Prenatal Dental Care
What Expecting Mom's should know
The earliest stages of dental development are found when the embryo is approximately 5 to 6 weeks old. Development of the primary teeth begins at this time.
At birth, there are normally 44 tooth buds present in various stages of development. Enamel formation is well under way on the primary teeth (also known as baby teeth).
Prior to birth, the mother's body provides nutrition to the developing child. Good nutrition before pregnancy helps carry the mother and child through the first few weeks of development, which are critical. Hormonal changes can cause pregnancy gingivitis (inflammation of the gums). Maintenance of good oral hygiene and removal of any irritants helps to reduce the inflammation.
During pregnancy, fever and illness can leave marks on the developing teeth. Antibiotics, particularly tetracycline, taken during pregnancy may cause yellow-brownish stain on the primary enamel. The staining does not usually effect the integrity of the tooth.
Pregnancy can cause changes in the mucous of the mouth that may be a concern. Good oral hygiene and proper nutrition is essential to keep the mother and child healthy. As a precaution, dental x-rays should be avoided during pregnancy. If a x-ray can not be avoided the mother will be protected with a lead apron with attached thyroid collar.
When Do I Begin Brushing My Child's Teeth?
A new-born's gums should be massaged daily with a clean, moistened gauze. When the teeth begin to show in the oral cavity a very small soft bristled, brush should be used without toothpaste until the child is approximately 18 months of age.
When the child is ready for toothpaste, only a tiny drop should be placed on the brush. Children have a tendency to swallow toothpaste and fluoride may be ingested in excessive quantities. Although fluoride is effective in preventing cavities, it is a toxic substance and should not be ingested. The child should be encouraged to spit out the excess and rinse their mouth with clear water.
Remember to change your toothbrush every 3 months. Make sure the head of the brush fits the child's mouth. A good way to measure is to place the head of the brush behind the lower teeth. Use light pressure with a soft bristle brush. Brushing should take approximately 3-4 minutes. Make tooth-brushing an enjoyable activity for the child and they will want to repeat the behaviour.
Fluoride absorbs into the enamel of the teeth making them more resistant to acid producing bacteria.
It is available in various flavours and can be applied to the teeth either with a fluoride tray that gently rests in the mouth for 4 minutes or the hygienist can apply fluoride by painting it on the teeth, if the child is less co-operative.
Fluoride is also present in the drinking water of many cities across North America.
Ensuring your child uses fluoride toothpaste and receives fluoride treatments will help to develop and maintain healthy teeth and bones.
Nursing Bottle Decay
Cavities can occur in very young children who routinely fall asleep while nursing on a bottle. The sugar in the nursing bottle (cow's milk, juice, formula or sugary drinks) turns to acid, dissolving tooth enamel.
Breast-fed babies are also susceptible if they constantly fall asleep with breast milk on their teeth. Early sings include white spots and tooth discoloration. Damage to primary (baby) teeth can jeopardize the development and proper eruption of the permanent teeth.
You can protect your child by not letting your baby go to bed with a bottle unless it contains plain water, clean your baby's mouth regularly and don't dip pacifiers in honey or other sweet ingredients.
Pit & Fissure Sealants
The placement of pit and fissure sealants on the first set of permanent molars is an important part of a total hygiene care program for maximum protection against tooth decay.
The pits of the teeth are the deep grooves on the chewing surface of the tooth and the fissures are channels that extend down the sides of the teeth, facing the cheek or tongue.
This type of dental treatment is recommended for primary or permanent teeth that contain deep, narrow pits on the chewing surfaces.
These pits are traps for bacteria, which will lead to decay. It is difficult, and often impossible, to reach these areas with a toothbrush during normal cleansing.
Pit and fissure sealants are of greatest benefit to children, especially when the first sets of permanent molars erupt into the dentition between the ages of 6 and 13. These are generally considered the cavity prone years.
The sealant material is made of a type of liquid plastic that bonds directly to the prepared tooth surface. Sealants can be white, clear, or opaque in colour and feel smooth when touched. There are no toxic effects from the use of chemical sealants and the application is painless.
Properly sealed teeth should retain their sealant material for 6-7 years or longer. During every 6 month continuing care appointment, the dentist or hygienist will re-examine the sealant to ensure that it remains in place to continue the protection. Research has shown that the placement of pit and fissure sealants has dramatically reduced the incidence of dental decay in children during their cavity prone years. They also reduce the need for more complex and costly procedures being required that could compromise the structure and integrity of the tooth.
Air abrasion is an alternative to drilling. It utilizes a small powerful stream of air and abrasive particles to remove decayed tooth structure while producing minimal noise except for the sound of blowing air.
This procedure is usually used on children because it is not effective at removing existing fillings with decay underneath.
Good dental health depends on an adequate supply of nutrients that are properly used by the body. The bacteria in plaque uses simple sugars as their food and reacts within the mouth by producing an enzyme (or acid) that will effect the enamel of teeth.
The types of foods that cause tooth decay contain refined sugars such as is found in candy, soft drinks, and crackers.
Refined sugars stay in the mouth often long enough to react to the bacteria in plaque. Natural sugars are found in fruits and vegetables but they usually clear the mouth rapidly before the sugar is converted. Dried fruits, such as raisins, contained a concentrated form of natural sugar that sticks to the teeth. If raisins are ingested with nuts or grains as in cereal, the stickiness is generally washed away from the teeth.
Children's chewables, whether they are in the form of vitamins or analgesics, should always be followed by the child rinsing their mouth with clear water. Aspirin and vitamin C both have an acid base and are mixed with sugar to make it more palatable for the child.
Thumbsucking can have a damaging effect on the growth of the jaw, the facial contour and even speech. It causes improper alignment of the jaw, which can be serious. Often this oral habit will disappear, but if it doesn't and it extends beyond 4 years of age, corrective action should be taken.
It is important to encourage your child to end the habit without causing embarrassment or shame.
You should ask your dentist to speak to your child while you are not present. Often children will listen to an adult with whom they are less familiar. If the child continues the habit, a habit-correction appliance can be inserted in the child's mouth as a reminder to keep the thumb out.