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Baby and Children Dental Health

Baby and Children Dental Health

  • A baby’s 20 primary teeth are already present in the jaws at birth and typically begin to appear when a baby is between six months and one year.
  • Most children have a full set of 20 primary teeth by the time they are three.
  • Baby teeth are very important to your child’s health and development. They help him or her chew, speak and smile. They also hold space in the jaws for permanent teeth that are growing under the gums. When a baby tooth is lost too early, the permanent teeth can drift into the empty space and make it difficult for other adult teeth to find room when they come in. This can make teeth crooked or crowded. That’s why starting infants off with good oral care can help protect their teeth for decades to come.
  • When should you start bringing your baby to the dentist? After the first tooth comes in and no later than the first birthday. Besides checking for cavities and other problems, the dentist can show you how to clean the child's teeth properly and how to handle habits like thumb sucking.
  • 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 six months of age, although some children don’t have their first tooth until 12 or 14 months.
  •  For children younger than three years, start brushing their 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 per day (morning and night) or as directed by a dentist or physician. Supervise children’s brushing to ensure that they use of the appropriate amount of toothpaste.
  • For children three to six 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.
  • 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 and a pea-sized amount of fluoride toothpaste. When your child has two teeth that touch, you should begin cleaning between their teeth daily.
    • FROM MEDLINE PLUS- medlineplus.gov/childdentalhealth.html
  • Start using a pea-sized amount of fluoride toothpaste when they are two years old. You might start sooner, if a dentist or doctor suggests it. Provide healthy foods and limit sweet snacks and drinks Schedule regular dental check-ups.
  • Cavities (also known as caries or tooth decay) are one of the most common chronic diseases of childhood in the United States. Untreated cavities can cause pain and infections that may lead to problems with eating, speaking, playing, and learning. Children who have poor oral health often miss more school and receive lower grades than children who don’t.
  • About one of five (20 percent) children aged five to 11 years have at least one untreated decayed tooth.1
  • One of seven (13 percent) adolescents aged 12 to 19 years have at least one untreated decayed tooth.1
  • Children aged five to 19 years from low-income families are twice as likely (25 percent) to have cavities, compared with children from higher-income households (11 percent).1
  • The good news is that cavities are preventable. Fluoride varnish can prevent about one-third (33percent) of cavities in the primary (baby) teeth.2 Children living in communities with fluoridated tap water have fewer cavities than children whose water is not fluoridated.3
    • Similarly, children who brush daily with fluoride toothpaste will have fewer cavities.4
  • Dental sealants can also prevent cavities for many years. Applying dental sealants to the chewing surfaces of the back teeth prevent 80 percent of cavities.5

What Parents and Caregivers Can Do

  • Here are some things you can do to ensure good oral health for your child:
  • Protect your child’s teeth with fluoride.
    • Use fluoride toothpaste.
      • For children younger than age six, watch them brush their teeth. Make sure they use only a pea-sized amount of toothpaste and always spit it out rather than swallow it.
      • For children younger than age two, do not use fluoride toothpaste unless your doctor or dentist tells you to.
      • Learn more about fluoride toothpaste and other sources of fluoride at Brush Up on Healthy Teeth.
  • As soon as the first tooth appears in the mouth, talk to your pediatrician, family doctor, nurse, or dentist about fluoride varnish.
  • If your drinking water is not fluoridated, ask your dentist, family doctor, or pediatrician if your child needs oral fluoride supplements. These are available in many forms, like drops, tablets or lozenges.
  • Talk to your child’s dentist about dental sealants.
  • Have your child visit a dentist for a first checkup by age one, as recommended by the American Academy of Pediatricshttps://www.cdc.gov/Other/disclaimer.html
  • Find a dentist if your child needs one. Use the Insure Kids Now Dentist Locatorhttps://www.cdc.gov/Other/disclaimer.html

