Q. Does a woman's oral health during a pregnancy have any effect on the fetus?
A. Yes, a pregnant woman's oral health can affect the fetus. Studies have shown that women with many decayed teeth and advanced gum disease may have babies who are born underweight or prematurely.
Q. What about the juices? Can they cause baby tooth decay?
A. Juice causes 20 times more baby tooth decay than milk. Any beverage other than water will cause damage to your child's baby teeth if it is given constantly in a bottle or sippie cup.
Children whose stomachs' are full of liquid may have less of an appetite and eat less of the more nourishing foods. White grape juice contains more fluoride than the other juices. Consumption of white grape juice should be limited before four years of age.
Q. How does one know if her baby needs a fluoride supplement?
A. Fluoride supplements are necessary only if the baby is receiving no fluoride. These supplements may begin at six months of age.
If an infant is strictly breastfed, fluoride may be prescribed for optimal oral health. However, there are many sources of fluoride besides your tap water.
The following contain fluoride:
- juices
- bottled water
- baby foods, (especially chicken)
Q. If the baby receives only bottled water, should a fluoride supplement be used?
A. Bottled water may contain significant amounts of fluoride. The time of year, the source of the water, including the water table and plant from which the water was obtained, will cause fluctuations in the amount of fluoride.
Q. When should one begin brushing the baby's teeth?
A. Brushing may begin with a soft-bristled brush as soon as the first baby teeth erupt. Do not use toothpaste. Toothpaste contains too much fluoride, the taste may be unacceptable and the foaming may upset your child.
Q. Any toothbrush tips?
A. A toothbrush with a small, rounded head is safer. Bristles should be extra soft. Rinse the brush with hot water before and after brushing.
Change the toothbrush as soon as the bristles appear to be frayed. The toothbrush should also be changed
after any illness.
Q. Can medicine harm baby teeth or second teeth?
A. >Tetracycline is the only antibiotic that can cause irreversible color change to the second teeth. It is no longer prescribed for children under eight years of age. Chronic illness and long-lasting high fevers may cause changes in the developing permanent teeth, but medication will not.
Children's medications are colored with dyes and have a very high sugar content to make them taste good. Some pharmacies are adding flavoring to improve the taste. The combination of the dye and sugar may cause staining of the teeth. This stain is easily removed when the teeth are polished during a cleaning by the pediatric dentist.
Q. What about injuries to the baby teeth?
A. If a baby tooth is knocked out, do not attempt to replace it in the tooth socket. This is not the same with permanent teeth.
Attempt to find the tooth. If the tooth cannot be located and your child is coughing, a chest X-ray must be performed in order to be sure that the tooth is not lodged in a lung. The baby tooth could also be intruded or pushed up into the gum and bone. This can be confirmed by an X-ray.
The baby tooth should come back into the mouth in six to eight weeks. Other treatment may be necessary, but not usually. Sometimes the permanent tooth that is developing in the bone just under the baby tooth is damaged when the baby tooth is pushed into the bone. The extent of the damage can not be predicted. When the permanent tooth erupts or comes in, the damage could range from a white spot to a dark indentation.
If the baby tooth is lost, a space maintainer with a denture tooth can be made. This may maintain the space for the permanent tooth and improve appearance, but it is not always necessary.
Q. When should my child have his or her first dental visit?
A. The American Academy of Pediatric Dentists recommends the first visit be within six months of the eruption of the first baby tooth. This is generally around 12 months of age.
Early intervention is much easier on you and your little one than an emergency visit for advanced baby tooth decay. Injury to the teeth and mouth are common as children progress through crawling to walking.
By establishing a relationship earlier with a pediatric dentist, you will not only have someone to call in the event of an emergency, but your child will be familiar with the pediatric dentist and the dental environment. Give yourself and your child the advantage of the best of oral health and schedule that first visit.
By Jane A. Soxman, DDS
