Click on the topic of your interest for more information.
Dental care for infants and toddlers
Dental problems can begin early. It is important for your child to have good habits from the start to prevent dental disease. Your child should visit a pediatric dentist when the first tooth comes in, usually between six and twelve months of age. During this visit, your pediatric dentist will help identify any signs of oral disease and develop an oral health care program base on your child's individual needs. Early examination and preventive care will protect your child's smile now and in the future.
Breastfeeding and bottle use
Baby Bottle Tooth Decay (BBTD) also known as Early Childhood Caries (ECC) is a disease that causes severe rapid decay of baby teeth. It usually affects the upper front teeth of infants and toddlers who fall asleep with a bottle of milk, formula, fruit juices, or any sweetened liquid. Lower front teeth are in general less affected since they are covered by the tongue. The process of tooth decay is the result of teeth being exposed for long periods of time to liquids containing sugars. The cavities first appear at the gum line as subtle, white, decalcified streaks. The process then begins to accelerate. In advanced cases, the crowns of the four upper incisors are completely destroyed, leaving decayed brownish-black stumps. By this time, baby teeth may either require crowns, root canal therapy, or even extraction.
Prolonged and unrestricted nighttime breastfeeding is also a cause of nursing decay. However, breastfeeding is associated with a low risk of developing tooth decay, compared with bottle feeding. Nevertheless, breast milk does contain carbohydrates, and some infants who breastfeed for long periods throughout the day or night may develop tooth decay. Although we encourage breastfeeding, to reduce the likelihood of nursing decay, infants should be removed from the breast when they finish feeding and have their front teeth wiped with a damp cloth.
Additionally, it is now recognized that mothers are the most common source of transmission of decay causing bacteria to their infants. Babies are not born with the bacteria that cause decay. Instead their mouth becomes “infected” from their mother’s saliva through food-tasting, pacifier-cleaning, and kisses.For additional information refer to the section Pregnancy and your baby’s teeth.
To help keep baby bottle tooth decay from affecting your child, follow these tips:
- After each feeding, wipe the baby's gums with a clean, damp washcloth or gauze pad. Begin brushing the child's teeth, without toothpaste, when the first tooth appears. Clean and massage gums in areas that remain toothless, and begin flossing when all the baby teeth have come in.
- Never allow your child to fall asleep with a bottle containing milk, formula, fruit juice or sweetened liquids (or when awake, sip on it for long periods of time as a pacifier).
- If your child needs comfort between regular feedings, at night, or during naps, fill a bottle with WATER or give the child a clean pacifier. Never give your child a pacifier dipped in any sweet liquid and always avoid filling your child's bottle with liquids such as sugar water, juice or soft drinks. Remember give always your child plain water for thirst.
- Start bottle weaning by at least a year. Weaning from the bottle or breast during the "terrible twos" can be extremely challenging. This struggle can be avoided by making the transition to the cup earlier in life, preferably shortly before or after the first birthday.
- During the transition from a bottle to a cup, the training/sippy cup should ONLY be filled with water unless being used at meal time. Also frequent drinking of sweet liquids such as juices, EVEN IF DILUTED should be avoided. Remember the frequent exposure of a child’s teeth for long periods of time to liquid containing sugars is the main cause of decay.
- Start dental visits by the child's first birthday. Make visits regularly and verify your child gets the fluoride needed to prevent decay.
- Additionally, parents play an important role in catching decay in the earliest stages. To inspect, parents should “lift the lip” to check for white spots along the gum line of the front upper teeth. These white spots are the early sign of baby bottle tooth decay and, if seen on your child’s teeth, are indications that your child should be seen by a dentist. It is essential to treat decay when present since this could lead to pain and infection for your child. Also remember children with caries on their baby teeth are at greater risk of having caries on their permanent teeth.
Children with healthy teeth can chew food easily, learn to speak clearly, and smile with confidence. Early dental intervention and monitoring may be the best way to prevent early childhood caries in the breast- and bottle-fed infant.
Diet
See section "Prevention of cavities"
Thumb sucking and pacifier use
See section "Oral Habits"
Kids & Teens Dentistry
Dr. M. Nikoui and Associates
3 Larkspur Drive, Ottawa, Ontario, K2H 6K8
Tel. (613) 820-8830
Fax (613) 820-8870
