Tips for Parents

Tips for Parents
Baby Bottle Tooth Decay

Baby Bottle Tooth Decay, Baby Bottle Syndrome, and Nursing Bottle Mouth are all terms used to describe a dental condition which involves the rapid decay of many or all of the baby teeth of an infant or child.

The teeth most likely to be damaged are the upper front teeth. They are some of the first teeth to erupt and thus have the longest exposure to sugars from bottle feeding. The lower front teeth tend to be protected by the tongue as the child sucks on the nipple of the bottle or the breast.

Baby Bottle Tooth Decay is caused by frequent exposure to liquid containing sugars for extended periods of time.
When your baby falls asleep with a bottle containing formula, milk or juice; a pacifier dipped in honey; or while breast feeding, liquids pool around the front teeth. During sleep, the bacteria present in all babies' mouths turns the milk sugar or other sugars to acids which cause decay.

Parents may not know there is a problem until serious damage has been done. Oral checks should be performed by parents to detect early signs of decay such as brown spots along the gum line; a preference for soft foods; frowning or crying when eating cold, sweet, or hard foods. If these symptoms are present, the child should be seen by a dentist to check for tooth decay.

By the time decay is noticed, crowns, pulp therapy, or even extraction of the decayed teeth may be necessary. As a result, your child may suffer from long term disorders which include speech impediments, possible psychological damage, crooked or crowded teeth, and poor oral health. You can prevent this from happening to your child's teeth by learning how to protect them.
  • Clean your child's teeth daily.
  • Never allow your child to fall asleep with a bottle filled with juice, milk, or formula (or when awake, sip on it for long periods of time as a pacifier).
  • Start bottle weaning by at least a year.
  • Give your child plain water for thirst.
  • Make sure your child gets the fluoride needed to prevent decay.
  • Schedule regular dental visits for your child beginning when their first tooth erupts. 
TIP:  Cut back on sugary bottles by gradually watering them down until they are only water. Most children begin life with strong, healthy teeth. Help your child's teeth stay that way. Your newborn is totally dependent upon you as a parent. The decisions you make will have a vital effect on your child's dental future.
Baby's First Teeth

Usually, the first baby teeth to erupt are the two bottom front teeth. They begin to appear when your child is about 6 to 8 months old. They are followed by the 4 upper front teeth. The remainder of your baby's teeth will appear periodically, usually in pairs on each side of the jaw, until the child is about 2 1/2 years old. By the time your child is 2 1/2 years old, all 20 baby teeth will most likely have come in. From this point until the child is 5 to 6 years of age, his/her first permanent teeth will begin to erupt. Some of the permanent teeth replace baby teeth, others don't. Do not worry if some teeth are a few months early or late as every child is different...just as every adult is different!

Even though baby teeth will eventually be lost, they are just as important as the adult teeth. They not only hold the space for incoming permanent teeth, but are also important for biting and chewing food, speech, and physical appearance. Early tooth loss due to dental decay can have a serious impact on your child's self-esteem and self-confidence. For this reason, it is important to teach your child the importance of eating a healthy diet and practicing daily oral hygiene to maintain healthy teeth and gums for a lifetime of smiles.
First Dental Visit for Your Child

Your child's first visit to our dental office should be around his/her first birthday, but could be as early as you'd like (as soon as the first tooth erupts or even sooner). Here are some Dos and Don'ts. 
    Do:
    • Have a tour of our dental office by coming in for a casual, friendly, get acquainted visit and checkup.
    • Make an appointment for a visual check of your child's teeth.
    • Have a discussion with us about oral health care for your child.
    • Familiarize your child with our dental office. Consider taking them along when you or a sibling has a dental appointment. 
    Don't:
    • Wait for an emergency for the first visit.
    • Over prepare your children for dental visits.
    • Use phrases like "It won't hurt much" or "It won't be too bad." Such phrases do not soothe; they only create anxiety. 
    Fluoride Info

    Dental decay is a common condition all over the world. One way to help prevent cavities from occurring is through the use of fluoride.

