Protecting Your Infant from Baby Bottle Tooth Decay
Caries (tooth decay) is the most common childhood disease—five times more common than asthma. As soon as your baby’s teeth emerge, they are susceptible to decay, paradoxically, from the nutritious formula or milk in a bottle (thus the name “baby bottle tooth decay”), which can lead to cavities and loss of primary teeth. But you can take steps to minimize or eliminate baby bottle tooth decay from your child’s mouth.
Tooth decay results from a bacterial infection. Since parents are the usual source of these bacteria in a child’s mouth, the first step to protect your child’s teeth is to maintain good oral health yourself.
What else can you do?
Because the bacteria in your infant’s mouth feed on the carbohydrates found in milk, juice and other beverages, wipe your child’s gums after bottle- or breastfeeding with a clean, wet gauze pad or washcloth. This helps remove bacteria and gets your baby accustomed to the idea of cleaning the mouth after eating. Once your baby’s first teeth appear, brush these teeth after every feeding―even when your baby takes medication because many medications contain carbohydrates. Use a soft-bristled, child-sized toothbrush and water.
One common problem arises when your baby falls asleep while drinking from a bottle or while breastfeeding, allowing sugars to accumulate on your baby’s teeth. The simple solution: Don’t give your child a bottle at naptime or bedtime. Always make sure your child has finished feeding before allowing him or her to fall asleep. That gives you time to clean your child’s teeth and gums, removing the decay-causing bacteria in a timely fashion.
By the time your child is 12 months old, he or she should use a sippy cup. Don’t let your child carry the cup around and drink sugary drinks (including milk and fruit juice) for long periods; instead, fill the sippy cup with water.
Baby’s first dental visit should be scheduled for no later than the first birthday. We will check for any decay and talk to you about how to keep your child’s teeth healthy and sound. No matter what your child’s age—or yours—your dentist is your best source of information on dental health.
Keeping the Color Off Your Child’s Teeth
Are your child’s pearly whites looking a tad less pearly lately? Just like adults, children can suffer from tooth discoloration in both primary (baby) and permanent teeth. Depending on what has caused your child’s teeth to become stained, we can recommend ways to improve the teeth’s appearance and make sure that the stains do not signify a more serious health issue.
A common cause of stained teeth is poor dental hygiene. When your child doesn’t brush and floss adequately, hard-to-remove plaque can develop and make the teeth appear yellow or orange. While we may be able to remove some of this debris during a cleaning, you can help your child’s teeth look whiter by helping your child become better at caring for his or her teeth.
Other Causes of Discoloration
- Vitamin supplements that include iron can cause dark stains on a child’s teeth; so can antihistamines and certain antibiotics (including a mother’s use of tetracycline during pregnancy).
- Trauma from an injury to the teeth or gums can make the teeth turn pink or gray.
- Some genetic conditions interfere with the development of tooth enamel, causing baby teeth to come in with a discolored appearance; newborn jaundice and certain infections may also be to blame.
- Even fluoride, usually considered a tool in your child’s dental health arsenal, can affect the appearance of teeth—excessive fluoride exposure from not spitting out toothpaste or drinking formula made with fluoridated water may lead to white streaks on tooth enamel.
Unless the discoloration is due to reasons of hygiene, the stains on your child’s teeth can be difficult to remove. Cosmetic whitening can be an option if you’re concerned about your child’s appearance. Most importantly, we can make sure that the staining is only a cosmetic problem, not the result of an underlying illness. That way, you can at least rest assured that those not-so-perfectly-pearly whites are still perfectly healthy.
Brush Away the Plaque, Not the Enamel
Consistent brushing is an essential part of dental health, along with flossing and regular dental visits. But wait—did you know that there is a danger in brushing too hard? Overbrushing, also known as toothbrush abrasion, can damage tooth enamel and cause the gums to recede, exposing the roots. Not only can this lead to increased sensitivity to heat and cold and the potential for developing cavities on the roots but it may raise your child’s risk for periodontal disease.
Toothbrush abrasion can happen to anyone who brushes too hard, but some people are at higher risk, including those who
- use medium- or hard-bristled brushes
- grind or clench their teeth
- have other risk factors for gum disease
Abrasion can also result from habits such as biting nails or chewing on pencils, or even from just using an overly abrasive toothpaste.
Once your child has toothbrush abrasion, there are several options for treatment. We can sometimes use fluoride treatments to reduce sensitivity. If parts of the teeth are already worn away, dental bonding or fillings might be necessary.
Better Than Treatment: Prevention
Because most people don’t know they are brushing too hard until they see the first visible signs of abrasion—a V-shaped indentation on the part of the tooth near the gumline—it’s better to prevent it altogether. Help your child understand that brushing better doesn’t mean brushing harder. Plaque actually comes off fairly easily, so there’s no need to scrub or scrape the teeth to prevent cavities. Have your child use a soft-bristled toothbrush, and gently brush each tooth with short strokes while avoiding the tendency to squash or push the bristles against the teeth and gums.
If you feel as if you’re sending mixed messages—“Brush your teeth! But don’t brush too hard!”―enlisting our help might help get the message across. We can go over brushing techniques with your child at your next appointment.
