7 Essential Tips in Baby Tooth Care

Most of us love the first glimpse of baby teeth when they appear. That's when the toothless smile, gets brighter and better. 

Although accompanied by irritation, grinding, crying and sometimes fever, baby teeth when start to appear are a milestone that all of us look forward to.

As parents we often know what to do when it comes to baby's teeth, what paste to use, how to brush, etc. However, it can be possible to miss some things, and before we know, something might have been overlooked, causing a little black spot to appear on your child's teeth that doesn't seem to be going away.

These 5 tips, are therefore compiled to give you a reference guide on what is important to keep track of, what are the absolute must-do's to ensure that your oversight or negligence doesn't cause harm to your child's teeth and often avoidable procedures at the hands of the pediatric dentist.

1. Begin even before baby teeth erupt - Even though baby teeth may not have appeared, your baby is drinking milk, and this leaves residues which should not be allowed to remain on the teeth or in the mouth.

Wiping the gums after every feed, with a soft, wet washcloth or gauze wrapped around your finger, or thimble-like rubber finger glove, will remove the excess food stuck on the teeth.

2. Care for them immediately when they appear - Once teeth erupt, take care of them immediately. Many parents think baby teeth are unimportant, since they will drop off eventually. However, these first teeth actually create the space for permanent teeth to grow and also help babies chew food and learn to articulate or talk. If left uncared for, they decay, causing gum infection or gingivitis, and mess up the space between teeth.

3. Avoid Cavities - Cavities in baby's teeth show up as discoloration or yellowing and pitting or dents in the teeth. Often, putting baby to bed with a milk bottle in the mouth is the main cause of this. 

Leaving an infant with a milk bottle in the mouth for long periods causes food collection and must be avoided. Comfort feeding or bottle chewing should also be stopped.

4. Finish meals with water, either drink or gargling - Since infants usually eat pureed food or drink milk, this can be washed off with a few sips of water. However, a good soft bristled toothbrush must be used as soon as possible so that the baby can get used to using it and it becomes a habit. A good brush will only be handy when the baby starts feeding on solids at or around 18 months. Sticky or sugary foods must be cleaned immediately with a soft brush or cloth in small babies and not left overnight.

5. Toothpaste must be used at 2 years of age - A drop sized amount of non-fluoride toothpaste must be used when toddlers begin eating semi-solid or solid food. Fluoride toothpastes must not be used until the child is much older, at 4 years or above, so they understand spitting out the paste rather than swallowing it.

Preparing Your Child For Their First Pediatric Dental Visit

A visit to the dentist must be a very important part of your child’s quarterly health checkup plan. Good oral hygiene promotes healthy teeth. Since gum problems are tied in to many other problems in the body, getting a headstart on this important aspect of health will keep your kids covered at least when it comes to their dental health.

From a child’s perspective, a trip to the dentist can be very daunting. Lying on a chair in an unfamiliar room filled with huge machines, and a doctor poking instruments into their mouth can scare even the most strong-hearted. Also, with milk teeth growing and falling off, and permanent teeth making an appearance, there might be many trips to the dentist in store for them.

As parents, it is the onus on you to make a trip to the clinic as comfortable and relaxed as possible. This will only make our work as dentists easier and quicker.

Here is what you can do to ease your child’s anxieties;

• Start very young – Children are very adaptable, and the earlier they see a dentist, the more comfortable they will be during a dental visit. Whether it is a regular checkup, preventive visit or even emergencies such as tooth impaction or Root Canal Treatment, they will be open to any procedures. We recommend bringing your child in at age 1 year, or when the first tooth erupts.

