Early Oral Health

Isis Parenting Expert Speaker Series

Femina Ali, D.M.D.

Ali & Ali

• Drs. Ali & Ali – both graduates of

Tufts Dental School

•Currently practicing dentistry since 1997

in Wellesley

Our family

I was pregnant once too!

Community means a lot

Reaching out to help• Started visiting 2nd graders in the classroom setting• Younger siblings• Met with preschoolers • Seeing infants

Pre-Pregnancy

Prevention is keyBrush twice a dayFloss dailyEat a healthy diet Use recommended prenatal vitamin with Folic AcidContinue regular check-ups at the dentistAsk for a screening for any gum disease, treat itGet necessary X-rays before pregnancyTake care of elective work before pregnancy

Getting pregnant

Bacteria present in periodontal disease may affect reproduction success and outcome of fertility treatment

Fertility treatments can affect gum health – a 2004 study showed that women receiving ovulation inducting medicines for three or more menstrual cycles had higher levels of gingival inflammation and bleeding

During Pregnancy

What to expectHormonal changes – increased progesterone and

estrogen causes gums to react differently to bacteria in plaque

Dietary changes – cravings and snackingMorning sickness Change of routine – feeling tiredFear, anxieties, and questions

What you can doEat healthy, balanced diet

Milk, cheese, and yogurt for CalciumChoose foods high in Vitamin C – strawberries, melons,

broccoli, papaya, bell peppersPhosphorous – chicken, eggs, legumes, dairy

If you have the urge to snackCarbohydrate rich foods can be an invitation to tooth decayBrush your teeth after snacking when possible

Floss dailyGet a dental cleaning once every 3 months during pregnancy,

some insurance plans even pay for the extra cleanings

If you need dental workX-rays for dental emergencies are okay if used to

diagnose major issues like infectionUntreated dental infection can be a risk to the fetusIt’s a myth that calcium is lost from mother’s teeth

during pregnancy

Gingivitis/Periodontal DiseaseEspecially common during months 2 – 8Occurs in 60-70% of pregnant womenLinks between pre-term, low birth weight babies and

gingivitis12 % of babies in the US are born preterm (before 37

weeks)Pregnant women who have periodontal disease may be

seven times more likely to have a baby that is born too early and too small*

What gingivitis looks like

Symptoms include red, swollen, bleeding gums

Treating gingivitisDeep cleaning (scaling and root planing) may be

recommended Periodontal therapy reduced pre-term birth and low

birth weight infants by 68% in women with pregnancy associated gingivitis

Pregnancy TumorsGrowths or swelling between the teethPlaque responseMost prevalent during second trimesterOften removed after baby is born

Fetal Development

Teeth begin to develop between the third and the sixth month of pregnancy

Use your calcium for tooth development20 primary teeth are present in jawbone at birth

Post Pregnancy

Bouncing back

Congratulations! You’ve had a baby!Hormones returning to pre-pregnancy levelsGums, if kept healthy during pregnancy, should be less

problematicRoutine hygiene visits and daily brushing and flossing still

very important

Fathers and CaregiversDecay causing bacteria, mutans

streptococci, are transmitted soon after the first tooth erupts

Reducing a parent’s or caregiver’s mutans streptococci count can help

Avoid sharing food utensils

Setting a good exampleStudy that shows children whose parents are regular at

the dentist have less problemsSeeing you brush and take care of your teeth is goodRoutine is key

February is National Children’s Dental Health Month

What you need to know to help your baby

First TeethFirst teeth usually arrive in the front, 6 – 12 monthsMay notice a change in behaviorDrooling and chewing Soft safe teething ring

Cleaning infant gumsAfter each feeding, wipe baby’s gums with a clean gauze

or clothEven before the first tooth, begin a daily routine of twice

daily cleaning When first tooth comes through, use soft bristle

toothbrush or finger brush to cleanUse water or a non-fluoridated cleansing gelChildren get used to you trying to clean their mouth

Breast feedingBreast milk is a complete form of nutrition for the

infants. Recommended for all except for those where

breastfeeding is determined to be harmful Frequent feeding should coincide with frequent cleaning

of gums

Bottle feedingClean the baby’s mouth and teeth after feeding a baby

with bottled milk or formulaLiquid concentrate or powdered formula should be

mixed with non-fluoridated water to not over fluoridate

Baby bottle decayNever let a baby fall asleep with a bottleIf your baby needs comfort, provide a pacifier instead of

bottleBacteria in mouth uses sugar as foods, which creates acid

that attacks teethFruit juice should never be put in a bottle

Decay

Weaning off bottlesThe A.D.A. recommends the introduction of training cups

at age one – doing so may help make the transition easier than if it was postponed