X Marks the Spot: Dental X-rays for Young Children
After we finish a thorough cleaning and dental examination of your child’s teeth, you hear us suggest taking a series of x-rays. Questions run through your mind: Is there something wrong with my child’s teeth that would warrant an x-ray? What about the risks of radiation? Is this really necessary, considering that my child still has his or her baby teeth?
Taking oral x-rays, even of young children with primary teeth, is actually a common practice for most pediatric dentists. X-rays can detect dental problems that can’t be seen with the naked eye—cavities between teeth, early signs of decay, orthodontic concerns and other dental issues. While it may seem odd to perform x-rays on teeth that your child is going to lose anyway, damage to the bones and gums can lead to long-term problems if not addressed in a timely manner. And, because your child’s mouth is rapidly growing and changing, regular x-rays are an important part of his or her dental care.
How frequently should your child have a dental x-ray?
The American Dental Association recommends taking bitewing x-rays every 12 to 24 months for children between the ages of 1 and 5 years, every 6 to 12 months if the child is at increased risk of dental disease. Bitewing x-rays allow us to see the upper and lower molars from the crown to the bone, helping us diagnose decay and gum disease. Of course, every child’s needs are different. Sometimes, additional x-rays may be recommended if we suspect problems in the front teeth, or if there is an injury or specific problem that requires further attention.
While it’s natural to be concerned about the radiation risks from x-rays, we are careful to use lead aprons, shields and equipment to ensure the least possible amount of radiation exposure.
As always, don’t hesitate to discuss any aspects of your child’s oral care, including the use of x-rays, with us. We can answer any questions you may have while explaining the reasons for the procedure and the benefits involved. Your child’s primary teeth may indeed be perfectly healthy. Our goal is to keep them that way.
How Eating Disorders Affect Oral Health
Eating disorders—including anorexia, bulimia and binge eating—affect as many as 30 million Americans of all ages and genders. A full 95% of individuals with eating disorders are between the ages of 12 and 25. Contrary to popular misconception, young men are not immune; in fact, an estimated 10% of individuals with anorexia or bulimia are male.
While these disorders have a significant impact on a person’s overall mental and physical health, they can be detrimental to a person’s oral health, as well. All eating disorders can lead to malnourishment, which can result in anemia, vitamin deficiencies and periodontal disease.
Bulimia is the eating disorder that most affects oral health. If your child suffers from bulimia, the effects on his or her dental health will likely be noticeable early on. Frequent vomiting brings stomach acids into the mouth and leads to erosion of the tooth enamel, especially on the back of the front teeth. Severe erosion can also affect a person’s bite. In addition, frequent vomiting can cause a person’s salivary glands to swell and the inside of the mouth to become red and sore.
If your child suffers from an eating disorder, you need to seek professional help. Even with treatment, it may take time to control episodes of induced vomiting. If your child continues to induce vomiting, we recommend that he or she rinse with a solution of baking soda and water afterward. We may also recommend a mouthwash containing fluoride. However, your child should not brush immediately after vomiting; stomach acids can weaken tooth enamel, which means that brushing too soon afterward can lead to further erosion.
Because changes in your child’s mouth are often the first signs of an eating disorder, we may notice its effects when your child comes in for his or her regular examination. As your child undergoes treatment, we can work with you to minimize the effects of the eating disorder on your child’s oral health.
Getting That Thumb Out of Your Child’s Mouth
When should you attempt to break your child’s thumb-sucking habit? How should you do it? Should you even worry about it? Most children who suck their thumbs (or fingers) as infants stop on their own by the time they turn 5 years old. Generally, thumb-sucking’s impact on mouth growth and tooth alignment—a child’s bite—arises only if the habit continues after permanent teeth have begun to come in.
If your child’s fifth birthday is approaching—or has passed—and he or she continues thumb-sucking, consider these strategies:
- Ask your child for ideas about how he or she can learn to stop thumb-sucking. If your child is not ready, explain that you’ll be there to help when the time is right.
- “Catch” your child when not sucking, and offer praise. Conversely, if your child seems at times to be unaware of sucking, gently point it out to promote self-awareness of the habit.
- If your child’s anxiety in particular situations fosters sucking, offer alternatives, such as a stuffed animal or blanket to snuggle with (not, of course, to suck).
- Compromise with your child by giving full permission to thumb-suck at bedtime or naptime, but asking him or her to try very hard to stop doing it during the course of the day.
Two products are marketed for breaking the thumb-sucking habit, but some doctors and psychologists have suggested that they may cause more harm than good:
- Nasty-tasting liquids. Sold over-the-counter just for this purpose, these bitter or sour preparations are applied to the favored thumb or finger. This method works in some children, but not in others.
- Plastic thumb guard. Used mostly at night and held in place with a wristband your child can’t remove, the thumb guard can be quite effective, although can create anxiety in the child.
As a last resort, we can fit your child with an intraoral appliance. This device physically prevents the sucking motion. It usually remains in place for three to six months, after which the habit should be broken.
Before you decide on a course of action, come see us. We can explain to your child—as we have to countless other children—why thumb-sucking can cause trouble for his or her future teeth. Then we can work together to develop an individualized plan to break the habit.