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Pediatric  Dental   Health

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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

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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