• Keep it Simple – The first time dental visit is the most important, to make kids feel comfortable. Try not to explain too many details to them. Giving unnecessary details and explaining procedures may cause anxiety, which isn’t a good frame of mind to enter the clinic. Maintain a positive attitude but don’t make it sound all rosy too. Most importantly, avoid saying everything will be fine. If your child ends up getting treatment and going through pain, he/she will distrust your judgement in the future.
• Mind your words – Putting words like ‘pain’, ‘injection’, and ‘hurt’ in their head, may make them associate such feelings with the dentist and their work. Let us at the clinic handle your kids. They will be taught specific words for such feelings that they can associate with. At Small Bites, we always begin by asking kids to show us their smile and count their teeth. Positive phrases like clean, healthy teeth sound good and do not alarm.
• Pretend Dental Visit – To get children a little accustomed to visiting a dentist, play pretend with them at home. All you need is a toothbrush and chair. Start by counting the number of teeth in their mouth, make your child look in the mirror. Ask them to pretend-play by brushing their doll’s teeth. The aim is to get them comfortable with the routine and open to a visit with us.

• Avoid taking them to your own dentist – Many parents take kids to their own dentist assuming that they can familiarize their kids with the place. Experts caution against this however. Often times your anxiety can trickle down to the kids, especially during certain procedures that your child may never really require. Also adult dental clinics are sterile, simple spaces which may scare them, while in pediatric clinics, there are kid-friendly toys, games and TV shows which will keep them relaxed.

Small Bites Dental clinic is a very kid-friendly place, where children can engage themselves with toys, rubber slides and television. The main examination room also has drawing and animated characters, including stuffed toys to keep kids engaged.

• Fuss over – Small children are oftentimes whiny, cranky, wiggly and do not open to new people. As parents, you have to keep calm and soothe your child gently to take their anxieties at bay. As dentists, we and the support staff are used to working with children and can guide you on what’s best for your child.
• Avoid bribery – Promising a special treat after being a good child at the dentist’s is a complete NO, since this only serves to increase their anxiety. Promising them a lollipop or candy, makes children wonder what they are in for, to deserve such a luxurious treat. Since we also emphasize on clean teeth and avoidance of sweets, it sends a wrong message to children. Instead, as parents you can praise your child's behavior and bravery for going through with the visit. 

• Emphasize the necessity – Teaching your child that a dental visit is a necessity not choice, from a very young age, will ensure they take care of their teeth for life. You can explain that the dentist helps keep teeth strong, prevents cavities from forming and is responsible for their beautiful smile. A calm practical and no-nonsense parental attitude will set the right premise for the child to continue with good oral health.

As parents your role in your child's dental health cannot be over-emphasized. Follow all of the above steps and it will be a breeze getting them to us. In case of any assistance or more help, do reach out to the us on pedopremila@gmail.com.  

More details can be found here.

Maintaining Children's Dental Hygiene After a Festival

After the long holiday for Diwali celebrations, it is time for the kids to get back to school. Although as parents you have taken much care to ensure that their teeth don’t suffer the damage from too many sweets, the kids will nevertheless be tempted to indulge in or buy similar stuff.

It is important to keep reminding the kids that milk teeth when not taken care of, can affect the growth of adult teeth. Gum problems and dental caries can cause permanent issues of the mouth, caries that may require medical intervention and also cause lots of absences from school and missed school and studies. Oral hygiene is important to be practiced at all times, and children should be aware of this on a daily basis.

Here is what you as parents can ensure;

• Pack lunchboxes rather than giving money to buy food – Although most parents prepare and pack their kid’s lunchboxes themselves, it does become tempting to give them money to eat outside, or grab readymade sweets and pastries while on the go for their lunch. Although this makes things easy, such foods are also high on sugar and starch. One fallout of this practice, is the expectation from the child that these foods are alright, the implicit approval from parents in indulging in them, and the other, is the damage such foods cause to the mouth and teeth. 

 

• Give water rather than juices or soda – Water is the only liquid that the body requires in plenty. Replacing it with soda and juices loaded with sugar not just harms health, but affects the enamel of the teeth. These liquids are also acidic, causing teeth to rot and discolor. Juices and soda contain chemicals, artificial sweeteners and preservatives that damage gums, and cause other health problems in the long run.

• Provide a potable dental kit for school and travel – Good oral hygiene when started at home, can carry on to school as well as everywhere else the child goes. A potable grooming kit with a small toothbrush and toothpaste can be sent with the child to school in case of particularly long hours, when kids travel, stay overnight with friends or indulge in too much of sugar laden foods.

