Children's Oral and Dental Health

Oral and dental health are integral parts of good overall health, and dental caries is the most common chronic infectious disease of childhood. Here are some tips for helping your child have good dental health.

Infants:  Steps can be taken to support your child’s oral health even before the first teeth appear.  Wipe your baby’s mouth and gums with a clean, damp cloth after feedings and before bed.  Start brushing with a soft infant brush and water when the first tooth comes in and start flossing when two teeth start to touch or when all the baby teeth are in – usually around 2-2½ years. It is best to introduce cups starting around 6 months of age.  Cups with a “no-spill” valve (often called sippy cups) are more like bottles – so to help your child learn the new skill of drinking from a cup, look for a cup without the no-spill feature.
 Toddlers:  Wean from a bottle by around 12-24 months.  Don’t let your child walk around with a cup or bottle – especially if it contains milk, juice, or other sweet drinks.  This causes sugar to remain on teeth longer, increasing the risk of decay.  If your child uses a cup or a bottle at bedtime or naps, put only water in it at that time.

Preschoolers:  Preschoolers and older children should brush their teeth at least twice a day and floss once a day.  Start by using a pea-sized amount of fluoride toothpaste when your child is around age two.  Encourage your child to help brush his or her own teeth, but remember that children are still developing fine motor skills, so they might need your help.  Supervise closely to make sure your child spits out, rather than swallows, the toothpaste.  In between meals and snacks, offer water instead of milk, juice, or sweetened drinks.
School Age:  Children typically need help brushing their teeth until around age 8 as this is when children gain the fine motor skills necessary to do the job well.  After children begin to lose their baby teeth around age 6, their permanent teeth begin to come in so encourage children to pick healthy snacks and limit sugary snacks and drinks.  School-age children are also often starting to participate in sports and other physical activities and it is important that they are using mouth guards and other protective equipment to prevent injury.

Dental caries is a dietary carbohydrate-modified infectious disease. It is the most common chronic infectious disease of childhood, with a prevalence of more than 40% by age 6 years in the primary dentition and more than 85% by age 17 years in the permanent dentition. Caries typically is described as a multifactorial process, involving specific oral microflora, diet, and a susceptible host. Prevention of dental caries therefore is aimed at 
  • Reducing cariogenic microbes in the oral cavity; 
  • Reducing the exposure of these microbes to a cariogenic substrate;  
  • Increasing the decay resistance of the tooth. A combination of dietary advice, coupled with mechanical plaque removal (e.g., brushing and flossing) and adequate fluoride exposure, is sufficient to control dental disease in most patients.

Recommendations to parents:
Do not put the infant to sleep with a bottle containing any liquid other than water. Infants who fall asleep while breastfeeding may be at higher risk for caries. Wean the infant from the bottle by 14 months of age. Avoid prolonged consumption of sweetened beverages or low-pH fruit juices from a bottle or "tippy" cup. Do not dip pacifiers in sweetened solutions or honey. 

Monitor the child's diet for the amount and frequency of exposure to fermentable carbohydrates. Restrict intake of sweets to mealtimes, when salivary flow is greater. Substitute less-cariogenic foods as snacks. 
 Clean the child's teeth after the intake of medications flavored with sucrose. 


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