As the AAP and other children’s organizations report, tooth decay (also called early childhood caries, or ECC) is the most common chronic children’s disease in the country. As a result, it is very important that parents work with their pediatrician to establish good oral health care from the first weeks of their baby’s life. Although most of us think of dental care in relation to our own dentists, parents will be working closely with their pediatrician even earlier than with a dentist.
“Traditionally, the assessment and treatment of oral health problems has not been considered to be the domain of pediatricians, but that is changing,” says Eileen M. Ouellette, M.D., past president of the AAP.
“Since pediatricians see young infants and children frequently for preventive health care visits, we are in an excellent position to identify children at risk for dental health problems, coordinate appropriate care and parent education, and refer affected and highrisk children to pediatric dentists.”
The Centers for Disease Control and Prevention (CDC) has stated that dental caries is five times more common than asthma and seven times more common than hay fever in children. More than 40 percent of children have tooth decay by the time they reach kindergarten. Children with dental caries in their baby teeth are at much greater risk for cavities in their adult teeth.
Health care professionals know that tooth decay is a disease that is, by and large, preventable. Because of how it is caused and when it begins, however, steps to prevent it ideally should begin prenatally with pregnant women and continue with the mother and young child, beginning when the infant is approximately 6 months of age. Pediatricians have become increasingly aware that their own proactive efforts to provide education and good oral health screenings can help prevent needless tooth decay in infants.
For parents who wish to establish good dental health for their infants, the following general guidelines may be of help:
Fluoride and Your Child: Fluoride is a naturally occurring mineral that is found in many foods, and it also is added to the drinking water in some cities and towns. It can benefit dental health by strengthening the tooth enamel, making it more resistant to acid attacks that can cause tooth decay. It also reduces the ability of plaque bacteria to produce acid. Check with your local water utility agency to fi nd out if your water has fluoride in it. If it doesn’t, ask your doctor if you should get a prescription for fluoride drops or chewable tablets for your child.
Check and Clean Your Baby’s Teeth: Healthy teeth should be all one color. If you see spots or stains on the teeth, take your baby to your dentist. Clean your child’s teeth as soon as they come in, using a clean, soft cloth or a baby’s toothbrush. Clean the teeth at least twice a day. It’s best to clean them right after breakfast and before bedtime. At about age 2, most of your child’s teeth will be in. Once your child can spit and not swallow the toothpaste (usually around ages 2 to 3), begin using fluoride toothpaste. Use a pea-sized amount of toothpaste to limit the amount she can accidentally swallow. As your child gets older let her use her own toothbrush. It is best if you put the toothpaste on the toothbrush until your child is about age 6. Until children are 7 or 8 years old, you will need to help them brush. Try brushing their teeth fi rst and then letting them finish. Be sure that you spread the toothpaste into the bristles of the brush and use only a pea-sized amount of toothpaste.
Feed Your Baby Healthy Food: Choose drinks and foods that do not have a lot of sugar in them. Give your child fruits and vegetables instead of candy and cookies. Be careful with dried fruits, such as raisins, since they easily stick to the grooves of the teeth and can cause cavities if not thoroughly brushed off the teeth.
Prevent Tooth Decay: Do not put your baby to bed with a bottle at night or at nap time. (If you do put your baby to bed with a bottle, fill it only with water.) Milk, formula, juices and other sweet drinks, such as soda, all have sugar in them. Sucking on a bottle filled with liquids that have sugar in them can cause tooth decay. During the day, do not give your baby a bottle filled with sweet drinks to use like a pacifier. If your baby uses a pacifier, do not dip it in anything sweet like sugar or honey. Near his first birthday, you should teach your child to drink from a cup instead of a bottle.
Talk With Your Pediatrician About Making a Dental Home: Since your pediatrician will be seeing your baby from the first days and weeks of life, plan to discuss when and how you should later develop a “dental home”—a dentist who can give consistent, high-quality, professional care—just as you have a “medical home” with your pediatrician. Usually, your dentist will want to see a child by his first birthday or within six months of the first tooth’s emergence. At this first visit, your dentist can easily check your child’s teeth and determine the frequency of future dental checkups.
This article was featured in Healthy Children Magazine. To view the full issue, click here.