Discuss with your pediatrician how much milk your child continues to need and when you may introduce plain water to the diet

FlourosisCondition resulting from too much fluoride in child’s dietCauses brown spots or discoloration on teethIf you see this in your child, check with your dentistMonitor children’s fluoride intake

Fluoridation levelsThe optimal level for the prevention of dental cavities

is .7 to 1.2 mg/L depending on how warm the climate isLocal towns that supplement the water supply to bring it

to an optimal level (1.0 mg/L):Needham, Westwood, Wellesley, Dedham, Newton, and

NatickLocal towns that are not supplementing:

Dover and MedfieldFind out more at

http://www.cdc.gov/OralHealth/index.htm

The American Academy of Pediatric Dentistry recommends all children see a dentist within 6 months of the first tooth or no later

than the child’s first birthday.

Toddler Dental Development

ToothbrushingBegin brushing your child’s teeth when the first tooth

comes throughUse a small, soft-bristled toothbrushNon-fluoridated toothpaste or gel until child can spitContinue to clean and massage the surrounding

toothless gumsBegin flossing as you see contact between teethUse of 2 minute sand timer makes things fun

Pacifier UseUse pacifiers instead of bottles if child requires that comfortThere are different sized and shapedpacifiersMay start to affect tooth position if used past age 3 – dentist can monitor changes in tooth positioningPositive interventionEncouragement

The Binky FlowerSome parents have suggested planting the binky in a pot of soil with some seeds When the seeds sprout and start growing, children are excited to see that their binky turned into a flower or plant

Thumb Sucking

Thumb sucking is usually not a problem unless it continues on for a long period of time

If child is still sucking thumb at age 3, help may be required to help the teeth position correctly

Age 3 and up 20 primary teeth

BrushingToothbrushes – Oral B stages

Power toothbrushesDisclosing tablets from dentist office

FlossingDisposable flossers

Children need your assistance until about 7 yearsDaily, at night after brushing

Fluoride and SealantsFluoride supplementation can be provided at the dentist

officeMost commonly given in a varnish or foam - varnish is

painted on and children can eat and drink afterSealants protect baby teeth and molars from cavities –

sometimes need to be done more than once

X-rays Start around age 3Usually “Bitewings”Show permanent teeth

beneath surface, cavitiesDigital x-rays emit less

radiationLead apron

Baby teeth are importantThey hold the space in the jaw for adult teethLosing a baby tooth too early can lead to crooked or

crowded teethAdjacent teeth drift

Extractions are not fun for childrenPrevention

Nutrition plays an important role in healthy teeth and gums

Foods to eat

• Grains•Vegetables• Fruits• Milk• Meats and Beans• Raw Carrots• Apple Slices• Yogurt

Foods to avoid

• Candy• Sticky sweets• Soda• Doughnuts• Foods with little nutritional value

Hidden “Bad” foodsThey aren’t “bad” foods, but they can be bad for the

teeth if not monitored or cleaned up after Raisins Fruit strips Sugary medicines

After eating…Have child brush after eating sticky foodsAfter most meals if possibleAt least twice a day – once after breakfast and once

before bedIf child had citrus or acidic drink, wait an hour before

brushing teeth

Teeth play a role Part of the digestive process, chewingSpeakingLooking goodSmiling

Costs of poor oral healthThe AAPD says that 51 million hours of school time are

missed by children each year because of dental issuesA 2007 report by the CDC says one in every 5 three-year-

olds suffers from tooth decayDecay can lead to fillings or lost teeth – which may lead

to orthodontics that otherwise would not be necessaryDental decay is entirely preventable

Finding a dental homeDentists can be a great resource as oral health doctorsSee issues as they ariseBuilding trust between you, your child, and the dentistMany options

Family dental officePediatricConvenience

Open CommunicationAsk your dentist any questions you may haveYour dentist may have questions for you, too It may take a while for your child to feel comfortableDon’t give up on dental visits if one goes poorly

Dental Resourceswww.WellesleyDentalGroup.com/blogAmerican Academy of Pediatric Dentistry

www.aapd.orgAmerican Academy of Periodontology

www.perio.orgAcademy of General Dentistry

www.knowyourteeth.comAmerican Academy of Pediatric Dentistry

www.aapd.org

Please feel free to contact me if you have ANY questions781-237-9071

www.WellesleyDentalGroup.comfemina@wellesleydentalgroup.com