Related Links for Health Professionals

Community Preventive Service Task Force Recommendations for Improving Oral Health: Preventing Dental Caries (Cavities)https://www.cdc.gov/Other/disclaimer.html

Oral Health and Learning

FROM MOUTHHEALTHY.ORG-https://www.mouthhealthy.org/en/babies-and-kids

 

When Teeth Erupt

  • Your baby is born with 20 teeth below the gums, and they usually start coming through between six months and a year. Most children have their full set of teeth by three years old. Learn more about what teeth are coming through and when.
  • Baby teeth are very important to your child’s health and development. They help him or her chew, speak and smile. They also hold space in the jaws for permanent teeth that are growing under the gums. When a baby tooth is lost too early, the permanent teeth can drift into the empty space and make it difficult for other adult teeth to find room when they come in. This can make teeth crooked or crowded. That’s why starting infants off with good oral care can help protect their teeth for decades to come.
  • Your child’s baby teeth are at risk for decay as soon as they first appear—which is typically around age six 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 may also be affected. In some cases, infants and toddlers experience decay so severe that their teeth cannot be saved and need to be removed.
  • The good news is that tooth decay is preventable! Most children have a full set of 20 baby teeth by the time they are three-years-old. As your child grows, their jaws also grow, making room for their permanent teeth.

 

Teething Signs and Symptoms

  •  Teething can be a rite of passage for babies and parents alike. As their teeth come in, some babies may become fussy, sleepless and irritable, lose their appetite or drool more than usual. Diarrhea, rashes and a fever are not caused by teething. If your baby has a fever or diarrhea while teething or continues to be cranky and uncomfortable, call your physician.
  • Teething is one of the first rituals of life. Although newborns usually have no visible teeth, most baby teeth begin to appear generally about six months after birth. During the first few years of your child’s life, all 20 baby teeth will push through the gums and most children will have their full set of these teeth in place by age three. A baby’s front four teeth usually erupt or push through the gums at about six months of age, although some children don’t have their first tooth until 12 or 14 months. As their teeth erupt, some babies may become fussy, sleepless and irritable, lose their appetite or drool more than usual. Diarrhea, rashes and a fever are not normal symptoms for a teething baby. If your infant has a fever or diarrhea while teething or continues to be cranky and uncomfortable, call your physician.

When to Start Brushing with Toothpaste

  • Decay can happen as soon as teeth first appear. If you see some pearly whites peeking out when your little one smiles, it's time to pick up a tube of fluoride toothpaste. Find one with the ADA Seal of Acceptance.

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.
  • 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 and a pea-sized amount of fluoride toothpaste. When your child has two teeth that touch, you should begin cleaning between their teeth daily.
  • For children younger than three 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 per day (morning and night) or as directed by a dentist or physician. Supervise children’s brushing to ensure that they use the appropriate amount of toothpaste.
  • For children three to six 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.

How Much Toothpaste to Use

  • It doesn't take much to clean your child's teeth. Until you're confident 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. If your child is three or younger, use a smear of toothpaste (about the size of a grain of rice). For children three or older, a pea-sized amount of fluoride toothpaste will do. Learn more about establishing healthy habits early.

When to Schedule Your Baby's First Dental Visit

First Dental Visit

  • As soon as your child’s first tooth appears, it’s time to schedule a dental visit. The ADA recommends that the first dental visit take place within six months after the first tooth appears, but no later than a child’s first birthday. Don’t wait for them to start school or until there's an emergency. Get your child comfortable today with good mouth healthy habits.
  • Although the first visit is mainly for the dentist to examine your child’s mouth and to check growth and development, it’s also about your child being comfortable. To make the visit positive:
    • Consider making a morning appointment when children tend to be rested and cooperative.
    • Keep any anxiety or concerns you have to yourself. Children can pick up on your emotions, so emphasize the positive.
    • Never use a dental visit as a punishment or 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 problems.
    • 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 check-up.
    •  

When to Start Cleaning Between Teeth

  • It doesn't matter if you clean between your child's teeth before or after they brush as long as you clean between any teeth that touch. You can use child-friendly plastic flossing tools to more easily clean between your child’s teeth until your child learns to do it.

