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Early Oral Health
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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