Dental caries, or cavities, that occur in infants and very young children are usually known as early childhood caries, or bottle feeding syndrome, the later being the less common. The process is initiated when liquids rich in fermentable sugars, such as breast or formula milk and juices, are given to the child in a bottle. These sugars tend to attach to the surface of teeth, which are then broken down into simple sugars by caries- causing bacteria in the mouth. The result is an increase in oral acidity which then causes de-mineralization, and eventually caries in the teeth.
How can Bottle Feeding Result in Cavities?
Children who sleep with a bottle of anything other than water in their mouth are at the highest risk of developing early childhood caries. This is because their teeth are constantly exposed to a high level of sugars present in the liquid. According to the American Academy of Pediatric Dentistry, bottle-feeding syndrome occurs because of a persistent interaction between the cariogenic bacteria and carbohydrates. The American Dental Association states that “what” you put in your child’s feeding bottle is less important. The more important thing, is “how frequently” you give it to your child, since repeated exposure to sugars is more dangerous than giving sugary drinks once or twice a day.
Similarly, some parents who dip their child’s pacifier into sugary syrups, or juices in an attempt to sooth their child. While this practice seems to be an effective way of calming the child down, it is highly detrimental to the teeth. For the whole duration the child keeps the pacifier in the mouth, the teeth are continuously exposed to sugars that can cause tooth decay.
What Are the Symptoms?
The teeth furthest in the back of the mouth, with more of a flat surface are most likely to become infected with caries. The upper anterior teeth are the most commonly affected with caries; however, the lower anterior and posterior teeth are just as vulnerable. The symptoms can vary depending on the severity and location. Some of these symptoms could include:
Mild to sharp pain when eating or drinking something sweet, hot or cold
Visible holes or pits in your teeth
Brown, black or white staining on any surface of a tooth
Pain when biting down
As a parent, you may not be aware that your child is forming a cavity until it is already present, requiring a fill. This is why it is important to begin your child’s dental visits at age one. If any of these symptoms are present, it is best to see your child’s dentist.
How to Prevent It?
The first step in preventing the development of bottle feeding syndrome is to create feeding times for your child to have the bottle for a shorter amount of time, rather than an all-day snack so to speak. Also, purchase juices made for children with less sugar content, or water down the juice. Additionally, parents must develop a habit of brushing their child’s teeth, starting from the time their first teeth appear. Your child’s teeth become vulnerable to dental caries as soon as they erupt, which usually occurs at the age of 6 months. Also, if your child is dependent on a bottle to sleep, replace the juice with water, and work to eventually wean from a bottle at night, altogether. Visit your child’s dentist once they observe the emergence of pearly white teeth in their mouth, usually by one year old. Regular visits to the dentist are recommended in order to prevent development of caries, which is most often not visible to the naked eye, unless it has progressed to an advanced stage.
The foremost principle in management is to immediately correct the dietary habits of the child. The milk teeth are ultimately replaced by the permanent teeth, and hence may not require restoration if the eruption of permanent teeth is expected in near future. It must be remembered that if primary teeth are lost at a very early age, there is a tendency for eruption of misaligned or crooked permanent teeth. Hence, taking care of your child’s milk teeth is very important, not only for the health of the adult teeth, but also for the practice of healthy oral habits.
Between the Lines: Flossing for Children
Kids aren’t usually a fan of sticking things between their teeth that isn’t candy or some other sweet treat, but, when it comes to flossing, developing a daily habit is vital in their oral health. Flossing is an important step in removing all the food particles from teeth where a toothbrush can’t reach, reducing the risk of gum disease and tooth decay. Studies have discovered that 30-35% of all cavities in children occur between the teeth, particularly the baby molar teeth. While you may be wondering how you could possibly get your child to start flossing, we would like to fill you in on the basics of flossing your child’s teeth and how you can introduce it into their daily routine and make it a positive experience.
When Should My Child begin Flossing?
For starters, children need to have their teeth before they can begin to floss. Once they’ve got the hang of brushing, teaching them how to floss is an important follow-up. When you introduce your child to brushing and flossing, they should be assisted by a parent or adult until the age of 4-5 years old, then supervised by an adult until they are 8-10 years old. Studies show that children are not coordinated well enough to brush and floss their own teeth until they can successfully tie their own shoe, which usually falls at the same age of 8-10 years old. Every child, however, is different and these numbers can vary. The American Academy of Pediatrics recommends that flossing should begin when the teeth begin to touch, typically between 2 and 2½ years of age. Some children may only need a few back teeth ﬂossed while others may need ﬂossing between each tooth, depending on the amount of spacing between teeth.
How Do I Floss My Child’s Teeth?
As important as daily flossing is, it is even more important to floss correctly. Flossing should be done once a day, preferably after dinner with the evening brushing, this way, all the food particles from the day are removed. You will need to floss your child’s teeth until they are capable of doing a thorough job on their own. Here are some steps to follow for flossing your child’s teeth:
- Wind about 18 inches of floss around your fingers. Most of it should be wrapped around the middle fingers of both hands.
- Use your thumbs and forefingers to lightly hold and guide about one inch of floss between your teeth.
- Use a back and forth motion to guide the floss between their teeth
- Tightly hold the floss and curve it into a C-shape against one tooth and slide it into the space between the gum and tooth, until you feel resistance.
- Gently scrape the floss down toward the tongue against the side to the tooth.
- Repeat this process for each and every tooth.
The sooner your child becomes aquatinted to consistently flossing their teeth, the more likely they will make and keep the habit. Flossing takes little time, especially when your child doesn’t have all of their teeth yet. Something to remember while you help your child floss is to be gentle. Children may still have periods of teething at 2-3 years old and may get fussy with brushing and flossing their tiny teeth. Another precaution is for children with loose primary teeth, be gentle and careful not to floss too deeply on the gum line around a loose tooth since it may already be tender. Floss the tooth beside it very gently and do not put any pressure against the tooth, to avoid bleeding or injury to the gum. Even though primary (baby) teeth eventually fall out, it is important to brush and floss them to create good oral hygiene habits for your kids and prevent conditions like gum disease and decay from setting in.
Introducing Your Child to Floss: Making it Fun
Just as children are fun, playful, and imaginative, so must parents be when it comes time to introduce them to the necessary tasks of life! Here are some tips for you to keep in mind when introducing your little one to flossing:
- Sing! Sometimes toddlers will try to sing along or smile so big they cannot help but open their mouth.
- Let them play with the floss string to get aquatinted with it, but be careful they do not wrap it around themselves.
- Brush and floss with them!
- Make animal sounds or “roar”
- Use a flossing “chart” and have them mark the days with favorite stickers
- Motivate them with a prize at the end of the week for good flossing
- Play a “good vs. evil” game involving the evil bacteria and the hero, floss! The best part is they get to be the hero!
- Teach your child to count by their teeth, while you floss!
- Use flossing tools such as floss sticks which come in colorful assortments, to make it easier for kids just learning to floss on their own.
Flossing doesn’t have to be a battle. Sometimes, however, children can put up a fuss and need to be reminded that their teeth need to be cleaned. If you’re into the tooth fairy, try telling them the tooth fairy gives extra change for clean teeth! While your child is learning to care for their teeth, remember that the best way they learn is by example! So
get between the lines and happy flossing!