    Fluoride helps harden the tooth enamel and make it more resistant to tooth decay. A small cavity can be stopped and even reversed by the remineralization process enhanced by fluoride. Fluoride can be delivered to the teeth in 2 ways: topically (direct contact on the teeth) and systemically (enters the blood stream). 
    Systemic Fluoride
    Systemic fluoride is delivered to the tooth surface via the bloodstream. Systemic fluoride can be derived from a food source, water source, or dietary supplements (pill, tablet, lozenge, drop). Fluoridated water is an effective way to reduce the problem of dental decay. It has been shown that fluoridated water and dietary supplements can reduce up to 60% of tooth decay. Some water supplies naturally contain fluoride, but for others fluoride is added to the water supply. If you would like to know if your community's water supply contains fluoride, call your local water or health department.

    Children from birth to 16 years of age will benefit the most from systemic fluoride. Sixteen is currently the age at which the American Dental Association recommends children can discontinue fluoride vitamin supplements. This is because when fluoride is ingested, it circulates through the bloodstream and into developing teeth. The fluoride is then built into the enamel structure of the developing tooth, making the tooth more resistant to acids.
    Topical Fluoride
    Even though the benefits of fluoride are maximized before the teeth erupt (come in), fluoride is still very beneficial for children and adults after the teeth are fully erupted. Topical fluorides are applied directly to the tooth structure to delay or slow down the tooth decay process.

    Topical forms of fluoride include:
    • Toothpaste - used daily, must have an ADA or CDA Seal of Acceptance on the label.
    • Professional fluoride application - this is a gel that is applied for 1 to 4 minutes, usually in a tray at the end of a dental appointment. Not everyone is given a professional fluoride application; it depends on your oral health needs.
    • Fluoridated home mouth rinses - can be purchased over-the-counter for children over 6 years of age, and adults who are susceptible to cavities. 
    • Home care fluoride gels - applied by trays or by brush, these gels are for those who are highly susceptible to cavities.
      These people would include: 
      • Adults with a high incidence of root cavities.
      • Those who experience an extremely dry mouth.
      • People who wear braces or orthodontic appliances. 
      • Those who have rampant or excessive cavities. 
    Even though the benefits of fluoride are maximized before the teeth erupt (come in), fluoride is still very beneficial as a daily fighter against decay. Fluoride gels can be bought over-the-counter or by prescription. Ask us for a daily home fluoride program that is individualized for your needs.
    Fluoride Safety
    • Fluoride is very effective in controlling dental decay when used properly. If not used in the proper doses, fluoride toxicity and dental fluorosis can occur.
    • Fluoride toxicity is when large amounts of fluoride are ingested during a short period of time. This can be dangerous to your health.
    • Symptoms may include nausea, diarrhea, vomiting, abdominal pain, increased salivation or increased thirst.
    • These symptoms would begin 30 minutes after ingestion and can last up to 24 hours.
    • Depending on the amount of the toxic overdose of fluoride, certain emergency procedures should be implemented. If you feel nausea, drink milk or try to induce vomiting and call us or physician. If these symptoms do not subside, or the conditions worsen (difficulty breathing), call an emergency service to transport you to the hospital.
    • Dental fluorosis - is an excess of fluoride intake during the stages of tooth development. Dental fluorosis ranges from mild (white specks on teeth) to severe (brown staining and pitting of enamel).
    To ensure that your child does not have any adverse effects from fluoride, follow these basic rules: 
    • Fluoridated products should not be swallowed.
    • Only a small amount of toothpaste, such as the size of a small pea is needed for a child.
    • Fluoridated products, especially mouth rinses should not be given to a child under 6 years of age, or to anyone who cannot rinse and spit (those you suspect are swallowing some of the product).
    • Keep fluoridated products out of reach of children.
    • Parental supervision is needed for children when brushing or using any fluoridated substances. 
    Oral Hygiene for Children

