BABY & INFANT TOOTH CARE
Babies are at risk for tooth decay as soon as the first primary tooth emerges – usually around the age of six months. For this reason, the American Academy of Pediatric Dentistry recommends a “well-baby checkup” with a pediatric dentist no later than the baby’s first birthday.
Maintaining the health of primary (baby) teeth is exceptionally important. Although baby teeth will eventually fall out and be replaced, they fulfill several crucial functions in the meantime. Baby teeth:
Aid with enunciation and speech production
Help a child chew food correctly
Maintain space for adult teeth
Prevent the tongue from posturing abnormally in the mouth.
When baby teeth are lost prematurely, adjacent teeth shift to fill the gap, causing impacted adult teeth and the potential need for orthodontic treatment.
Keep reading to learn more about Baby Bottle Tooth Decay and the effects of pacifiers & thumb sucking.
BABY BOTTLE TOOTH DECAY
The term “baby bottle tooth decay” refers to early childhood cavities, which occur in infants and toddlers. Baby bottle tooth decay may affect any tooth (or all teeth) but is most prevalent in the front teeth on the upper jaw.
If baby bottle tooth decay becomes too severe, the pediatric dentist may be unable to save the affected tooth. In such cases, the damaged tooth is removed, and a space maintainer is provided to prevent misalignment of the remaining teeth.
Scheduling regular checkups with a pediatric dentist and implementing a good homecare routine can completely prevent baby bottle tooth decay.
How does baby bottle tooth decay start?
Acid-producing bacteria in the oral cavity cause tooth decay. Initially, these bacteria may be transmitted from mother or father to baby through saliva. Every time parents share a spoon with the baby or attempt to clean a pacifier with their mouths, the parental bacteria invade the baby’s mouth.
However, the most prominent cause of baby bottle tooth decay is frequent exposure to sweetened liquids. These liquids include breast milk, baby formula, juice and sweetened water – almost any fluid a parent might place in a baby bottle.
When sweetened liquids are used as a naptime or bedtime drink, they are a heightened risk because they remain in the mouth for an extended period of time. Oral bacteria feed on the sugar around teeth and emit harmful acids. These acids wear away tooth enamel, resulting in painful cavities and pediatric tooth decay.
Infants who are not receiving an appropriate amount of fluoride are at increased risk for tooth decay. Fluoride protects tooth enamel, simultaneously reducing mineral loss and promoting mineral re-uptake. Through a series of questionnaires and examinations, the pediatric dentist can determine whether an infant needs fluoride supplements or is at high-risk for baby bottle tooth decay.
What can I do at home to prevent baby bottle tooth decay?
Baby bottle tooth decay can be completely prevented by a committed parent. Making regular dental appointments and following the guidelines below will keep each child’s smile bright, beautiful and free of decay:
Avoid transmitting bacteria to your child via saliva exchange. Rinse pacifiers and toys in clean water and use a clean spoon for each person eating.
Clean gums after every feeding with a clean washcloth.
Use an appropriate toothbrush and ADA-approved toothpaste to brush when teeth emerge. Fluoride-free toothpaste is recommended for children under the age of two.
Use a pea-sized amount of ADA-approved fluoridated toothpaste when the child has mastered the art of “spitting out” excess toothpaste. Though fluoride is important for the teeth, too much consumption can result in a condition called fluorosis.
Avoid placing sugary drinks in baby bottles or sippy cups; only fill these containers with water, breast milk or formula. Encourage the child to use a regular cup (rather than a sippy cup) when the child reaches 12 months old.
Do not dip pacifiers in sweet substances (such as honey).
Review your child’s eating habits. Eliminate sugar-filled snacks and encourage a healthy, nutritious diet.
Do not allow the child to take a liquid-filled bottle to bed. If this is unavoidable, fill the bottle with water as opposed to a sugary alternative.
Clean your child’s teeth until he or she reaches the age of seven. Before this time, children are often unable to reach certain places in the mouth.
Ask the pediatric dentist to review your child’s fluoride levels.
PACIFIERS & THUMB SUCKING
For most infants, the sucking of thumbs and pacifiers is a happy, everyday part of life. Since sucking is a natural, instinctual baby habit, infants derive a sense of comfort, relaxation and security from using a thumb or pacifier as a sucking aid.
According to research from the American Academy of Pediatric Dentistry (AAPD), the vast majority of children will cease using a pacifier before the age of four years old. Thumb sucking can be a harder habit to break and tends to persist longer without intervention. Children who continue to suck thumbs or pacifiers after the age of five (and particularly those who continue after permanent teeth begin to emerge) are at high risk for developing dental complications.
How can thumb sucking and pacifiers damage children’s teeth?
Pacifier and thumb sucking damage can be quite insidious. Both can be difficult to assess with the naked eye, and both tend to occur over a prolonged period of time. Below is an overview of some of the risks associated with prolonged thumb sucking and pacifier use:
JAW MISALIGNMENT – Pacifiers come in a wide range of shapes and sizes, most of which are completely unnatural for the mouth to hold. Over time, pacifiers and thumbs can guide the developing jaws out of correct alignment.
TOOTH DECAY – Many parents attempt to soothe infants by dipping pacifiers in honey, or some other sugary substance. Oral bacteria feed on sugar and emit harmful acids, which attack tooth enamel and can lead to pediatric tooth decay and childhood cavities.
ROOF NARROWING – The structures in the mouth are extremely pliable during childhood. Prolonged, repeated exposure to thumb and pacifier sucking actually cause the roof of the mouth to narrow (as if molding around the sucking device). This can cause later problems with developing teeth.
SLANTING TEETH – Growing teeth can be caused to slant or protrude by thumb and pacifier sucking, leading to poor aesthetic results. In addition, thumb sucking and pacifier use in later childhood increases the need for extensive orthodontic treatments.
MOUTH SORES – Aggressive sucking (popping sounds when the child sucks) may cause sores or ulcers to develop.
If you do intend to purchase a pacifier, we encourage you to follow these helpful tips:
Buy a one-piece pacifier to reduce the risk of choking.
Buy an “orthodontically correct” model.
Do not dip it in honey or any other sugary liquid.
Rinse it with water (as opposed to cleansing with your mouth) to prevent bacterial transmissions.
How can I encourage my child to stop thumb or pacifier sucking?
In most cases, children naturally relinquish the pacifier or thumb over time. As children grow, they develop new ways to self-soothe, relax and entertain themselves. When thumb sucking or pacifier use persists past the age of five, a gentle intervention may be required. Here are some helpful suggestions to help encourage the child to cease thumb sucking or pacifier use:
Ask the pediatric dentist to speak with the child about stopping. Often, the message is heard more clearly when delivered by a health professional.
Buy an ADA-recommended specialized dental appliance to make it difficult for the child to engage in sucking behaviors.
Implement a reward system (not a punishment), whereby the child can earn tokens or points towards a desirable reward for not thumb sucking or using a pacifier.
Apply a bitter nail polish (such as Mavela Stop) to the thumbnails to deter sucking.
Wrap thumbs in soft cloths or mittens at nighttime.
If the above suggestions do not seem to be working, your pediatric dentist can provide more guidance. Remember, the breaking of a habit takes time, patience and plenty of encouragement!