Protecting the health of baby teeth

In North America, 40 to 50 per cent of children have dental caries, commonly known as tooth decay, by the time they reach kindergarten.

The severe form of early childhood caries can begin soon after the eruption of the first teeth and progresses rapidly. Early detection and intervention is critical. Of even more importance is the prevention of this disease in the first place.

What’s so important about primary (baby) teeth anyway?

The answer to that is many things. Firstly, they are used to chew food, which is not only important for proper digestion/nutrition (and therefore your child’s overall health and development), but the physical act of chewing helps in the proper development of the craniofacial complex – bones, muscles, soft tissues of the face.

Secondly, they maintain space in the dental arches for the permanent teeth to grow – premature loss can lead to space loss and crowding issues which will then require orthodontic therapies (e.g., braces) to correct.

They aid in the learning and development of speech and also give your child a nice appearance and smile, which is important for their social acceptance and psychological development.

Early childhood caries is an infectious disease that, if left untreated, can (and will) cause your child significant pain, suffering and can quickly spread to the permanent teeth as soon as they begin to erupt (first permanent molars erupt around age 6).

It is important to stress that the primary cuspids and molars are not lost until your child reaches their early teens. Untreated abscessed primary teeth can also severely damage the permanent teeth developing below them.

Is dental caries ‘preventable’ and if so, how?

Some strategies may include:

For the mother, father, siblings and primary caregiver – regular and timely dental care in conjunction with good oral hygiene strategies to decrease the transmission of cavity-causing bacteria to infants/children.

Minimising saliva-sharing activities, like sharing utensils, between the infant/child and his family/cohorts.

Begin brushing with a soft age-appropriate toothbrush and a “smear” of “fluoridated toothpaste” at the time of eruption of the first primary tooth.

Establish a ‘Dental Home’ by your child‘s first birthday – this is the key to prevention and will allow regular check-ups, cleanings, fluoride treatments, etc.

Avoid cavity-promoting feeding behaviours – although both the American Academy of Pediatrics and the American Academy of Pediatric Dentistry acknowledge that “breast-feeding ensures the best possible health and psychosocial outcomes for the infant”, both organisations “discourage extended or excessive frequency (demand feeding) after the eruption of the first teeth”.

Also, avoid putting your child to nap or bed with a bottle containing any fermentable carbohydrates (milk, formulas, juices, sodas). Extended use of a sippy (no-spill) cup is also strongly discouraged unless water is the only ingredient.

For more information on both professional and at-home strategies, you can contact your paediatric dentist. A caries risk assessment will be used to give you a better idea of what risk level your child is at for developing early childhood caries or any other oral problems.

High-risk children will be identified, the transmission and cause of dental caries will be discussed (including feeding and dietary habits that promote the disease), and strategies for prevention (such as proper oral hygiene, preventive dental appointments and fluoride management) will be implemented.

The American Academy of Pediatric Dentistry encourages you to discuss both in-office, as well as at-home strategies with your paediatric dentist. 
Sean Childers is a local dentist board-certified in paediatric dentistry.

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