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This guide is a compilation of articles from the European Academy of Pediatric Dentistry. We believe it has immense value for prospective mothers, therefor we republished it on our dentist London website. I hope you find it useful.

Dentist, Mother and Child

Table of Contents

Pregnancy and Oral Health

Pregnancy is a wonderful period for every woman, accompanied by many changes, bodily as well as psychologically. Most of the future mothers devote themselves entirely to the child they are expecting, and neglect themselves and certainly their oral health, as well. The purpose of this pamphlet is to provide all the necessary information to future mothers, so that they will understand the importance of their own oral health, and to inform them what they must do in order to ensure the infant's good oral health in the future.

What do I have to know about my health and my nutrition during my pregnancy?

Your health and nutritional habits during your pregnancy are very important not only for the development of the fetus, but also for the development of its teeth. By taking care of these factors you have already started to take good care of the health and the teeth of your infant.

Your bones and your nutrition, and not your own teeth, are the sources which provide calcium for bone and tooth development of your baby. The myth saying that the infant is «stealing» calcium from its mother, who then starts having dental problems, does not have any scientific base. In general your nutrition should include meat, milk, dairy products, fruit, vegetables, starch-containing foods; meanwhile you should not consume alcohol, nor smoke.

Pregnant women tend to have snacks between their main meals. Usually these snacks contain sugar in considerable quantities, which, in the end, is the factor that causes damage to their teeth. For this reason, it is recommended that you minimize consumption of these snacks between main meals.

What kind of dental problems could we face during pregnancy?

Pregnancy is a time period in which secretion of many different hormones takes place. This hormonal disturbance might result in swelling, pain or bleeding of a pregnant woman’s gums. This is a problem that is related to pregnancy and disappears as soon as she gives birth. The severity of this situation can be improved with the systematic brushing of the teeth and the use of dental floss.

Do I have to visit my dentist during pregnancy?

The regular examination of your teeth and gums during pregnancy is important, especially if you experience symptoms such as the ones described above. It is preferable to visit your dentist before the delivery, because after that you may have to wait for 3 months before you arrange an appointment with your dentist and have any dental work done. Of course you will have to inform your dentist that you are pregnant, because this might change the treatment plan or the medication that might be used in your case.

The First Dental Problems of the Infants

When do the teeth of the infant start to develop?

The primary teeth of the baby start to form in the first trimester and the permanent teeth in the second trimester of pregnancy. That is why any disturbances in the pregnant women’s health might cause damage not only to the primary, but also to the permanent teeth of the baby. Some medicines (i.g. tetracycline) might also influence the color and the formation of the teeth. Therefore you have to be very careful with the medicine you take during pregnancy and you must always consult a physician.

When is the time for my baby to have the first visit to the Paediatric Dentist?

Paediatric Dentists are specially trained dentists capable of taking care of children's oral health, effectively. A paediatric dentist is responsible for the oral health of a baby, like a pediatrician is responsible for its health in general. The first visit to the paediatric dentist should take place as soon as the first tooth comes through. During this first visit, the paediatric dentist will organize and give you a complete preventive dental program to follow; he/she will also examine the dental development of your child, will give you advice concerning its nutrition, and will inform you on how to avoid possible problems.

The second visit should take place when your child is 2,5 - 3 years old and approximately when all primary teeth have erupted. The purpose of this visit is to check if all teeth have developed and erupted properly. Teeth will be checked for toorh decay and if any preventive dental program has been followed and finally to design a program made for your child.

The third visit should take place at 3,5-4 years of age. At this visit the paediatric dentist will examine if the development of the child’s teeth and jaws are normal, and if any tooth decay has occurred. The preventive program will be adjusted again according to the needs of your child. The first fluoride treatment will take place at this time. Your paediatric dentist should examine your child 1-2 times per year in order to check the development of teeth and tooth decay, to adjust the preventive program and to give fluoride treatment as needed.

When do the first teeth appear in the mouth?

The first tooth appears during the first 6-8 months and by the age of three, 20 teeth should appear in the child’ s mouth. Both the earlier and the delayed appearance of teeth is usually hereditary and is not necessarily related to any problems. If your baby, however, does not have any teeth by the 12th month of its life, you should consult your paediatric dentist.

What are the symptoms related to teething and what can I do to help my baby?

The usual symptoms that appear when the primary teeth start erupting are:

  • Red and swollen gums
  • Increased quantity of saliva ( salivation )
  • Anxiety and grumbling
  • A change in nutritional habits
  • Lack of appetite
  • Difficulty in sleep

In general the symptoms that are related to the appearance of the child’s first teeth are mild. If you observe fever, rashes, vomiting or diarrhea, you must visit your pediatrician, because something else, not related to the teeth, is happening.