It is difficult for children to get into a routine, especially after coming out of a festival and the accompanying celebratory mood. By ensuring they follow strict dental hygiene, they become equipped to deal with their teeth both within the home and outside it.

Bruxism - Teeth Grinding Isn't Always Harmless

When children are growing, there are several things you need to be aware of, their weight gain, their food intake and the general state of their health. Often parents tend to ignore the mouth, assuming that as long as teeth are brushed and general mouth hygiene is maintained, everything will be alright.

Teeth brushing and observing the regular milestones of milk and permanent teeth aren’t the only things that need to be observed, since there are many other problems that point out to underlying issues in children, which if not treated affect teeth and their physical health, as well as add to the stress as they grow up.

One such condition that many parents tend to overlook, is Teeth Grinding or Bruxism. Although not a symptom, it points to an underlying .

Teeth grinding, teeth gnashing, or the unconscious act of clenching and unclenching teeth is present in most kids, with 2-3 out of 10 children having this problem. Most children grow out of it by the age of 7 years, but many others carry this habit well into adulthood. 

 Although the reasons are unknown, experts have given a few reasons for this condition,

• Stress induced teeth grinding, especially when children aren’t able to cope with a new situation, such as a test at school or meeting new people. An argument with parents or siblings or arrival of a second sibling is also seen as a probable cause
•  Mal-aligned top and bottom teeth which causes irritation and subsequent teeth gnashing
•  Pain anywhere in the face is also a cause, whether earache or appearance of new teeth 
•  Hyperactivity and restlessness
•  Kids with medical conditions ( such as cerebral palsy) or who take certain medication.

 How does one whether your child is grinding their teeth?

Have you heard your child’s jaw moving continuously or regular sounds from their mouth during bedtime? If you hear them grind their teeth while asleep, without being aware of it, and they experience a painful jaw or mouth on waking up or pain when chewing, it indicates they suffer from the condition.

What harm can it cause?

Bruxism as such is a temporary harmless condition, and children most often outgrow it. In those children where this condition persists, symptoms of headache or earaches are often complained. 

What harm can it cause the teeth?

A side effect of bruxism is the harm it can do to the child’s teeth. Nightime grinding, gnashing and clenching the teeth, can wear down tooth enamel, gradually chip off teeth, make the tooth temperature sensitive and also cause lingering jaw and mouth problems and pain.

It is important to take the child to a pediatric dentist, before the condition causes severe irreparable damage to the teeth in the long run. A dentist will examine the child’s teeth for chipped tooth enamel, and any other wear and tear.  In addition questions related to stress or tension will try to be discerned.

All these observations will give the dentist information on whether the cause for bruxism is psychological (stress induced) or structural (misaligned teeth) and treat the child accordingly. 

 Treatment

While the condition is outgrown by most children, some kids who have severe pain and wearing out, are prescribed a mouthguard; a thin protective mouthpiece moulded to the child’s teeth that acts as a barrier between the opposing sets. This can take care of the major problem.

If the cause is emotional or psychological, the underlying cause needs to be found out by talking to the child, understand reasons that are upsetting them, and try and resolve the issue. If it seems more complicated, then their fears will need to be eased by counseling.

Bruxism usually stops when the milk teeth are lost. In few cases the condition might continue well into teenage years. The condition cannot altogether be avoided, because most often, it is a coping mechanism in children, and their natural reaction to growth and development. It can however be avoided by talking to children frequently, letting them open up and ensuring regular visits to the pediatric dentist are carried out for optimal dental health.

Cleft Lip - Handling This Congenital Anomaly In Children

Teeth are important accessories that develop in humans, much before they are born, and depend entirely on how well they are used and looked after. In children, tooth development begins in the womb, but they appear much later, when the baby attains the age of 6 to 9 months. The complete set of 20 primary teeth in children (called milk teeth or baby teeth) comes in usually by the age of 3 years.

