Encourage your child to drink from a cup as early as possible. Not sleeping with the bottle or nursing your child to sleep after the first baby tooth erupts is critical in preventing Early Childhood Caries. As soon as the first teeth erupt, they should be cleaned with water or fluoride-free toothpaste. A toothbrush, gauze pad, or washcloth over the finger can be used, wiping the teeth gently. This should be done at least twice a day and following feedings, when possible. A tiny “pea sized” amount of fluoride toothpaste can be introduced to provide extra benefits and then when the “art” of spitting it out is mastered, more toothpaste can be introduced. Be careful that excessive amounts are not ingested regularly since the potential exists to cause damage to the developing permanent teeth. Children do not have the manual dexterity to clean their teeth effectively so you must be an active participant in your child’s oral hygiene.
Dental Caries is an Infectious Disease
Keep in mind dental caries is an infectious and transmissible disease. The mutans streptococci (MS) are infectious agents most strongly associated with dental caries. Some studies have demonstrated that infants acquire MS from their mothers only after the eruption of primary teeth.
A high level of bacteria in the mother’s mouth can increase the rate of transmission to her infant which in turn places the child’s mouth at greater risk for developing cavities. Optimizing the oral health of the mother through the reduction of cavity causing bacteria not only benefits her, but her child as well. Mothers can translate this newly reported information into action by:
- Not passing saliva that might find its way into her child’s mouth (through kissing or cleaning a pacifier with saliva)
- Reducing levels of oral bacteria through good oral hygiene
- Using antimicrobial mouth rinses to reduce the bacterial levels as advised by her dentist
- Maintaining regular visits to the dentist
Timing for First Dental Visit
When the first teeth erupt, it is a good idea to plan for the first dental visit. At that time the dentist will examine the child, determine the child’s risk for dental disease, review feeding and dietary practices, instruct the parent on proper hygiene, and counsel the parent regarding habits that could be detrimental to the child’s dental development. If needed, a cleaning will be performed along with any preventive procedures which might be helpful in maintaining good oral health. Along with the American Academy of Pediatrics and American Dental Association, we recommend children should receive oral health risk assessments every six months beginning at the age of 1.
Early Childhood Caries (also known as baby bottle tooth decay or nursing caries) are caused when an infant’s teeth are frequently exposed to liquids containing sugar e.g. milk (including breast milk), formula, juices, or other sweetened liquids over extended periods of time. There is significant risk of tooth decay from using a bottle during naps, at night, or when nursing occurs continuously. If a baby is allowed to fall asleep with a bottle, liquids collect around the teeth, thereby subjecting them to the acids being produced by bacteria. Frequent exposures to these fluids in the bottle or while nursing increases the acidic attacks, thereby placing these teeth at higher risk for severe decay. Encourage your child to:
- Drink water following the bottle or nursing
- Feed from a cup
- Wean from the bottle (by age one)
- Wean from at will breast feeding
Pacifier and Finger Habits
Pacifier and finger habits are normal for babies and young children. It provides security for some children and is a way for babies to make contact with and learn about the world. In fact, babies begin to suck on their fingers or thumbs even before they are born. These habits may also help
induce sleep which explains why children often use pacifiers or fingers in the evenings or at other times when they are tired.
Prolonged habits can result in problems relating to the proper growth of the mouth and alignment of the teeth. The frequency and intensity of the sucking action are factors which determine whether or not dental problems will result. Should finger habits continue past the age of four, discuss them with the dentist to see if there are ways to help your child discontinue it through conditioning, reinforcement, and other motivational methods. Sometimes mouth appliances are helpful with children who are interested in stopping, but cannot on their own. Pacifiers are easier habits to break since parents have more control over their use. Maturity is often the best cure, however the age that maturity occurs varies from child to child. So, we must be patient, give support, and hopefully, peer pressure will be the motivating factor that will bring us success in breaking these habits. Some other tips that might be helpful:
- Offer praise for not sucking instead of scolding for sucking.
- Focus on correcting the cause or any anxiety that might be a stimulus for these habits.
- Reward your child when they avoid the habits during difficult times.
- Reminders could be helpful (e.g. bandaging the thumb, placing a sock over your child’s hand at night).
- Expect to work hard at helping your child with the habit, being sympathetic, supportive, yet persistent in your efforts.
- Use a chart to have your child participate in so they can gauge their successes and reinforcing with gifts when established goals are achieved.