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Mouthing off Baby Care

Mouthing off

If the eyes are the window to the soul, your little one’s tiny pink mouth may be the doorway to well-being.

Even if baby’s smile is just a gummy grin, it’s not too soon to start taking care of the mouthful of teeth she’ll eventually depend on to chew, speak and socialize. By the time she’s born, a baby’s 20 primary teeth (and her 32 permanent teeth) are already forming below the surface. Protecting them is essential not only for your child’s oral health, but also for her health overall.

“Your mouth, your teeth, they’re part of your body,” explains Mary Hayes, DDS, a Chicago-based pediatric dentist and spokesperson for the American Dental Association. “If they go bad, it can cause all kinds of problems. It affects everything.”

Unfortunately, cavities are more common than both asthma and hay fever among American children. According to data from the Centers for Disease Control and Prevention, 8 percent of 2-year-olds already have some form of tooth decay, while nearly 1 in 4 children have cavities by the time they turn 5.

To keep that little smile sparkling, brush up on oral health advice from medical and dental experts who offer tips for every stage of your baby’s development.

A healthy mouth starts with mom
Your newborn’s teeth begin developing well before she’s born (at about six to eight weeks into pregnancy for primary, or baby, teeth and at 20 weeks for permanent teeth) and so should good oral hygiene habits. Making dental care part of prenatal care can help reduce your baby’s risk for decay later in life, says Maggie Park, MD, a pediatrician and mom of two in Stockton, California.

“Even before her baby is born, a mother should get her own cavities under control,” says Park. That’s because cavities develop when bacteria in the mouth feed on sugars in our food and produce acid, which gradually breaks down tooth enamel.

“When we kiss our babies and share food and spoons with our babies, we’re also sharing these bacteria,” Park notes. So treating cavities before giving birth means there’s less bacteria to pass on.

Let your dentist know you’re pregnant, advises Park, and don’t skip checkups while awaiting your new arrival. According to the American College of Obstetricians and Gynecologists, routine dental care— including X-rays and local anesthetics—is safe during pregnancy. In fact, it’s imper- ative because expectant women are at increased risk for oral health complications. For example, hormone changes can lead to pregnancy gingivitis, or bleeding and swelling of the gums. Plus, the vomiting that sometimes comes along with morning sickness can erode tooth enamel.

Caring for teeth before they appear
Even before your newborn has any teeth, cleaning her mouth after feedings can help ensure you’re not also feeding cavity- causing bacteria. Start with a finger brush or a clean, wet cloth, and gently wipe down your baby’s gums after she eats, Park advises.

If you can’t manage to clean your munchkin’s mouth after every meal—and, let’s face it, that’s not always practical—aim to do it at least after her last nighttime feeding. “The most important time to wipe the gums down is at bedtime,” Park says. “If the milk is just sitting on the gums, it can be a breeding ground for bacteria.”

It’s also important to avoid letting your baby fall asleep on the breast or with a bottle, adds Hayes. “Breast milk is great stuff, but there is sugar in milk, whether that milk comes from a bottle or the breast,” she says. “If it sits around in the mouth long enough, bacteria will work at it.”

Saliva naturally protects teeth from bacteria, but our mouths tend to be drier at night. “The bacteria have a happier time without as much saliva,” Hayes explains. “A child who is nursing through the night is at more of a risk.”

Easing teething pain
Does your newborn seem fussier (and droolier) than usual? Just not quite herself? She might be teething—but, then again, she might not be. “Many moms come up to me and ask if their baby is teething,” Park says. “In general, teething doesn’t start before 3 months. If you have an irritable, fussy baby and she’s only a month or two old, it’s probably not because of teething.”

Babies typically get their first teeth around 6 months old, starting with the bottom front teeth. Teething can cause swollen gums, discomfort and sometimes a low-grade fever, but other symptoms, including diarrhea or a temperature higher than 100.4 degrees Fahrenheit, aren’t normal and should be checked out by a doctor.

When it comes to soothing teething pain, medical professionals recommend that parents avoid over-the-counter remedies. “Of course it’s stressful to see your baby irritable and fussy,” Park sympathizes. “You want to do something, and the easiest thing is to run to the pharmacy. But we advise you to try other methods first.”

Start with a cold (but not frozen) cloth or teething ring. Massaging baby’s tender gums with a clean finger can also ease her discomfort. If that doesn’t seem to be enough, ask your doctor about acetamin- ophen or ibuprofen. But don’t reach for teething tablets or numbing gels, Park says. In recent years, the Food and Drug Administration has issued warnings against both products because of potentially dangerous side effects.

But what if your baby is 6 months old— or even older—and there are still no signs of teeth? Try not to panic, says Hayes. Infants develop at their own pace, and some are just late teethers. “I’ve seen a few babies who haven’t gotten teeth until after their first birthday.”

If your baby is still toothless at 15 months, though, a dentist may want to take an X-ray, just to make sure nothing is amiss. “But late,” Hayes reassures nervous parents, “is usually OK.”

Taking a bite out of tooth decay
While it’s true that your child will eventually lose her first set of teeth, don’t be mistaken: Those baby chompers are just as important as permanent teeth, according to the American Dental Association. Baby teeth hold space in the jaw for permanent teeth to grow in properly. They also help with chewing and speaking. Plus, cavities in primary teeth can be painful and lead to increased risk for tooth decay as your child grows.

Ideally, your child’s first trip to the dentist should come no later than her first birthday. “As soon as they have teeth, they can get cavities,” notes Hayes. During that first visit, you’ll likely hold your baby in your lap while the dentist checks to make sure the teeth and jaws are developing normally. He’ll also clean the teeth and might ask questions about your baby’s diet and the family’s oral health history.

“One of my jobs is to inform the parents of where they might need to pay especially close attention,” Hayes explains. “How rigorous do we have to be with the brushing and the care, and what are we looking for if something goes wrong?”

Getting your little one used to brushing her teeth and visiting the dentist from an early age can also prevent anxiety later on. “Babies are smart,” says Hayes. “When they see you for the first time, many of them are skeptical. But I can always tell the ones whose parents have been brushing their teeth. I use a toothbrush as part of my exam, and the babies who are unfamiliar will react with surprise or dismay. The babies who have had their teeth brushed before know exactly what to expect, and that, to me, is so gratifying. I know the parents have incorporated oral health into the
new baby’s routine.”