In order to relieve your baby from all these discomforts you must clean its mouth 2-3 times/day with a wet gauze and give it cold objects -that are manufactured especially for this purpose- or a cold clean cloth to bite.

Should the child use a pacifier?

Babies have an intense instinct of sucking, which on one hand satisfies the need of feeding, on the other hand it replaces the connection with their mother. Because of this it offers them great pleasure. In order to satisfy this need the child uses its fingers or other objects. The pacifier is an important and very common means for satisfying the sucking need of the child. It can function preventively against the habit of finger sucking. Efforts to avoid the use of a pacifier lead to finger sucking which is a simple replacement of the pacifier habit and causes serious consequences on the development of the jaws. In general, the use of a soother is preferred over the use of fingers because it can be stopped easier, at a younger age and generally causes less damages.

When should the use of a pacifier be stopped?

The use of the pacifier or the habit of finger sucking should stop before the age of 4. The reason being that if there are any deformities of the jaws they will be selfcorrected with time. However, if these habits are extended beyond this age as it is seen with finger - sucking, it is possible that the deformities will be permanent and difficult to correct. In such cases the most suitable person to consult is your paediatric dentist, who will advise you about the ways of treating and breaking these habits.

What should the right pacifier be like?

The pacifier must be of such a size that the baby will not be able to put it entirely in its mouth.

The nipple must be soft with a thin and flexible neck. It is preferable for the shape of the nipple to be symmetrical, so the baby can place it in its mouth the right way.

The shield of the pacifier must be concave so to touch the area around the mouth firmly and gently and to have ventilation holes allowing air to circulate to help prevent rashes,.

In general a pacifier should be constructed in such a way that the child will not be able to take it apart.

Finally, it is totally forbidden to tie the pacifier with a ribbon around babies’ necks: danger of strangulation.

Nutrition and Tooth Decay in Infancy

What should I pay attention to concerning my child’s diet?

There is no doubt that breast-feeding is the ideal nutrition for an infant since mother's milk contains all necessary ingredients that help the balanced upbringing of a newborn baby. Since you have decided to bring a baby in this world it would be a great pity to deprive it of such a precious experience. After the first months you will, of course, start improving its feeding step by step.

The basic dietetic habits of the child are created during the first years of its life, when its parents have the absolute control of the diet. For this reason the choice of food and the habits that are introduced to the child are very important. Try to avoid food that contains large quantities of sugar, and putting sugar in your child’s food or milk.

If the child needs to have snacks between meals, you should avoid food containing sugar (chewing gum, candy, cookies, soft drinks, fruit juices that contain sugar). Recommended foods are vegetables (carrot, celery, cucumber), fruit and fruit juices without sugar. Also, yellow cheeses would be a very good choice, because they help in fighting tooth decay. Children accept these foods easier if they haven’t been previously used to foods with large quantities of sugar.

Bad nutritional habits generally promote the appearance of tooth decay in all ages. An example of the effect of nutrition in tooth decay, is the baby-bottle tooth decay or nursing caries syndrome.

What is the nursing caries syndrome?

Nursing caries syndrome is a severe form of tooth decay, which is primarily due to bad feeding habits (feeding in bed while sleeping). This tooth decay usually affects the anterior primary teeth of children 2-5 years of age.

How does nursing caries syndrome occur?

The most usual cause of this form of decay is the use of the nursing bottle during sleep. During sleep the quantity of saliva in the mouth is reduced and the milk, whether on its own or with sugar remains, on the teeth causing tooth decay. We will have the same result if instead of milk we put fruit juice in the bottle, even if it is diluted, water with sugar or honey, or if we give the child a pacifier that has been dipped in honey or sugar. Even the mother’s milk can cause this kind of damage, if the child is allowed to nurse after the age of 1 year and whenever it wants to during night-time.

What is the best way to deal with nursing caries?

The best way of confronting baby-bottle decay is PREVENTION. Its prevention can be accomplished by informing the parents on what they have to do and what they have to avoid.

How can I prevent nursing bottle syndrome?

Keep on breast-feeding your baby at least till its 4th or 6th month.

Put only milk or water in the baby’s bottle and use it only during daytime and never when the baby is asleep.

Never put juices or other fluids in the bottle, until the child is able to drink from a glass by itself try to feed it with a spoon.

