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Pediatric Dental Health
Does Breast Milk Cause Cavities Or
Not?
According to a recent article in the March/April 1999
issue of Pediatric Dentistry, "It is concluded that human breast milk is
not cariogenic." This study utilized extracted teeth to obtain most of its
results and studied children only for determining the pH changes in dental
plaque.
The reality, however, is that breastfeeding children can develop dental caries
if other factors are present.
1. Parents and clinicians need to be aware that children who are breast fed
during their sleep are at risk for developing nursing caries. This is because
the flow of saliva is greatly diminished when a child sleeps. Salivary flow
during normal waking hours helps to cleanse teeth.
2. Daily consumption of other fluids and solids containing sugar will also cause
caries. One example would be frequent ingestion of fruit juices.
The bottom line in protecting a baby's teeth is: limit the intake of sweets,
cleanse the baby's teeth every day, and give only water at bedtime or nap time!
Erickson PR, Mazhari E: Investigation of the role of human breast milk in
caries development. Pediatric Dentistry 21:86-90,1999.
For related information, read
Breast
Milk
Does Your Child Grind His Teeth At
Night? (Bruxism)
Parents are often concerned about their child's bruxism
(grinding of the teeth at night). The first indication of pediatric bruxism may
be the noise created by the child's forceful dental grinding during sleep.Most
cases of bruxism have a psychological component. A child may be adjusting to a
new situation or may be experiencing stress due to a family problem.
Althought most cases of pediatric bruxism do not require treatment, a mouthguard
or nightguard may be indicated if excessive wear of the baby teeth (attrition)
occurs.
If you suspect that your child has bruxism, discuss it with your pediatrician or
pediatric dentist.
Please read more about Bruxism.
Failure To Thrive And Early Childhood
Caries
A number of research articles abstracted in PubMed
have implicated early childhood caries (ECC) as a factor in pediatric failure to
thrive (FTT).
Many infants with FTT do not receive early dental exams as recommended by the American
Academy of Pediatric Dentistry.
As a result, dental caries may be overlooked. Subsequent dental pain may cause a
child to avoid eating nutritious meals, contributing to FTT.One research article
concluded that "the restoration of the dentition, even in children with a
seemingly organic basis for failure to thrive, can result in an acceleration of
weight gain."
Compend Contin Educ Dent. 1998 Feb;19(2):164-8, 170-1.
Pediatric dentists encourage dental and oral examinations for infants when they
reach one year of age.
In cases where treatment was needed, mothers have frequently commented on their
children's improved appetite after the completion of dental rehabilitation.
For more information on the relationship between early childhood caries and
failure to thrive, click on Compendium
Oral Diagnosis
Did you know that the mouth is a window to your child's
health? Consider the following examples.
The first thing we notice is the lips. Purple lips warn us about the presence of
inadequate blood perfusion or cyanotic heart disease.
Sores on the corners of the mouth may imply a vitamin deficiency or a candida
infection.
Inability to keep the lips together might alert us to an airway problem, such as
enlarged adenoid tissues.
Green teeth could be an indication of severe liver disease.
Inflamed and red gums can alert us to the presence of a reactive airway disease or a severe problem such as cyclic neutropenia. Blisters on the gums may indicate the presence of herpes simplex virus, or a drug reaction such as erythema multiforme.
A big delay in the eruption of baby teeth might indicate hypothyroidism or
failure to thrive in infants.
White areas on the tongue of an infant might alert us to a candida infection
(thrush).
Small, flat, red areas on the soft palate might indicate pharyngitis, or
thrombocytopenia.
For more interesting facts about oral medicine and pathology, click on Oral Pathology-UofIowa
Brushing Baby Teeth
Brushing baby teeth can be quite a challenge for new
parents. Some infants and toddlers may refuse to let parents brush their teeth.
What can parents do?
Parents can experiment with various rewards for good behavior during brushing.
The initial tooth brushing attempts need to last only 5 seconds or so - and some
little reward should be provided immediately thereafter. The time spent brushing
the teeth can be gradually increased later on.
Using this "rewards technique," parents can follow the first
successful attempt at tooth brushing with letting their baby "play with a
favorite toy" or "play a favorite game with mom or dad."
Brushing and cleansing should begin as soon as baby's first teeth appear.
For more information on brushing baby teeth, click on
American Dental Association
Early Childhood Caries
Let's discuss some of the steps you can take to prevent
early childhood caries. Begin by NOT sharing your eating utensils with your
infant, and vice versa.
Your mouth contains millions of bacteria, including the infectious mutans
streptococci. These bacteria are the initiators of the caries disease process.
When a parent puts the baby's feeding spoon into his or her mouth, the mutans
streptococci bacteria from the parent's mouth will be transferred back to the
baby's mouth and infect the baby's teeth. This process can take place as early
as eleven months of age. The danger of infecting an infant's teeth is actually
increased when the mother already has the caries disease herself.
To read the rest of this article, click on ParenthoodWeb
Is Tongue-Tie A Problem For Children?
Three questions need to be answered before deciding on any
treatment for ankyloglossia (tongue-tie).
First: is their a nursing or feeding problem? If an infant or child is
well-nourished, there is no immediate need for treatment. Consultation with your
pediatrician will be helpful in making a decision.
Second: is there a problem with speech development? Consultation with your
pediatrician and/or a speech pathologist may be necessary when a child is
between 24 to 30 months old.
Third: is there a dental alignment or periodontal (gum tissue) problem?
Consultation with your pediatric dentist will provide answers.
Treatment for infants, when necessary, is usually performed after the age of
nine months, and involves a simple snipping (frenotomy) of the lingual frenum.
This could be done without numbing (anesthetizing) the area.
Treatment for children older than eight years of age may require surgical
removal (frenectomy) of the tissue that is limiting tongue movement. In this
case, the area under the tongue will need to be anesthetized with a local
anesthetic. Although most cases of ankyloglossia resolve on their own and do not
require treatment, you should consult your pediatrician or pediatric dentist if
you have any questions. For more information, read
Tongue-Tie
When Should Your Baby's First
Teeth Come In?
There is a wide range of variation in the normal eruption
time for infants' teeth. Some children get their first teeth when they are 12 or
18 months old. Please see Teething
and New Teeth
Is Dental Caries Really An Infectious
Disease?
Yes! Caries is a dynamic bacterial disease!
The offending bacteria, mutans streptococci, are transmitted from parents
or playmates to a child's
mouth as early as 11 months of age!
M. streptococci levels are elevated in children who are at high risk for
developing dental caries.
Factors which promote the caries disease include: elevated levels of microflora,
a high sucrose diet, poor plaque control, inadequate flow of saliva, inadequate
fluoride exposure, inappropriate bottle feeding, nighttime nursing of infants,
and a compromised medical history.
For more information click on Cariology
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