You Can Prevent Baby Bottle Tooth Decay

  • Baby bottle tooth decay most often occurs in the upper front teeth (but other teeth may also be affected). Frequent, prolonged exposure of the baby’s teeth to drinks that contain sugar can cause tooth decay. This can happen when the baby is put to bed with a bottle, or when a bottle is used as a pacifier for a fussy baby.

Keep Their Mouths Clean

  • The next time your child’s pacifier goes flying, don’t pick it up and put it in your mouth because you think that makes it cleaner. Cavity-causing bacteria can be passed through saliva, so you could actually be introducing germs to your child instead of protecting him or her from them. The same goes for mealtime. It can be second nature to offer a bite of your food to your baby from your fork or use their spoon to make sure their food is ready to eat. Keep your utensils, and your germs, separate for healthy mouth and body.

Water Works!

  • When your child has worked up a thirst, water is the best beverage to offer—especially if it has fluoride! Drinking water with fluoride (also known as “nature’s cavity fighter”) has been shown to reduce cavities by 25 percent. While sweetened drinks like fruit juice (even those labeled 100 percent natural), soda and sports drinks can cause cavities, water with fluoride protects teeth. Sugary drinks also contribute to weight gain, and water is calorie-free.

 

There’s One More Way to Keep Cavities at Bay

  • Brushing and flossing go a long way to protecting your teeth against cavities, but sealants form an extra barrier between cavity-causing bacteria and your child’s teeth. School-age children without sealants have almost three times more cavities than children with sealants. According to the Centers for Disease Control and ADA’s Center for Evidence-Based Dentistry, sealants have been shown to reduce the risk of decay by nearly 80 percent in molars.

 

Pacifiers

  • Infants and young children may suck on thumbs, other fingers or pacifiers. Pacifiers dipped in sugar, honey, juice or sweetened drinks, can lead to tooth decay. Tooth decay can also begin when cavity-causing bacteria pass from saliva in a mother or caregiver’s mouth to the baby. When the mother or caregiver puts the baby’s feeding spoon in her mouth, or cleans a pacifier in her mouth, the bacteria can be passed to the baby.

 

Breastfeeding: Six Things Nursing Moms Should Know About Dental Health

  • Breastfeeding is one of the first (and most personal) decisions a mother makes for her baby. It can help your baby’s body fight infections and reduce health risks like asthma, ear infections, SIDS and obesity in children. Nursing moms may lower their chances of developing breast and ovarian cancer. But did you know breastfeeding can impact the dental health of both baby and mom? Here’s how:
     

Breastfeeding May Help Build a Better Bite

  • Several recent studies, one in Pediatrics in 2015 and one in the August 2017 issue of the Journal of the American Dental Association, found that babies who were exclusively breastfed for the first six months were less likely to have teeth alignment issues such as open bites, crossbites and overbites, than those exclusively breast fed for shorter lengths of time or not at all.

    Still, this doesn’t mean your exclusively breastfed baby won’t need braces someday. Other factors, including genetics, pacifier use, and thumb sucking, affect alignment. “Every baby, every child is different,” said Dr. Ruchi Sahota, mother and American Dental Association spokesperson. “The best thing for mom to do is to take the child to the dentist and make sure the dentist is able to monitor eruption, that baby teeth are coming out at the right time and permanent teeth are coming in at the right time.”
     

You Don’t Have to Wean When Your Baby Gets Teeth

  • It’s a question that often pops up in parenting message boards and conversations with new moms: Should I stop breastfeeding when my baby starts teething? The answer is not if you don’t want to.