Never give the child pacifiers dipped in sugar or honey. It is the worst thing to do to your child's teeth.

From the moment the child's first teeth appear, clean them after every meal. Start with a wet gauze and later with a small and soft toothbrush without toothpaste.

When you bottle-feed the baby hold it, as well as the bottle. This way the child learns that its parents are the ones who control the bottle. Under no circumstances should you confuse the time the child eats with the time it sleeps. These should be two separate activities.

Visit the paediatric dentist with your child as soon as it has some teeth and, certainly, never later than the age of 3.

When should I stop the habit of feeding the child with the bottle?

From the age that the child can sit by itself, it can and should drink from a training cup. In general, the child should stop the use of the baby-bottle before it is 12 months old.

How can I help my baby forget its milk bottle?

There are 3 methods that can be used for the discontinuation of this drinking habit.

The most drastic way is to throw the bottle in the garbage after the 12th month.

Another way is to gradually dilute the contents of the bottle with water so that after two weeks the contents of the bottle will be pure water.

The third way is to reduce the quantity of fluid in the bottle daily until the habit stops.

Replace the bottle with a training cup with a special spoot on its cover. This will gradually lead the baby to the ordinary cup.

Prevention is Effective When it Starts Early

Why are primary teeth important?

They are necessary for chewing food.

Damaged teeth with an abscess influence the general health of the child causing pain and sometimes fever.

They are necessary for speech, especially during the age children learn to talk.

They maintain the space the permanent teeth need when they erupt.

They help the proper development of the jaws.

Healthy primary teeth give a beautiful smile to the child, which helps the picture it has about itself.

In general, teeth with caries create an infected environment in the mouth, in which the permanent teeth are affected easier when they erupt. For this reason primary teeth are as important as the permanent ones and neglecting them with the pretence that they will be changed is a serious mistake.

How can I protect my child’s teeth?

The best way to protect your child's teeth is the initiation of correct preventive measures at a young age. These measures include the cleaning of teeth, correct diet, the use of fluoride and the frequent visits to your paediatric dentist. Your aim is to maintain the teeth’s health until the age of 16-18 years. If you succeed in this, your child will have healthy teeth for the rest of its life.

When should brushing of the teeth start?

We have already mentioned that the cleaning of the teeth should start as soon as the child's first tooth appears in the mouth. Until the end of the child's second year, a wet gauze or a thin toothbrush can clean the primary teeth at least once a day, preferably after every meal, without causing any irritations. As the child grows, a small and soft toothbrush with a smear layer of toothpaste may be used.

What is fluoride and how can I use it?

Fluoride is an element which makes teeth more resistant to tooth decay. It has been found that it can reduce the appearance of tooth decay up to 60%. Fluoride, in other words helps children have stronger teeth and parents spend less money.

It must be given in proper quantities, according to age, and the geographic area in which each child lives. For this reason you must consult your paediatric dentist, who will inform you properly, about the dosage and the way of use according to your child’s needs.

What must I do if my child injures its teeth?

It is true that when the child begins to make its first steps, it usually has its first accidents. If it injures its teeth, then the paediatric dentist should examine it and find out if the permanent tooth has been injured as well.

Conclusion

In general, you have to realize that the knowledge and the techniques of the paediatric dentist today have led to the creation of complete preventive programs that are able to prevent tooth decay and gum problems in children. However, this requires your own information, your determination and your consistency in the application of these programs so your child will enjoy its whole life without any dental problems.

We will conclude this pamphlet by presenting three true facts for prevention in our life.

The one is that the main dental problems such as tooth decay, gum diseases and soft tissue diseases can be prevented almost 100%, especially if prevention begins from a very young age.

The second is that although dentists do perform high quality dental restorations, none of these restorations last forever . What lasts forever is prevention, because it gives us healthy teeth and good oral health.

Restorations cost too much even though they don’t last, while prevention costs very little and lasts for ever. Prevention means that you visit your dentist at least once a year to prevent problems and not when you hurt. Because then it may be too late.

Dear parents, prevention means health, it means cleverness, it means investment. Clever people invest in prevention and good health. Be one of them!

About Forest & Ray

Forest & Ray is a private dentist in London (Holborn, Camden) practice offering a wide range of treatments (basically everything), same-day appointments 7 days a week and affordable prices. The key behind a beautiful smile is self confidence, and success. At Forest & Ray we ensure to help you to the best of our ability. If you place your trust in us, we will make sure you achieve your goals and maintain oral hygiene to the maximum of its capacity. Regardless of any age or condition, we promise painless treatments and a professional team.

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