Infant Oral Examination
It is vital that you are well informed from the start when it comes to your baby’s oral care. Although the first teeth that come in are temporary, they may still develop infection and decay. Quite often, a mother transfers the bacteria that cause cavities (caries) to her child. Understanding the proper way to approach oral care for every stage of an infant’s development will help you to give the best oral care you can to your baby.
The U.S. CDC reports that the most common infectious disease in children is dental caries. Over forty percent of children have cavities before they are five years old.
Early childhood cavities can be particularly difficult, and start very soon after a tooth erupts. The cavities can develop on smooth surfaces and progress rapidly, having a long lasting negative effect upon your child’s teeth.
What Causes Cavities (Dental Caries)
Dental caries is actually a transmissible disease that results from bacteria that adhere to teeth. The bacteria that causes this is called MS (mutans streptococci). This bacteria metabolizes sugars and an acid is produced which is a byproduct of metabolism, that damages teeth.
MS is the type of bacteria that is responsible for cavities. An infant may become colonized with MS at any time after they are born. Increased MS colonization happens after the first teeth erupt, since the teeth provide a surface upon which the bacteria can adhere. Furrows within the tongue can also harbor these bacteria before the first teeth erupt.
Transmission of this cavity causing bacteria from a mother to her child has been well documented. Mothers with a high level of MS bacteria in their saliva have a much higher chance of transmitting them to their child. Additional factors that affect mother to child transmission include the mother’s snack frequency, oral hygiene, and the presence of periodontal disease.
Infant Oral Care And Mom’s Oral Care Are Synonymous
Good infant oral care begins with his or her mother’s dental health. As mentioned above, disease causing MS bacteria are easily transferred from a mother to her baby, which can cause dental decay in the child.
Bad dietary habits can cause the mother to have a higher level of MS bacteria, which increases the risk of transmission to her child. Therefore, a good diet and oral hygiene practices by the mother will reduce the risk of transmission to her child.
Dental caries in early childhood is quite prevalent in the U.S. However, it is also avoidable if the proper steps are taken at each stage of a child’s development.
Infant Oral Health Recommendations
All infants should have an infant oral examination from one of our pediatric dentists by the time they are six months old. This first examination will evaluate the infant’s risk of developing any type of oral disease, including their risk for developing dental caries. Education will be provided on infant oral health care and fluoride exposure will also be evaluated.
Barnes, McDonnell, and Parsons pediatric Dentistry will be established as the child’s dental home. The first visit will include the complete medical history of the child along with the dental history of the parent.A complete oral exam, a tooth brushing demo that’s age appropriate, and prophylaxis will be discussed. A fluoride treatment may be administered if needed.
There will also be an assessment of the risk of caries developing in the child and a plan to prevent them will be developed along with a schedule for future office visits. Guidance on what to expect with regard to oral and dental development, teething, sucking habits, oral hygiene instruction, injury prevention and the impact of diet on dentition are also parts of the first visit.
Teething can cause pain in the area where a tooth is erupting. There may also be excessive salivation and irritability associated with teething. However, it does not present any problems for some children. To treat symptoms, children are often given an oral analgesic, such as Tylenol, or given a chilled ring to gum.Topical anesthetics, such as gels, are not recommended for teething pain because they have the potential to be toxic.
Oral hygiene practices should be used from the time the first tooth erupts. Teeth should be brushed twice a day by the parent with a soft tooth brush that is sized according to the age of the child. The proper amount of toothpaste containing fluoride should also be used. (See the fluoride section below)
Research has shown that breast-feeding and human milk provide infants with general health, developmental, nutritional, social, environmental, and psychological advantages, while at the same time lowering the risk for a number of diseases. Human milk provides the infant with optimal nutrition and it hasn’t been associated with dental caries.Frequent bottle feeding at night with milk has been associated with dental caries. Bottle feeding at night with juice, use of sippy (no-spill) cups, and between meal snacks that contain sugar or sugary drinks greatly increase the chance of getting dental caries.
Exposure to the optimal amount of fluoride is important for a child’s dentition. Decisions regarding fluoride administration are based upon the individual requirements of each child. Using fluoride for the prevention of caries has been proven to be effective and safe. When assessing the risk-reward tradeoffs of using fluoride, the main issue is prevention of dental diseases versus mild fluorosis. The proper quantity of toothpaste containing fluoride must be used twice a day. Only a smear of the toothpaste must be used for a child less than three years of age. A pea sized quantity must be used for a child who is between three and six years old.Fluoride that is applied topically, by one of our dentists, may be contemplated for a child who is at a high risk for dental caries. A fluoride containing supplement will be considered if the child’s drinking water does not contain fluoride. Fluoride intake should be monitored carefully.