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.

Management of Autistic Children at The Dentist

Children with an Autism Spectrum Disorder have impaired social interaction and limited communication abilities, combined with a restricted amount of activities and interests. While parents are often able to manage them in familiar places and situations like the home, it becomes difficult to do the same outside, especially when visiting specialized healthcare providers including dentists.

Considering that 1 in ever 30 Indian children displays signs of ASD, pediatric dentists are very sensitive to their dental needs and specialized management. Even so, parents have a large role to play in ensuring all procedures go smoothly, and children come away with the least amount of stress and mental trauma.

Dentists managing autistic children are aware of them exhibiting specific observable behavior;

IMPAIRED SOCIAL RESPONSE - Children are unable to read and respond to feelings and experiences, with absolute no understanding most times

IMPAIRED COMMUNICATION - Children are unable to use and understand gestures, repetition of words (echolalia) and a rigid body stance is often displayed

Besides the atypical behavioral and impaired communication skills that are observed and need careful handling, below are often the main dental problems that such children exhibit;

* Bruxism or teeth grinding, often when asleep or the child isn't aware of it

* Tongue thrusting or repeated tongue movements

* Chewing at all odd times without presence of food

* Self-injury, where pinching gums, biting lips and creating wounds is common

* Erosion of teeth

* Caries, when teeth aren't brushed thoroughly because the child finds it unpleasant

* Poor oral care at home, because of difficulty in managing the child

* Limited dietary preferences. Autistic children have very strong likes and dislikes (Only pureed food, no vegetables, dislike of particular vegetable color, etc.)

Management of an Autistic Child at the dentist, can be divided into two phases;

PRE MANAGEMENT or BEFORE CHILD MEETS THE DENTIST

• It is important to plan a desensitizing appointment with the dentist to help the child familiarize themselves with the doctor and the staff
• Allow the child to bring things that can comfort them, a favorite blanket, stuffed toy or even hold the parent's hand
• Parents need to discuss with the doctor about the child's tolerance to pain and discomfort, and their threshold
• Share the child's intellectual and understanding abilities with the doctor, so that they can phrase sentences or relate with the child accordingly

POST MANAGEMENT or AFTER THE CHILD MEETS THE DENTIST

• The dentist will communicate with the child at a level he/she can understand. They use phrases such as 'Tell', 'Do', 'Show' when explaining any procedures or methods, always speaking in clear, precise tones
• Oral examination is begun with only fingers first, while the hard feel of dental instruments is brought in later
• Dental instruments are only shown later. Suddeness of movements by the dentist is kept to a minimum and light is kept away from the child's face. Sensory input of any kind is kept as less as possible to avoid distraction
• Dentists place same staff at all examinations and interruptions are kept minimal
• Child's co-operative behavior is always encouraged with positive words and nods
• The child's unusual body movements are always observed and pre-empted

Most pediatric dentists are aware of the extra care and effort it takes to manage autistic children, and are extra cautious while carrying out any kind of dental procedures. As a parent, it is important to know what to expect, understand how the process can be made easy and prepare the child for any kind of dental visit.

5 Books That Prepare Your Child For Their First Dental Visit

The high backed chairs, plenty of equipment, unfamiliar space and a doctor poking around inside your mouth....this can be so very intimidating for most of us adults. Imagine what it can do to our kids?

Visiting a pediatric dentist for the first time is a new experience for little ones. They don't know what is being done, and despite parents being there, can resist the experience of a new person handling them from such close quarters.

It is very important for parents, and for us doctors to make them familiar with a few things before their first visit or during subsequent ones. While we take care of them inside the clinic, using the most gentlest way to handle their fears, as parents what you can do, is make the entire process less stressful for them.

Books we have found, are one of the ways to make things more relatable. When a child understands how his teeth work, what is happening in his mouth, through pictures and illustrations, he knows what to expect. It is also a great way to communicate to kids in their own language.

Here are 10 children books, for different ages that explain about dental health, pediatric dentist visit and some of the procedures in ways that will make them understand, relate and reduce stress.

1. Dentist (First Time)

Author, Illustrator: Jess Stockham

Age Group: 2+

First time at a dentist's can be a very nerve wracking experience. This book is part of a series of 'First Time' which rather than telling a story, shows different children experiencing treatment, and the general interaction with a dentist. There is a waiting room, a scene which shows teeth being counted, a look at the equipment, step by step on how a child undergoes dental fillings.

The text is conversational, brightly illustrated, helps children see different situations, and understand procedures.

2. Harry and the Dinosaurs say 'Rahhhh'

Author: Ian Whybrow

Illustrator: Adrian Reynolds

Age Group: 3+

Harry and all his dinosaurs have a dental appointment and everyone is nervous - especially T-Rex who has many teeth. With Harry's reassurances and a special button that makes him grow big, T-Rex lets Dr.Drake examine his teeth.