Unlike the normal healthy growth of teeth in children and milestones that occur at specific ages, children with developmental disorders of the mouth do have a delayed or impaired growth of teeth.

Cleft Palate is one such congenital disorder of the mouth where the cleft occurs in the lip, gum (alveolus) or palate/roof of the mouth resulting in a variety of dental problems. Children are often born with this defect, and the anomaly may affect the way their teeth develop, affect speech and also eating.

TYPES OF CLEFTING

Cleft palate may affect the number of teeth, their size, shape, and also position of both the baby and permanent teeth. The teeth that are most commonly affected by the clefting process are those surrounding the area of the cleft, mainly the lateral incisors. Clefts occur between the cuspid (eye tooth) and the lateral incisor. In some cases, it is also seen that the lateral incisor may be entirely absent. In other cases, there may be a “twinning” of the lateral incisor, so that one is present on each side of the cleft. In a majority of the cases, the incisor may be present but poorly formed with an abnormally shaped crown and/or root. Finally, around the area the area of the cleft, the teeth may be displaced, resulting in them coming up in abnormal positions when permanent teeth erupt.

As it is often seen, although a cleft palate is a visible albeit minor facial deformity, not much attention is given to the way it may affect teeth growth or placement, which in turn can result in biting and swallowing problems in children and also speech issues at a later stage in life.

It is important to evaluate the cleft and take any preventive measures to ensure that this anomaly doesn’t affect the child in the long run.

HOW DOES DENTAL CARE DIFFER IN CLEFT PALATE

There is no difference between a regular child and someone with cleft palate, except that these children require a preventive and restorative care that is more specific than the others.

The evaluation by a paediatric dentist for these children must start early, because of the malformed, missing and mis-positioned teeth, and accompanying problems that these children are sure to face.

EARLY DENTAL CARE

Following a regular routine of cleaning, good nutrition and fluoride treatment, children with cleft lip or palate can have healthy teeth. Besides this, the following will help,

• Appropriate and regular cleaning with a soft, -bristled toothbrush should begin as soon as teeth erupt.
• First visit to a paediatric dentist must happen on completion of one year of age, or even earlier
• Oral hygiene instructions and preventative counselling prescribed by a dentist must be regularly followed
• Treatment prescribed may differ from one child to the other. Some may need only preventative care while others may require filling or tooth removal

ORTHODONTIC CARE

Even before the teeth erupt, orthodontic intervention will look into the development and growth of the jaws, thereby focusing entirely on facial growth. This is done to prepare the mouth to accommodate the natural growth of the teeth. If the child’s upper teeth for example, don’t fit together or occlude with the lower ones, the dentist can suggest an early treatment to correct this. Later as the natural growth of teeth occurs, plans can be made for the child’s short term and long term dental development.

SURGICAL CARE

There are instances when a bone defect has given rise to the cleft palate, which can cause resultant mis-positioning of teeth. At such times, surgical intervention in conjunction with dental care can be done, where reconstruction of the cleft defect is accomplished by a bone graft performed by a surgeon. Surgical care to correct the cleft defect is to be done under the supervision of a paediatric dentist and only when absolutely necessary.

At adolescence, medical care can be provided in such a way where an orthodontist and surgical dentist can work together to ensure the teeth are aligned and any intervention given appropriately, for them to grow normally.

PROSTHODONTIC CARE

Having tried orthodontic intervention, if it is observed that additional support is required, then a  maxillofacial prosthodontist  can help, by making artificial teeth and appliances that not just improve the appearances of individuals with cleft, but also aid in speech, and functional requirements like eating. Oral appliances such as “speech bulbs” or “palatal lifts”, help close the nose from the mouth so that speech will sound more normal or a dental bridge can be created to replace missing teeth. In all of this, the dentist ensures that everything comes together to help the child be as normal as possible in speech and eating.

As seen above, the treatment of cleft palate is a co-ordinated effort by a number of specialists brought together by a dentist who can identify and advocate the right course of treatment. This treatment and looking after the development of teeth, has to begin at a very young age, in order to ensure that the child’s speech and oral development progresses as naturally as possible.