Establish Your Child’s Oral Health Before Birth

Your infant's first year of life is an important one—with rapid development that sets the stage for health later in life. While you might already be thinking about establishing routines such as sleeping, don’t neglect the importance of establishing an oral health care routine with your child.

Research suggests that the earlier you start, the better. In fact, some studies show that nearly 20% of 2- and 3-year-olds have severe early childhood cavities. Those children may require invasive treatment—even hospitalization. However, if you start learning about oral health during pregnancy and continue throughout your child's first year, your children have a better chance of being free from cavities.

If you are pregnant, schedule a dental visit now. A recent scientific study found that children of mothers who received information about children's oral health during pregnancy and then continued learning during their child's first year of life had fewer cases of severe early childhood cavities.

Be aware that the Internet and other similar sources of information can be unreliable. That’s why it’s critical to receive information from a qualified dentist. Topics you should discuss range from nutrition and oral hygiene to the use of pacifiers.

Dental Care and Quality of Life

Dental care has a significant positive impact on your child’s quality of life. A lack of dental care can also have a significant impact—but negatively. Research shows that early childhood cavities can lead to

  • physical symptoms, such as pain and malnutrition/delayed growth from reluctance to eat
  • functional difficulties, including poor chewing and restricted communication resulting from poor speech and a loss of space in the mouth
  • psychological effects from low self-esteem that results when a child’s mouth and teeth don’t look their best
  • higher risk of future cavities

Don’t wait until your child experiences problems before visiting your dentist. Infancy is a critical time when it comes to laying down a foundation for good oral health. It is much more difficult to change unhealthy habits later on than it is to set up an effective oral health routine early.

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Pacifiers and Toothbrushes: What’s Hiding on Them?

Keeping your child’s mouth healthy is important to prevent cavities and other diseases. But while pacifiers and toothbrushes start out sanitary and free from germs, they soon become a breeding ground for bacteria, viruses and fungi. In fact, it takes just one session of tooth-brushing to contaminate your child’s toothbrush with an array of microbes.

Pacifier nipples can harbor just as many problems. They come in regular contact with saliva, which essentially coats them with oral microflora. On top of that, many kids drop their pacifiers on the floor, further subjecting them to contamination. Thrush, a yeast infection of the mouth, is more common in children who use pacifiers. And studies have found that the use of pacifiers is associated with dental cavities.

Traditional Sterilization

Many parents just rinse toothbrushes and pacifiers with water—either cool or boiling. However, a recent scientific study concluded that sterile tap water was not sufficient to clean toothbrushes and pacifiers of bacteria. This means that microbes still remain on toothbrushes after being washed with tap water. However, researchers found other methods that performed significantly better while being simple and cost-effective.

Cleaning the Right Way

Research suggests that either microwaving the pacifier or toothbrush, or rinsing it with chlorhexidine, an ingredient found in oral rinses, kills Streptococcus mutans, a bacteria known to be a key offender when it comes to causing tooth decay. Given that chlorhexidine is a prescription medication, the use of microwaving—after appropriate parental instruction—may be the most useful disinfection method.

Keeping Toothbrushes and Pacifiers Clean

Ensuring that toothbrushes and pacifiers are sterilized is important to safeguard your child’s health. Good oral health starts with the actions you take in the home to protect your family’s well-being. By making sure you sterilize toothbrushes and pacifiers properly, you can help to protect your child’s health.

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Dental Phobia—Overcoming the Problem

Many children suffer from fear and anxiety about dental treatment. One large study showed that 23% of American children aged 5 to 11 years feared going to the dentist. Such anticipatory anxiety may lead to avoidance of needed dental treatment. Several theories have been put forth suggesting ways to reduce dental anxiety in children, among them giving the child a sense of control, allowing the child to hold a favorite toy, having the dentist spend social time with the child and using various behavioral control techniques (e.g., voice control and distraction).

Social learning theory proposes exposing the child to positive information or images of dental treatment. This creates an image that dentistry is beneficial and nothing to be afraid of. Two studies—one involving British children, the other involving Nigerian children—reached opposite conclusions about the effectiveness of this technique in relieving dental anxiety.

A recent study revisited this question. One group of 25 children was given a pamphlet titled “Check Out a Visit to the Dentist” while waiting to see the dentist. The other group of 25 children was given a pamphlet about healthy eating. The anxiety level of children in both groups dropped slightly, but not enough to demonstrate that reading positive information about dental treatment had any effect. However, the authors of the study admitted that the children, chosen randomly, did not have a great amount of dental anxiety to begin with.

The fact that both groups did demonstrate a drop in dental anxiety after reading something suggests that intellectual or cognitive processing may be beneficial for children facing dental anxiety. Currently, studies are underway using cognitive behavioral therapy to relieve dental anxiety among adults. Perhaps having children engage before an appointment in a high level of cognitive processing, such as reading, could help relieve some dental anxiety.

