Patient Info
1. Oral Hygiene Instructions:
2. Perinatal Oral Health Care
3. Infant Oral Health Care
4. Adolescent Oral Health Care
5. Dietary Instructions
6. Emergency Care
1. Oral Hygiene Instructions:
For the best prevention of dental cavities, it is best to begin oral hygiene measures at birth. Although the baby teeth do not erupt until approximately 6 months of age, it is important to wipe down the infant’s mouth with a damp washcloth after feedings. This helps to prevent fungal infection. Parents should perform the oral hygiene measures as the teeth erupt and continue to provide the oral hygiene for their children until the child has good manual dexterity (hand skills) to perform the tasks, which is approximately age 9. The American Academy of Pediatric Dentistry recommends that toothpaste be used as soon as the teeth erupt. Initially only a small smear of toothpaste is necessary, but as the children are better able to expectorate the paste (around age 2) than a small pea size amount of toothpaste should be used.
This indicates a comparison of a smear (left) with a pea-sized (right) amount of toothpaste.
Illustration © American Academy of Pediatric Dentistry
How To Brush
1. Use a extra soft or soft bristle toothbrush, or an electric toothbrush.
2. Hold your brush at a 45 degree angle towards the gums. The bristles should contact both the teeth and the gums.
3. Gently brush the outer tooth surfaces of 2-3 teeth using a gentle circular motion. Move the brush to the next group of 2-3 teeth and repeat.
4. Repeat the same motion on the inside surfaces of all the teeth.
5. Brush the inside surfaces of the front teeth by tilting the brush vertically with gentle, short up and down brush strokes.
6. On the chewing surfaces, hold the brush flat and use a gentle scrubbing motion. Don’t forget to brush your tongue to keep your breath fresh.
7. Remember to replace your toothbrush at least every 3-4 months.
Illustrations and Instructions © 2006 P&G
Electric or battery powered toothbrushes are very popular now with children. Many manufacturers make very inexpensive and very effective toothbrushes that make taking care of your child’s teeth alot of fun. Some adult electric toothbrushes such as the SoniCare brand are much too intense for young children to use. Our office recommends the disposable battery powered toothbrushes designed specifically for use by children. In our opinion, any of the brands designed specifically for children will work just fine … remember that the toothbrush that does the best job …
is the one that makes it into your child’s mouth
How To Floss
1. Wrap the ends of a 18 inch to 24 inch section of floss around your middle fingers.
2. Hold the floss between your thumbs and forefingers. Leave about 1 inch of floss between your hands.
3. Gently work the floss between your teeth. When you reach the gumline, curve into a “C” shape around the tooth, making sure to go below the gumline.
4. Gently glide the floss up and down several times between each tooth, including your back teeth. Apply pressure against the tooth while flossing. Unwind new floss as needed.
Illustrations and Instructions © 2006 P&G
2. Perinatal Oral Health Care
The perinatal period is an optimal time to educate expectant mothers on self-care and future childcare and to perform dental treatment. Frequent snacking, morning sickness and hormonal changes are some of the factors that might lead to an increase in gum disease and cavities. It is recommended to brush at least twice daily and floss at least once daily to dislodge food and reduce the bacterial plaque levels. Use of fluoride toothpaste, chewing xylitol-containing gum, routine professional dental care and eating healthy all contribute to a reduced cavity rate. For expectant women who frequently vomit, it is recommended to rinse with a cup of water with a teaspoon of baking soda and wait 1 hour before brushing to minimize tooth erosion. Preventative services and healthy choices will not only help to keep the expectant mother healthy, but also the baby within.
3. Infant Oral Health Care
Sadly, more than 40% of children have cavities by the time they enter kindergarten. Since cavities are preventable, let’s focus on how we can stop this trend.
Brush Daily:Teeth should be brushed a minimum of 2 times a day. As soon as the first baby tooth erupts it is advised to begin brushing with a washcloth or soft toothbrush. The younger you start, the easier it is to develop the habit.
Floss Daily: Toothbrushes do not successfully clean in between the teeth so the only way to remove the food and debris from those areas is with a daily flossing regimen. Flossing should be initiated when adjacent tooth surfaces cannot be cleansed with a toothbrush.
