What to Expect the Toddler Years (169 page)

Sound defense.
There are numerous reasons to protect your toddler by putting up a sound defense against loud noises. Exposure to excessive noise has been associated with noise-induced hearing loss (NIHL); can hamper a child’s ability to learn to communicate through language and to receive other auditory signals (such as the warning honk of a car horn); can quicken pulse and heartbeat, affect other body systems, and interfere with sleep;
and can be annoying (for a particularly sensitive child, it can be almost maddening). So it makes sense to keep your toddler’s environment as free of loud and extraneous noise as possible, by following these ear-healthy recommendations:

When buying new appliances or power tools, look for those that are quieter.

Monitor the volume of television, radio, and stereo in your home; maximum volume should never be louder than normal speech. A “limiter,” available on some such appliances, can be helpful; it allows you to set a maximum volume. Be vigilant, too, when your child is using earphones. If you can hear the sound when the earphones are in use, the volume is probably too high. Keep in mind, however, that if you’ve spent years listening to loud rock music (or have experienced long-term exposure to other kinds of loud noise), you probably have some hearing loss yourself and may not be a good judge of what is “too loud.”

Prohibit very noisy toys, such as cap pistols.

In noisy situations, where you need to shout in order to be heard (when, for example, you’re attending rock concerts, fireworks displays, riding the subway, mowing the lawn, blowing snow, or using other power tools), tuck soft foam
ear plugs (available at pharmacies) in your toddler’s ears or supply him or her with sound-proofing “ear muffs.” If you use these yourself, it will probably be easier to persuade your toddler to follow your model.
Do not
rely on wadded-up cotton balls or tissue paper to do the job because these materials allow damaging sound waves to pass through, even if the sound seems muffled.

Teach your child to cover his or her ears when unexpectedly encountering a loud noise (such as a fire engine’s blaring siren).

If you live in a high noise area (near an elevated train or an airport, for instance; see page 486), try to reduce noise levels inside your home. When your child plays outdoors, soundproofing “ear muffs” may be useful (but be sure your child can hear speech, auto horns, and so on, with the ear muffs in place).

Teach your child never to shout in anyone else’s ears or to let someone shout in his or her ears. And practice the sound control you preach; try never to scream loudly—at least not in or near your toddler’s ears.

The toddler years are a busy, busy time in a child’s mouth. While some children bite into their first birthday with only a single tooth, most sport a full set of twenty primary teeth by the time they turn three (see page 491). Though these “baby” teeth aren’t “for keeps,” they must take a child through the next five to ten years of eating; the last of them won’t be replaced by permanent teeth until somewhere between ages twelve and fourteen. And since each tooth is vulnerable to decay from the moment it breaks through the gum, it’s important to make good dental hygiene a priority early on.

Professional care.
There is general agreement that keeping a toddler’s teeth healthy requires a three-way partnership of child, parent, and dentist. There isn’t complete agreement, however, on when the dentist’s involvement becomes necessary. The American Academy of Pediatrics (AAP) currently recommends a first visit to the dentist by the age of one. Likewise, the American Academy of Pediatric Dentistry (AAPD) advises that visits to the dentist begin as soon as his or her first tooth appears, or by age one, whichever comes first. However, some pediatric dentists do not schedule appointments for a child who doesn’t have a dental problem until age two and a half.

When you decide to schedule that first dental visit will depend on the condition of your toddler’s teeth as well as on his or her doctor’s advice, the recommendation of the dentist, and your own judgment. Any signs of abnormality (an open, unaligned, or otherwise “bad” bite, misaligned teeth; dark spots or uneven coloration on the teeth) require a prompt dental evaluation. Early attention to dental problems can prevent not only the premature loss of primary teeth from decay, but mouth irregularities (malocclusions) that may interfere with speech development.

When selecting a dentist, keep in mind that a pediatric dentist has had additional training in the treatment of children, is familiar with their special needs, and is better prepared than a general dentist to deal with their fears, questions, and restlessness in the dental chair.

A professional cleaning every six months, once all the teeth are in and regular dental visits begin, will help protect gums as well as teeth from the ravages of plaque (which actually starts forming in a
baby’s mouth
before
the teeth arrive). Fluoride treatments (see page 492) will help strengthen tooth enamel. Later on, when the first of the permanent molars are in (around the age of six or seven), the dentist may apply a protective sealant (a thin, clear, or light-colored plastic coating) to chewing surfaces. This sealant fills in the pits and crevices in the chewing surfaces and prevents the trapping of debris and the colonization by decay-causing bacteria. Sealants should not replace regular brushing and flossing, however.

For dealing with fear of the dentist, see page 308.

Home care.
Good dental health that lasts a lifetime depends on acquiring the habit of daily dental care. So, if you haven’t already done so, get your toddler into the habit of brushing regularly each morning and evening (and after lunch, too, when possible).

Select a toothbrush designed for young children (some brands specify on the box the age group the brush is appropriate for), with a small head and soft, rounded bristles. There are many brushes made for little fingers that make positioning the brush easier, and many come decorated with favorite cartoon characters. Some models have lights that flash or that play music for 2 minutes—the amount of time the American Academy of Pediatric Dentistry recommends children spend brushing. Whichever kind you use, remember to rinse the toothbrush thoroughly after each use, and keep it in a holder, rather than lying around where it can pick up bacteria. Replace the brush after three months, or sooner if it’s looking worn—and never allow the sharing of toothbrushes, even among family members. Also replace the brush after your child’s been sick so that germs hidden in the bristles won’t cause reinfection.

Brush your toddler’s teeth with a gentle back and forth motion across the chewing surfaces; use a circular motion along the sides and the outer gum lines, a back-and-forth motion on inner surfaces, if you can. Lightly brush the gums where teeth haven’t yet erupted, or wipe them with a gauze pad, baby finger brush, or washcloth. Skip the toothpaste until your toddler is able to rinse and spit out the residue or use an infant/toddler tooth and gum cleanser that is nonabrasive, nonfoaming, and fluoride-free.