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The journey to having healthy teeth for life begins even before birth. What can you do, both during and after pregnancy, to help your child get off to a great start? This session will cover steps to take during pregnancy to keep gums and teeth healthy, how a mother’s oral health can affect her baby, caring for infant and toddler teeth (and making it fun), nutrition for healthy teeth, and cavity prevention. Dr. Femina Ali of Wellesley Dental Group will also answer some of the most common questions on bottle use, teething, dental injuries, and pacifier use.
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Isis Parenting Expert Speaker Series
Femina Ali, D.M.D.
Ali & Ali
• Drs. Ali & Ali – both graduates of
Tufts Dental School
•Currently practicing dentistry since 1997
in Wellesley
Our family
I was pregnant once too!
Community means a lot
Reaching out to help• Started visiting 2nd graders in the classroom setting• Younger siblings• Met with preschoolers • Seeing infants
Pre-Pregnancy
Prevention is keyBrush twice a dayFloss dailyEat a healthy diet Use recommended prenatal vitamin with Folic AcidContinue regular check-ups at the dentistAsk for a screening for any gum disease, treat itGet necessary X-rays before pregnancyTake care of elective work before pregnancy
Getting pregnant
Bacteria present in periodontal disease may affect reproduction success and outcome of fertility treatment
Fertility treatments can affect gum health – a 2004 study showed that women receiving ovulation inducting medicines for three or more menstrual cycles had higher levels of gingival inflammation and bleeding
During Pregnancy
What to expectHormonal changes – increased progesterone and
estrogen causes gums to react differently to bacteria in plaque
Dietary changes – cravings and snackingMorning sickness Change of routine – feeling tiredFear, anxieties, and questions
What you can doEat healthy, balanced diet
Milk, cheese, and yogurt for CalciumChoose foods high in Vitamin C – strawberries, melons,
broccoli, papaya, bell peppersPhosphorous – chicken, eggs, legumes, dairy
If you have the urge to snackCarbohydrate rich foods can be an invitation to tooth decayBrush your teeth after snacking when possible
Floss dailyGet a dental cleaning once every 3 months during pregnancy,
some insurance plans even pay for the extra cleanings
If you need dental workX-rays for dental emergencies are okay if used to
diagnose major issues like infectionUntreated dental infection can be a risk to the fetusIt’s a myth that calcium is lost from mother’s teeth
during pregnancy
Gingivitis/Periodontal DiseaseEspecially common during months 2 – 8Occurs in 60-70% of pregnant womenLinks between pre-term, low birth weight babies and
gingivitis12 % of babies in the US are born preterm (before 37
weeks)Pregnant women who have periodontal disease may be
seven times more likely to have a baby that is born too early and too small*
What gingivitis looks like
Symptoms include red, swollen, bleeding gums
Treating gingivitisDeep cleaning (scaling and root planing) may be
recommended Periodontal therapy reduced pre-term birth and low
birth weight infants by 68% in women with pregnancy associated gingivitis
Pregnancy TumorsGrowths or swelling between the teethPlaque responseMost prevalent during second trimesterOften removed after baby is born
Fetal Development
Teeth begin to develop between the third and the sixth month of pregnancy
Use your calcium for tooth development20 primary teeth are present in jawbone at birth
Post Pregnancy
Bouncing back
Congratulations! You’ve had a baby!Hormones returning to pre-pregnancy levelsGums, if kept healthy during pregnancy, should be less
problematicRoutine hygiene visits and daily brushing and flossing still
very important
Fathers and CaregiversDecay causing bacteria, mutans
streptococci, are transmitted soon after the first tooth erupts
Reducing a parent’s or caregiver’s mutans streptococci count can help
Avoid sharing food utensils
Setting a good exampleStudy that shows children whose parents are regular at
the dentist have less problemsSeeing you brush and take care of your teeth is goodRoutine is key
February is National Children’s Dental Health Month
What you need to know to help your baby
First TeethFirst teeth usually arrive in the front, 6 – 12 monthsMay notice a change in behaviorDrooling and chewing Soft safe teething ring
Cleaning infant gumsAfter each feeding, wipe baby’s gums with a clean gauze
or clothEven before the first tooth, begin a daily routine of twice
daily cleaning When first tooth comes through, use soft bristle
toothbrush or finger brush to cleanUse water or a non-fluoridated cleansing gelChildren get used to you trying to clean their mouth
Breast feedingBreast milk is a complete form of nutrition for the
infants. Recommended for all except for those where
breastfeeding is determined to be harmful Frequent feeding should coincide with frequent cleaning
of gums
Bottle feedingClean the baby’s mouth and teeth after feeding a baby
with bottled milk or formulaLiquid concentrate or powdered formula should be
mixed with non-fluoridated water to not over fluoridate
Baby bottle decayNever let a baby fall asleep with a bottleIf your baby needs comfort, provide a pacifier instead of
bottleBacteria in mouth uses sugar as foods, which creates acid
that attacks teethFruit juice should never be put in a bottle
Decay
Weaning off bottlesThe A.D.A. recommends the introduction of training cups
at age one – doing so may help make the transition easier than if it was postponed
Discuss with your pediatrician how much milk your child continues to need and when you may introduce plain water to the diet
FlourosisCondition resulting from too much fluoride in child’s dietCauses brown spots or discoloration on teethIf you see this in your child, check with your dentistMonitor children’s fluoride intake
Fluoridation levelsThe optimal level for the prevention of dental cavities
is .7 to 1.2 mg/L depending on how warm the climate isLocal towns that supplement the water supply to bring it
to an optimal level (1.0 mg/L):Needham, Westwood, Wellesley, Dedham, Newton, and
NatickLocal towns that are not supplementing:
Dover and MedfieldFind out more at
http://www.cdc.gov/OralHealth/index.htm
The American Academy of Pediatric Dentistry recommends all children see a dentist within 6 months of the first tooth or no later
than the child’s first birthday.
