dental health when used regularly after meals. Xylitol is a synthetic sweetening agent that is processed from xylan, extracted from birch trees. Xylitol has been studied over many years and has been shown to be both safe and effective when used to promote oral health. Sugar (sucrose) present in many foods and beverages as an added ingredient can cause tooth decay, as the bacteria in the dental plaque easily convert sugar into acids that will destroy the teeth. Xylitol cannot be converted by the bacteria, so it does not cause any acid production. For this reason, xylitol is added to items like chewing gum and sugar-free candies, as a sugar substitute, to help reduce tooth decay. When selecting a xylitol product for its oral health benefits, check the ingredients to confirm that there are no additional sugars.

Should my child wear a mouthguard during athletics and sports?

Mouthguards, or mouth protectors, help cushion a knock to the teeth and jaws. Many sports increase the risk of injury to the mouth and face. While collision or contact sports have the greatest risk of injury, some non-contact activities, such as gymnastics, also pose a risk. Typically, the mouth can be protected from accidents by wearing a properly constructed and professionally fitted mouthguard. Mouthguards are an essential item of athletic gear that should be used from an early age


Seek the advice of your dentist, pediatric dentist, or pediatrician before your child engages in sports that increase the risk of injury. The most effective mouthguards are professionally-fitted and made at the dental office. However, they tend to be the most expensive. Other types can be purchased in sports stores and drug stores. Although these do not fit as well, they still provide some protection from permanent injury.


Remember to have the mouthguard examined at each dental check-up visit. A loose-fitting mouthguard may not be as effective, and one that has become too tight due to the child’s growth may damage the mouth.

How should a mouthguard be cared for and kept hygienically clean?

  • Rinse it in warm water before and after each use.
  • Occasionally brush it with a toothbrush and toothpaste or wash in soapy water.
  • Do not place in a dishwasher; the heat will cause distortion
  • Store the mouthguard in a container that has vents, and try to avoid leaving it among sweaty athletic clothing where fungi may easily grow.

 

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