Preventing tooth decay in babies and infants

The habits of good dental care should begin as early as possible and its important to take steps to avoid problems with infants and children.

Children need strong, healthy teeth to chew their food and baby teeth also keep a space in the jaw for the adult teeth.

If a baby tooth is lost too early, the teeth beside it may drift into the empty space. So, when it's time for the adult teeth to come in, there may not be enough room. This can make the teeth crooked or crowded.

The name given to decay in infants and children is baby bottle tooth decay.

It can destroy the teeth and most often occurs in the upper front teeth - though other teeth may also be affected.

Decay can happen when sweetened liquids are given to an infant and are then left clinging to their teeth for long periods. Many sweet liquids cause problems, including milk, formula and fruit juice.

What happens is that bacteria in the mouth use these sugars as food and then produce acids that attack the teeth.

It's not just what you put in your child's bottle that causes decay, but how often. Giving your child a bottle of sweetened liquid many times a day isn't a good idea.

Here are some tips to avoid baby bottle tooth decay in your children:
- After each feeding, wipe the baby's gums with a clean gauze pad. Begin brushing your child's teeth when the first tooth erupts. Clean and massage gums in areas that remain toothless, and begin flossing when all the baby teeth have erupted, usually by age 2 or 2.
- Never allow your child to fall asleep with a bottle containing milk, formula, fruit juice or sweetened liquids.
- If your child needs a comforter between regular feedings, at night, or during naps, give them a clean pacifier recommended by your dentist or physician. Never give your child a pacifier dipped in any sweet liquid.
- Avoid filling your child's bottle with liquids such as sugar water and soft drinks.
- If your local water supply does not contain fluoride (a substance that helps prevent tooth decay), ask your dentist how your child should get it.

Start dental visits by the child's first birthday and make visits regularly.

If you think your child has dental problems, take the child to the dentist as soon as possible.

When Teeth Hurt from Seasonal Allergies

When is your child’s toothache not really a toothache? When the pain results from a seasonal allergy. In the spring and fall, natural allergens such as flower and tree pollens and molds can seriously affect some children (and adults, too). Other allergens that can spark similar reactions year-round include dust mites and animal dander.

Once an allergic child inhales allergens from the air, the child’s body senses that these substances are foreign and “need” to be eliminated. So the body produces a response—but that response is imperfect. It includes the production—and often overproduction—of thick mucus.

If there is more mucus than necessary and it can’t be easily discharged, it pools in head cavities called sinuses. These spaces are normally filled only with air, but they become receptacles for mucus when it’s produced. The pressure from the overabundant mucus can lead to a sinus headache.

What does this have to do with the teeth? The maxillary sinuses are located just above the roots of the back top teeth (premolars and molars). When these sinuses are swollen and overflowing, they exert pressure on the roots, causing pain that feels exactly as a toothache would feel if there were something wrong with a tooth. Symptoms include oversensitivity to cold, throbbing and pain when biting down or if the tooth is tapped from the outside.

However, no dental problem actually exists. Adults have a difficult time telling the difference between a sinus-induced problem and a true tooth issue; it’s even more difficult for a child.

So, if your child complains of a toothache but is also susceptible to seasonal allergies, try to address the allergic symptoms first and see if the tooth pain lessens. In consultation with your pediatrician, you may want to try an antihistamine, decongestant and/or nasal spray.

In some cases, the toothache may be gone faster than that new box of tissues.

Activities That Teach Respect

This month's PACE character trait is Respect.  With school starting, it's the perfect time of the year to talk to your children about how to put their best foot forward when meeting their new teachers and classmates.  Here are some activities (from eHow.com) to help you teach respect at home:

Explain Why Manners Are Important

When teaching your children manners, explain why the desired behavior is so important.  For example, explain that thanking someone for a gift shows how much we appreciate the thought, time and money that went into choosing and purchasing the gift.  A child needs to hear that we look people in the eye when they speak to us to show that we are respectful listeners, and we don't interrupt.  Don't assume your children will naturally know these things without being told.

Household Rules

In their book "Teaching Your Children Values," co-authors Richard and Linda Eyre say, "Extend respect and then expect respect." Establish household rules, the same way teachers do in a classroom, so that your children know what behavior is expected of them. When sibling quarrels escalate, gently warn your children that they are beginning to show each other disrespect. When you see your children showing respect for another person, compliment them.

Real Life Teachable Moments

Because children learn so much through experience, take the opportunity to have a discussion with your child when you see someone acting either very respectfully or very disrespectfully. If you encounter a disrespectful individual when your child is with you, resist the urge to respond in anger. According to the U.S. Department of Education, "our examples of good behavior can teach our children to take the high road when other roads look tempting."

Role Play

Role playing is a wonderful way to demonstrate a concept for elementary-aged children. Role play a disagreement between two people, so your children learn that they can disagree without disrespecting. If your child has a birthday party coming up, role play with him how he will greet his guests and thank them for his gifts.

Read About Respect

When reading to your child, choose titles that demonstrate characters learning about and showing respect.  Recommend such titles to your children who read independently.  Some titles to explore are "Dragonfly's Tale," by Kristina Rodanas (Gr. K-2); "Through Grandpa's Eyes," by Patricia Maclachlan (Gr. 3-4); and "The Cay," by Theodore Taylor (Gr. 5-6).  Your public library's children's librarian or school librarian can suggest new titles to you that deal with the theme of respect.

The Surprising Ear-Nose-Tooth Connection

The link in children between dental malocclusion—condition in which upper and lower teeth are not correctly aligned—and the common middle-ear infection (otitis media) remains unclear. A child with ear infections appears to be more likely to have a posterior crossbite (a kind of malocclusion), but no significant connection between any kind of malocclusion and ear infection has been determined.

However, a child who has dental malocclusion—or its beginnings—and a tendency to develop ear infections may actually have an underlying problem that causes both: mouth breathing. Just as the name suggests, mouth breathing occurs when the nasal passages experience chronic blockage, and because the child can’t breathe well out of his nose, he breathes primarily through his mouth.

So, what can cause chronically blocked nasal passages? Seasonal allergies, surely. Another major cause is swollen tonsils and/or adenoids.

The change from nasal to mouth breathing often results in chronic middle ear infections, sinusitis, upper airway infections and sleep disturbances such as apnea and snoring. And mouth breathing has been shown to affect the growing face, causing not only the teeth and jaw to be mismatched but, over time, significant abnormal facial development that can affect a child emotionally and socially, especially if it occurs during the critical growing years.

If a child sleeps poorly, he may well act tired, behave poorly and have difficulty concentrating, especially at school—all of which can lead to a (mis)diagnosis of ADHD. In many such children, when the enlarged tonsils and/or adenoids are removed, “behavior, attentiveness, energy level, academic performance, and growth and development” all improve, according to Yosh Jefferson, DMD, in an article he wrote for the journal General Dentistry in 2010.

Once mouth breathing is resolved, dental malocclusions and craniofacial issues can then be addressed—leading to a happy, if often initially unexpected, ending.