    Should I clean my baby's teeth?
    Definitely! Even before the first tooth appears, use a soft, clean cloth to wipe your baby's gums and cheeks after feeding. As soon as the first tooth appears, begin using a small, soft bristled toothbrush to clean the tooth after eating. Don't cover the brush with toothpaste. Young children tend to swallow most of the toothpaste, and swallowing too much fluoridated toothpaste can cause permanent spots on baby teeth called dental fluorosis.
    I find brushing my child's teeth awkward. Do you have any suggestions?
    Try having your child lie down. Put your child on your lap or on the floor, keeping his/her head steady with your legs. If your child is standing, have his/her back to you with their head tilted slightly and resting against your body. Have your child hold a mirror while you brush and floss their teeth so your child can see what is being done.
    Is it important to brush before bed?
    Yes. If you have to miss a brushing, the bedtime one is probably the worst one to miss. If you don't get rid of the bacteria and sugar that cause cavities, they have all night to do harm. While you are awake, saliva helps keep the mouth clean. When you are asleep, there is less saliva produced to clean the mouth. For this reason it is important to brush before bedtime.
    How to brush your child's teeth:
    • Every day plaque forms on the inner, outer, and chewing surface of teeth and the gums. Tooth brushing is one of the most effective ways to remove the plaque.
    • The best kind of toothbrush to use is one with soft, round-tipped bristles.
    • A child will need a smaller brush than an adult.
    • Young children do not have the manual dexterity to brush properly. Your child will need your supervision and help brushing until he or she is 8-10 years old to ensure a thorough brushing has been done.
    • When the bristles become bent or frayed, a new brush is needed.
    • Start flossing your child's teeth when the teeth touch each other and you can no longer brush in between them. 
    Pacifier Info

    For babies, sucking is very natural. It is how they nourish and soothe themselves. When a baby is not eating, the pacifier is better to use for soothing than a finger, thumb, or a toy.

    Pacifiers are less likely to cause a malocclusion and are usually discontinued at an earlier age than thumb sucking. It is easier to take away a pacifier than to discourage using a finger or thumb. Thumb suckers typically continue the habit until 3-5 years of age.
    Thoughts on Pacifiers
    • If you notice your child beginning to suck their fingers or thumbs during the first 3 months of life, consider introducing your child to a pacifier.
    • To avoid any trauma to the gums, it's important to buy a pacifier with a nipple made of rubber
    • Do not use the pacifier around the clock, only when necessary
    • In rare instances, pacifiers may cause complications like abnormal swallowing patterns
    • Check the pacifier daily for breakage. They do not last forever and should be replaced when wear or damage is noticed. A damaged pacifier can cause choking.
    • Do not hang the pacifier around your baby's neck with a string. This practice is dangerous and can cause strangulation. 
    Choosing a Pacifier 
    Avoid improper breathing and abnormal molding of the baby's jaws by choosing a pacifier that resembles the natural nipple and breast.
    Pacifier use can cause abnormal development of the jaws and teeth. Some reasons are:
    • Improperly sized and shaped pacifier
    • Strength of sucking action
    • Length of time the pacifier is present within the mouth 
    Sealant Info

    • Sealants are thin plastic coatings applied in the dental office onto the chewing surfaces of the back teeth, a prime spot for cavities. Sealants act as a barrier to prevent bacteria and food from collecting in the grooves and pits of the teeth.
    • Sealants are best suited for permanent first molars which erupt around the age of 6 and second molars that erupt around the age of 12. It is important to have the sealant applied as soon as the tooth has fully erupted. They may also recommended for the pre-molars if there are deep pits and fissures present.
    • Before the sealant material is applied, the tooth surface is prepared by cleaning with a dental solution that helps the sealant stick to the tooth by penetrating the enamel.
    • Sealants may last for several years once applied, but should always be examined at the child's regular checkup. Even if the sealant becomes lost, the material that has penetrated the enamel will still provide protection. Sealants are easily replaced if necessary.
    • Sealants are nearly 100% effective in preventing decay in the chewing surfaces of the back teeth. Fluoride helps fight decay on the smooth surfaces of the teeth.
    Snack Facts

