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Early Oral HealthIsis Maternity Expert Speaker SeriesFemina Ali, D.M.D.
Ali & Ali Drs. Ali & Ali – both graduates of Tufts Dental School
Currently practicing dentistry  since 1997 in WellesleyOur family I was pregnant once too!
Community means a lot
Reaching out to helpStarted visiting 2nd graders in the classroom setting
 Younger siblings
 Met with preschoolers
  Seeing infantsThe Mother's HealthPre-Pregnancy
Prevention is keyBrush twice a day			How to floss videoFloss dailyEat a healthy diet Use recommended prenatal vitamin with Folic AcidContinue regular check-ups at the dentistAsk for a screening for any gum disease, treat itGet necessary X-rays before pregnancyTake care of elective work before pregnancy
Getting pregnantBacteria present in periodontal disease may affect reproduction success and outcome of fertility treatmentFertility 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 HealthDuring Pregnancy
What to expectHormonal changes – increased progesterone and estrogen causes gums to react differently to bacteria in plaqueDietary changes – cravings and snackingMorning sickness Change of routine – feeling tiredFear, anxieties, and questions
What you can doEat healthy, balanced diet Milk, cheese, and yogurt for CalciumChoose foods high in Vitamin C – strawberries, melons, broccoli, papaya, bell peppersPhosphorous – chicken, eggs, legumes, dairyIf you have the urge to snackCarbohydrate rich foods can be an invitation to tooth decayBrush your teeth after snacking when possibleFloss dailyGet a dental cleaning once every 3 months during pregnancy, some insurance plans even pay for the extra cleanings
If you need dental workX-rays for dental emergencies are okay if used to diagnose major issues like infectionUntreated dental infection can be a risk to the fetusIt’s a myth that calcium is lost from mother’s teeth during pregnancy
Gingivitis/Periodontal DiseaseEspecially common during months 2 – 8Occurs in 60-70% of pregnant womenLinks between pre-term, low birth weight babies and gingivitis12 % 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 likeSymptoms include red, swollen, bleeding gums
Treating gingivitisDeep 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 TumorsGrowths or swelling between the teethPlaque responseMost prevalent during second trimesterOften removed after baby is born
Fetal DevelopmentTeeth begin to develop between the third and the sixth month of pregnancyNeed calcium for tooth development20 primary teeth are present in jawbone at birth
Mother’s HealthPost Pregnancy
Bouncing backCongratulations!  You’ve had a baby!Hormones returning to pre-pregnancy levelsGums, if kept healthy during pregnancy, should be less problematicRoutine hygiene visits and daily brushing and flossing still very important
Fathers and CaregiversDecay causing bacteria, mutans streptococci, are transmitted soon after the first tooth eruptsReducing a parent’s or caregiver’s mutans streptococci count can help Avoid sharing food utensils
Setting a good exampleStudy that shows children whose parents are regular at the dentist have less problemsSeeing you brush and take care of your teeth is goodRoutine is key
Children's Dental HealthThis is National Children’s Dental Health Month
Infant Dental DevelopmentWhat you need to know to help your baby
First TeethFirst teeth usually arrive in the front, 6 – 12 monthsMay notice a change in behaviorDroolingand chewing Teething rings
Cleaning infant gumsAfter each feeding, wipe baby’s gums with a clean gauze or clothEven 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 cleanUse water or a non-fluoridated cleansing gelChildren get used to you trying to clean their mouth
Breast feedingBreast 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 feedingClean the baby’s mouth and teeth after feeding a baby with bottled milk or formulaLiquid concentrate or powdered formula should be mixed with non-fluoridated water to not over fluoridate
Baby bottle decayNever let a baby fall asleep with a bottleIf your baby needs comfort, provide a pacifier instead of bottleBacteria in mouth uses sugar as foods, which creates acid that attacks teethFruit juice should never be put in a bottle
DecayEarly childhood decay is recognized as an infectious diseaseRising tooth decay rates, now affects 28% of preschoolers
Weaning off bottlesThe A.D.A. recommends the introduction of training cups at age one – doing so may help make the transition easier than if it was postponedDiscuss with your pediatrician how much milk your child continues to need and when you may introduce plain water to the diet
FlourosisCondition resulting from too much fluoride in child’s dietCauses brown spots or discoloration on teethIf you see this in your child, check with your dentistMonitor children’s fluoride intake
Fluoridation levelsThe optimal level for the prevention of dental cavities is .7 to 1.2 mg/L depending on how warm the climate isLocal towns that supplement the water supply to bring it to an optimal level (1.0 mg/L):Needham, Westwood, Wellesley, Dedham, Newton, and NatickLocal towns that are not supplementing:Dover and MedfieldFind out more at http://www.cdc.gov/OralHealth/index.htm
Going to the dentistThe 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
ToothbrushingBegin brushing your child’s teeth when the first tooth comes throughUse a small, soft-bristled toothbrushNon-fluoridated toothpaste or gel until child can spitContinue to clean and massage the surrounding toothless gumsBegin flossing as you see contact between teethUse of 2 minute sand timer makes things fun
