How to prevent tooth decay in babies?

How to prevent tooth decay in my baby?

[mme_highlight] Tooth decay has a high prevalence among young children but can be prevented with simple measures: keep your child’s mouth cleaned, take her/him to the dentist on a regular basis, do not give your child a bottle to walk around with or while in bed. [/mme_highlight]

Preventing tooth decay in your children should start even before the first tooth appears, with healthy oral hygiene habits. Other names you can hear referring to tooth decay in babies are “baby bottle tooth decay” and “early childhood caries”. Untreated dental disease can result in pain and infection, impair speech, and lead to learning and eating problems and often trigger a lifetime of dental treatment – that is why the focus should be on preventive strategies. It is estimated that about 6.3% of young children (1 to 3 year-olds) have caries in United States of America.

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Proportion of Children  aged 2 to 4 years old who have ever had caries in  primary teeth  (United States National Health and Nutrition Examination Survey; 95% Confidence Interval)

– 1988-1994: 18%
– 1999-2004: 24%
– “Healthy People” (U.S. government program) goal for 2010: 11%

Proportion of Children  aged 2 to 4 years with untreated tooth decay in  primary teeth  (United States National Health and Nutrition Examination Survey; 95% Confidence Interval)

– 1988-1994: 16%
– 1999-2004: 19%
– “Healthy People” (U.S. government program) goal for 2010: 9%

Prevalence – The total number of cases of a disease in a given population at a specific time.
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Why do baby caries appear?

Both in adults and children, this is a complex process, but the resulting pattern is unique in young children, as it involves primary maxillary incisors, followed by the maxillary and mandibular primary first molars and the mandibular primary cuspids, in this order.

Tooth decay appears after a continuous exposition to aliments which collect around teeth and gums, being then transformed in acid by bacteria present in mouth. This acid can dissolve the enamel of teeth, causing tooth decay. This can happen particularly if parents put children in bed with a bottle of milk, juice or other sugared drinks, as well as when parents allow children to drink from a sippy cup, suck on a bottle or breastfeed for long periods.

What are the factors that influence tooth decay?

Studies have shown that factors such as low social status, drink from a bottle in bed or for long periods as well as snacking are risk factors for tooth decay; in the other hand, regular visits to the dentist are a protective factor.

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Risk and Protecting factors for tooth decay in young children  (statistical significantly results)
(Study design: 88 children suffering from baby bottle tooth decay and 88 children with no dental caries, multivariate analysis applied)

– Low social class: 6 times more risk for tooth decay (OR 6.39 [95% CI, 1.45–28.11])
– Prolonged bottle feeding or bedtime feeding: 153 times more risk for tooth decay (OR 153.2 [95% CI, 11.77–1994.96])
– Snacking: almost 6 times more risk for tooth decay (OR 5.94 [95% CI, 1.35–26.2])
– Regular dental visits: decreases the risk for tooth decay by 87% (OR 0.13 [95% CI, 0.02–0.77])

OR – Odds Ratio; CI – Confidence Interval
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What can I do to prevent tooth decay in my child?

  • Teach your child to drink from a bottle as early as possible: this diminishes the exposition of teeth to liquids compared to bottles and sippy cups.
  • Do not put your child to bed with a bottle: this has multiple risks – exposition of teeth and gums to sugar, risk for ear infections and for chocking.
  • Give a bottle to your child only during meals and fill it with water: do not let your child walk around with a sippy cup or bottle for long periods.
  • Take your child to be examined as soon as you notice signs of tooth decay: white spots at the gum line on the upper front teeth are the first signs and can be difficult to notice at first.
  • Keep your baby’s mouth cleaned: use a gauze with water during the first 8 months of life. After that use a toothbrush twice a day.
  • Do not forget the time for the first dentist visit: which is as soon as teeth start appearing.

What is the importance of tooth brushing?

The best moments for tooth brushing are after breakfast and before bed. Start with a fluoride-free toothpaste. When children are able to spit and not swallow the toothpaste – which happens between 2 and 3 years of age – you can start using a fluoride one. A Scottish study has shown that a twice a day brushing with a smear of medium-strength fluoride toothpaste can be about 25% more effective in preventing tooth decay that non-fluoride brushing.

Summary and Recommendations

  • Tooth decay has a high prevalence among young children but it is a preventable disease.
  • Tooth decay can be prevented with simple measures: keep your child’s mouth cleaned, take her/him to the dentist on a regular basis, do not give a bottle to your child to walk around with or while in bed.
  • The American Academy of Pediatrics recommends that all infants should have an oral health assessment by 6 months.

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References

  • Broderick E, Mabry J, Robertson D, Thompson J. Baby bottletooth decay in Native American children in Head Start centers. Public Health Rep. 1989 Jan-Feb;104(1):50-4.
  • Khadra-Eid J, Baudet D, Fourny M. [Development of a screening scale forchildren at risk of baby bottle tooth decay]. Arch Pediatr. 2012 Mar;19(3):235-41.
  • http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5802a3.htm (accessed 14.10.2013)
  • http://www.cdc.gov/nchs/data/hpdata2010/hp2010_final_review_focus_area_21.pdf (accessed 14.10.2013)
  • Scottish children brush away tooth decay. Br Dent J. 2005 Dec 10;199(11):698.

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