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Tips For Parents

i) Baby's First Teeth

Usually the first baby teeth to come into the mouth are the two bottom front teeth. They begin to appear when your child is about 6 to 8 months old. They are followed by the 4 upper front teeth. The remainder of your baby's teeth will appear periodically, usually in pairs on each side of the jaw, until the child is about 2 1/2 years old. By the time your child is 2 1/2 years old, all 20 baby teeth will most likely have come in. From this point until the child is 5 to 6 years of age, his/her first permanent teeth will begin to erupt. Some of the permanent teeth replace baby teeth, others don't. Do not worry if some teeth are a few months early or late as every child is different...just as every adult is different!

Even though baby teeth will eventually be lost, they are just as important as the adult teeth. They not only hold the space for incoming permanent teeth, but are also important for biting and chewing food, speech, and physical appearance. Early tooth loss due to dental decay can have a serious impact on your child's self-esteem and self-confidence in their appearance.


iI) Baby Bottle Tooth Decay

Baby Bottle Tooth Decay, or Baby Bottle Syndrome, or Nursing Bottle Mouth are all terms used to describe a dental condition which involves the rapid decay of many or all the baby teeth of an infant or child.

The teeth most likely to be damaged are the upper front teeth. They are some of the first teeth to erupt and thus have the longest exposure time to the sugars in the bottle. The lower front teeth tend to be protected by the tongue as the child sucks on the nipple of the bottle or the breast.

Baby Bottle Tooth Decay is caused by frequent exposure of a child's teeth for long periods of time to liquid containing sugars. When your baby falls asleep with:

• A bottle containing formula, milk or juice.
• A pacifier dipped in honey.
• While breast feeding.

The liquid pools around the front teeth. During sleep, the bacteria living in every baby's mouth, turns the milk sugar or other sugars to acid which causes the decay.

Parents may not know there is a problem until serious damage has been done:

• Oral checks should be performed by parents to detect early signs of the disease.
• Brown spots along the gumline on your child's teeth are signs which should alert you.
• If your child prefers soft foods, frowns or cries when eating cold, sweet, or hard foods, they should    be checked for tooth decay

By the time tooth decay is noticed it may be too late and crowns, pulp therapy, or even extraction of the decayed teeth may be necessary. As a result, your child may suffer from long term disorders which include speech impediments, possible psychological damage, crooked or crowded teeth, and poor oral health.

• You can prevent this from happening to your child's teeth by learning how to protect them.
• Clean your child's teeth daily.
• Never allow your child to fall asleep with a bottle filled with juice, milk, or formula (or when awake, sip    on it for long periods of time as a pacifier).
• Start bottle weaning by at least a year.
• Give your child plain water for thirst.
• Make sure your child gets the fluoride needed to prevent decay.
• Have regular dental visits for your child beginning when their first tooth erupts.

TIP: Cut back on sugary bottles by gradually watering them down until they are only water. Most children begin life with strong, healthy teeth. Help your child's teeth stay that way. Your newborn is totally dependent upon you as a parent. The decisions you make will have a vital effect on your child's dental future.

For this reason, it is important to teach your child from an early age, the importance of eating a healthy diet, and practicing daily oral hygiene to maintain healthy teeth and gums for a lifetime of smiles.

iII) Teething Information

Teething may make your baby restless and irritable. If fever, vomiting, or diarrhea occurs do not relate this automatically to teething, as it is not generally the cause of these conditions. See your pediatrician first.

Some signs that your baby may be teething:
• red cheeks or rash on cheeks
• increased saliva/drooling
• restlessness
• irritability
• loss of appetite

What to do?

Let your child chew on a cold, hard object, such as a teething ring. The coldness helps ease the discomfort and the hardness will speed up the eruption of the tooth.
• Massaging your child's gums with a clean finger can help reduce pain and discomfort during teething.
• Teething gels or ointments (ask your pharmacist for a brand name) are used to numb the gums and    reduce the discomfort.
• Teething cookies or biscuits are not a good choice as they contain sugar and may lead to tooth decay.

iv) Thumb-sucking

Thumb-sucking or finger-sucking is a habit that occurs with many infants. Your child will usually give it up naturally by the age of four. If the sucking habit continues beyond the time when permanent teeth start to erupt, your child may develop crooked teeth and a malformed palate (roof of the mouth). This results from pressure applied by the thumb on the teeth and roof of the mouth. The severity of the problem depends on frequency, intensity, duration and also the position in which the thumb is placed in the mouth. The relationship between the upper and lower jaws may also be affected. Speech defects can occur from misaligned teeth resulting from thumb-sucking and/or finger-sucking.


• The best prevention is to get your newborn to take up the pacifier instead of thumb-sucking or    finger-sucking. Although prolonged use of the pacifier can lead to similar problems, it is not attached     to the child and can be removed.
• Children should be helped to give up the habit before they enter school to prevent teasing.
• Timing of treatment is important. Your child should be willing to give up thumb-sucking or finger-   sucking. If your child is not willing to stop, therapy is not usually indicated. Pressure you apply to    stop may only lead to resistance and lack of cooperation. Try again later.
• Give your child attention and understanding and gently discourage the habit. Reminders such as a    band-aid on the thumb can help.
• Offer rewards (star on chart, dimes, extra story) for days when your child is successful. Praise your    child when successful.
• Also indulge your child in activities where hand skills are required so that his thumb –sucking is    automatically discouraged .


After daytime sucking is controlled:

• Help your child to give up the sucking habit during sleep. This is usually an involuntary process and a glove, sock, or thumb/finger guard can help stop the habit.
• Take one step at a time. Encourage your child not to suck during one daytime activity, like story time or television watching. Gradually add another activity until daytime sucking is controlled.
• If these considerations are not successful, let us know. By the time your child's permanent teeth    begin to erupt (at around 6 years of age), it should be brought to their attention. We may suggest other options such as a reminder bar that is placed in the upper arch.

v) Oral Hygiene for Children


Should I clean my baby's teeth?

Definitely! Even before the first tooth appears, use a soft, clean cloth to wipe your baby's gums and cheeks after feeding. As soon as the first tooth appears, begin using a small, soft bristled tooth brush to clean the tooth after eating. Don't cover the brush with toothpaste. Young children tend to swallow most of the toothpaste, and swallowing too much fluoridated toothpaste can cause permanent spots on their teeth called dental fluorosis.

I find brushing my child's teeth awkward. Do you have any suggestions?

Try having your child lie down. Put your child on your lap or on the floor, keeping his/her head steady with your legs. If your child is standing, have his/her back to you with their head tilted slightly and resting against your body. Have your child hold a mirror while you brush and floss their teeth so your child can see what is being done.

Is it important to brush before bed?
Yes. If you have to miss a brushing, the bedtime one is probably the worst one to miss. If you don't get rid of the bacteria and sugar that cause cavities, they have all night to do harm. While you are awake, saliva helps keep the mouth clean. When you are asleep, there is less saliva produced to clean the mouth. For this reason it is important to brush before bedtime.

How to brush your child's teeth:

• Every day plaque forms on the inner, outer, and chewing surface of teeth and the gums. Tooth brushing is one of the most effective ways to remove the plaque.
• The best kind of toothbrush to use is one with soft, round-tipped bristles.
• A child will need a smaller brush than an adult.
• Young children do not have the manual dexterity to brush properly. Your child will need your supervision and help brushing until he or she is 8-10 years old to ensure a thorough brushing has been done.
• When the bristles become bent or frayed, a new brush is needed.
• Start flossing your child's teeth when the teeth touch each other and you can no longer brush in between them.

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