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Eight Steps to Prevent Cavities

The number of very young children with dental cavities has been increasing in recent years. Health professionals think a major reason is the consumption of too many unhealthy foods and sugary drinks. That creates an oral environment in which the acid-producing bacteria responsible for tooth decay flourish. Children are also drinking more non-fluoridated water, reducing the amount of fluoride, a nutrient essential for healthy tooth development, they consume.

Because cavities in baby teeth can be a forerunner of decay in the permanent teeth, it’s important to take special care to prevent cavities early on. Here are some steps parents can take.

  • Don’t let your baby fall asleep with a bottle in his or her mouth. Some of the feeding fluid will remain in the mouth, bathing the erupting teeth in sugary juice or formula. If you must give a drink during the night, make it water.
  • If the water in your community is fluoridated, use it, not bottled water, which is not fluoridated. If you don’t like what comes out of your tap, buy a filter for your faucet or a filtered pitcher.
  • Choose healthy foods, which will improve your family’s overall health as well as dental health. These should include low-fat dairy products, whole grain breads, raw vegetables, fruits and nuts.
  • If you give your child sweets, do so only as a dessert after the main meal. Frequent snacking, especially at night, is a major cause of tooth decay.
  • Don’t share cups, utensils or anything else that’s normally put in the mouth. The bacteria that cause cavities are contagious; if you have any, you can pass them on.
  • If you smoke, stop. Researchers have found that children of parents who smoke are more likely to develop cavities.
  • Teach your child how to brush the teeth properly, using short, side-to-side and up-and-down strokes for at least two minutes twice a day.
  • Finally, take your child to a dentist regularly, beginning before the first birthday, for an examination and, if needed, for cleaning and fluoride application. While you're at the dental office, ask questions. Your dentist is your best source of information on dental health.

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Helping Your Child Brush Correctly

Parents often assume that their 6-year-old children are old enough to brush their teeth unsupervised. But whether the children are brushing their teeth effectively is an important question. Good oral hygiene is necessary to remove plaque, the bacterial film that clings to teeth and is responsible for caries (cavities) and other dental problems. Proper tooth-brushing at least twice a day with a fluoride-containing toothpaste is considered an effective caries-prevention method.

Because the motor skills needed to brush the teeth effectively continue to develop throughout childhood, it’s recommended that you help your child until he or she is several years older than 6 years of age. A study of Swedish school children aged 6 to 12 supports this.

Overall, the children’s plaque removal was found poor. Only about 30% was removed from the teeth, with 6-year-olds leaving behind almost twice as much as the 10-year-olds. This poor plaque removal correlated with insufficient time spent brushing, especially among the youngest children. Although over 90% of all the children said they brushed twice a day or more, about two-thirds spent less than two minutes brushing, while half the 6-year-olds spent less than one minute.

How can your child achieve better results?

First, your child has to know what good brushing technique is: brushing all surfaces of the teeth, not just the tops, for two minutes at least twice a day. Your child's dentist can explain proper technique. But if your child lacks the requisite motor skills, you need to help out.

One frequently asked question is what about electric toothbrushes? It’s generally accepted that electric toothbrushes remove plaque better than manual toothbrushes. However, a child should be familiar with and adept at manual brushing before being introduced to an electric device.

Periodic visits to the dentist will indicate how well toothbrushing is going. You should be able to give your child increasing responsibility for this job, but count on being involved until he or she is about 10 years old. Establishing a routine for good oral hygiene before adolescence will set a pattern for life.

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Bring Bruxism to a Grinding Halt

Don’t think it’s unusual if you notice your child often clenching his jaw or, especially when asleep, grinding his teeth. These are signs of what is called bruxism, and it affects an estimated 20% to 30% of children. Bruxism can be a cause of earaches, headaches, jaw pain and sometimes tooth damage from the repeated grinding together of the top and bottom teeth.

Just what causes bruxism isn’t clear. In some cases the teeth are not properly aligned; a dentist can tell if that’s the problem and can usually fix it. More often stress is a factor. A child could be tense and worried about anything from an upcoming test or social occasion to a move to a new town or a family crisis like divorce. Hyperactive children and those taking antidepressants are at increased risk.

Whether or not you are aware of a stressful situation that could be causing the clenching or grinding, talk to your child; try to learn what he or she is feeling and what’s going on in his or her life. Sometimes reassurance is enough to relieve the stress. If talking to your child doesn’t resolve the problem, you may take your child to see a mental health professional.

Encourage your child to participate in healthy physical activity, and teach him or her to relax with tension-relieving measures like warm baths, massages or soothing music. If daytime clenching or grinding is the problem, a child can be made aware of it—when it happens, prompt your child to relax his or her jaw.

Applying an ice pack or hot compress can provide relief to an aching jaw. If the jaw is sore or the teeth are becoming damaged, a dentist may prescribe a tooth guard, similar to the protective mouthpieces worn by football and hockey players, to be worn at night. Your child may need some time to get used to wearing a tooth guard while sleeping, but it quickly will bring positive results.

Happily, most children outgrow bruxism by their early teens. A combination of parental observation and dental visits can help keep the problem in check until they do.

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