1. start right PARENTS MAKE THE DIFFERENCE
A practical guide to your baby’s dental health
A PROJECT OF THE
MISSOURI DENTAL FOUNDATION
A CHARITABLE SUBSIDIARY OF
MISSOURI DENTAL ASSOCIATION
PROJECT FUNDED BY THE
MISSOURI FOUNDATION FOR HEALTH

2. Presented by members of the Missouri Academy of Pediatric Dentistry & Missouri Dental Association

3. Importance of Baby Teeth
Help a child to chew and speak
Hold space for the adult teeth & guide teeth during eruption
Aid in jaw and face formation
Influence the child’s overall health
The early childhood dental visit can help educate the parent as well as categorize the potential dental disease risk of the child.

4. When Teething Starts Baby teeth usually start to come in at 6 months
20 primary teeth usually present in our jaw bone at birth
The front four teeth erupt first, followed by the first molars and then the cuspids
The second molars are the last to erupt, usually by age 2 ½ to 3 years of age

5. Primary Teeth Eruption Chart

6. Comforting Your Teething Baby
Comforting babies who are irritable because of teething
Chew on a cool washcloth or spoon
Chew on a teething ring
Massage gums with a clean finger
Give children’s Tylenol or ibuprophen an hour before bedtime so sleep isn’t interrupted

7. Avoid Numbing Medications
High levels can be toxic
Babies can injure their numb lips or tongue if rubbed against their teeth

8. Tips for Preventing Decay What parents can do
Proper Baby Bottle Usage
Good Oral Home Care
Good Nutrition Habits (Eating & Drinking)
Checking teeth regularly
Scheduling child’s first dental visit

9. Tips for Preventing Decay It’s not the bottle, it’s the beverage
H2O X X

10. Proper Baby Bottle Usage

11. Tips for Preventing Decay Proper Bottle & Sip Cup Usage
Don’t allow your baby to fall asleep with a bottle or “sip cup” filled with anything other than water

12. Tips for Preventing Decay Proper Bottle & Sip Cup Usage
Milk and other sugary liquids can pool against the back of the top front teeth for the several hours the baby is sleeping
Because of this, cavities can occur on the backs of the top front teeth, undetectable to parents
Note: Going to bed with bottle can also cause liquid to pool in ear tubes, causing ear infections

13. Decay on Teeth from Bottle
Decay on the back side of top front teeth, caused from improper bottle usage, is not always visible on the front of teeth
This is a mirror shot shows which shows the front of the upper front teeth at the bottom of the slide. Dental caries due to prolonged bottle feeding usually begins on the backside of the upper front teeth. It is not visible from the front and therefore difficult to detect without a dental mirror. This child is less than two years of age because the right second molar has not even erupted yet.

14. Tips for Preventing Decay Good Oral Home Care
Have parents get into the habit of wiping the baby’s gums after feedings, even before teeth have erupted
As teeth come in, brush them with a finger or child’s toothbrush with water or child-safe (non-fluoride) toothpaste
Don’t use fluoride toothpaste until child can spit (can be toxic if swallowed)
Parents need to be the ones in charge of oral hygiene. Kids who are independent can brush first, but the care giver should still give a once over afterwards.

15. Gauze or a burp rag can wipe an infant's mouth before there are teeth
Gauze or a burp rag can wipe an infant's mouth before there are teeth. The Finger toothbrush finger cot is good to gently wipe the anterior teeth and massage the gums. Children under the age of three can't spit sufficiently and should use only water or a non-fluoride tooth cleanser on the toothbrush.

16. Tips for Preventing Decay Good Oral Home Care
Parents need to be the ones in charge of oral hygiene. Kids who are independent can brush first, but the care giver should still give a once over afterwards.

17. Tips for Preventing Decay Creating Good Hygiene Habits
Kids under age 6 need help brushing
Some kids over age 6 may still need supervision
Bedtime is the most important time to make sure the teeth are free of plaque
Flossing should be initiated as soon as teeth begin to touch
Any plaque left on the teeth at night has several hours to become cariogenic since there is decreased saliva flow during sleep. The plaque can also mineralize into calculus and be more difficult to brush away in the morning.

18. Tips for Preventing Decay Toothpaste & Fluoride
Fluoride is important for fighting cavities
However, if children younger than 6 years old swallow too much, their permanent teeth may have white spots
Use only a small amount of toothpaste (about the size of a pea)
At about age 3, you can teach child to spit out the toothpaste and to rinse well after brushing

19. Once children reach age 3, a pea-size amount of toothpaste can be used
A pea-size amount of toothpaste is recommended to decrease the amount that can be potentially swallowed. The blue bristles can show the parent where to place the toothpaste.

20. Tips for Preventing Decay Toothpaste & Fluoride
Replace worn toothbrushes
Brushes may have bent bristles, even though “blue” indicator color isn’t gone
Infants/Toddlers may wear out toothbrushes sooner because of chewing on bristles
The middle blue bristles on these Oral-B toothbrushes are supposed to fade away after 4-6 months indicating time to get a new toothbrush. Toothbrushes have very soft bristles and may need to be replaced before the indicator dye disappears.

21. Tips for Preventing Decay Good Nutrition Habits
Food doesn’t cause decay, but rather “eating” food in general
Children’s dental health depends less on what they eat and more on how often they eat it
Sugary snacks should be consumed within a short period of time as opposed to "grazing" throughout the day. This will give the mouth a chance to clear away the sugary foods from the teeth.

