Teething, Tooth & Toddler!
Many a time I am asked what is the correct age to introduce or commence brushing for an infant, to which my very simple reply remains – “as soon as the first tooth starts erupting in to the oral cavity.” The first primary or deciduous teeth also called as “Milk” teeth start erupting as early as when the baby is but six months old and the last of the milk teeth to erupt is approximately at 30 months. Teething starts a few weeks before the first tooth erupts. This is characterized by redness in the infants’ gums, fever, pain, refusal to feed, irritability, restlessness etc. This is just a stage and passes as the teeth erupt, which can be alleviated with symptomatic measures like use of simple antipyretics, topical gels and teething toys. Some infants may not even go through this phase.
Reasons why there is negligence in infant dental care are because of ignorance and carelessness. These can be attributed to the fact that parents are unaware that, primary teeth are just as important as their permanent successors and that they must be preserved till the time they shed. An untimely loss of deciduous teeth can lead to all sorts of complications affecting the permanent dentition hence it is absolutely necessary to preserve and protect the primary dentition until their shedding.
It is very important to start some form of oral hygiene measures at a tender age. By this I do not mean that an actual toothbrush and toothpaste have to be employed, but some form of cleansing must be adopted at this stage. A simple sterile clean soft cloth or gauze piece can be used effectively on the infants’ teeth to cleanse away what remains after each feed. This is very important on two grounds – firstly it prevents tooth decay and secondly an effective method in getting the child to get used to oral cleansing procedures at an early age. This is particularly important because if care is not taken most of the milk teeth can get decayed as soon as they erupt. Many parents are unaware of the potential damage the normal infant feed it self can do to the child’s teeth, this is attributed to the carbohydrate content in the feed which can initiate the carious process in the infants’ teeth. Many infants also develop a habit of going off to sleep with the bottle. This is a very damaging habit. This leads to a situation called “Nursing Bottle caries” which affects the primary teeth because of the long hours the milk remains in contact with the teeth and a decay onslaught takes place when the baby is sleeping. So never ever put the baby off to sleep with the bottle and some simple form of cleansing must be done after every feed. Timely administration of fluoride drops must be done as a part of the infants’ regular immunization schedule to prevent future complications.
Conventional tooth brushing procedures can be taught to the child when they are a bit older, initially without toothpaste because the child’s natural tendency is to swallow. When the child has learned voluntarily to distinguish between swallowing and spitting, then normal fluoridated toothpastes can be introduced in the brushing. One brushing a day must be parent supervised and brushing must be recommended after all meals and definitely before bedtime. A visit to the dentist, once in six months, just to monitor and check for early detection of problems is an added advantage.
As for the diet regime, a well balanced diet with the right sources of vitamins, calcium and iron is a must for growing infants. Your pediatrician can properly instruct this. All snacks in between meals are to be avoided completely. Make sure that the meals consumed have a lesser quantity of refined carbohydrate contents in them i.e. avoid the various forms of junk food. Also introduction of foods with increased fiber content in the meals i.e. foodstuffs that require a good amount of chewing help.
Finally, for a million dollar query whether chocolates have to be completely off limits. The answer in absolute honesty is “NO”! Children can enjoy the luxury of chocolates if proper hygiene measures are exercised and with a few do’s and don’ts’ chocolates can be safely consumed out of harm’s way. Chocolates are not the enemy and the amount of chocolates consumed is also not the problem, provided the normal diet is not compromised. The problem lies in the time interval between the consumptions, the frequency of the consumption and whether any oral hygiene measures are practiced after the consumption. In other words, consuming many bars of chocolates after food and brushing immediately does not cause any harm when compared to eating just one chocolate bar over a period of time or frequently and not brushing. This makes all the difference.
A child may not comprehend this difference. He/she must be effectively trained to eat chocolates, lets say, on a particular day of the week with a fixed time that day and after his meal; as many as he/ she wants but most importantly brush after eating the chocolates; and only the following week can he do the same. This regime not only puts in a sense of discipline in the child also prevents all sorts of damage associated with any unsolicited candy consumption. If such a protocol cannot be practiced then the only way out is simply to avoid candy in between mealtime and immediately brush after one; this keeps the teeth out of harm’s way and making sure the normal meals are not compromised.
Dr. Murali Srinivasan, MDS.
© COPYRIGHT 2005 ALL RIGHTS RESERVED prodents.com