Pacifier UseUse pacifiers instead of bottles if child requires that comfortThere are different sized and shapedpacifiers May start to affect tooth position if used past age 3 – dentist can monitor changes in tooth positioningPositive interventionEncouragement
The Binky FlowerSome 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 SuckingThumb sucking is usually not a problem unless it continues on for a long period of timeIf child is still sucking thumb at age 3, help may be required to help the teeth position correctly
As the children growAge 3 and up 20 primary teeth
BrushingToothbrushes – Oral B stagesPower toothbrushesDisclosing tablets from dentist office
FlossingDisposable flossersChildren need your assistance until about 7 yearsDaily, at night after brushing
Fluoride and SealantsFluoride supplementation can be provided at the dentist officeMost commonly given in a varnish or foam - varnish is painted on and children can eat and drink afterSealants protect baby teeth and molars from cavities – sometimes need to be done more than once
X-rays Start around age 3Usually “Bitewings”Show permanent teeth beneath surface, cavitiesDigital x-rays emit less radiationLead apron
Baby teeth are importantThey hold the space in the jaw for adult teethLosing a baby tooth too early can lead to crooked or crowded teethAdjacent teeth driftExtractions are not fun for childrenPrevention
NutritionNutrition plays an important role in healthy teeth and gums
Foods to eat Grains
Vegetables
 Fruits
 Milk
 Meats and Beans
 Raw Carrots
 Apple Slices
 YogurtFoods to avoidCandy

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Early Oral Health

  • 1. Early Oral HealthIsis Maternity Expert Speaker SeriesFemina Ali, D.M.D.
  • 2. Ali & Ali Drs. Ali & Ali – both graduates of Tufts Dental School
  • 3. Currently practicing dentistry since 1997 in WellesleyOur family I was pregnant once too!
  • 5. Reaching out to helpStarted visiting 2nd graders in the classroom setting
  • 7. Met with preschoolers
  • 8. Seeing infantsThe Mother's HealthPre-Pregnancy
  • 9. Prevention is keyBrush twice a day How to floss videoFloss dailyEat a healthy diet Use recommended prenatal vitamin with Folic AcidContinue regular check-ups at the dentistAsk for a screening for any gum disease, treat itGet necessary X-rays before pregnancyTake care of elective work before pregnancy
  • 10. Getting pregnantBacteria present in periodontal disease may affect reproduction success and outcome of fertility treatmentFertility 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
  • 12. What to expectHormonal changes – increased progesterone and estrogen causes gums to react differently to bacteria in plaqueDietary changes – cravings and snackingMorning sickness Change of routine – feeling tiredFear, anxieties, and questions
  • 13. What you can doEat healthy, balanced diet Milk, cheese, and yogurt for CalciumChoose foods high in Vitamin C – strawberries, melons, broccoli, papaya, bell peppersPhosphorous – chicken, eggs, legumes, dairyIf you have the urge to snackCarbohydrate rich foods can be an invitation to tooth decayBrush your teeth after snacking when possibleFloss dailyGet a dental cleaning once every 3 months during pregnancy, some insurance plans even pay for the extra cleanings
  • 14. If you need dental workX-rays for dental emergencies are okay if used to diagnose major issues like infectionUntreated dental infection can be a risk to the fetusIt’s a myth that calcium is lost from mother’s teeth during pregnancy
  • 15. Gingivitis/Periodontal DiseaseEspecially common during months 2 – 8Occurs in 60-70% of pregnant womenLinks between pre-term, low birth weight babies and gingivitis12 % 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*
  • 16. What gingivitis looks likeSymptoms include red, swollen, bleeding gums
  • 17. Treating gingivitisDeep 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
  • 18. Pregnancy TumorsGrowths or swelling between the teethPlaque responseMost prevalent during second trimesterOften removed after baby is born
  • 19. Fetal DevelopmentTeeth begin to develop between the third and the sixth month of pregnancyNeed calcium for tooth development20 primary teeth are present in jawbone at birth
  • 21. Bouncing backCongratulations! You’ve had a baby!Hormones returning to pre-pregnancy levelsGums, if kept healthy during pregnancy, should be less problematicRoutine hygiene visits and daily brushing and flossing still very important
  • 22. Fathers and CaregiversDecay causing bacteria, mutans streptococci, are transmitted soon after the first tooth eruptsReducing a parent’s or caregiver’s mutans streptococci count can help Avoid sharing food utensils
  • 23. Setting a good exampleStudy that shows children whose parents are regular at the dentist have less problemsSeeing you brush and take care of your teeth is goodRoutine is key
  • 24. Children's Dental HealthThis is National Children’s Dental Health Month
  • 25. Infant Dental DevelopmentWhat you need to know to help your baby
  • 26. First TeethFirst teeth usually arrive in the front, 6 – 12 monthsMay notice a change in behaviorDroolingand chewing Teething rings
  • 27. Cleaning infant gumsAfter each feeding, wipe baby’s gums with a clean gauze or clothEven 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 cleanUse water or a non-fluoridated cleansing gelChildren get used to you trying to clean their mouth
