A Healthy Mouth for Your Baby

• Before Your Baby is Born
• Ann Talks with Maria
• Protect Your Baby's Teeth with Fluoride
• Check and Clean Your Baby's Teeth
• Feed Your Baby Healthy Food
• Prevent Baby Bottle Tooth Decay
• Take Your Child to the Dentist

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Before Your Baby is Born

What you eat when you are pregnant is important. Eating right will help you and your growing baby stay healthy. Follow your doctor's advice for eating the right foods and taking vitamins.

It's also time to think about how you'll feed your baby. Remember, breast-feeding is best!

Ann Talks with Maria "What are you doing?" asked Ann. Ann and her friend, Maria, were watching Maria's children play. "I'm cleaning my baby's teeth," said Maria. "But your baby hardly has any teeth!" said Ann. "Yes, but my dentist said there are things I can do to keep my baby from getting tooth decay," said Maria. "But don't baby teeth just fall out?" asked Ann. "Yes, but tooth decay can cause pain for the baby. And baby teeth hold space for adult teeth," said Maria. "What else did the dentist say?" asked Ann. "She told me how fluoride protects teeth. She also said to feed my baby healthy foods and not to put my baby to bed with a bottle," said Maria. "When do you have to start taking care of a baby's teeth?" asked Ann. "As soon as they come in. Teeth can decay as soon as they appear in the mouth," said Maria. "I'll have to start thinking of those things soon!" laughed Ann.

1. Protect Your Baby's Teeth with Fluoride

Fluoride (said like floor-eyed ) protects teeth from tooth decay and helps heal early decay.

• Fluoride is in the drinking water of many towns and cities.

Ask your dentist or doctor if your water has fluoride in it. If it doesn't, talk to your dentist or doctor about giving you a prescription for fluoride drops for your baby.

2. Check and Clean Your Baby's Teeth

Check your baby's teeth

Healthy teeth should be all one color. If you see spots or stains on the teeth, take your baby to your dentist.

Clean your baby's teeth

as soon as they come in with a clean, soft cloth or a baby's toothbrush. Clean the teeth at least once a day. It's best to clean them right before bedtime.

At about age 2, most of your child's teeth will be in. Now you can start brushing them with a small drop of fluoride toothpaste. Use a drop of toothpaste about as big as this --

Young children cannot get their teeth clean by themselves. Until they are 7 or 8 years old, you will need to help them brush. Try brushing their teeth first and then letting them finish. And be sure that you put the toothpaste on the brush----use only a pea-sized amount of toothpaste.

3. Feed Your Baby Healthy Food

Choose foods that do not have a lot of sugar in them. Give your child fruits and vegetables instead of candy and cookies.

4. Prevent Baby Bottle Tooth Decay

Do not put your baby to bed with a bottle at night or at nap time. (If you put your baby to bed with a bottle, fill it only with water. )

Milk, formula, juices, and other sweet drinks such as soda all have sugar in them. Sucking on a bottle filled with liquids that have sugar in them can cause tooth decay. Decayed teeth can cause pain and can cost a lot to fill.

During the day, do not give your baby a bottle filled with sweet drinks to use like a pacifier.

If your baby uses a pacifier, do not dip it in anything sweet like sugar or honey.

Near his first birthday, you should teach your child to drink from a cup instead of a bottle.

5. Take Your Child to the Dentist

Ask your dentist when to bring your child in for his first visit. Usually, the dentist will want to see a child by his first birthday. At this first visit, your dentist can quickly check your child's teeth.

Development of permanent teeth

Both baby and permanent teeth have fairly well-defined times of eruption. The ages listed are the typical ages that an adult tooth has fully emerged.

UPPER and LOWER	ERUPTS BY
Central incisor	7th Yr
Lateral incisor	8th Yr
Canine (Cuspid)	11-12th Yr
First premolar (Bicuspid)	9th Yr
Second premolar(Bicuspid)	10th Yr
First molar	6th Yr
Second molar	12-13th Yr
Third molar	17-25th Yr

Tooth anatomy

The structure of the tooth includes dentin, pulp and other tissues, blood vessels and nerves imbedded in the bony jaw. Above the gum line, the tooth is protected by the hard enamel covering.

Development of baby teeth

Both baby teeth (deciduous or milk teeth) and permanent teeth have fairly well-defined times of eruption. The ages listed are the normal ages that a baby tooth emerges.

UPPER	ERUPTS BY		LOWER	ERUPTS BY
Central incisor	8-10 Mo		Central incisor	6-9 Mo
Lateral incisor	8-10 Mo		Lateral incisor	15-21 Mo
Canine (Cuspid)	16-20 Mo		Canine (Cuspid)	15-21 Mo
First molar	15-21 Mo		First molar	15-21 Mo
Second molar	20-24 Mo		Second molar	20-24 Mo

Dental cavities

Definition

Cavities are holes, or structural damage, in the teeth.

