Caries is the most prevalent infectious disease. Dental caries is 5 times more common than asthma and 7 times more common than hay fever in children. Unfortunately, childhood caries spread rapidly, within the time frame of 6-12 months.
Early childhood caries (ECC) is commonly referred to as “nursing caries,” “baby bottle caries,” and “baby bottle tooth decay”, has a great morbidity. American Academy of Pediatric Dentistry defined ECC as
The presence of one or more decayed (noncavitated or cavitated lesions), missing (due to caries), or filled tooth surfaces in any primary tooth in a child in a child 71 months of age or younger.
How can caries affect a child?
- Caries in primary teeth can affect children’s physical growth and development.
- Caries or early loss of milk teeth can disturb the eruption sequence and position of teeth, leads to malocclusion.
- Pain, swelling and infection which can affect a child’s ability to eat and result in reduced body weight and failure to thrive.
- Caries in the primary dentition has been indicated as a risk factor for the future dental caries in the permanent dentition.
- Overall quality of life is reduced.
When should I take my child to the dentist?
As per the American Academy of Pediatric Dentistry, the first dental visit should occur within six months after tooth erupts or 12 months of age, but no later than the child’s first birthday.
The main aim of the of dental care at an early age is to avoid future complications, cropped up due to oral hygiene negligence. Dental treatment for children can be very difficult and traumatic, therefore, establishing regular dental visits at an early age can be important in identifying patients at high risk for dental caries in an effort to reduce their risk of dental treatment needed in the future.
What to expect during the first dental visit?
1. Evaluation of proper oral development and oral pathology like active dental lesions, Baby Bottle decay risk, tongue tie.
2. Assessment of risk factor of developing oral diseases of soft and hard tissues.
3. Assessment of infant oral health and hygiene, Oral Hygiene Instructions
5. Diet and Nutritional counselling
6. Evaluation of Fluoride Needs
7. Parent education of dental decay process, teething, correction of habits and injury prevention.
- Oral hygiene measures should be implemented no later than the time of eruption of the first primary tooth.
- Dental care is important for kids as it can set a pattern of oral health
- Cleansing the infant’s teeth as soon as they erupt with a soft toothbrush will help reduce bacterial colonization.
- Toothbrushing should be performed for children by a parent twice daily, using a soft toothbrush of age-appropriate size.
- In children with moderate or high caries risk under the age of 2, a “smear” off Fluoridated toothpaste should be used. In all children aged 2 –5 years, a “pea‑size” amount should be used.
- Oral health education: Parents should avoid saliva-sharing behaviours (eg, sharing spoons and other utensils, sharing cups, cleaning a dropped pacifier or toy with their mouth) to prevent early colonization of caries-causing bacteria in infants.
Diet counselling during infant oral health visit
- Infants should be exclusively breastfed during the first 6 months of life followed by the addition of iron‑enriched solid food between 6 and 12 months of age
- Do not to put their children to sleep with the bottle.
- Breastfeeding for over 1 year and at night beyond eruption of teeth may be associated with Early Childhood Caries. AAPD suggests that children should be weaned from breast or bottle by 12–14 months of age and should drink from a cup as they approach their first birthday.
- Night time bottle feeding with juice,
repeated use of a sippy or no-spill cup, and frequent in between meal consumption of sugar-containing snacks or drinks should be avoided.
- Infant formulas are acidogenic and possess cariogenic potential.
- Infants older than 6 months and with exposure to <0.3 ppm fluoride in their drinking water need dietary fluorides supplement of 0.25 mg fluoride per day.
- For infants under the 6 months of age, irrespective of fluoride exposure in water dietary supplements should not be prescribed.
- Reduce sugar consumption frequency of the child. Avoid sugary drinks and food. AAP suggests that infants should consume only 4–6 oz of fruit juice per day. Mashed pureed whole fruit consumption should be encouraged rather than fruit juice.
- Avoid powdered beverages or soda pop. Miron-fortified infant cereals along.
- Cow’s milk should be completely avoided in the 1st year of life and restricted to 24 oz per day in the 2nd year of life
Teething can lead to intermittent localized discomfort in the area of erupting primary teeth, irritability, and
excessive salivation. Treatment of symptoms includes oral analgesics
and chilled rings for the child to gum.
Avoid food material.which may be choking potential. Infants should be given food only when they are seated and are supervised by an adult.
Practitioners should provide age-appropriate injury prevention counselling for orofacial trauma. Initially, discussions would include play objects, pacifiers, car seats, and electric cords. The use of properly fitted mouth guards in other organized sporting activities that carry the risk of orofacial injury should be mandatory. The coaches/administrators of organized sports should consult a dentist with expertise in orofacial injuries before initiating practices for a sporting season, for recommendations for immediate management of sports‑related injuries (e.g, avulsed teeth). The dentists should prescribe, fabricate, or provide the referral forum with a mouth guard protection for patients at increased risk for orofacial trauma.
Nonnutritive oral habits(e.g, digit or pacifier sucking, bruxism, and abnormal tongue thrust) may apply forces to teeth and dentoalveolar structures. It is important to discuss the need for early sucking and the need to wean infants from these habits before malocclusion or skeletal dysplasias occur.