Baby Pearly Whites – Handle With Care!

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February 27, 2014

How much should we care about “baby teeth”?  After all, there’s another set of “real” teeth coming in a few years, right?  When we look at the facts, there’s a lot of reason to care about those pearly white primary teeth and it’s not just about the tooth fairy!  

What was once known as “baby bottle tooth decay” is now more formally called early childhood caries (ECC).  ECC can be caused by more than just baby bottles, though.  It’s associated with a diet high in refined sugars and poor oral hygiene.  But if children are destined to lose these primary teeth, why should we care so much about preventing caries?  Here are a few reasons to chew on:

— Several studies link ECC with anemia, iron deficiency, protein deficiency and Vitamin D deficiency.

— Children who suffer from ECC often experience severe pain and sleep disturbance which can impact their nutritional intake and overall well-being.

— ECC can progress into major infections including oral abscesses or abscesses in other parts of the body including the brain.  Treatment can be very involved and may include intravenous antibiotics or even surgery.  

— Severe caries often require tooth extractions, done in an operating room with general anesthesia because it is a painful procedure that children will not tolerate otherwise. While this can usually be done safely, every procedure involves risks and general anesthesia is not one to take lightly.  Prevention is surely a better alternative.

— The unsightly appearance of tooth decay can affect a child’s self-esteem.

The American Academy of Pediatrics (AAP) advises that those at highest risk for ECC are children on Medicaid, children whose caregivers/siblings have caries, special needs children, children who use a bottle beyond 15 months of age or who have more than 3 sweet or starchy snacks per day.  

What do caries look like?  If you’re waiting to see brown spots to detect caries, that’s too late. Childhood caries start off with the appearance of chalky white spots or bands along the gum line. This shouldn’t be ignored and needs the prompt attention of a dentist to prevent it from progressing to more severe decay.

The key is establishing a good dental routine with your children.  Primary teeth begin erupting around 3-4 months and continue on until about 3 years of age.  In this time, it’s crucial for parents and little ones to develop good dental hygiene habits. Here are some tips:

• Once teeth erupt, only water should be in any bedtime or naptime bottle.  
• Don’t share utensils with young children. This can encourage the transfer of cavity-causing bacteria to their mouths and promote caries. Parents cleaning a dropped baby’s pacifier by sucking on it – NOT a good idea!
• If breastfeeding overnight, implement dental hygiene after overnight feedings. (Remember, most babies over 6 months should be able to sleep through the night anyway. This is a great time to wean them from overnight feedings.)
• Start using sippy cups at 6 months and eliminate bottle use by 1 year of age.
• Avoid frequent sugary drinks.  Sugar is food for the bacteria that cause caries.
• Use toothpaste without fluoride in children less than 2 years old and assist them in brushing their teeth twice per day.
• Fluoride toothpaste can be used after age 2 and tooth-brushing should be supervised until children demonstrate a good grasp of brushing technique.
• Remind children not to swallow fluoridated toothpaste.
• Check with your pediatrician or your dentist to see if your child needs additional fluoride treatments or with your local water supplier to find out about the fluoride content in your water source.  

For expecting moms, good dental hygiene during pregnancy is especially important. Pregnancy hormones can predispose women to gingivitis (inflammation of the gums) which, when left untreated, can cause chronic dental problems. Sometimes your dentists may suggest more frequent visits and cleanings to prevent gingivitis. The establishment of good dental hygiene and eating habits can lead to a lifetime of good oral health and avoid unnecessary pain and illness caused by early dental caries.


American Academy of Pediatrics. A Pediatric Guide to Children’s Oral Health. Elk Grove Village, IL: American Academy of Pediatrics;2009.