1. start right PARENTS MAKE THE DIFFERENCE A practical guide to your baby’s dental health Daniel Ravel DDS, FAAPD Fayetteville, North Carolina

2. 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

3. 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

4. Primary Teeth Eruption Chart

5. 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

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

7. 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

8. H2OH2O X X Tips for Preventing Decay It’s not the bottle, it’s the beverage

9. Proper Baby Bottle Usage

10. 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

11. 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

12. Decay on the back side of top front teeth, caused from improper bottle usage, is not always visible on the front of teeth Decay on Teeth from Bottle

13. 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) Tips for Preventing Decay Good Oral Home Care

16. 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

17. 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

18. Once children reach age 3, a pea-size amount of toothpaste can be used

19. 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

20. 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

21. 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

22. 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

23. Tips for Preventing Decay Good Nutrition Habits Fruit roll-ups, gummy fruit snacks and raisins BAD FOR THE TEETH!

24. These snacks look nutritious, but are they?

25. 3 of the Top Ingredients are Sugars!

26. 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

27. 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

28. 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

29. 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

30. 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

31. 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

32. 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

33. 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

34. 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

35. 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

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

37. 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

38. Screening for Dental Decay What do cavities need to start TEETH No Caries DECAY TIME PLAQUE IS ON TEETH PLAQUE (BACTERIA) REFINED CARBOHYDRATES (FOOD)

39. 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

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

41. White or chalky areas can turn into brown spots (cavities)

42. Lift the lip to see gumlines better

43. Large cavities can damage the nerves of the teeth, leading to abscesses

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

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

46. Starting Right Means a Lifetime of Smiles