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Early Infant Oral Care Topics / FAQ
Perinatal & Infant oral health
Breastfeeding benefits, recommendations and troubleshooting
Your child's first dental visit
When will my baby start getting teeth?
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 bacteria that causes cavities to their young children. Mother's should follow these simple steps to decrease the risk of spreading cavity-causing bacteria:
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Visit your dentist regularly.
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Brush and floss on a daily basis to reduce bacterial plaque.
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Proper diet, with the reduction of beverages and foods high in sugar & starch.
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Use a 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.
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Don't share utensils, cups or food which can cause the transmission of cavity-causing bacteria to your children.
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Use of xylitol chewing gum (4 pieces per day by the mother) can decrease a child’s caries rate.
Breastfeeding Recommendations, Benefits, and Troubleshooting
"The American Academy of Pediatrics recommends exclusive breastfeeding for the first 6 months of an infants life, followed by complementary introduction of solid foods at 6 months and continued breastfeeding up to age 2 or as long as mutually desired. The advantages of breastfeeding are the child's optimal nutrition and immunity, promoting bonding and social interactions, and helping stimulate proper growth and development of the airway and structures of the mouth and face. Breastfeeding is a foundational oral skill that is succeeded by other oral skills, such as chewing, swallowing, and speaking." (Baxter, R. Tongue Tied. Chapter 4, p35)
While 81% of mothers start breastfeeding, only 22% make it to the 6 month mark. A few popular reasons for stopping breastfeeding include difficulty obtaining a successful latch, persistent and/or severe pain for the mother, and inadequate milk supply or a baby that "just prefers a bottle." In all of these cases, a tongue and/or lip tie may be the culprit. It is estimated that one in four children have a restrictive tie beneath the tongue. Many of these go un-diagnosed and overlooked by well-meaning healthcare providers whose solutions include nipple shields and bottle feeding. While these may be effective, they do not resolve the root cause of the problem. As a result, we believe it is worthwhile to at least have a consultation with a healthcare professional trained in evaluation of tongue ties or "tethered oral tissues" (TOTs) before giving up on breastfeeding. We are happy to provide this evaluation and/or refer you to another trained allied health professional in the field.
When Will My Baby Start Getting Teeth?
Teething, the process of baby (primary) teeth coming through the gums 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 age of 6-8 months.
See "Growth and Development of your Child’s Teeth" for more details.
Baby Bottle Tooth Decay (Early Childhood Caries)
The most serious form of cavities 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 (including breast milk), formula, fruit juice and other sweetened drinks.
When the baby is feeding on breast milk only, the amount and frequency is not a concern. However, once other foods are introduced to the diet, putting a baby to bed for a nap or at night with a bottle containing anything 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 contain only water. If your child won't fall asleep without the bottle and its usual beverage, gradually dilute the bottle's contents with water over a period of two to three weeks until it is only water.
After each feeding, 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 the 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.
Sippy Cups
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 throughout the day, 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, it soaks the child’s teeth in cavity causing bacteria.
Thumb Sucking and Pacifier Habits
Sucking is a natural reflex and infants and young children may use thumbs, fingers, pacifiers and other objects on which to suck. It may make them feel secure and happy, or provide a sense of security at difficult periods. Since thumb sucking is relaxing, it may induce sleep.
Sucking habits that last more than a few years will cause problems with the proper growth of the mouth and tooth alignment. How intensely a child sucks will determine how quickly and severely these problems develop.
To best prevent permanent changes to the shape of the jaws and position of the teeth, the sucking habit should ideally be eliminated by 36 months of age. The further past this age that the habit continues, the more likely it will be that some or all of the growth changes become permanent. At that point, orthodontics will be needed to reposition the teeth. However, a sucking habit is even more powerful than braces, and if the habit continues during orthodontic treatment, it will be a never-ending tug of war!
Eliminating a sucking habit can be extremely difficult. There are a variety of methods you can try, and every child responds differently to each technique. For some, peer pressure at preschool or kindergarten is enough to cause them to stop. Other proactive techniques include:
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Substitution of comforts, such as giving them a special blanket or stuffed animal to hold instead
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A reward system, where the child gets a star on the calendar for each day they do not repeat the habit, with prizes at certain intervals (week, month)
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If it is a subconscious habit, wearing mittens to sleep or painting “Mavala,” a foul-tasting material on the fingernails, is another effective technique.
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If all else fails, a special type of retainer can be made to block the thumb out of the mouth.
