The first dental visit should be at 6 months of age or before the child’s first birthday.

This helps in building a dental home for the child.

Pre-birth visit:

Visit to the dentist even before the child is born.

The information which can be gathered during the pre birth visit includes various instructions such as

1.      Feeding practices

2.      Cleaning of gumpads

3.      Cleaning of tongue

4.      Natal and neonatal  teeth

5.      Cleft lip and palate

6.      Teething myths and facts

7.      Natural teething rings

8.      Right age to start  brushing

9.      Right type of brush

10.  Type of toothpaste to be used

11.  Amount of toothpaste to be used

12.  Flossing

13.  Fluoride use

14.  Sealants

15.  Prevention of traumatic dental injuries

 

EXPECTING MOTHER

Instructions and precautions:

1.      Oral hygiene maintenance

2.      Decrease in microbial count

·         Chlorhexidine mouth rinse

·         Xylitol gums

§  2-3 chewing gums/day after meals.

§  Each gum can be chewed for about 7 minutes.  

3.      Open carious lesions –treatment.

4.      Best time to undergo treatment – 2^nd trimester.

5.      Oral changes which occur during pregnancy will regress most of the times after pregnancy.

6.      X-ray radiation is to be avoided as it causes harmful effects to the developing infant.

7.      First dental visit – after 6 months or atleast before the child’s first birthday.

8.      The importance of establishing a dental home for the child is to be emphasized.

Instructions and precautions to be followed after the baby is born:

1.      Feeding practices

2.      The link between diet and oral health

3.      Mothers milk >bovine milk> milk formulas

§  Mothers milk less cariogenic and milk formulas – more cariogenic.

4.      Cleaning of gum pads – oral wipes

5.      Tongue cleaning

6.      Teething and milestones of development

7.      Proper use of fluoride

8.      Oral habits, including finger and thumb sucking

9.      Ways to prevent accidents that could damage the face and teeth.

 

 

Birth to 6 months:

·         At birth, the oral cavity – sterile

·         Microorganisms start appearing in the first 48 hours.

·         Frequent kissing of the child should be avoided.

·         Mother’s milk is best because it provides passive immunity to the child.

·         Bovine milk can also be used.

·         After every feed the oral cavity of the child is to be wiped with moist cotton cloth or oral wipes.

·         The child should not be put to sleep with bottle in his mouth.

·         The oral cavity should be checked for any curdy white patches or any ulcers, etc.

·         Starch containing foods should be avoided before 3 months as the activity of alpha amylase is not completely developed.

·         Weaning should be started from 4 months.

·         The child can be given milk based formulas, but precaution should be taken not to add any additional sugars.

·         Teething rings can be given from 5 to 6 months.

·         Honey dipped, sugar coated pacifiers are not recommended.

·         Frozen fruits, vegetables can be used as teething rings.

·         Topical local anesthetic sprays, gels can also be applied.

6 months to 3 years:

·         The first tooth erupts into the oral cavity at about 6-7 months.

·         Finger brush should be used for brushing the child’s teeth.

·         Fruit juices can be given to the child and they should be limited to half a cup.

·         Caned juices and foods are not to be given to the child.

·         The use of sippy cup is to be encouraged instead of bottle.

·         The dental home is to be established for the child.

·         At around 6 months the child usually develops the habit of grasping things and puts whatever he gets into his mouth.

·         Electric wires, hot vessels, sharp and tiny objects should be kept away from children.

·         At around 9 to 12 months the child starts walking so the parents should be careful in order to avoid any trauma to the face and dentition.

·         The child if at all has the habit of sleeping with a bottle at night it has to be discouraged at this age because it leads to development of cavities in the teeth.

·         Instead of milk, plain water can be substituted during night times.

·         Streptococcus mutans colonize into the oral cavity once the teeth erupt and these are the main microorganisms responsible for initiation of dental caries.

·         Hence the teeth should be checked once in a month for any white/brown spots/cavities.

·         Sharing of utensils, foods should be avoided as it can also lead to transfer of S.mutans.

·         By 2.5 or 3 years all the primary teeth will be erupted in the oral cavity.

·         Stories involving their favorite character’s visit to dentist, Audio visual aids help in behavior modification of the child.

·         Topical application of fluoride in the form of varnish or gel can be done for the child.  

·         Sealant – an extra layer can be advised if there are deep pits and fissures.

 

 

3 – 5 years:

·         The child’s oral cavity should be looked for carious lesions.

·         Early childhood caries – most prevalent during this age.

·         Early childhood caries – associated with multiple decayed teeth in the child which even affects the general health of the child.

·         Time to time dental visits along with counseling can help us in eliminating /treating ECC.

·         In the initial visit, the general and oral examination of the child is carried out, followed by counseling.

·         Diet chart and diet diary is to be recorded.

·         In the subsequent visits, restorative, preventive, interceptive treatments will be done.

·         If the oral habits not corrected in the earlier stages and still persistent, appliance therapy can be used as a last resort for their correction.

 

 

“PRIMARY TEETH ACT AS A FOUNDATION FOR THE DEVELOPMENT OF ORAL CAVITY AND ERUPTION OF THE PERMANENT TEETH.

EVERY ATTEMPT SHOULD BE MADE TO PRESERVE THEM UNTIL THEIR NATURAL EXFOLIATION. “