Oral Health

View PDF

Good oral hygiene begins before baby’s first teeth erupt

Diana Swift

Nothing warms a mother’s heart more than an infant’s first toothless smile. But that gummy grin needs protection just as much as the toothy one that will follow it. Canadian Health talked about oral health care for infants with Calgary paediatric dentist Dr. Sarah Hulland.

“The first recommendation is that even before the eruption of the first teeth, the parent or caregiver should wipe the baby’s gums with a piece of damp gauze or a baby facecloth after each feeding episode,” says Hulland. That includes breastfeeding sessions since breast milk, though highly nutritious, is laden with sugar and contains a lot of protein, which allows the milk to stick to the gums. “The sugar can provide a food source for the development of the fungal infection thrush on the gums long before the teeth erupt,” she says.

And although infant gums are not generally prone to bacterial infections — they provide scant places in which germs can colonize —  they are prone to acquiring the bacteria later associated with tooth decay. “They are susceptible to this transmission as early as two months of age,” says Hulland.

“Parents need to be aware that children are not born with these bacteria but acquire them from caregivers,” she adds. Transmission occurs through such practices as popping a dropped pacifier into your mouth to clean it off, then giving it back to the baby, or, say, testing the temperature of baby food by tasting from the infant’s spoon.

After the first tooth erupts, wiping can be supplemented by brushing with a finger brush, a device that fits over the caregiver’s finger and is gently applied to Baby’s brand new pearly white.

As for the fluoride question, infant formula should not be mixed with fluoridated tap water. “The rationale for not using fluoridated water for rehydrating infant formulas is that infants receive all their nutrients in fluid form,” she says. “With this volume of fluid ingestion, tap water would lead to babies’ consuming too high a concentration of fluoride, which can cause significant health problems.”

Hulland recommends waiting until your child is a year old before giving fluoridated tap water and consulting your dentist about the appropriate time to use a fluoride toothpaste for your child.” (In early 2010, the Canadian Dental Association and Health Canada will issue new recommendations about the use of fluoride toothpaste in children under age three based on seven high-risk characteristics.) 

Fluoride supplements are contraindicated for infants. “Supplements contain high doses in a bolus effect that comes in one big wave,” says Hulland, and are too conentrated for infants. “Fluoride works best in frequent low doses that steadily bathe the dentition over time.”

For more information on what to expect as your child’s teeth develop over the years, visit Canadian Dental Association website at www.cda-adc.ca.