  • 28. Breast feedingBreast 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
  • 29. Bottle feedingClean the baby’s mouth and teeth after feeding a baby with bottled milk or formulaLiquid concentrate or powdered formula should be mixed with non-fluoridated water to not over fluoridate
  • 30. Baby bottle decayNever let a baby fall asleep with a bottleIf your baby needs comfort, provide a pacifier instead of bottleBacteria in mouth uses sugar as foods, which creates acid that attacks teethFruit juice should never be put in a bottle
  • 31. DecayEarly childhood decay is recognized as an infectious diseaseRising tooth decay rates, now affects 28% of preschoolers
  • 32. Weaning off bottlesThe A.D.A. recommends the introduction of training cups at age one – doing so may help make the transition easier than if it was postponedDiscuss with your pediatrician how much milk your child continues to need and when you may introduce plain water to the diet
  • 33. FlourosisCondition resulting from too much fluoride in child’s dietCauses brown spots or discoloration on teethIf you see this in your child, check with your dentistMonitor children’s fluoride intake
  • 34. Fluoridation levelsThe optimal level for the prevention of dental cavities is .7 to 1.2 mg/L depending on how warm the climate isLocal towns that supplement the water supply to bring it to an optimal level (1.0 mg/L):Needham, Westwood, Wellesley, Dedham, Newton, and NatickLocal towns that are not supplementing:Dover and MedfieldFind out more at http://www.cdc.gov/OralHealth/index.htm
  • 35. Going to the dentistThe 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.
  • 37. ToothbrushingBegin brushing your child’s teeth when the first tooth comes throughUse a small, soft-bristled toothbrushNon-fluoridated toothpaste or gel until child can spitContinue to clean and massage the surrounding toothless gumsBegin flossing as you see contact between teethUse of 2 minute sand timer makes things fun
  • 38. Pacifier UseUse pacifiers instead of bottles if child requires that comfortThere are different sized and shapedpacifiers May start to affect tooth position if used past age 3 – dentist can monitor changes in tooth positioningPositive interventionEncouragement
  • 39. The Binky FlowerSome 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
  • 40. Thumb SuckingThumb sucking is usually not a problem unless it continues on for a long period of timeIf child is still sucking thumb at age 3, help may be required to help the teeth position correctly
  • 41. As the children growAge 3 and up 20 primary teeth
  • 42. BrushingToothbrushes – Oral B stagesPower toothbrushesDisclosing tablets from dentist office
  • 43. FlossingDisposable flossersChildren need your assistance until about 7 yearsDaily, at night after brushing
  • 44. Fluoride and SealantsFluoride supplementation can be provided at the dentist officeMost commonly given in a varnish or foam - varnish is painted on and children can eat and drink afterSealants protect baby teeth and molars from cavities – sometimes need to be done more than once
  • 45. X-rays Start around age 3Usually “Bitewings”Show permanent teeth beneath surface, cavitiesDigital x-rays emit less radiationLead apron
  • 46. Baby teeth are importantThey hold the space in the jaw for adult teethLosing a baby tooth too early can lead to crooked or crowded teethAdjacent teeth driftExtractions are not fun for childrenPrevention
  • 47. NutritionNutrition plays an important role in healthy teeth and gums
  • 48. Foods to eat Grains
  • 52. Meats and Beans
  • 55. YogurtFoods to avoidCandy
  • 59. Foods with little nutritional valueHidden “Bad” foodsThey aren’t “bad” foods, but they can be bad for the teeth if not monitored or cleaned up afterRaisinsFruit stripsSugary medicines
  • 60. After eating…Have child brush after eating sticky foodsAfter most meals if possibleAt least twice a day – once after breakfast and once before bedIf child had citrus or acidic drink, wait an hour before brushing teeth
  • 61. Teeth play a role Part of the digestive process, chewingSpeakingLooking goodSmiling
  • 62. Costs of poor oral healthThe AAPD says that 51 million hours of school time are missed by children each year because of dental issuesA 2007 report by the CDC says one in every 5 three-year- olds suffers from tooth decayDecay can lead to fillings or lost teeth – which may lead to orthodontics that otherwise would not be necessaryDental decay is entirely preventable
  • 63. Finding a dental homeDentists can be a great resource as oral health doctorsSee issues as they ariseBuilding trust between you, your child, and the dentistMany options Family dental officePediatricConvenience
  • 64. Open CommunicationAsk your dentist any questions you may haveYour dentist may have questions for you, too It may take a while for your child to feel comfortableDon’t give up on dental visits if one goes poorly
  • 65. Dental Resourceswww.WellesleyDentalGroup.com/blogAmerican Academy of Pediatric Dentistrywww.aapd.orgAmerican Academy of Periodontology www.perio.orgAcademy of General Dentistrywww.knowyourteeth.comAmerican Academy of Pediatric Dentistry www.aapd.org
  • 66. Thank you very much!Please feel free to contact me if you have ANY questions781-237-9071www.WellesleyDentalGroup.comfemina@wellesleydentalgroup.com