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Early Oral Health

Early Oral Health



"Early Oral Health" and what parents need to know discusses some of the ways to help your children's oral health, even before they are born. Presented for the first time at Isis Maternity in Needham, ...

"Early Oral Health" and what parents need to know discusses some of the ways to help your children's oral health, even before they are born. Presented for the first time at Isis Maternity in Needham, MA by Dr. Femina Ali.



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    Early Oral Health Early Oral Health Presentation Transcript

    • Early Oral Health
      Isis Maternity
      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
    • The Mother's Health
    • Prevention is key
      Brush twice a day How to floss video
      Floss daily
      Eat a healthy diet
      Use recommended prenatal vitamin with Folic Acid
      Continue regular check-ups at the dentist
      Ask for a screening for any gum disease, treat it
      Get necessary X-rays before pregnancy
      Take 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
    • The Mother's Health
      During Pregnancy
    • What to expect
      Hormonal changes – increased progesterone and estrogen causes gums to react differently to bacteria in plaque
      Dietary changes – cravings and snacking
      Morning sickness
      Change of routine – feeling tired
      Fear, anxieties, and questions
    • What you can do
      Eat healthy, balanced diet
      Milk, cheese, and yogurt for Calcium
      Choose foods high in Vitamin C – strawberries, melons, broccoli, papaya, bell peppers
      Phosphorous – chicken, eggs, legumes, dairy
      If you have the urge to snack
      Carbohydrate rich foods can be an invitation to tooth decay
      Brush your teeth after snacking when possible
      Floss daily
      Get a dental cleaning once every 3 months during pregnancy, some insurance plans even pay for the extra cleanings
    • If you need dental work
      X-rays for dental emergencies are okay if used to diagnose major issues like infection
      Untreated dental infection can be a risk to the fetus
      It’s a myth that calcium is lost from mother’s teeth during pregnancy
    • Gingivitis/Periodontal Disease
      Especially common during months 2 – 8
      Occurs in 60-70% of pregnant women
      Links between pre-term, low birth weight babies and gingivitis
      12 % 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 gingivitis
      Deep 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 Tumors
      Growths or swelling between the teeth
      Plaque response
      Most prevalent during second trimester
      Often removed after baby is born
    • Fetal Development
      Teeth begin to develop between the third and the sixth month of pregnancy
      Need calcium for tooth development
      20 primary teeth are present in jawbone at birth
    • Mother’s Health
      Post Pregnancy
    • Bouncing back
      Congratulations! You’ve had a baby!
      Hormones returning to pre-pregnancy levels
      Gums, if kept healthy during pregnancy, should be less problematic
      Routine hygiene visits and daily brushing and flossing still very important
    • Fathers and Caregivers
      Decay 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 example
      Study that shows children whose parents are regular at the dentist have less problems
      Seeing you brush and take care of your teeth is good
      Routine is key
    • Children's Dental Health
      This is National Children’s Dental Health Month
    • Infant Dental Development
      What you need to know to help your baby
    • First Teeth
      First teeth usually arrive in the front, 6 – 12 months
      May notice a change in behavior
      Droolingand chewing
      Teething rings
    • Cleaning infant gums
      After each feeding, wipe baby’s gums with a clean gauze or cloth
      Even 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 clean
      Use water or a non-fluoridated cleansing gel
      Children get used to you trying to clean their mouth
    • Breast feeding
      Breast 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 feeding
      Clean the baby’s mouth and teeth after feeding a baby with bottled milk or formula
      Liquid concentrate or powdered formula should be mixed with non-fluoridated water to not over fluoridate
    • Baby bottle decay
      Never let a baby fall asleep with a bottle
      If your baby needs comfort, provide a pacifier instead of bottle
      Bacteria in mouth uses sugar as foods, which creates acid that attacks teeth
      Fruit juice should never be put in a bottle
    • Decay
      Early childhood decay is recognized as an infectious disease
      Rising tooth decay rates, now affects 28% of preschoolers
    • Weaning off bottles
      The 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
    • Flourosis
      Condition resulting from too much fluoride in child’s diet
      Causes brown spots or discoloration on teeth
      If you see this in your child, check with your dentist
      Monitor children’s fluoride intake
    • Fluoridation levels
      The optimal level for the prevention of dental cavities is .7 to 1.2 mg/L depending on how warm the climate is
      Local towns that supplement the water supply to bring it to an optimal level (1.0 mg/L):
      Needham, Westwood, Wellesley, Dedham, Newton, and Natick
      Local towns that are not supplementing:
      Dover and Medfield
      Find out more at http://www.cdc.gov/OralHealth/index.htm
    • Going to the dentist
      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
    • Toothbrushing
      Begin brushing your child’s teeth when the first tooth comes through
      Use a small, soft-bristled toothbrush
      Non-fluoridated toothpaste or gel until child can spit
      Continue to clean and massage the surrounding toothless gums
      Begin flossing as you see contact between teeth
      Use of 2 minute sand timer makes things fun
    • Pacifier Use
      Use pacifiers instead of bottles if
      child requires that comfort
      There are different sized and shaped
      May start to affect tooth position if
      used past age 3 – dentist can monitor
      changes in tooth positioning
      Positive intervention
    • The Binky Flower
      Some 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
    • As the children grow
      Age 3 and up
      20 primary teeth
    • Brushing
      Toothbrushes – Oral B stages
      Power toothbrushes
      Disclosing tablets from dentist office
    • Flossing
      Disposable flossers
      Children need your assistance until about 7 years
      Daily, at night after brushing
    • Fluoride and Sealants
      Fluoride supplementation can be provided at the dentist office
      Most commonly given in a varnish or foam - varnish is painted on and children can eat and drink after
      Sealants protect baby teeth and molars from cavities – sometimes need to be done more than once
    • X-rays
      Start around age 3
      Usually “Bitewings”
      Show permanent teeth beneath surface, cavities
      Digital x-rays emit less radiation
      Lead apron
    • Baby teeth are important
      They hold the space in the jaw for adult teeth
      Losing a baby tooth too early can lead to crooked or crowded teeth
      Adjacent teeth drift
      Extractions are not fun for children
    • Nutrition
      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” foods
      They aren’t “bad” foods, but they can be bad for the teeth if not monitored or cleaned up after
      Fruit strips
      Sugary medicines
    • After eating…
      Have child brush after eating sticky foods
      After most meals if possible
      At least twice a day – once after breakfast and once before bed
      If child had citrus or acidic drink, wait an hour before brushing teeth
    • Teeth play a role
      Part of the digestive process, chewing
      Looking good
    • Costs of poor oral health
      The AAPD says that 51 million hours of school time are missed by children each year because of dental issues
      A 2007 report by the CDC says one in every 5 three-year- olds suffers from tooth decay
      Decay can lead to fillings or lost teeth – which may lead to orthodontics that otherwise would not be necessary
      Dental decay is entirely preventable
    • Finding a dental home
      Dentists can be a great resource as oral health doctors
      See issues as they arise
      Building trust between you,
      your child, and the dentist
      Many options
      Family dental office
    • Open Communication
      Ask your dentist any questions you may have
      Your dentist may have questions for you, too
      It may take a while for your child to feel comfortable
      Don’t give up on dental visits if one goes poorly
    • Dental Resources
      American Academy of Pediatric Dentistry
      American Academy of Periodontology
      Academy of General Dentistry
      American Academy of Pediatric Dentistry
    • Thank you very much!
      Please feel free to contact me if you have ANY questions