The illustrations are simple, funny and text easily understandable. It will help relieve the anxiety of this important life lesson for the little ones.

3. Dentist Trip (Peppa Pig)

Author: Lady Bird

Age Group: 3+

Peppa, George and Mr. Dinosaur visit the dentist to get their teeth checked. Although George is nervous, he does get through the procedure while having fun in the process. The story is one among a series revolving around Peppa and her family, and the challenges they face. 

The book has very relatable characters, great illustrations and a simple explanation, which helps kids connect. Since the characters are also favorites among kids, it makes it easier to connect with them.

4. Open Wide

Author, Illustrator: Laurie Keller

Age Group: 3+

32 students (8 incisors, 4 canines, 8 premolars and 12 molars) are taken through a class on how to care for teeth through questions and quizzes. Mr.Flossman, their teacher, peppers their classes with fun facts, and plenty of questions on tooth care.

The book has wonderfully vivid illustrations, is hilarious full of interesting facts and connects all the different procedures that happen during a checkup.

5. How Many Teeth?

Author: Paul Showers

Illustrator: True Kelley

Age Group: 3+

One of the oldest books (30 years), teaching kids about taking care of their teeth, the books starts from the basics, explaining to kids the number of teeth they have, what happens when baby teeth fall off and big teeth come in. The book relates their growth to the fall of the teeth.

Illustrations are older but very familiar with our childhood, text simpler and the book is very engaging. The relation of teeth with growth is simple and easily explained.

Books are the best way to teach kids about life. When it comes to their teeth, there is no better thing than books to make them relate to what their teeth go through. 

Do let us know if there are any other books related to dental health in kids that you may know of. It will help us and other parents add more to their list.

Brushing Teeth, a Wonderful Habit To Give Your Children

Brushing your babies' teeth can be quite a stressful ritual. Babies are restless and don't understand why their mothers would want to force open their mouths and insert an object like a brush, that is not just uncomfortable, but oftentimes painful.

As much as parent's may delay this or procrastinate in the hopes of getting children to be more accepting of brushing teeth when they are older, it actually works in the reverse. The older the child gets, the more difficult it is for him/her to make brushing a regular part of their routine. Truth is, the results cannot be observed immediately, and most often children find brushing unnecessary and a chore even when they are older.

Caring for your babies' teeth should begin as soon as they start to appear. Parents are also the best people to lead the way when it comes to teaching kids this important skill.

Teeth are the most vulnerable part of the mouth, do a whole lot of work....masticating, gnashing, biting, chewing, and also have to weather acids from foods that are constantly fed into the mouth. Looking after them must begin when they start to erupt. It's alright if teeth can't be brushed from the start. What matters, is introducing this habit as a part of their daily routine. Start by showing them that brushing is what you do each day, everyday and its the best example you could give.

 In addition to the above,

• Use just a little dab of paste on the finger for babies, and little more than a pea-sized amount for toddlers
• Start with light brushing, and then a little thoroughly, brushing all along the tooth sides and surfaces, twice a day, after waking up and before bedtime.
• Don't turn teeth brushing into a war, pushing and shoving, yelling and fighting which usually happens. Some children take a long while to get used to it. Make this a game, brush yours first and ask them to follow suit, or sing a little rhyme when you do.
• Place your baby in a way that both of you are comfortable. Sit them on your knee and head on your chest and clasp their chin. For older children, stand behind them and tilt their heads upwards.
• Use small circular movements when brushing teeth. This covers all the tooth surfaces, and your child can spit out the paste when they're done. Flouride free toothpastes are better to use when smaller, since kids tend to swallow them otherwise. 

• For babies, it is also important to lightly massage their gums, especially when teething. This can be done after brushing their teeth.
• Teeth brushing is a practiced art which parents need to guide their child on, till they reach an age where they can do it on their own. It has been seen that by age 5-7 years, children are able to do a great job of brushing their teeth.
• The most important aspect of introducing brushing and helping the child take care of their teeth, is the involvement of a pediatric dentist in the entire process. A dentist is not just required to fix things after the teeth are gone bad/caried, but must be a part of the process from the beginning. A regular teeth checkup will ensure that any irregularities, caries, congenital and developmental disorders of the teeth and mouth are looked into at the earliest and treated. This must ideally begin around the age of one year.

This video, explains the act of brushing teeth, and can be shown to your child to make them understand better.

Teeth brushing is as important as eating food, and teeth disorders are linked to various other health and body disorders which can strike later in life. A healthy and regular brushing schedule when started young, will lay the foundation for strong teeth that will last your children for the rest of their life.