Sippy cups, juice and raising cavity-free kids

A sippy cup looks like harmless toddler gear. It keeps the carpet clean, it keeps the car ride quiet, and it gives a small child something to carry around. The trouble is not the cup itself. The trouble is what goes in it and how often it gets sipped.

Why the sipping matters more than the sugar

Cavities start when bacteria in the mouth feed on sugars and make acid. That acid softens the outer layer of the tooth, called enamel. Saliva works to wash the acid away and put minerals back, but it needs time to do that job. Every sip of a sugary drink restarts the acid attack, and a child who carries a cup of juice around all morning never gives saliva a break.

That is why a glass of juice with lunch does less harm than the same amount sipped slowly over three hours. The sugar is the same. The exposure is not. A sippy cup, especially one with a valve that lets a child draw out a little at a time, makes constant sipping very easy.

Baby teeth also have thinner enamel than adult teeth, so acid gets through faster. Parents sometimes figure baby teeth do not matter because they fall out anyway. They matter more than people think. They hold space for the adult teeth coming in behind them, they help a child chew and speak, and a sore tooth makes a small child miserable. A cavity that reaches the nerve of a baby tooth can call for real treatment.

What belongs in the cup

Water is the easy answer for anything a child carries around between meals. Plain milk is fine with a meal or a snack, and then the cup can go in the sink. Juice, flavored milk, sports drinks, soda and anything sweetened are best kept to mealtimes, served in a regular open cup, in small amounts. Juice sold as 100 percent fruit still contains natural sugar, and the bacteria in a mouth cannot tell the difference.

A few habits make the biggest difference:

• Treat the sippy cup as a stepping stone. Many families start moving toward an open cup or a straw cup somewhere around the first year, and your child's doctor or dentist can help you time it.
• Fill the cup with water between meals, and keep juice and milk at the table.
• Do not let a cup become a pacifier for errands, car rides and long afternoons on the couch.
• Take the cup away when it is empty rather than leaving it in a small hand to be chewed and dribbled on.
• Rinse or wipe the mouth with water after sweet drinks when brushing is not practical.

Bedtime is the riskiest time

When a baby falls asleep with a bottle of milk or juice, the liquid pools around the upper front teeth for hours while saliva flow is at its lowest. Dentists call this baby bottle tooth decay. The upper front teeth are usually hit first. Early damage can look like chalky white lines near the gum, then turn into brown spots, then into chipped or crumbling edges.

The fix is simple, even if the bedtime routine is hard to change. Finish any milk or juice before brushing, brush, and then offer water only. If your child needs a bottle or cup to settle down, make it plain water. Brushing should be the last thing that touches the teeth at night.

Brushing, flossing and what to watch for

Brushing should begin when the first tooth appears. Use a soft, child-size brush and a tiny smear of fluoride toothpaste, about the size of a grain of rice, until your child can spit reliably. After that, a pea-size amount is the usual guideline. Young children cannot brush well on their own, so plan to do the brushing yourself or to finish the job after they have had a turn, well into the early school years.

Once two teeth touch each other, a toothbrush cannot reach the tight space between them. That is the time to start flossing. A child-size floss pick can make it easier for a parent to reach.

Cavities in children are easy to miss, because kids rarely say anything until a tooth hurts. Look in your child's mouth now and then, especially at the upper front teeth. Call your dentist if you notice any of these:

• White, chalky bands or lines near the gumline
• Brown or dark spots on any tooth, or a tooth that looks chipped
• Swollen or red gums, or a small bump on the gum
• A child who pulls away from cold, hot or sweet foods, or who chews on only one side

Bring your questions to the dentist

Mill Creek Family Dental treats children and adults, and Dr. Cronkhite and his team share dental care tips so parents can raise cavity-free kids. The practice says it does not judge or criticize, so ask the things you have been wondering about, from how to handle a child who refuses to brush to when to move on from the bottle. If you are in Lafayette and want to set up a visit for your child, call 765-471-6025. The office is open Monday through Thursday from 8 AM to 5 PM and Friday from 8 AM to 1 PM.