Infants who fall asleep drinking from a bottle have a greater chance of tooth decay. Prolonged thumb-sucking can cause crooked teeth. And children younger than 2 years old should not use fluoridated toothpaste.

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Parents should make their children's dental health a priority, said Dr. Derek Tom, a pediatric dentist in 'Aiea.

Especially considering the statistics: Tooth decay is nearly 100 percent higher among Hawai'i children than among children on the Main-land, according to Healthy Smiles Hawai'i, a dental health education program by Dental Health Hawai'i.

"We like to start seeing children from an early age to rule out any form of pathology — cysts, tumors, abscesses — or habits that may affect jaw or tooth development," Tom said. "Baby-bottle tooth decay, fluoride supplements, space maintenance and pre-orthodontics need to be evaluated from an early age."

Tom addresses some common questions parents have about dental health for their children:

Q. When should my child first see a dentist?

A. Your child should visit a pediatric dentist when the first tooth comes in, usually between 6 and 12 months of age. The earlier the dental visit, the better the chance of preventing dental problems like baby-bottle tooth decay. Children with healthy teeth chew food easily, learn to speak clearly and smile with confidence.

Q. How can I prevent tooth decay from bottle feeding or nursing my child?

A. Encourage your children to drink from a cup as they approach their first birthday. Children should not fall asleep while breast feeding or with a bottle. At-will nighttime breast-feeding should also be avoided after the first baby teeth begin to erupt. Children should be weaned from the bottle at 12 to 14 months of age.

Q. Should I worry about thumb- and finger-sucking?

A. Thumb-sucking is perfectly normal for infants; most stop by age 2. If your child does not, discourage it after age 4. Prolonged thumb-sucking can cause crowded, crooked teeth or bite problems. Your pediatric dentist can suggest ways to address a prolonged thumb-sucking habit.

Q. Should my child be taking fluoride supplements or using a fluoridated toothpaste?

A. Children under 2 years of age should not use a fluoridated toothpaste, as it puts them at risk for enamel fluorosis. Since most of the water in Hawai'i is not fluoridated (military housing is the exception), a fluoride supplement is usually prescribed for your child at 6 months of age. Starting a regulated fluoride supplement early in life can decrease cavities in baby teeth, and in permanent teeth as well.

Q. Do sports drinks have any harmful effects on teeth?

A. According to the American Journal of General Dentistry (spring 2005) sports drinks have been found to cause more damage to teeth than soda. Since we live in a climate that requires drinking a lot of fluids, and youth sports are very popular in Hawai'i, those who consume sports drinks are at risk of developing cavities. Drinking lots of water and rinsing with water after drinking sports drinks is highly recommended.

Reach Zenaida Serrano at zserrano@honoluluadvertiser.com.