    The American Academy of Pediatrics recommends breastfeeding for the first year of a baby’s life; the World Health Organization encourages moms to go for two. “As it goes with breastfeeding, every child is different, every mother is different,” said Dr. Sahota. “You should stop breastfeeding when you think it’s the best for you and the baby but not just because the teeth come in.”
     

Breastfeeding Reduces the Risk for Baby Bottle Tooth Decay

  • Another benefit of exclusive breastfeeding, Dr. Sahota says, is a reduced risk of baby bottle tooth decay, the frequent, prolonged exposure of the baby’s teeth to drinks that contain sugar. This type of tooth decay often occurs when a baby is put to bed with a bottle – even ones containing formula, milk or fruit juice. (Water is fine because the teeth won’t be bathed in sugary liquids for a prolonged time.) It most often occurs in the upper front teeth, but other teeth may also be affected.
     

Breastfed Babies Can Still Get Cavities

  • It’s one of the most common questions nursing mothers ask: Can breastfeeding cause cavities? Yes, it can. Although natural, breast milk, just like formula, contains sugar. That is why, breastfed or bottle-fed, it’s important to care for your baby’s teeth from the start. A few days after birth, begin wiping your baby’s gums with a clean, moist gauze pad or washcloth every day. Then, brush her teeth twice a day as soon as that first tooth emerges. Use fluoride toothpaste in an amount no more than a smear or the size of a grain of rice.
     

Need Dental Work Done? Double Check Your Medications

  • If you need to have a dental procedure that requires medication while nursing, check with your dentist, personal physician and pediatrician to make sure it is safe for baby. “It’s important to know there are antibiotics we can give you that won’t hurt the baby,” said Dr. Sahota. “It’s not only safe to go to the dentist while you’re pregnant and while you’re nursing, it’s very important to do so for the best health of your child.”

    Another helpful resource for nursing moms is the U.S National Library of Medicine’s Drugs and Lactation Database (LactMed). Simply search for any medication and get information about how it affects your supply, your baby and if there’s an alternative available. Talk to your doctor about what you find.
     

Mom, Take Care of Yourself

  • Dr. Sahota says there’s one thing she sees in new moms, breastfeeding or not. “I definitely see moms who are, as simple as it sounds, are not able to take care of themselves as well as they did before the baby,” said Dr. Sahota. “Moms that are just not brushing as much as they used to, whether they’re brushing once a day or not brushing at all.”
  • A dip in dental care could lead to more gum disease and cavities. Cavity prevention is especially crucial for moms, as even the simple act of sharing a spoon with could transfer that bacteria into your baby’s mouth. “It’s really important to do the basics: Brush twice a day, floss once a day. See your ADA dentist regularly,” she says. “Make sure you have prevented decay and don’t have any cavities so you don’t transfer that to your baby.”
  • Dr. Sahota says she also sees more teeth grinding (bruxism) in moms. “I see a lot more head and neck muscle tension, which causes our jaws to be a little bit more tense and then that causes us to grind our teeth,” says Dr. Sahota. “Trouble sleeping when we’re pregnant, that can cause us to grind our teeth a little bit. Postnatal, stress can increase and it can also be an issue.”
  • All moms need to stay hydrated, especially if breastfeeding. “Not drinking enough water, that in itself is a very dangerous thing for your mouth,” said Dr. Sahota. “If we have a dry mouth, we put ourselves at risk for gum disease, for cavities, so many things.”
  • And there’s one last piece of advice Dr. Sahota gives all moms. “Just like if you’re on an airplane, you have to put your oxygen mask on first before you put it on your child,” she says. “If you’re not healthy, you will not have the time and the energy to make sure your children are also healthy.”

