Children’s Oral Health Services
Early Childhood Tooth Decay (ECTD)Dental Services, Middlesex-London Health UnitEarly Childhood Tooth Decay (ECTD) is also known as Baby Bottle Tooth Decay, Nursing Bottle Mouth as well as some other names.
Early Childhood Tooth Decay (ECTD) is seen as cavities especially in the upper front teeth of infants and young children.
The cavities are seen shortly after the teeth erupt, sometimes in children as young as 9 months.
Due to the child’s age and the extent of the decay, it often requires special and expensive dental treatment.
It is ENTIRELY PREVENTABLE. The decay usually results from unhealthy feeding practices by the parent(s), (People use food and drinks, particularly in bottles, to quiet or comfort the child).
All liquids (excluding water but including milk, formula, unsweetened juices) contain some sugar. This sugar combines with some bacteria in the mouth to make acid which dissolves the teeth.
DO NOT put your child to bed with a bottle or sippy cup. If the child must have one, use ONLY water in it.
DO NOT DIP soothers in sugar or sweetened substances like honey, syrup.
Teeth may be cleaned with a toothbrush and water. For children under 7 years, use a fluoride toothpaste only twice per day and use only a small amount (pea size or smear). Use a non-fluoride toothpaste from birth to age 3.
Parental Example – set a good example for your children with your own mouth cleaning.
“Clean” the teeth regularly, as soon as they erupt. They should be cleaned at least twice daily.
Babies usually switch from bottles to drinking or sippy cups around one year of age. Do not use bottles or sippy cups (or food) to “quiet” the child. Feeding should occur for a specific period of time. Do not allow your child to become a “bottle walker” (walk around with a bottle or sippy cup). Except for water, it is the liquid in the bottle/sippy cup that may cause tooth decay. The chances of tooth decay increase when bottles/sippy cups are used often and for longer times.
Lift the child’s lip regularly to check the teeth and gums. If you see any chalky, white spots or brown spots, visit the dentist immediately.
Important Dental Ages:
1 year old: The child should have stopped using a bottle around one year of age.
3 years old: All the child’s first teeth should be in the mouth. No later than 3 years of age, the child should have visited the dentist.
The dental literature indicates that there is some concern about the effects on the formation of children’s teeth if excessive amounts of fluoride from toothpaste are swallowed . Some dental fluorosis may occur.
The appearance of dental fluorosis may vary from small white flecks to larger white areas or in some cases to pitting or brown areas. It is difficult to predict if fluorosis will occur and what it will look like. It is important to note that fluorosis occurs while the teeth are forming below the gums [usually during ages 0-6 years], not after the tooth erupts into the mouth.
The Health Unit recommends:
“Clean” your child’s teeth as soon as they appear in the mouth.
Use a small, soft toothbrush (it may be further softened by running it under hot water).
Use a NON-FLUORIDE toothpaste, or no toothpaste, until the child is 3 YEARS OLD unless a dental professional advises differently.
If the FLUORIDE LEVEL naturally occurring in the water is OVER 1.5 MG/L (PPM), continue to use a NON-FLUORIDE TOOTHPASTE until the child is 7 YEARS OLD. Check with the Middlesex London Health Unit for “Elevated Fluoride Recommendations”. There are only a few communities in Middlesex County with these levels (eg. Granton, Thorndale). However, persons with private wells must check their fluoride levels.
Beginning at 3 YEARS OF AGE, use a FLUORIDE toothpaste but only 2 TIMES PER DAY.
Brushing should take 2 minutes. (“2 for 2” – Brush at least twice daily for 2 minutes each time).
Always use only a PEA SIZED amount of toothpaste (or smear). Teeth may be cleaned more frequently than 2 times without fluoride toothpaste.
The Health Unit suggests that parents dispense the toothpaste and supervise or do the brushing until the child is 7 years old.
Children should be encouraged not to swallow toothpaste, to SPIT OUT EXCESS TOOTHPASTE and RINSE well after brushing.
If children 6 and under swallow too much fluoride, their permanent teeth that are forming may develop some dental fluorosis (white spots and areas).
These may be difficult to locate and are far more expensive. Health food stores generally have non-fluoride toothpastes. Larger pharmacies may carry some brands (eg. Early Years, Kidz Pre Step, Tom’s of Maine).
No later than 3 years of age (earlier if problems are noted) the child should begin dental visits and continue at least yearly. Parents should regularly “lift the child’s lip” and look for any dental problems.
For more information call Dental Services at the Middlesex-London Health Unit at 663-5317, ext. 2231.
Sealants are used almost exclusively on the biting surfaces of posterior, or back teeth. These areas are especially vulnerable to cavities because these teeth see the bulk of chewing duty, and their surfaces are so irregular. They are usually covered with pits, fissures, indentations, and small cracks which tend to retain food and conceal plaque deposits.
The sealant material is a durable plastic adhesive that fills in these irregularities, making it much more difficult for cavities to develop.
Before sealants are applied, a thorough examination of the teeth must be done. The surfaces of the teeth must be free of decay, and the teeth themselves must be viable candidates for the sealing process. It is recommended that the sealant be applied as soon after the teeth erupt as possible, to prevent the development of any decay.
The procedure begins with the teeth being thoroughly cleaned and dried. An etching gel is then applied to the fissures and enamel immediately surrounding the area for thirty to sixty seconds.
The sealant material is then simply painted onto the surface of the tooth. Once in place the sealant is polymerized, or hardened, with a high-intensity light source.
The procedure is absolutely painless, and only takes about three minutes per tooth. Applying the sealant can almost ensure that the treated teeth will remain cavity-free for a very long time.
Source: Discuss Dental, Patient Education.