See also: Early childhood caries

Alternative Names

Caries; Tooth decay; Cavities - tooth

Causes

Tooth decay is one of the most common of all disorders, second only to the common cold. It usually occurs in children and young adults but can affect any person. It is a common cause of tooth loss in younger people.

Bacteria are normally present in the mouth. The bacteria convert all foods -- especially sugar and starch -- into acids. Bacteria, acid, food debris, and saliva combine in the mouth to form a sticky substance called plaque that adheres to the teeth. It is most prominent on the back molars, just above the gum line on all teeth, and at the edges of fillings. Plaque that is not removed from the teeth mineralizes into tartar. Plaque and tartar irritate the gums, resulting in gingivitis and ultimately periodontitis.

Plaque begins to build up on teeth within 20 minutes after eating (the time when most bacterial activity occurs). If this plaque is not removed thoroughly and routinely, tooth decay will not only begin, but flourish.

The acids in plaque dissolve the enamel surface of the tooth and create holes in the tooth (cavities). Cavities are usually painless until they grow very large and affect nerves or cause a tooth fracture. If left untreated, a tooth abscess can develop. Untreated tooth decay also destroys the internal structures of the tooth (pulp) and ultimately causes the loss of the tooth.

Carbohydrates (sugars and starches) increase the risk of tooth decay. Sticky foods are more harmful than nonsticky foods because they remain on the surface of the teeth. Frequent snacking increases the time that acids are in contact with the surface of the tooth.

Symptoms

• Toothache -- particularly after sweet, hot, or cold foods and drinks
• Visible pits or holes in the teeth

Exams and Tests

Most cavities are discovered in the early stages during routine checkups. The surface of the tooth may be soft when probed with a sharp instrument. Pain may not be present until the advanced stages of tooth decay. Dental x-rays may show some cavities before they are visible to the eye.

Treatment

Treatment can help prevent tooth damage from leading to cavities.

Treatment may involve:

• Fillings
• Crowns
• Root canals

Dentists fill teeth by removing the decayed tooth material with a drill and replacing it with a material such as silver alloy, gold, porcelain, or composite resin. Porcelain and composite resin more closely match the natural tooth appearance, and may be preferred for front teeth. Many dentists consider silver amalgam (alloy) and gold to be stronger, and these materials are often used on back teeth. There is a trend to use high strength composite resin in the back teeth as well.

Crowns or "caps" are used if tooth decay is extensive and there is limited tooth structure, which may cause weakened teeth. Large fillings and weak teeth increase the risk of the tooth breaking. The decayed or weakened area is removed and repaired. A crown is fitted over the remainder of the tooth. Crowns are often made of gold, porcelain or porcelain attached to metal.

A root canal is recommended if the nerve in a tooth dies from decay or injury. The center of the tooth, including the nerve and blood vessel tissue (pulp), is removed along with decayed portions of the tooth. The roots are filled with a sealing material. The tooth is filled and a crown may be placed over the tooth if needed.

Outlook (Prognosis)

Treatment often saves the tooth. Early treatment is less painful and less expensive than treatment of extensive decay.

You may need numbing medicine (novacaine), nitrous oxide (laughing gas), or other prescription medications to relieve pain during or after drilling or dental work.

Nitrous oxide with novacaine may be preferred if you are afraid of dental treatments.

Possible Complications

• Discomfort or pain
• Fractured tooth
• Inability to bite down on tooth
• Tooth abscess
• Tooth sensitivity

When to Contact a Medical Professional

Call your dentist if you have a toothache.

Make an appointment with your dentist for a routine cleaning and examination if you have not had one in the last 6 months to 1 year.

Prevention

Oral hygiene is necessary to prevent cavities. This consists of regular professional cleaning (every 6 months), brushing at least twice a day, and flossing at least daily. X-rays may be taken yearly to detect possible cavity development in high risk areas of the mouth.

Chewy, sticky foods (such as dried fruit or candy) are best if eaten as part of a meal rather than as a snack. If possible, brush the teeth or rinse the mouth with water after eating these foods. Minimize snacking, which creates a constant supply of acid in the mouth. Avoid constant sipping of sugary drinks or frequent sucking on candy and mints.

Dental sealants can prevent cavities. Sealants are thin plastic-like coating applied to the chewing surfaces of the molars. This coating prevents the accumulation of plaque in the deep grooves on these vulnerable surfaces. Sealants are usually applied on the teeth of children, shortly after the molars erupt. Older people may also benefit from the use of tooth sealants.

Fluoride is often recommended to protect against dental caries. It has been demonstrated that people who ingest fluoride in their drinking water or by fluoride supplements have fewer dental caries. Fluoride ingested when the teeth are developing is incorporated into the structure of the enamel and protects it against the action of acids.

Topical fluoride is also recommended to protect the surface of the teeth. This may include a fluoride toothpaste or mouthwash. Many dentists include application of topical fluoride solutions (applied to a localized area of the teeth) as part of routine visits.