22. Tips for Preventing Decay Good Nutrition Habits
Anything that breaks down into sugars/carbohydrates can cause cavities
Candy and cookies are NOT the only bad things for teeth!
This includes starchy foods like potato chips and crackers

23. Tips for Preventing Decay Good Nutrition Habits
Sticky foods, like gummy fruit snacks and raisins can be worse for the teeth
Get stuck in chewing surfaces and in between teeth
Don’t wash off the teeth as quickly

24. Tips for Preventing Decay Good Nutrition Habits
Fruit roll-ups, gummy fruit snacks and raisins
BAD FOR THE TEETH!
Everyone knows that candy is bad for you. Sticky snacks like fruit rollups, fruit snacks and raisins, once touted as "nature's candy" can be just as destructive to teeth.

25. These snacks look nutritious, but are they?

26. 3 of the Top Ingredients are Sugars!

27. Tips for Preventing Decay Good Nutrition Habits
Don’t allow children to "graze" throughout the day on snacks/drinks (except water)
Encourage balanced meals at “mealtimes”
Sugary snacks/drinks should be consumed within a short period of time
This will give the mouth a chance to clear away the sugary foods from the teeth
Have kids brush after meals
Sugary snacks should be consumed within a short period of time as opposed to "grazing" throughout the day. This will give the mouth a chance to clear away the sugary foods from the teeth.

28. Tips for Preventing Decay Good Nutrition Habits
Provide better choices
Healthy snacks like fresh fruit and cheese are better not only for the teeth, but for the overall health of the baby

29. Tips for Preventing Decay Good Nutrition Habits
Stop the Pop!
Soda should never be encouraged
Diet soda can also cause cavities due to the acid in the carbonation

30. Tips for Preventing Decay The First Dental Visit
It is recommended the first dental visit be within 6 months of the first tooth eruption
This is usually around the child’s first birthday

31. Tips for Preventing Decay The First Dental Visit
Pediatric dentists are specially trained and may feel more comfortable examining young children than general dentists
A child’s pediatrician should be able to assess if a child is at high risk for dental decay

32. Tips for Preventing Decay The First Dental Visit
This 3-year-old is at the dentist for the first time
Unfortunately, one of his teeth is already infected and an abscess is present

33. About Dental Decay Did you know?
Dental caries is the most common chronic disease in children, 5 times more common than asthma
More than 40% of children have tooth decay by the time they reach kindergarten
More than 51 million school hours (85,000 school days) are lost each year due to dental related illness

34. About Dental Decay Did you know?
80% of dental cavities are found in 20% to 25% of children
18% of children between the ages of 2 to 4 have visible cavities
Infants of low socioeconomic status, whose mothers have a low education level, and who consume sugary foods are 32 times more likely to have caries at age 3 than children in whom those risk factors are not present

35. About Dental Decay Did you know?
Tooth decay is a disease that is, by and large, preventable
The ultimate goal of early assessment is the timely delivery of educational information to prevent decay

36. Screening for Dental Decay Getting Started
Following are guidelines only
Goal is to help parent educators feel comfortable educating parents
Empower parents to do screenings on their child and know what to look for

37. Screening for Dental Decay Getting Started
What you need
Dialogue with parent/consent to do screening
Good light source to see teeth

38. Screening for Dental Decay Getting Started
The knee-to-knee lap exam allows the parent to help hold child’s hands while the examiner is able to look at the teeth

39. Screening for Dental Decay What do cavities need to start
TEETH
No Caries
No Caries
PLAQUE
(BACTERIA)
REFINED
CARBOHYDRATES
(FOOD)
DECAY
Dental caries cannot exist without the Strep Mutans flora, plaque (carbohydrates) on teeth, and enough time for the plaque to create changes in the enamel structure.
No Caries
No Caries
TIME PLAQUE IS ON TEETH

40. Screening for Dental Decay What do cavities need to start
What to look for:
Plaque along the gumlines
White chalky lines along the gumlines
Brown spots or discolorations on the fronts of teeth
Holes in the chewing surfaces of the teeth

41. Plaque is an invisible film that is noticeable when scraped off the teeth

42. White or chalky areas can turn into brown spots (cavities)
Once the decalcifications are present, continued exposure to plaque can break them down into full-fledged cavities.

43. Lift the lip to see gumlines better
This dental decay is due to plaque that has rested up against the gum lines for a long period of time. These cavities began as white lines on the enamel which, if detected early could have been reversed with fluoride applications.

44. Large cavities can damage the nerves of the teeth, leading to abscesses
Early childhood caries can get larger if not treated. They can grow to the other tooth surfaces, and even damage the nerve of the tooth, causing abscesses to occur.

45. Primary molars do not fall out until age 10-12
Primary molars do not fall out until age Cavities in these teeth need to be treated right away.

46. Screening for Dental Decay
Large cavities can be repaired, but it’s expensive and the child is always more cavity prone…

47. As a Parent Educator What’s your role?
Educate parents about good early childhood oral hygiene
Provide parents with tips to make healthy choice and prevent decay in primary teeth

48. As a Parent Educator What’s your role?
Conduct screenings to identify children at risk for dental disease
Help parents learn to know what to look for when checking their child’s teeth for decay
Direct parents with any concerns to dental health professionals

49. Thanks you for your interest
The Dental Community
Thanks you for your interest
in helping the children of Missouri obtain good oral hygiene and healthy brushing and eating habits to prevent early childhood decay

50. Starting Right Means a Lifetime of Smiles

51. Contact Information
Missouri Dental Association
Program Coordinator
Melissa Albertson

52. Start Right: Parents Make the Difference A project of the Missouri Dental Foundation The charitable subsidiary of the Missouri Dental Association
The Start Right project is funded through a grant provided by the Missouri Foundation for Health. The Missouri Foundation for Health is a philanthropic organization whose vision is to improve the health of the people in the communities it serves.
All “Start Right” materials and presentation © Missouri Dental Foundation & Missouri Dental Association