Chapter 8, Dental Health

NORMAL DENTAL HEALTH

The lower two front teeth usually come in at about 6 months of age, although this may vary from 3 ‑ 12 months. All the baby teeth (20 primary teeth) will be in by 2 ‑ 3 years of age. Primary teeth are as important as permanent teeth. Even though baby teeth are replaced by permanent teeth, they are very important to children’s appearance, for eating and speaking properly, and, most importantly, they act as guideposts (markers) for proper eruption of permanent teeth. We often blame teething for illness caused by other health problems; teething is normal but can cause some discomfort and fussiness.

Young child brushing her teethDENTAL CARE FOR SMALL CHILDREN

Clean teeth with a clean washcloth or a small, soft toothbrush as soon as the teeth come in. Children in child care should be provided with individual toothbrushes and given time after at least one meal to brush their teeth. Use a fluoridated toothpaste and place a “smear” amount on the brush. Up to the age of five, the adult should brush the child’s teeth at least once a day.

If it is not possible to brush after eating, have children rinse out their mouths with water. Rinsing with water helps to clean decay-causing foods from the mouth.
Children should first visit the dentist around 1 year of age and regularly thereafter. However, if a child has any problems in the mouth, a dentist should be seen sooner.

CARE OF TOOTHBRUSHES

When individual toothbrushes are used in child care, precautions must be taken to decrease the risk of spreading disease by improper storage. Do not store toothbrushes in a single container. Individual hooks spaced apart are an acceptable means of storing toothbrushes. Be sure to rinse toothbrushes thoroughly after use.

TOOTH DECAY/CAVITIES

Small children can easily get tooth decay (cavities). Diet plays a central role in the development of tooth decay. Soft drinks or fruit drinks, candy, baby formulas and even “health” foods such as raisins can cause tooth decay. Foods most likely to cause tooth decay are ones that contain sugar and stick to teeth and gums (such as soft candy or raisins).

Tooth decay is a contagious disease. After eruption of a child’s teeth has begun, the bacteria that cause decay are generally transmitted from a child’s primary caregiver. Mothers with active tooth decay are more likely to transmit decay-causing bacteria to their child. It is important that mothers and primary care givers maintain their own oral health. Teeth decay because the bacteria in plaque (which can build up on teeth) use the food left on teeth and gums to make acid that breaks down tooth enamel.

WAYS TO PREVENT TOOTH DECAY

  • Limit frequent snacking, especially on foods high in sugar.
  • Brush and floss daily.
  • Use fluoride toothpaste.
  • Ensure that children drink fluoridated water or receive fluoride supplements.

Child sucking thumbPACIFIERS AND THUMB-SUCKING

Some children suck on pacifiers or their thumbs to help them relax. If the child needs a pacifier, be sure it is an “orthodontic” shaped pacifier that will help maintain proper growth and development of the upper jaw. Old-fashioned, round pacifiers or the child’s thumb or fingers can place pressure on the growing jaw and teeth and cause the teeth to be permanently out of position. This can result in an “open bite” where the front upper and lower teeth do not touch. Correcting an open bite requires orthodontic treatment.

BABY BOTTLE TOOTH DECAY

This is a severe form of decay of the primary teeth of infants and toddlers. Sometimes, infants or young children who are allowed to suck excessively on a nursing bottle or sweetened pacifier develop a condition called “Baby Bottle Tooth Decay” or “Nursing Bottle Mouth.”

Baby Bottle Tooth Decay is painful and can destroy the teeth of young children. The teeth most likely to be damaged are the upper front teeth, the ones that make a difference when a child smiles. The damage can begin shortly after the teeth have erupted.

CHILDREN CAN GET BABY BOTTLE TOOTH DECAY BY:

  • Prolonged use of a bottle containing anything but water, such as cow’s milk, formula, fruit juice, sweetened water, jello water or soda pop. This is true especially at bed or nap time, or during the day if the child uses the bottle as a pacifier, is walking around with a bottle or is sitting playing with a bottle.
  • Use of a sweetened pacifier. Pacifiers should not be dipped in any kind of sweetened syrup or liquid.

BABY BOTTLE TOOTH DECAY CAN CAUSE:

  • Pain, toothache
  • Cavities, abscessed teeth
  • Loss of teeth
  • Crooked permanent teeth
  • Ear and speech problems
  • Possible emotional problems

Children with Baby Bottle Tooth Decay may require special hospital care to have their teeth treated.

PREVENTION

HOW TO PREVENT BABY BOTTLE TOOTH DECAY

  • Never allow children to fall asleep with a bottle that contains anything but water, e.g., milk, formula, fruit juice or any sweet liquid.
  • Do not let children walk around or sit with a bottle during the day. If a child needs to suck, offer a pacifier, not a bottle.
  • Bottles should be used only to feed infants formula or water. Children old enough to drink juice should drink it from a cup.
  • Trade the bottle for a cup by 1 year of age. Begin teaching infants to drink from a cup at age 6 ‑ 9 months. It may be messy, but it is worth the effort. Praise children and make it a sharing time. Children love learning a new skill. By age 12 months, children will prefer drinking from a cup.

Happy children with big smilesHOW TO BREAK THE HABIT

Children should be encouraged to drink from a cup and should be weaned from a bottle by 1 year of age. If children have become attached to the bottle, it may be a difficult habit to break. Children may cry or fight giving up the bottle at bed or nap time, but this will usually only last a short time.

SUGGESTIONS TO DISCUSS WITH PARENTS:

  • Dilute the liquid you usually put in the nap time bottle until there is only water.
  • Use a clean pacifier. Do not dip the pacifier in honey, syrup, or anything sweet.
  • You may involve an older child in deciding when to stop using the bottle.

Better yet, put children to bed without a bottle. Here are some substitutes:

  • Give a security blanket or a teddy bear.
  • Sing or play music.
  • Hold or rock the child.
  • Give a back rub.
  • Use a musical mobile.
  • Read or tell a story.


CHILD CARE PROVIDERS CAN HELP PREVENT BABY BOTTLE TOOTH DECAY

 

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