Baby, Oh Baby, What Pretty Teeth You Have!

Lots of toothdecay already! 

Your sweet, precious baby!   What would you do to keep him or her healthy for their entire lives?  Just about anything, I bet!   Please add oral care to help your baby be his or her best, healthiest self.  Why should we care about "baby" teeth when they are going to "lose" them anyway?  What's the appropriate age to bring baby into a dental office?  What would they do for a baby in the dental office?   What difference will it make to their health?  Let's explore those questions and if you have any others- please let me know!

Why Care for Baby Teeth?

Please, please care for baby's teeth as if they were your own - for so many reasons. They are as important to baby as yours are to you!  Infected decayed teeth can and will eventually hurt.   Decay bacteria are contagious!  The decay bacteria can infect the permanent tooth erupting underneath, as well as all the other teeth in the mouth.  "Baby" or primary teeth are vital to proper jaw development.  They hold the space for the permanent teeth to erupt properly.  In addition, esthetics, clear speech,  and a well-formed smile are just as vital to children as to adults.  Smiling aids in our connections with our child and helps their development!  A healthy smile is an important part of a child's self esteem.

Baby will use her primary teeth to chew and digest food for over a decade.  (You wouldn't spend your thirties or forties simply ignoring your mouth, would you??)  Besides being painful, infected baby teeth hurt the entire body.  Children have died from infected teeth.  The bacteria that cause tooth decay enter the body through the infected tooth, causing further infections and, if left unnoticed and untreated, can lead to death. (it can happen in adults, too)  The bottom line is: DON'T. IGNORE. TOOTH. DECAY.   More on tooth decay from my blog post- Conquering Cavities in Kids.

What age should your baby see a dentist?

Within six months of her first tooth erupting, bring baby into the dental office.***  The American Dental Association, the American Dental Hygienists' Association, as well as numerous other professional organizations all recommend this early start date!  If Baby's teeth are "late in erupting", plan on their first visit by their first birthday!

Why?

Traditionally, children haven't gone into see a dentist until age three (3).  They have all their baby teeth by then, but unfortunately, some children have cavities already at this age.  By seeing a dentist before age one, the dental office can do many things to help you help your child never have a cavity or dental disease!  Go when baby is young to establish a "dental home."  The dental office's job is to help educate you in cavity and gum infection prevention.  Tooth decay is 100% preventable.  Did you know tooth decay is contagious from parent or caregiver to child??! (Just seeing if you are paying attention)  So, ideally, your dental visit for baby would include information for mom, dad and caregivers to help them be decay free as well.

What would a dentist do for baby at that age?

Here's what should happen at this first appointment:


     - Record the oral and physical history.  Questions the dental team should ask: Has baby been ill?  Taking any medications?  Any prenatal issues?  When did baby's teeth erupt?
     - Evaluate both parent and baby's tooth decay risk level.  Review diet, decay history in parents, bottle and/or sippy cup use, special needs, medical history, saliva flow, fluoride availability. Fill out a decay risk assessment form.  You can look over this form now by clicking the highlighted link.  Then do one on yourself!
     - Parent education:  Review oral development stages, review maternal health, discuss tooth decay transmission,  non-nutritive sucking early importance and how it is destructive later in life.
     - Discuss the importance of baby teeth. As an avid reader, you know the answers to this question!
 
    - Risk assessment of Baby's decay risk level and bacteria load.  If Baby is at high risk, preventive steps should be taken immediately!   Oral hygiene instructions, preventive measures, remineralization information, and fluoride varnish application should all be done at this time.  Fluoride varnish can be applied at the conclusion of this appointment.  It's fast, easy and makes the teeth stronger.

Knee to knee 

Doctor and mom or dad sit knee to knee, and Baby is gently reclined right into doctor's lap.  Baby will probably scream at this point but, hey, that's okay!  Their mouth will be open and doctor can get a really good look.  Lift that lip- look for tongue ties, lip ties, and then plaque on the teeth, as well as tooth decay and early signs of decay- the white spot lesion.  Doctor can then paint fluoride varnish right on the teeth.

While this appointment is probably only 30 minutes long, you can see, there's a lot of information flowing both ways.

What Homecare Should You be Doing for Baby?

Before baby's even conceived:

It would be great if both mom and dad worked hard to eliminate the bad bacteria in their mouths and be decay free.  Getting five servings of xylitol daily before even getting pregnant would be ideal for mom and dad, and would be an excellent start to long-term health for the entire family!

Infants: 

Baby can harbor decay bacteria even though he may not have teeth yet.  They lurk in the furrows of the tongue.  So, as soon as Baby's born you gently pull out the lip and wipe the entire mouth with a xylitol wipe- I recommend Spiffies.  Do this after every meal or diaper change. Strive for five times a day!  Xylitol is a safe sugar, it's natural and tastes great.  Best of all, it helps change the decay bacteria in the mouth to healthy bacteria.  Read more about the wonders of xylitol here and here!  Easy, quick, and promotes excellent oral health.

Wrong on so many levels!

 Review nutrition.  Watch fermentable carbohydrates, no juice unless it's 100% juice (infants should not be getting juice anyway!!)  and then only with meals.  Those fermentable carbs facilitate tooth decay.   No teething biscuits, no mushy food, no sippy cups, no bottles in bed, no dangling bottles while they walk around, no almond milk in bottles!  Baby needs to chew; this promotes proper jaw development. (See my post: Chew on This!)