Fluoride use: Fluoride is a mineral that helps the teeth to be stronger and fights against the bacteria that causes cavities. A tiny smear of fluoride toothpaste should be used as soon as teeth erupt. When children are able to adequately spit out the majority of the toothpaste, a pea-sized amount can be used. Fluoride is also found in city drinking water and many prepared foods and beverages. Professionally applied fluorides, as well as at-home fluoride treatments, are recommended for all children with a high-caries rate.
Don’t Share Germs: Cavities are caused by bacteria. The bacteria is passed from person to person through saliva. 71% of infants receive this bacteria from their mother or primary care-giver. Sharing utensils, cups, or toothbrushes can pass this bacteria on from person to person. Regular brushing and routine dental care by both the mother and child can lower the risk of spreading the cavity causing bacteria.
Wean from bottle by 12 months of age: Begin offering a sippy cup at 6 months of age and wean from the bottle by 12 months of age. Limit sweetened beverages; instead offer water for your child’s sippy cup.
No Bottles in Bed: Formula, milk, juice and breast milk cause cavities when left in your child’s mouth while they sleep. The healthiest habit is to brush your child’s teeth right before bed and not offer anything else until the next morning.
Be Proactive in Injury Prevention: As children are developing their motor skills falls and injuries are more common. Take care to child proof your house, practice electrical cord safety and always protect your child in a car seat when in the car.
Take Care of Yourself: Children learn by example. Show them the value of a clean and healthy mouth by brushing and flossing your teeth daily and making regular dental visits.
Take your Child to the Dentist: All children should have their teeth checked by a dentist by their first birthday.
4. Adolescent Oral Health Care
Adolescence is a complex time of growth and development. Due to an increase in availability of sweetened food and beverages, independence to seek care or avoid it, a low priority for oral hygiene and additional social factors, adolescence is also marked as a time of distinctive oral health care needs.
High Cavity Rate: To combat cavities, prevention through optimal brushing, flossing, fluoride use, dietary management and professional evaluations and professional removal of plaque and calculus should be utilized.
Trauma: Trauma to the permanent teeth occurs most frequently secondary to falls, following traffic accidents, violence or sports injuries. A significant reduction in dental and facial injuries can be obtained through protective equipment such as mouthguards and face guards. Mouth guards help prevent broken teeth, and injuries to the lips, tongue, face or jaw. A properly fitted mouth guard will stay in place while your child is wearing it, making it easy for them to talk and breathe.
Orthodontic Considerations: When appliances, brackets, and bands are fitted to the teeth it is necessary to implement proper cleansing of your mouth every time you eat. Teeth with braces are harder to clean, and food can be trapped very easily. If food is left lodged on the bracket and wires, it can cause etching of the enamel surface of your tooth. Additionally, symptoms of gum disease will show in your mouth. The gums will swell and bleed and the pressure from the disease will slow down the tooth movement, and thus prolong your orthodontic care.
Tobacco Use: Tobacco use in any form can jeopardize your child’s health and cause incurable damage. If your child is a tobacco user you should watch for the following early signs of oral cancer:
- A sore that won’t heal
- White or red leathery patches on the lips, and on or under the tongue
- Pain, tenderness or numbness anywhere in the mouth or lips
- Difficulty chewing, swallowing, speaking or moving the jaw or tongue; or a change in the way the teeth fit together.
Because the early signs of oral cancer usually are not painful, people often ignore them. If it’s not caught in the early stages, oral cancer can require extensive, sometimes disfiguring, surgery. Even worse, it can kill. Help your child avoid tobacco in any form. By doing so, they will avoid bringing cancer-causing chemicals in direct contact with their tongue, gums and cheek.
Oral Piercings: Piercings of the tongue, lips or cheeks are a bad idea.
There are many risks involved with oral piercings, including chipped or cracked teeth, blood clots, blood poisoning, heart infections, brain abscess, nerve disorders (trigeminal neuralgia), receding gums or scar tissue. Your mouth contains millions of bacteria, and infection is a common complication of oral piercing. Your tongue could swell large enough to close off your airway!
Common symptoms after piercing include pain, swelling, infection, an increased flow of saliva and injuries to gum tissue. Difficult-to-control bleeding or nerve damage can result if a blood vessel or nerve bundle is in the path of the needle.
