Promoting Oral Health in Infants – Birth to 11 Months

Cleaning the infant’s gums before the first primary tooth erupts helps to maintain a healthy oral environment. Parents can wrap a moistened gauze square, washcloth, or disposable Spiffies™ around an index finger and gently massage the gingival tissues. Commercial infant gum massagers are also available for this purpose. Parents may introduce a soft bristled toothbrush, such as the Child’s Safety Toothbrush^{® Step 1}, during this age (3mos to 3 1/2 years). A product that can be used by the child and the parent without fear of accident or injury is essential when trying to develop dental Habits that will last a lifetime. Parents should begin brushing twice a day as soon as a tooth erupts and continue this practice until the child has the manual dexterity to perform the task alone (age 8 or 9).

Oral hygiene practices should be well implemented by the time the first tooth erupts. The Childs oral habits begin well before the first tooth erupts, and this is important when teaching parents how to introduce brushing. Parent’s traditionally take brushes away from their children throughout the day for fear of accident or injury, then expect the child to respond favorably to brushing before bed. This practice leads to frustration from the parent and non compliance by the child. There are products in the market such as the afore mentioned Safety Toothbrushes® Step 1 for infants, and Step 2 for toddlers that are designed to help make this a cooperative event for both the child, and parent. The first oral evaluation should be performed within the first six months of the eruption of an infant’s first primary tooth and no later than 12 months of age.

After the first primary teeth erupt, restricting bottle/breast-feeding to normal meal times and not allowing the infant to feed at will or while sleeping helps to prevent ECC. Encourage parents to wean the infant by 12 to 14 months of age.Diet counseling at the infant oral health visit includes instructions on limiting sugar intake and frequency. Infants should not consume more than 4 to 6 oz of fruit juice per day. As finger foods are introduced, foods containing sugar should be limited to meals. Encourage parents to develop a regular snack and meal schedule and avoid “grazing”. Parents should also be cautioned regarding the potential of various foods that constitute a choking hazard. Preventive Dental Specialties has licensed their Safety Toothbrushes® with General Mills, (the Cheerios® Brand), to help create awareness from both the nutritional, and the functional plaque removal aspects of children’s dental health, to help prevent early child hood dental disease.

The dental professional should also ascertain the infant’s fluoride exposure and provide guidance regarding the benefits of adequate fluoride ingestion as well as risks of over-exposure. Anticipatory guidance for infants should include a discussion on thumb sucking, pacifier habits, and oral injury prevention.

Sandra Boucher-Bessent is the National Program Director for the National Children’s Oral Health Foundation (NCOHF), which was founded with the singular focus of providing treatment and preventive education to eliminate pediatric dental disease through a balanced approach of therapeutic treatments, aggressive preventive therapies, and interactive, educational programs. For more information visit http://www.ncohf.org or call 704-350-1600.

David T. Carroll is President, and Founder of Preventive Dental Specialties. He created his Company around a simple product The Safety Toothbrush® and A Passion to help change the way we as Dental Professionals introduce brushing to infants and toddlers, by creating products that can be given to the child instead of taken away. I have devoted my career to make those changes a reality. Preventive Dental Specialties manufactures a variety of early intervention products, as well as products for the handicapped.

For more information on these products visit the Medical Arts Press Website.

REFERENCES
[1] Definition of Early Childhood Caries (ECC). Available at: http://www.aapd.org/media/Policies_Guidelines/D_ECC.pdf. Accessed 12/28/2007. 

[1] Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove, Il: American Academy of Pediatrics.  

[1] Sanchez OM, Childers NK. Anticipatory Guidance in Infant Oral Health: Rationale and Recommendations. American Family Physicians 01/01/2000. Available at: http://www.stfm.org/oralhealth.  Accessed 12/28/07. 

[1] Douglass JM, Douglass AB, Silk HJ. A Practical Guide to Infant Oral Health. American Family Physicians 12/01/2004; Vol.70 No.11:2113-20. Available at: http://www.aafp.org/afp/20041201/2113.html. Accessed 12/28/07.