Don't chew baby's food for him!!  Really, do I need to say this? And, remember, oral bacteria are contagious!!  Also, licking the pacifier, even kissing on the lips- all transfer saliva and bacteria. Same goes for testing the food temp, and eating off the same utensils.  

Baby with teeth:  

As soon as there are teeth, they need to be brushed!  It's okay to use a smear of toothpaste.  I also love the taste of Spiffies toothpaste for babies called Lusterbrush.  It's okay to swallow this paste.  Baby should have a new toothbrush every two to three months, or after any illness (just like you should!).  Over the counter toothpastes that contain fluoride are okay if you only SMEAR the paste.   If you have a paste your child likes, great!  Just say smear!


Avoid numbing agents for teething.  Instead, use a cool teething ring, or a cold washcloth.  I've seen too many parents overdose their baby with numbing gel. It could numb the back of their throat, plus they taste horrible- Have you tried it on yourself?  You should before you lather baby's mouth up! Yuck! Plus, most important- Some babies are sensitive to its use.  Methemoglobinemia is a reaction to the numbing agent benzocaine in baby numbing gels and the result is bad.  My suggestion- Just don't use them!  Teething hurts and pain management is important- talk with your child's doctor about the best medicine for him or her.

Toddlers: 

Help your children brush their teeth.  They can not do it properly until they are 10 years old or even older. (I had a 17 year old patient who missed all her front teeth when she brushed.)

  Toddlers love to be independent, so here's what I did with my children.  I brushed, then they brushed, and then I finished up with that smear of toothpaste.  My turn, your turn, then my turn again.  Then I scraped their tongue with a tongue scraper. The goal is to brush all their teeth-- every surface, as well as the roof of the mouth, and cheeks.  
At home I'd either position myself to the side of the child, cup their head in my arm and hold their chin while sitting on the floor, or sit on the (closed) toilet seat, have my daughter sit with her back to me and lean  her head back into my lap.
Baby will probably suck on the toothpaste, which is why a "safe to swallow" toothpaste like Lusterbrush is important.  I started my daughters with a dry toothbrush-  no foam, no tastes, and no mess and a clear view of their teeth.  They graduated to"toothpaste" when they could indeed spit. 

But baby won't open, what do I do?

Start right from the beginning with the Spiffies.  Baby may accept things in his mouth if you start young.  If you are starting later in Baby's life and he is objecting, do your best. Squirt some xylitol gel in.  Again, Lusterbrush is perfect for this. Or, a xylitol spray- called Rain.  Five serving daily will help reduce the plaque biofilm in his mouth by 50%, and that's without even brushing!  Forgot to brush before bed and don't want to wake him up to brush?  Spritz some xylitol spray right in while he's in bed!

Tools

Manual toothbrush for infants- my fav is the Nimby.  It is super soft.

As soon as there are teeth and they can tolerate it, get an electric brush.  All children should have the same tools as adults have, just kid sized.  Don't give them the cheap stuff.
Electric toothbrushes-  I  do love the Sonicare - they have a version for children.  Get the best you can afford- Watch out for the cheap electric brushes, some of them remind me of a choppy electric knife...    Dr Fresh makes a very good, inexpensive children's brush.  It plays music for one minute, though that probably isn't long enough to get a good clean, so go for another round of the song!

Cleaning in between-  okay,  who flosses their children's teeth?  Let's be real here.  Look for piksters or other interproximal brushes.  I do like Gum Chucks  for flossing children's teeth.  Make it easy on both of you!

Oops, back to the sink! 

Disclosing tablets- stain the plaque hot pink.  How well did you do getting all the plaque off the teeth?

Homemade toothpaste- baking soda and xylitol, wet it and brush it in.
Realistically, go with Carifree Gel or Lusterbrush, much easier. They taste better to little folks, and why struggle?

Decay Prevention:

Ozone therapy- ozone gas can immediately change the entire oral flora and keep things healthy for three to four months.  I love using ozone in our dental office.  Ozone changes the oral flora, killing the bad bacteria and fungus, letting your saliva remineralize the teeth.  It is truly magical gas.  It can reverse decay, as well as kill the bad bacteria and allow the saliva to work it's magic.  And remember, saliva is liquid gold. :)

Change the pH - tooth decay is a pH disease.  When the mouth is acidic, decay happens.  I recommend baking soda (but children don't care much for baking soda taste), and then Carifree products.   Xylitol lollies by Carifree are fabulous!  Read more about pH on my post Tooth Decay, What's pH got to do with it?  Watch acidic foods and beverages. 

MI Paste-contains tooth minerals!  It can be used safely in children as well as pregnant women.  Another fabulous product to remineralize teeth.  It is not a tooth paste- smear some on after tooth brushing and leave it there.  It's a milk based product and safe to swallow.  

Good oral hygiene is an important part of a healthy body.  Baby deserves a healthy mouth!  You can make that happen. Remember, tooth decay is contagious, and it is in your power to prevent.  Start baby on the road to a healthy life.  Include oral care right from the start.  See your dentist, start good habits, be your baby's best example! They are watching and learning from you.

Still have questions?  Email me at  TopGums4u@msn. com
Keep Smiling!

Barbara