5. Dietary Instructions
A healthy diet is a balanced diet that naturally supplies all the nutrients your child needs to grow. Such a diet includes daily servings from all the major food groups, including: fruits and vegetables; breads and cereals; milk and dairy products; and meat, fish and eggs.
A balanced diet is essential for proper development of your child’s teeth as well as healthy development of gum tissues. A diet high in certain kinds of carbohydrates however, such as sugar and starches, can place your child at increased risk of tooth decay.
One particular challenge in raising children today is that we are surrounded by sweets and food, including not just soda and candies, but also bread, crackers, pasta, pretzels and potato chips. Some processed foods such as catsup and salad dressings and even peanut butter can also be high in sugar. These sugary foods create and acidic environment in the mouth and adhere to the teeth.
In the end, we are not asking you to avoid all sugar. But we do encourage a more moderate and balanced approach to diet, such as:
- Try serving foods high in sugar or starch only during mealtimes.
- If you must provide sugar during snack times, choose nutritious varieties (e.g., fruits) over the plain sugar varieties (e.g., candies).
- If your child chews gum or sips soda, choose gums and sodas without sugar.
- Limit the number of snack times during each day. Frequent or “at will” feeding of any carbohydrate, juice, milk, or snacks, can be damaging to the teeth because it allows for less time for the mouth to create a non-acidic environment where the teeth can re-mineralize and recover from and damage.
- Sometimes a few sensible steps, such as not stocking your pantry full with sugary or starchy snacks, can often go a very long way towards developing good oral health!
6. Emergency Care
Trauma: The greatest incidence of trauma to primary teeth occurs in children between 2 and 3 years old due to their developing motor coordination. For toddlers it is important to be proactive in injury prevention through electrical cord safety, child proofing your home, wearing pads and helmets when necessary and always using car seats in the back seat of automobiles.
Injuries to permanent teeth occur most commonly secondary to falls, traffic accidents, violence or sports injuries. For athletes mouthguards are a proven protective device to reduce dental and orofacial injuries.
- Bumped tooth: If tooth is slightly loose but no fracture or other trauma is evident call office immediately for consultation.
- Fractured tooth care:Gently clean area with warm water. Place a cold compress in the area of the injury to decrease swelling. Come immediately to office; please call 879-7977 while you are on your way so we might prepare a room for your child.
- Knocked-out tooth/Avulsion: Gently rinse dirt/debris from tooth. Do not scrub tooth or remove any tissue particles from root. If possible replace tooth into socket and hold in place. If replantation is not possible place tooth in cup of milk. Come immediately to office; please call 879-7977 while you are on your way so we might prepare a room for your child.
Toothache: Several reasons may be the underlying cause of a toothache. To help alleviate the discomfort rinse your child’s mouth with warm water (it is okay to add a little salt to the water to aid in antibacterial action) every hour as needed. Clean the area around the affected tooth thoroughly. This includes brushing well in the area and using floss or even a toothpick. An ice pack placed on the affected site may also help relieve pain. Do not give your child aspirin or place aspirin on the gums. Aspirin can cause burning of the gum tissue. If needed, give your child the recommended dosage of either Tylenol (Acetaminophen) or Motrin (Ibuprofen) for their pain. If swelling is present around his/her eye, apply an ice pack and take child to emergency room immediately.
Possible causes of toothache:
- Deep cavities
- Broken or lost fillings or crowns
- Food stuck in gums (like popcorn wedged in gums or in between teeth
- Periodontal disease
- Abscess (dental infection)
Loose baby tooth: In children, the natural exfoliation process of the baby tooth or trauma usually causes a loose baby tooth. If no trauma has occurred than it is likely that a visit from the tooth fairy will be forthcoming. Have your child “wiggle” the tooth themselves, pushing it everyday a little at a time. As more of the root of the tooth goes away, the primary tooth may fall out by itself. This may happen spontaneously, or during eating and chewing food. If you can see the new tooth coming in through the gums and the primary tooth is only slightly loose but not enough for your child to remove it, call our office for an appointment. It is important to remove over-retained primary teeth so that the new permanent tooth can come in straight.
Cut or Bitten Tongue, Lip or Cheek: Apply ice to injured areas to help control swelling. If there is bleeding, apply firm but gentle pressure with a gauze or cloth. If bleeding cannot be controlled by simple pressure, call a doctor or visit the hospital emergency room.