    Sugar Snack Facts:
    • Frequent snacking on foods containing sugar increases a child's risk of getting cavities.
    • Each time your child eats sugar, plaque in the mouth combines with sugar to produce acid.
    • This acid attacks the teeth and over time can destroy the tooth structure.
    • Your child should eat a variety of foods including grains, milk and milk products, meat, vegetables, and fruits. Avoid establishing a "sweet tooth" by limiting foods high in sugar.
    Tips for Good Snacking Habits:
    • Cut down on high-sugar snacks. Offer your child snacks that are low in sugar, such as vegetables, cheese, or pretzels. These do not promote tooth decay
    • Cut down on the number of times per day that your child eats sugar in food and snacks. With frequent snacks, the acidity of the mouth stays high. This exposes the teeth to acid for extended periods. High frequency of sugary snacks increases the risk of developing cavities
    • Avoid soft, sticky sweets that lodge on and between tooth surfaces such as toffee, dried fruits, etc. Sticky foods are retained in the mouth longer and as a result, the acid that destroys the tooth is produced for a longer period of time. The consistency of the snacks increases the risk of getting cavities more than the amount eaten.
    • Natural sugars (found in breast milk, fruit, milk, bananas) have the same effect on your child's teeth as refined sugars (found in soda pop, ice-cream, cake). Healthy foods should obviously not be avoided and brushing after eating is important in the prevention of tooth decay.
    • Don't give your child sugar-rich foods that stay in the mouth and prolong the acid attack, such as gum, hard candies, lollipops, etc.
    • If you do serve sweets, serve them with meals. Increased saliva flow during meals helps neutralize the effects of sugar on the teeth.
    • Brushing and flossing after snacks and meals is important for preventing cavities that can form from exposure to sugar.
    Teething Information

    Teething may make your baby restless and irritable. If fever, vomiting, or diarrhea occurs do not dismiss this automatically as due to teething, as it is not generally the cause of these conditions. These symptoms should be discussed with your pediatrician.

    Some signs that your baby may be teething:
    • red cheeks or rash on cheeks
    • increased saliva/drooling
    • restlessness
    • irritability
    • loss of appetite
    What to do?
    Let your child chew on a cold, hard object, such as a teething ring. The coldness helps ease the discomfort and the hardness will speed up the eruption of the tooth.
    • Massaging your child's gums with a clean finger can help reduce pain and discomfort during teething.
    • Teething gels or ointments (ask your pharmacist for a brand name) are used to numb the gums and reduce the discomfort. Teething cookies or biscuits are not a good choice as they contain sugar and may lead to tooth decay.
    Thumb-sucking Information

    Thumb-sucking or finger-sucking is a habit that forms in many infants. Your child will usually give it up naturally by the age of four. If the sucking habit continues beyond the time when permanent teeth start to erupt, your child may develop crooked teeth and a malformed palate (roof of the mouth). This results from pressure applied by the thumb on the teeth and roof of the mouth. The severity of the problem depends on frequency, intensity, duration and also the position in which the thumb is placed in the mouth. The relationship between the upper and lower jaws may also be affected. Speech defects can occur from misaligned teeth resulting from thumb-sucking and/or finger-sucking.
      Treatment:
      • The best prevention is to get your newborn to take up the pacifier instead of thumb-sucking or finger-sucking. Although prolonged use of the pacifier can lead to similar problems, it is not attached to the child and can be more easily discouraged.
      • Children should be helped to give up the habit before they enter school to prevent teasing.
      • Timing of treatment is important. Your child should be willing to give up thumb-sucking or finger-sucking. If your child is not willing to stop, therapy is not usually indicated. Pressure to stop may only lead to resistance and lack of cooperation. Try again at a later time.
      • Give your child attention and understanding and gently discourage the habit. Reminders such as a Band-Aid on the thumb can help.
      • Offer rewards (star on chart, dimes, extra story) for days when your child is successful. Praise your child when successful.
      After daytime sucking is controlled:
      • Take one step at a time. Encourage your child not to suck during one daytime activity, like story time or television watching. Gradually add another activity until daytime sucking is controlled.
      • Help your child to give up the sucking habit during sleep. This is usually an involuntary process and a glove, sock, or thumb/finger guard can help stop the habit.
      • If these considerations are not successful, let us know. By the time your child's permanent teeth begin to erupt (at around 6 years of age), it should be brought to our attention. We may suggest other options such as a reminder bar that is placed in the upper arch.
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