early childhood caries​, baby bottle caries, tooth decay

Teething in children

Your baby is drooling so much that you have to change his bib frequently. He is also putting everything into his mouth to ‘chew’. He has swollen and red gums, flushed cheeks and his sleeping pattern seems disrupted. Nothing you do seems to help. He is grouchy, irritable and restless. These are common signs of teething. 

A baby’s first tooth usually appears from about 6 months of age, though for some babies this may be earlier or later. The two lower front teeth (incisors) are the first to appear. The full set of baby teeth is usually visible in the mouth by the time he​ is about 3 years old. The full transition from baby to adult teeth will take place until 12-14 years old.

How to ease the discomfort 

A tooth pushing its way out of the gums can be uncomfortable. Since the process takes days, this can mean extended discomfort for your little one. Here are what you can do to make it less unpleasant for him: 

  • Give him something to chew on. Teething rings, chilled rubber teething toys and hard biscuits or rusks remove the pressure on your baby’s gums. Make sure that these rings or toys are clean before giving them to him.​
  • Rub or massage his gums with clean fingers or a cold towel. This will help soothe the discomfort. 
  • Cuddle and play with him to provide him with assurance and comfort and distract him from the uncomfortable feeling. 
  • Give your baby cool food and water to help numb the discomfort. For example, frozen fruits can be given in a baby feeder mesh bag to avoid risk of choking on chunks of food, done under adult supervision and with baby sitting or propped upright. Foods like chilled yogurt, blended peaches, and apple sauce can be more appetizing than warm or room-temperature foods, and can ease uncomfortable gums.
  • If your baby cannot be soothed, consult your doctor for some pain-relief medication. ​
  • ​Food and Drug Administration (FDA) advises against topical application of teething gels as they may contain agents harmful to children under 2 years old. 
  • Symptoms like fever and diarrhoea are not often associated with teething. If your baby has the above-mentioned conditions for prolonged periods, please take him/her to a doctor. ​

Cultivating good oral habits from young 

Milk teeth or baby teeth are important. They help your child to chew and speak properly. They also create space for the permanent teeth to erupt in the mouth. Healthy looking teeth are a tremendous boost to a child’s self-confidence and self esteem. ​​

Start your baby on good oral habits early. Begin by cleaning your baby’s gums daily from birth with a small piece of clean wet muslin cloth or a piece of gauze. This will help your baby get used to the daily routine of cleaning his teeth later on. 

Brush your baby’s teeth as soon as they appear. Use a soft bristled toothbrush that is specially designed for babies. Remember to wipe the surface of his tongue as well.

Fluoride in toothpaste protects your child’s teeth from tooth decay by strengthening it. However, children can get fluorosis on permanent teeth from swallowing too much fluoride toothpaste. Fluorosis results in a change in colour or texture of the teeth.

To prevent fluorosis, it is important to ensure that an appropriate amount of toothpaste according to your child’s age is dispensed and that your child does not swallow the toothpaste.

Use a fluoridated toothpaste containing at least 1000ppm fluoride twice a day to prevent tooth decay. For children below 3 years old with high risk of decay, a smear amount (size of a rice-grain) of fluoride toothpaste is recommended.

Visit a dentist who can advise you on your child’s risk of developing tooth decay and on the appropriate use of toothpaste. For children 3 years old and above, use a pea-sized amount of fluoridated toothpaste.

It is important to cultivate the habit of brushing your baby’s teeth twice a day from young, once in the morning and​ once at night before sleeping. Having good oral hygiene practices from young will go a long way in keeping his teeth healthy in adulthood too. 

Early childhood caries

Some parents give their babies a bottle of milk or sweetened beverage to drink while putting them to sleep. The milk or sweetened drink will pool around their teeth and cause tooth decay. This is called early childhood caries. 

How to prevent early childhood caries 

  • After each feed, clean your baby’s gums with a small piece of clean wet muslin cloth or a piece of gauze.

  • As soon as your baby’s first tooth appears, start brushing it. Visit a child-friendly dentist who can advise you on your child’s risk of developing tooth decay and the appropriate use of toothpaste.

  • Use a fluoridated toothpaste containing at least 1000ppm fluoride twice a day to prevent tooth decay. For children below 3 years old with high risk of decay, a smear amount (size of a rice-grain) of fluoride toothpaste is recommended. Visit a dentist who can advise you on your child’s risk of developing tooth decay and on the appropriate use of toothpaste. For children 3 years old and above, use a pea-sized amount of fluoridated toothpaste.

  • By the time your child turns 1 year old, attempt to wean off the milk bottle for night feed. Teach your child to drink from a cup as soon as he can hold one.

  • Do not let your baby go to bed with a bottle of milk by the time he/she turns one year old. The liquid will pool in the mouth, creating a breeding ground for bacteria. This can lead to tooth decay. Try to put your ​child back to sleep at night with other means such as cuddling a favourite toy, or fingering the edge of a sleep suit.

  • Brush your child's teeth after (not before) their last milk feed.

  • Frequent consumption of sweetened beverage (eg: formula milk, juice) in a milk bottle can cause severe tooth decay. Once a child turns 1, do not use a bottle of milk/juice in a bottle as a pacifier in the day.

  • Arrange regular dental checkups for your baby from as early as his first birthday. 

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