Dental Care For Your Baby

Perinatal & Infant Oral Health

The American Academy of Pediatric Dentistry (AAPD) recommends that all pregnant women receive oral healthcare and counseling during pregnancy. Research has shown evidence that periodontal disease can increase the risk of preterm birth and low birth weight. Talk to your doctor or dentist about ways you can prevent periodontal disease during pregnancy.

Additionally, mothers with poor oral health may be at a greater risk of passing the bacteria which causes cavities to their young children. Mother's should follow these simple steps to decrease the risk of spreading cavity-causing bacteria:

• Visit your dentist regularly.
• Brush and floss on a daily basis to reduce bacterial plaque.
• Proper diet, with the reduction of beverages and foods high in sugar & starch.
• Use a fluoridated toothpaste recommended by the ADA and rinse every night with an alocohol-free, over-the-counter mouth rinse with .05 % sodium fluoride in order to reduce plaque levels.
• Don't share utensils, cups or food which can cause the transmission of cavity-causing bacteria to your children.
• Use of xylitol chewing gum (4 pieces per day by the mother) can decrease a child’s caries rate.

Baby Bottle Tooth Decay (Early Childhood Caries)

One serious form of decay among young children is baby bottle tooth decay. This condition is caused by frequent and long exposures of an infant’s teeth to liquids that contain sugar. Among these liquids are milk (including breast milk), formula, fruit juice and other sweetened drinks.

Putting a baby to bed for a nap or at night with a bottle other than water can cause serious and rapid tooth decay. Sweet liquid pools around the child’s teeth giving plaque bacteria an opportunity to produce acids that attack tooth enamel. If you must give the baby a bottle as a comforter at bedtime, it should contain only water. If your child won't fall asleep without the bottle and its usual beverage, gradually dilute the bottle's contents with water over a period of two to three weeks.

After each feeding, wipe the baby’s gums and teeth with a damp washcloth or gauze pad to remove plaque. The easiest way to do this is to sit down, place the child’s head in your lap or lay the child on a dressing table or the floor. Whatever position you use, be sure you can see into the child’s mouth easily.

Sippy Cups

Sippy cups should be used as a training tool from the bottle to a cup and should be discontinued by the first birthday. If your child uses a sippy cup throughout the day, fill the sippy cup with water only (except at mealtimes). By filling the sippy cup with liquids that contain sugar (including milk, fruit juice, sports drinks, etc.) and allowing a child to drink from it throughout the day, it soaks the child’s teeth in cavity causing bacteria.

Caring for Gums

Even before your baby’s first tooth appears, the gums can benefit from your careful attention. After breast- or bottle-feeding, wrap one finger with a clean, damp washcloth or piece of gauze and gently rub it across your baby’s gum tissue. This practice both clears your little one’s mouth of any fragments of food and begins the process for building good daily oral care habits.

Baby’s First Tooth

When that first tooth makes an entrance, it’s time to upgrade to a baby toothbrush. There are usually two options: a long-handled toothbrush that you and your baby can hold at the same time, and a finger-puppet-like brush that fits over the tip of your pointer finger. In each case, the bristles are soft and few.

At this stage, toothpaste isn’t necessary; just dip the brush in water before brushing. If your little one doesn’t react well to the introduction of a toothbrush, don’t give up. Switch back to a damp washcloth for a few months and try the toothbrush again. During the teething process, your child will want to chew on just about anything, and a baby toothbrush with a teether can become a favorite toy during this period.

Brushing with Toothpaste

When a few more teeth appear, you can start using toothpaste with your child’s brush. At this stage, use only a tiny amount of fluoridated toothpaste (the size of a grain of rice). From the beginning, have your little one practice spitting the toothpaste out after brushing, which should not be swallowed at any age.

Avoiding Cavities

Don’t give your baby any sort of sweetened liquids such as flavored drinks or soda. Even the sugars present in fruit juice, formula, and milk (this goes for breast milk as well) can cause decay, so regular teeth and gum cleaning is vital. Also, make sure your baby never goes to bed with a bottle; sugary liquids in prolonged contact with teeth are a guarantee for early-childhood decay, also called baby-bottle caries.