 

Six Ways to Reduce Your Child’s Sugary Snacking

  • When working with her young patients, pediatric dentist and ADA spokesperson Dr. Mary Hayes teaches them this simple, but important, saying: “Sugar is fun to eat, but not good for your teeth!”
  • Your child might love sweet treats, but the bacteria in his or her mouth loves them even more. “Sucrose (sugar) is the ‘food’ for the bacteria that cause tooth decay,” said Dr. Hayes. “Those bacteria produce acid that etches away the teeth.”
  • Limiting the amount of sugar your entire family eats is good for your teeth and key to your overall health. Here are some dentist-recommended ways to start saying good-bye to unnecessary sugar throughout the day.
     

Know the Limits

  • When choosing a snack, keep an eye on added sugar (sweeteners like corn syrup or white sugar that are added to prepared foods). Naturally occurring sugars are less worrisome, as they are found in healthy choices like milk and fruit.

    The U.S. Food and Drug Administration recommends that people age three and older should consume no more than 12.5 teaspoons each day of added sugar. (The same as one can of soda.) The World Health Organization states that adults should consume no more than six teaspoons of added sugar, and children should have no more than three teaspoons.

    When reading labels, you’ll see sugar is listed in grams. Since 1 teaspoon of sugar equals four grams, aim to make sure the foods you are feeding your child fall between 12 to 50 grams a day.
     

The Truth about Juice

  • Because juice is high in sugar and calories, water and milk are always the best options for your little one. In fact, if your child is under one years old, the American Academy of Pediatrics suggests completely removing juice from his or her diet.

    Older children can occasionally drink juice, but if they do, there are two things to remember:

Children ages one to six should have no more than four to six ounces of juice each day, according to pediatric guidelines. Children ages seven to 18 should drink no more than eight to12 ounces (Many juice boxes are about six ounces, so younger children should have no more than one per day, and older children no more than two.)

Allowing your child to sip on juice throughout the day puts him or her at higher risk for tooth decay because you’re giving that cavity-causing bacteria more opportunities to eat and produce the acid that eats away at teeth. This can also happen with juice that is watered down. “Even though the volume of sugar has decreased, you’ve added the time that it takes to drink it,” says ADA spokesperson Dr. Jonathan Shenkin.

  • So what’s a parent to do? Limit the amount of juice your children drink, and always offer water or milk first. If your child does drink juice, serve the recommended, age-appropriate limits at mealtimes only. When your family is done eating, clean up any leftover juice instead of letting your children leave the table with it.
     

Skip the Soda

  • Call it soda, call it pop. But sugary, carbonated beverages by any name are bad news for your child’s teeth. “One can of soda is the amount of sugar recommended for three days for a child,” said Dr. Hayes,

    In fact, a February 2016 study in the Journal of the American Dental Association found a strong association between sugary drinks and poor dental health in teenagers. Researchers asked teens fourteen to nineteen in Mexico about how many sugary beverages they drank, then examined their teeth. They found 31.7percent had tooth erosion, which means their enamel had been eaten away. The main culprit? Soda.
     

Be Picky About Sticky Snacks

  • If you’ve been under the impression that gummy or sticky fruit snacks are healthy alternatives, you’re not alone. Many parents are surprised to learn they are really closer to candy than fruit, especially when it comes to sugar. “Fruit rollups and other dried fruit snacks are like nature’s candy,” said Dr. Shenkin. “It is like candy, but in some respect it’s worse than candy because it sticks to teeth longer than things like milk chocolate, which is easier to wash away.”

    Foods like raisins, which are often promoted as an all-natural snack option, can be troublesome. “The raisin is one of the worst foods because they’re so sticky and they actually adhere to teeth and stay there for an extended amount of time,” said Dr. Shenkin. “The sugar in that food is being consumed by the bacteria in our mouth during that time.”
     

Serve Carbs with Care

Set an Example

  • You’d do anything for your kids. Now, are you ready to do all of the above for yourself too? Dr. Shenkin says setting an example can make a big difference in your whole family’s health. Eat well, brush twice a day for two minutes and clean between your teeth once a day. “If you want to change your child’s habits, it isn’t just about what they do,” said Dr. Hayes. “Do the same thing with them.”