Toddler Dental Development
ToothbrushingBegin brushing your child’s teeth when the first tooth
comes throughUse a small, soft-bristled toothbrushNon-fluoridated toothpaste or gel until child can spitContinue to clean and massage the surrounding
toothless gumsBegin flossing as you see contact between teethUse of 2 minute sand timer makes things fun
Pacifier UseUse pacifiers instead of bottles if child requires that comfortThere are different sized and shapedpacifiersMay start to affect tooth position if used past age 3 – dentist can monitor changes in tooth positioningPositive interventionEncouragement
The Binky FlowerSome parents have suggested planting the binky in a pot of soil with some seeds When the seeds sprout and start growing, children are excited to see that their binky turned into a flower or plant
Thumb Sucking
Thumb sucking is usually not a problem unless it continues on for a long period of time
If child is still sucking thumb at age 3, help may be required to help the teeth position correctly
Age 3 and up 20 primary teeth
BrushingToothbrushes – Oral B stages
Power toothbrushesDisclosing tablets from dentist office
FlossingDisposable flossers
Children need your assistance until about 7 yearsDaily, at night after brushing
Fluoride and SealantsFluoride supplementation can be provided at the dentist
officeMost commonly given in a varnish or foam - varnish is
painted on and children can eat and drink afterSealants protect baby teeth and molars from cavities –
sometimes need to be done more than once
X-rays Start around age 3Usually “Bitewings”Show permanent teeth
beneath surface, cavitiesDigital x-rays emit less
radiationLead apron
Baby teeth are importantThey hold the space in the jaw for adult teethLosing a baby tooth too early can lead to crooked or
crowded teethAdjacent teeth drift
Extractions are not fun for childrenPrevention
Nutrition plays an important role in healthy teeth and gums
Foods to eat
• Grains•Vegetables• Fruits• Milk• Meats and Beans• Raw Carrots• Apple Slices• Yogurt
Foods to avoid
• Candy• Sticky sweets• Soda• Doughnuts• Foods with little nutritional value
Hidden “Bad” foodsThey aren’t “bad” foods, but they can be bad for the
teeth if not monitored or cleaned up after Raisins Fruit strips Sugary medicines
After eating…Have child brush after eating sticky foodsAfter most meals if possibleAt least twice a day – once after breakfast and once
before bedIf child had citrus or acidic drink, wait an hour before
brushing teeth
Teeth play a role Part of the digestive process, chewingSpeakingLooking goodSmiling
Costs of poor oral healthThe AAPD says that 51 million hours of school time are
missed by children each year because of dental issuesA 2007 report by the CDC says one in every 5 three-year-
olds suffers from tooth decayDecay can lead to fillings or lost teeth – which may lead
to orthodontics that otherwise would not be necessaryDental decay is entirely preventable
Finding a dental homeDentists can be a great resource as oral health doctorsSee issues as they ariseBuilding trust between you, your child, and the dentistMany options
Family dental officePediatricConvenience
Open CommunicationAsk your dentist any questions you may haveYour dentist may have questions for you, too It may take a while for your child to feel comfortableDon’t give up on dental visits if one goes poorly
Dental Resourceswww.WellesleyDentalGroup.com/blogAmerican Academy of Pediatric Dentistry
www.aapd.orgAmerican Academy of Periodontology
www.perio.orgAcademy of General Dentistry
www.knowyourteeth.comAmerican Academy of Pediatric Dentistry
www.aapd.org
Please feel free to contact me if you have ANY questions781-237-9071