First Visit to the Dentist

It’s recommended that you bring your baby in for a visit within six months of the first tooth’s eruption – usually around his or her first birthday. Since decay can occur in even the smallest of teeth, the earlier your baby visits us, the more likely he or she is to avoid problems. We’ll look for any signs of early problems with your baby’s oral heath, and check in with you about the best way to care for your little one's teeth. Remember that preparing for each dental visit with a positive attitude goes a long way toward making your child comfortable with regular checkups.

Thumb Sucking

Sucking is a natural reflex and infants and young children may use thumbs, fingers, pacifiers and other objects on which to suck. It may make them feel secure and happy, or provide a sense of security at difficult periods. Since thumb sucking is relaxing, it may induce sleep.

Thumb sucking that persists beyond the eruption of the permanent teeth can cause problems with the proper growth of the mouth and tooth alignment. How intensely a child sucks on fingers or thumbs will determine whether or not dental problems may result. Children who rest their thumbs passively in their mouths are less likely to have difficulty than those who vigorously suck their thumbs.

Children should cease thumb sucking by the time their permanent front teeth are ready to erupt. Usually, children stop between the ages of two and four. Peer pressure causes many school-aged children to stop.

Pacifiers are no substitute for thumb sucking. They can affect the teeth essentially the same way as sucking fingers and thumbs. However, use of the pacifier can be controlled and modified more easily than the thumb or finger habit. If you have concerns about thumb sucking or use of a pacifier, consult your pediatric dentist.

A few suggestions to help your child get through thumb sucking:

• Children often suck their thumbs when feeling insecure. Focus on correcting the cause of anxiety, instead of the thumb sucking.
• Children who are sucking for comfort will feel less of a need when their parents provide comfort.
• Reward children when they refrain from sucking during difficult periods, such as when being separated from their parents.
• Your pediatric dentist can encourage children to stop sucking and explain what could happen if they continue.
• If these approaches don’t work, remind the children of their habit by bandaging the thumb or putting a sock on the hand at night. Your pediatric dentist may recommend the use of a mouth appliance.

What Is Pulp Therapy?

The pulp of a tooth is the inner, central core of the tooth. The pulp contains nerves, blood vessels, connective tissue and reparative cells. The purpose of pulp therapy in Pediatric Dentistry is to maintain the vitality of the affected tooth (so the tooth is not lost).

Dental caries (cavities) and traumatic injury are the main reasons for a tooth to require pulp therapy. Pulp therapy is often referred to as a "nerve treatment", "children's root canal", "pulpectomy" or "pulpotomy". The two common forms of pulp therapy in children's teeth are the pulpotomy and pulpectomy.

A pulpotomy removes the diseased pulp tissue within the crown portion of the tooth. Next, an agent is placed to prevent bacterial growth and to calm the remaining nerve tissue. This is followed by a final restoration (usually a stainless steel crown).

A pulpectomy is required when the entire pulp is involved (into the root canal(s) of the tooth). During this treatment, the diseased pulp tissue is completely removed from both the crown and root. The canals are cleansed, disinfected and, in the case of primary teeth, filled with a resorbable material. Then, a final restoration is placed. A permanent tooth would be filled with a non-resorbing material.

Setting a Good Example

As part of the natural learning process, little ones are expert mimics, and you can take advantage of this talent. Brush and floss daily while your child is watching, and he or she will intuit at an early age the importance of your good habits. As soon as your child shows interest, offer a toothbrush of his or her own and encourage your toddler to “brush” with you. (You’ll find toothbrushes with chunky, short handles that are easy to grip.)

Most children don’t have the dexterity necessary to thoroughly clean their own teeth until they’re about six or seven, so you’ll have to do that part of the job. Try different tactics to make brushing fun: flavored toothpaste, a toothbrush with a favorite character on it, or singing songs about brushing. The primary goal is to instill healthy oral habits at an early age to set your child up for a lifetime of healthy, cavity-free teeth!