Early Infant Oral Care
Perinatal & Infant Oral Health
The American Academy of Pediatric Dentistry (AAPD) recommends that all pregnant women receive oral healthcare and counseling during pregnancy. Research has shown evidence that periodontal disease can increase the risk of preterm birth and low birth weight. Talk to your doctor or dentist about ways you can prevent periodontal disease during pregnancy.
Additionally, mothers with poor oral health may be at a greater risk of passing the bacteria which causes cavities to their young children. Mother’s should follow these simple steps to decrease the risk of spreading cavity-causing bacteria.
- Use of xylitol chewing gum (4 pieces per day by the mother) can decrease a child’s cavity rate
- Don’t share utensils, cups, or food which can cause the transmission of cavity-causing bacteria to your children
- Use fluoridated toothpaste recommended by the ADA and rinse every night with an alcohol-free, over-the-counter mouth rinse with .05% sodium fluoride in order to reduce plaque levels.
- Proper diet, with the reduction of beverages and foods high in sugar & starch
- Visit the dentist regularly.
Your Child’s First Dental Visit
When your child’s first tooth appears or first birthday (whichever comes first), talk to your dentist about scheduling the first dental visit. Treat the first dental visit as you would a well-baby checkup with the child’s physician. Remember: starting early and routine visits are the key to a lifetime of good dental health. For more information about nutrition and your baby, visit the Academy of Nutrition and Dietetics.
- Consider making a morning appointment when children tend to be rested and cooperative
- Keep any anxiety or concerns to yourself. Children can pick up on your emotions, so emphasize the positive
- Never use a dental visit as a punishment or a threat
- Never bribe your child
- Talk with your child about visiting the dentist
During this visit, you can expect the dentist to:
- Inspect for oral injuries, cavities, or other problem
- Let you know if your child is at risk of developing tooth decay
- Clean your child’s teeth and provide tips for daily care
- Discuss teething, pacifier use, or finger/thumb sucking habits
- Discuss treatment, if needed, and schedule the next appointment
When will my baby start getting teeth?
Teething, the process of baby (primary) teeth coming through the gums and into the mouth, is variable among individual babies. Some babies get their teeth early and some get them late. In general, the first baby teeth to appear are usually the lower front (anterior) teeth, and they usually begin erupting between the ages of 6-8 months. See “Eruption of Your Child’s Teeth” for more details.
Baby Bottle Tooth Decay
One serious form of decay among young children is baby bottle tooth decay. This condition is caused by frequent and long exposures of an infant’s teeth to liquids that contain sugar. Among these liquids are milk, formula, fruit juice, and other sweetened drinks.
Tooth decay is a disease that can begin with cavity-causing bacteria being passed from the mother (or primary caregiver) to the infant. These bacteria are passed through the saliva. Then when the mother puts the baby’s feeding spoon in her mouth, or cleans a pacifier in her mouth, the bacteria can be passed on to the baby.
Putting a baby to bed for a nap or at night with a bottle other than water can cause serious and rapid tooth decay. Sweet liquid pools around the child’s teeth, giving plaque bacteria an opportunity to produce acids that attack tooth enamel. If you must give the baby a bottle as a comforter at bedtime, it should only contain water. If your child won’t fall asleep without a bottle and its usual beverage, gradually dilute the bottle’s contents with water over a period of one to two weeks.
If your child uses a pacifier, provide one that is clean, and be sure to never dip it in sugar or honey, as this can lead to tooth decay.
Breastmilk is proven to be extremely beneficial for babies. However, breastmilk in combination with other foods and sugars can be very dangerous for young teeth.
After each feeding, it is best to wipe the baby’s gums and teeth with a damp washcloth or gauze pad to remove plaque. The easiest way to do this is to sit down, place your child’s head in your lap, or lay the child on a dressing table or the floor. Whatever position you use, be sure you can see into the child’s mouth easily.
Good Diet = Healthy Teeth
Healthy eating habits lead to healthy teeth. Like the rest of the body, the teeth, bones, and the soft tissues of the mouth need a well-balanced diet. Children should eat a variety of foods from the five major food groups. Most snacks that children eat can lead to cavity formation. The more frequently a child snacks, the greater chance for tooth decay. How long food remains in the mouth also plays a role. For example, lollipops, hard candy, gum and breath mints stay in the mouth a long time. This allows for longer “sugar” attacks on the tooth’s enamel. If your child must snack, choose nutritious foods such as vegetables, low-fat yogurt or low-fat cheese, which are healthier and better for children’s teeth
How Do I Prevent Cavities?
Your child’s baby teeth are at risk for decay as soon as they first appear – which is typically around age 6 months. Tooth decay in infants and toddlers is often referred to as Baby Bottle Tooth Decay. It most often occurs in the upper front teeth, but other teeth might also be affected. In some cases, infants and toddlers may experience decay so severe that their teeth cannot be saved and need to be removed.
The good news is that tooth decay is preventable! Good oral hygiene removes bacteria and left over food particles that combine to create cavities. For infants, use a wet gauze or clean washcloth to wipe the plaque from teeth and gums. Avoid putting your child to bed with a bottle, sippy cup, etc. filled with anything other than water. See “Baby Bottle Tooth Decay” for more information.
Cleaning Your Child’s Teeth
- Begin cleaning your baby’s mouth during the first few days after birth by wiping the gums with a clean, moist gauze pad or washcloth. As soon as teeth appear, decay can occur. A baby’s front four teeth usually push through the gums at about 6 months of age, although some children don’t have their first tooth until 12 or 14 months.
- For children younger than 3 years, caregivers should begin brushing children’s teeth as soon as they begin to come into the mouth by using fluoride toothpaste in an amount no more than a smear or the size of a grain of rice. Brush teeth thoroughly twice a day (morning and night) or as directed by a dentist or physician.
- For children 3 to 6 years of age, use a pea-sized amount of fluoride toothpaste. Brush teeth thoroughly twice per day (morning and night) or as directed by a dentist or physician. Supervise children’s brushing and remind them not to swallow the toothpaste.
- The tongue should also be brushed to remove bacterial plaque.
Until you’re comfortable that your child can brush on his or her own, continue to brush your child’s teeth twice a day with a child-size toothbrush. Do not use an adult-sized toothbrush.
When Children Should Start to Floss?
Parents should start flossing when tooth surfaces are next to each other. It is important to floss at least once a day. Proper flossing removes plaque and food particles in places where a toothbrush cannot easily reach. It helps prevent cavities between the teeth.
Why Are the Primary Teeth Important?
It is very important to maintain the health of the primary (baby) teeth. Neglected cavities can and frequently do lead to problems which affect developing permanent teeth. Primary (baby) teeth are important for (1) proper chewing and eating, (2) providing space for permanent teeth and guiding them into the correct position (3) permitting normal development of the jaw bones and muscles. Primary teeth also affect the development of speech and add to an attractive
Sippy cups should be used as a training tool from the bottle to a cup and should be discontinued by the first birthday. If your child uses a sippy cup, fill the sippy cup with water only (except at mealtimes). By filling the sippy cup with liquids that contain sugar (including milk, fruit juice, sports drinks etc.) and allowing a child to drink from it throughout the day, provides food for cavity causing bacteria.