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" Pop quiz: What&amp;#039;s the number one chronic disease affecting 5- to 17-year-old kids in America today?   Give yourself an A+ if you answered tooth decay. More than one-fourth of children ages 2 to 4 have dental decay, and by ages 6 to 8 half have cavities, according to the Centers for Disease Control (CDC). The good news? &amp;quot;Dental decay is largely avoidable if parents take the proper preventive measures starting before baby teeth come in,&amp;quot; assures David M. Perry, D.D.S., chairman of the Dental Health Foundation. Here, easy-to-enforce guidelines for keeping kids&amp;#039; smiles bright and beautiful.   What to Do Before Teething Begins  Don&amp;#039;t swap saliva. Seemingly innocent habits like sharing a spoon with your little one can pass on decay-causing bacteria found in your saliva. And unfortunately, young infants may be particularly vulnerable to these bacteria: There&amp;#039;s a critical period as teeth erupt when &amp;quot;good&amp;quot; oral bacteria compete with &amp;quot;bad&amp;quot; acid-producing ones to establish dominance in the mouth, says H. Pitts Hinson, D.D.S., former president of the American Academy of Pediatric Dentistry. If the bad bacteria win, they&amp;#039;ll make a child more prone to tooth decay for life. Of course, the easiest way to keep your bacteria to yourself is to avoid swapping spit. But if you must sample a spoonful of those pureed peaches, chew gum made with the sweetener xylitol, such as Carefree Koolerz, beforehand: A recent study found that infants whose moms chewed xylitol gum had 70 percent fewer cavities at age 5 than those whose mothers didn&amp;#039;t. Exactly how xylitol fights cavities is unclear, but researchers have a theory: &amp;quot;Oral bacteria can&amp;#039;t break it down for fuel, so they lack the energy to procreate or produce tooth-decaying acids,&amp;quot; says Perry.  Give gums a gentle swipe. After feeding, wipe your baby&amp;#039;s mouth, gums, and tongue with a moist cloth, says Pitts Hinson. &amp;quot;This removes the food residue that feed cavity-causing bacteria, so that when teeth do erupt, your child&amp;#039;s oral bacteria count will be low,&amp;quot; he says. What to Do When the First Tooth Erupts  Brush without fluoride. Brush baby teeth with a soft-bristled brush and fluoride-free toothpaste in the morning and at night, says Pitts Hinson. Excessive swallowing of and long-term exposure to fluoride can cause fluorosis, a condition characterized by white streaks on teeth (see next page for more info). &amp;quot;Children this age can&amp;#039;t spit well, so they&amp;#039;re likely to inadvertently ingest the toothpaste,&amp;quot; says Perry. Continue to help your child brush her teeth until she can manage it on her own.  Visit the dentist. Make your baby&amp;#039;s first dental appointment when his first tooth appears, and schedule one every six months thereafter. During the appointment, ask if fluoride supplements \u2014 tablets, drops, or lozenges \u2014 are necessary. &amp;quot;A dentist will make this decision based on factors such as fluoride levels in your local water and your child&amp;#039;s age and diet,&amp;quot; says Pitts Hinson. (To find out about fluoride levels in your water supply, contact your local water utility company; optimal levels are between 0.7 and 1.2 parts fluoride per 1 million parts water.) Finally, ask about a fluoride varnish, a concentrated fluoride resin that&amp;#039;s brushed on teeth two or three times a year. It&amp;#039;s not always covered by dental insurance (try claiming it as a &amp;quot;topical fluoride application&amp;quot;), but a study of children ages 6 months to 3 and a half years found that those who had biannual fluoride varnishes cut their risk of developing tooth decay by almost 75 percent. What to Do Between Ages 2 and 5  Switch to a &amp;quot;big kid&amp;quot; fluoride toothpaste. Once your child is able to spit, begin using a fluoride toothpaste \u2014 but use only a pea-size amount to minimize accidental ingestion. &amp;quot;If your child has trouble hitting the sink, get her a fun, colorful bathroom cup specifically for spitting into,&amp;quot; says Robin Lucas, D.M.D., a general and cosmetic dentist in Hoboken, NJ, and a mom of two. &amp;quot;It teaches her to spit in a controlled manner, while catching any wayward foam.&amp;quot;  Make brushing an adventure. Many dentists advise two minutes of brushing \u2014 one minute on the upper teeth and one on the lower. But try making that happen with a go-go-go toddler. To get yours to keep at it, Pitt Hinson suggests playing the &amp;quot;road-map game&amp;quot;: Tell him to imagine his toothbrush is an explorer taking a trip around his mouth, and the adventure isn&amp;#039;t over until the brush has visited all the teeth, front and back.  What to Do Through Adolescence  Seal in healthy teeth. As your child&amp;#039;s permanent molars start erupting, her dentist will determine whether she needs dental sealants. These adhesive coatings \u2014 applied to the molars&amp;#039; crevices and pits \u2014 serve as a barrier against tooth-attacking food and bacteria. Unlike fluoride varnish, sealants are being covered by more dental insurance plans. Considering that, according to the CDC, kids who receive sealants have 60 percent fewer new instances of decay in the back teeth (where 90 percent of decay occurs) for up to five years after a single application, that&amp;#039;s news to smile about.  Are your kids getting too much fluoride? Dental fluorosis \u2014 a condition caused by excess fluoride exposure that creates white streaks on teeth \u2014 has increased by 9 percent among kids ages 6 to 19 in the past 20 years, according to recent analysis by the CDC. The rise is small \u2014 but is it cause for alarm? &amp;quot;There&amp;#039;s no evidence of any negative health effects linked with dental fluorosis,&amp;quot; says Mary J. Hayes, D.D.S., an American Dental Association spokesperson. &amp;quot;And fluoride is an invaluable tool against tooth decay.&amp;quot; "^^<http://www.w3.org/2001/XMLSchema#string>
<http://www.redbookmag.com/life/mom-kids/advice/a235/safeguard-smiles-hl/>