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Oral Tips


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

The teeth most likely to be damaged are the upper front teeth. These are usually some of the first teeth to erupt and thus have the longest exposure time to the sugars in the bottle. 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 of a child's teeth for long periods of time to liquid containing sugars. Liquid pools around the front teeth when your baby falls asleep with:

  • a bottle containing formula, milk or juice,
  • a pacifier dipped in honey,
  • while breast feeding.

During sleep, the bacteria living in every baby's mouth turns the milk sugar or other sugars to acid which causes the 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 the disease.
  • Brown spots along the gumline on your child's teeth are signs which should alert you.
  • If your child prefers soft foods, frowns or cries when eating cold, sweet or hard foods, they should be checked for tooth decay.

By the time tooth decay is noticed it may be too late and crowns, nerve treatment or even extraction of the decayed tooth may be necessary. As a result, your child may suffer from long term disorders which include speech impediments, possible psychosocial problems, crooked or crowded teeth, and poor oral healthNew.

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
  • Have regular dental visits for your child beginning when their first tooth erupts

Most children begin life with strong, healthNewy 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.

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First Aid - Injuries to Teeth

Fractured Tooth:

  • Find the broken tooth fragment if possible
  • Visit a paediatric dentist. The dentist can usually restore the broken tooth even if you cannot find the broken part.

Primary (Baby) tooth knocked out:

  • Do not put the tooth back.
  • Visit a paediatric dentist. The dentist will advise you if further treatment is necessary.

Permanent tooth knocked out:

  • Find the tooth
  • Hold it by the crown - not the root
  • Rinse it gently in cool water
  • If possible put it back in the socket - if unable to do so put it in milk or cool water
  • Visit a paediatric dentist

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First Dental Visit
Your child's first visit to the dental office can be as early as his/her first birthday, but could be as early as you'd like (as soon as the first tooth erupts). Here are some Do's and Don'ts.

Do:

  • have a tour of the dental office by going in for a friendly, get acquainted visit and checkup
  • make an appointment for a visual check of your child's teeth
  • have a discussion with the dental hygienist or dentist about oral health care for your child
  • familiarize your child with the dental office. Consider taking them along when you or a sibling have a dental appointment

Don't:

  • wait for an emergency for the first visit
  • use phrases like 'it won't hurt much'. This only creates anxiety.

Remember, future visits to the dental office will be much easier for your child if the first visit is a positive experience.

Niagara Region Public Health Department wishes to thank the University of Manitoba for the dental health education material.

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Fluoride
Fluoride is a mineral that occurs naturally in almost all foods and water supplies. Fluoride is the major reason that tooth decay has been reduced dramatically over the past several decades.

The use of fluoride toothpastes is the most common and effective way to obtain the necessary quantity of fluoride. Fluoride makes the tooth structure stronger, so teeth are more resistant to acid attacks. It also helps repair the early stages of tooth decay before cavity formation begins.

Fluoride acts on the smooth surfaces of teeth, while fissure sealants protects the tooth from decay on the pits and grooves on the chewing surfaces.

Sometimes children do not receive the adequate levels of fluoride. Your dentist will advise you if any additional fluoride is recommended. In this case, fluoride may be obtained through other sources such as:

  • Community water fluoridation
  • Fluoride toothpastes
  • Fluoride drops
  • Fluoride tablets
  • Fluoride mouthrinses (over 6 years of age)
  • Professionally applied topical fluoride

Guidelines for Fluoride Supplementation for Children

Table 1: Recommendations for dietary fluoride supplements for children living in areas where the concentration of fluoride in the drinking water is less than 0.3 PPM

  Recommended daily dose of fluoride, mg  
Age Canadian Paediatric Society (applies to all children) Canadian Dental Association (applies to children at high risk of caries
6 mo-2 yr .25 0
3-5 yr .50 25 (0.50 if fluoridated toothpaste is not used regularly)
6-12 yr Not applicable
1.00
6-16 yr 1.00 Not applicable

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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. Do not cover the brush with toothpaste. Young children tend to swallow most of the toothpaste. Swallowing too much fluoridated toothpaste can cause permanent spots on their teeth called dental fluorosis.

I find brushing my child's teeth awkward. 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 do not 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.
Niagara Region Public Health Department wishes to thank the University of Manitoba for providing dental educational material.

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Sealants
Sealants are thin plastic coatings applied on the chewing surfaces of back teeth, a prime spot for cavities. Sealants act as a barrier to prevent bacteria and food from collecting and sitting on the grooves and pits of 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.

Before the dental professional applies the sealant material, the tooth surface is prepared by using a dental solution which cleans the tooth surface and helps the sealant stick to the tooth by penetrating the enamel layer.

Sealants may last for several years once applied, but should always be examined at regular intervals. Even if the sealant becomes lost, the material that has penetrated the enamel will still provide protection. Sealants are easily replaced if lost.

Sealants are nearly 100% effective in preventing decay on the chewing surfaces of the back teeth. Fluoride helps fight decay on the smooth surfaces of the teeth.

So, sealants + fluoride + good oral cleaning habits + wise eating
= a great reduction in cavities.

Check with your oral heath professional to see if your child is
ready for sealants.


Niagara Region Public Health Department wishes to thank the University of Manitoba for dental healthNew education material

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Teething
From six months old up to the age of three years, your child may have sore gums when teeth erupt. The baby may cry, become nervous or even have a fever (in case of fever visit your doctor for advice). Other signs that your baby may be teething include:

  • Red cheeks or rash on cheeks
  • Restlessness
  • Irritability
  • Loss of appetite
  • Increased saliva/drooling
Should your child appear to show any of these signs there are some simple remedies that can be tried such as the following
  • Many babies like a cool spoon or cold wet wash cloth placed on the gums
  • There are teething rings designed specifically for teething
  • You may rub the baby's gums with a clean finger
  • Teething gels or ointments are NOT recommended because they may numb the baby's throat and cause choking.

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Thumb-sucking
Thumb-sucking or finger-sucking is a habit that occurs with 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 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 malaligned 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, the pacifier, at least, can be removed. It is not recommended that breastfed infants be introduced to a soother until after breastfeeding is well established, after the first six to eight weeks of life.

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 you apply to stop may only lead to resistance and lack of cooperation. Try again later.

* 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 stories) for days when your child is successful. Praise your child when successful.

After 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.

Take one step at a time. Encourage your child not to suck during one daytime activity, like storytime or television watching. Gradually add another activity until daytime sucking is controlled.

* If these considerations are not successful, see your dental professional or doctor for further support. By the time your child's permanent teeth begin to erupt (at around age 6), it should be brought to their attention.

Niagara Region Public Health Department wishes to thank the University of Manitoba for the dental health education material.

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 Revised: Wednesday, April 30, 2008
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