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Infant Dental Care
How many teeth does a baby have? Count them… 8? 16? 20? Would you believe 52? This is surprising, but it is true. At birth 20 baby teeth (primary) and several adult teeth (permanent) are forming. By age 3, almost all of the 32 permanent teeth are well on their way. What is even more amazing is that there are several steps you can take now, while your child is a child, that will determine good oral health when they become adults.
The two lower front teeth are usually the first to arrive around 6-10 months of age. Teething continues until about 2 1/2 years of age, when the second primary molars erupt. When they part, the baby’s gums may look a little red and puffy, and they may experience swelling and tingling. Other symptoms of teething can include: loss of appetite, difficulty sleeping, and a temporary low-grade fever. If your baby experiences: a high or prolonged fever, a rash, or vomiting, these are signs that something else could be wrong and you should talk to your pediatrician.
To help ease teething discomfort, you can give your child a cool teething ring or frozen washcloth to chew on. The cold will help turn the gums and the chewing will help the new teeth cut through. Care must be taken not to allow your child to chew on objects that could break apart and pose a choking hazard. Infant Tylenol and preparations that release the gums should be used sparingly and only as a last resort.
BABY TEETH IS IMPORTANT
Although it is true that the primary teeth will eventually be replaced, they serve very important roles. Like your permanent teeth, your child’s primary teeth are essential for: proper chewing and eating, speech development, and attractive appearance. In addition, the primary teeth play an important role in developing the jaw bones and muscles, and they help guide the permanent teeth into position. Second primary molars are usually not replaced until 12-14 years and usually have to serve for 10 years or more.
Cleaning should be started even before the first teeth appear. After every feed you should gently clean your baby’s gums with a damp cleanser or a clean washcloth. This allows you to ensure that everything appears normal and creates a healthy oral environment for the first teeth to erupt. You can continue to clean the first new primary tooth with gauze or a washcloth. Once your fingers are at risk, it’s time to graduate to a soft, child-sized toothbrush. Brushing should be done at least twice a day, and most importantly, before bedtime.
Fluoride toothpaste is not intended to be swallowed and should not be used by young children until they can floss and spit reliably. If they are getting the right amount of dietary fluoride, babies do not need the extra fluoride from teething. There are now a number of teething foods available in pharmacies and supermarkets that are specially formulated for babies. These toothpastes contain no fluoride, are safe to swallow, and are less abrasive than regular children’s and adult toothpaste.
Once your child is able to floss and spit, fluoride toothpaste should be used. Parents of young children should be especially careful with “good tasting” children’s toothpaste. Because of their pleasant taste, some children like to eat these toothpastes. This should be strongly encouraged. Parents should ensure that only a small pea-sized dab of fluoride toothpaste is used with each brushing.
Fluoride is one of the most effective tools we have to fight tooth decay. By strengthening the teeth, it helps to prevent cavities between teeth, where the toothbrush cannot reach. Fluoride can also reverse small microscopic cavities before they grow large enough to restore. Because the water in Suffolk and Nassau counties does not contain fluoride, most children living here should begin taking a dietary fluoride supplement by six months of age. A pediatric dentist or pediatrician can advise you on the right fluoride supplement for your child.
FRIEND OF THE GAILS
One of the most emotionally and physically devastating oral diseases is early childhood caries. It causes rapid hard decay in baby teeth and can cause a child to have an attractive smile. Often, the four upper front teeth may need to be extracted before the age of 2. The good news is that this disease is 100% preventable.
Early childhood caries usually occurs when a baby is allowed to fall asleep with a bottle of milk, formula, juice, or sweetened water as a pacifier. During sleep, these liquids accumulate around the baby’s teeth for long periods of time. The naturally occurring bacteria (plaque) in the child’s mouth produce acids that attack the surface of the tooth. If not treated quickly, it can completely destroy the primary teeth and cause infections and disorders that can damage the growing permanent teeth.
So what can you do? Prevention is easy. If your child needs a comforter at nap time, bedtime, or between regular feedings, give them a bottle filled with chilled water only. If they are getting enough nutrition during regular feeding, they don’t need milk or juice at bedtime. If your child already uses a bottle of milk/juice, it may be difficult to change the routine. Be persistent, don’t give in. The few sleepless nights that may result will be a valuable investment in your child’s future smile.
Many children’s medicines are sweet, sticky syrups. If left around the teeth, they can also lead to early childhood caries. To prevent complications: clean your child’s mouth after each administration, and avoid giving medications at bedtime when they cannot swallow the entire dose.
SUCHA MOR AND PACIFIC
The sucking reflex is very strong in newborns. A sonogram often shows the baby’s thumb sticking out while still in the womb. Thumb sucking and pacifier habits are normal for babies and toddlers. These practices are better than using a milk/juice bottle at bedtime for comfort, as they do not cause tooth decay. If abandoned by age 3 1/2, chewing habits have little chance of causing orthodontic problems in the permanent teeth.
VISIT THE PEDIATRIC DENTIST
Preventive dental care should start “the younger, the better”. The American Academy of Pediatric Dentistry recommends that parents schedule their child’s first visit before 12 months of age. Early, routine dental care will ensure that any problems can be detected and treated early, or even avoided altogether. Experience shows that children who have a “dental home”, and who participate regularly in a preventive program, have significantly lower rates of dental disease than those seen from time to time. Additionally, enjoyable visits to the pediatric dentist will help your child establish trust and confidence that will last a lifetime. Our office does not charge for “well baby” dental visits for children under 24 months of age. By getting an early start on preventive dental care, you can help ensure that your baby’s 52 teeth are part of a healthy, attractive smile for life.
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