Image courtesy: American Dental Association

Image courtesy: American Dental Association

Oral health doesn’t start and end with the dentist. Times are changing as the Washington Dental Service Foundation has trained 1,600 pediatricians and family physicians throughout the state on the importance of oral hygiene in young children. Pediatricians are now applying fluoride during well-child check-ups and counseling families more comprehensively on how to prevent dental decay while also referring to dentists for prevention and acute dental problems. Just last month I attended the 1-1/2 hour oral health training with a pediatric dentist. That learning coupled with a new policy statement from The American Academy of Pediatrics highlighting the importance of oral health inspired me to get the word out. I suspect we can all do a bit better protecting our children’s mouths. Recommendations for fluoridated toothpaste have recently changed (use it with the very first baby tooth!) as has knowledge and reminders about how we share our bacteria with our children. What we do for our mouth may have direct effects on our children’s.

The Most Common Chronic Childhood Disease

  • The facts about oral health in children are a little surprising. By their first birthday 8% of toddlers have cavities in their mouth and the Pediatrics policy detailed 24% 2-4 year-olds, 53% 6-8 year-olds and 56% 15 year-olds also have dental disease. Since oral health (even in babies and toddlers) is an integral part of overall health of children this is problematic. Dental disease has strong links between diabetes, respiratory infections and heart disease. The numbers for children with dental disease are high (!!) which makes dental disease the most common infection of childhood.
  • Good news is much of this disease can be prevented (or corrected) and because infants and young children see the pediatrician more frequently than the dentist, it’s becoming clear that pediatricians need to hone skills on oral health, the disease process, prevention and dentist interventions when necessary.

4 Things I Learned About Oral Health

  • Your mouth is different for 20 mins after eating! After every bite and every sip of liquid with calories or sugars (think about that latte you drink or the sippy cup your child sucks on in the car or the snacks with carbohydrates our children consume).
    • After eating, elevated acid levels persist for 20-40 minutes in the mouth. That acid, combined with the present bacteria lead to demineralization which in turn erodes the enamel of the the teeth and sets kids up for cavities. Therefore it’s far better to eat and drink at the same time and take breaks between meals.  Your teeth need breaks between meals to stay strong. So do your children’s, especially as their primary teeth (baby teeth) have thinner layers of enamel.
  • Power of a kiss, parents transfer bacteria!
    • Mom & Dad can pass cavity-causing bacteria to babies when exchanging any amount of saliva. If our mouth is full of more aggressive bacteria (from caries and decay) we pass those onto our children. Therefore if you’ve had a history of lots of cavities, it’s important to check in with your dentist about improving your oral health — we pass our flora (colonies) of bacteria to our children by:
      • Kissing on the mouth transfers your bacteria to your baby. I’m a big fan of smooching babies so no need to stop lovin’ on your sweet babies, just tidy your mouth by seeing the dentist as recommended so you’re not passing on more aggressive bacteria because of caries in your own mouth. Seeing the dentist to tidy up your mouth is especially true if you’re pregnant or you have children in your home.
      • Sharing utensils during meals (or taking a little bit of their baby food or soup first) passes bacteria from your mouth to theirs.
      • Cleaning a pacifier with your mouth. Although some have gotten excited about doing this after a pacifier hits the floor I’d hesitate before ever “cleaning” a pacifier with your mouth. Chances are we contaminate it more than we “sterilize” it!
      • Pre-chewing food. Need I say more? Really, no need to pre-chew food for infants or toddlers (the teeth and gums help with this). Resist the urge to act like a celebrity here...
  • Early mouth health matters: Window of infectivity in the mouth with bacteria starts early as bacteria set-up camp in the mouth — the first 3 years are an important window for your child’s mouth. What you do early in their life changes their primary baby teeth but also the environment when the adult teeth come in.
  • Fluoridated toothpaste after first tooth! This is new. Recommendations by pediatric dentists and pediatricians are now different. We want all babies to have a fluoridated toothpaste from the get-go. The training toothpaste doesn’t accomplish anything better than water (I wouldn’t recommend it) and we want babies to have fluoride on their new teeth twice daily from day one. This habit should then, of course, continue through childhood and adulthood. For babies and toddlers/preschools who can’t spit use a rice-sized smear (see photo) on toothbrush. For children/teens/adults who can spit (usually this delicious skill starts by age 3 years) used a pea-sized amount of toothpaste. Don’t rinse with water after brushing — let that tiny amount of fluoride left on the teeth after brushing protect the teeth all night long!

More on new data and tips for taking care of baby teeth next week.