Pregnancy Prenatal Care and Oral Healthcare for Children

1. Pregnancy Prenatal Care and Oral Healthcare for Children

2. My Niece…Morgan

3. Pregnancy and the oral – systemic link • The facts: • According to the National Institute for Dental and Craniofacial Research at the National Institute of Health, research has shown that since a pregnant woman shares blood with her unborn baby, any infection of the mouth - such as a cavity or gum (periodontal) disease — can affect the baby. • What this means: • Pregnant women who have gum disease may be more likely to have a baby that is premature. • It is also thought that gum disease may be implicated in fertility issues.

4. Pregnancy and oral health Changes in hormones and behaviour patterns can result in a range of problems: • Decay – from increase bacteria • Gag reflex – can compromise brushing • Erosion – wearing away of the enamel from acids such as morning sickness • Epulis – lumps on the gum • Gingivitis – swelling and tenderness of the gums • Periodontal disease – infection of the gums and surrounding bone

5. How do I increase the chances of a healthy pregnancy? A dental perspective • When preparing for, or during your pregnancy, remember to visit to your hygienist/dentist. • During your pregnancy, your teeth and gums need special attention. • Regular brushing and flossing, eating a balanced diet and visiting your hygienist regularly will help reduce dental problems that can accompany pregnancy.

6. Visit the hygienist when you are pregnant • Tell your hygienist/dentist you are pregnant. • Discuss any stresses, past/current health and pregnancy complications and medications. These factors will all influence how your hygienist attends to your needs. • A thorough examination of your teeth and gums will be carried out. A treatment plan or maintenance plan will then be recommended.

7. What if I am diagnosed with periodontal disease during pregnancy? • Treatment is safe and poses less of a risk than leaving the problems untreated. • Your dentist or hygienist might recommend scaling and root planing. This is a common procedure that meticulously removes contamination, toxins, micro-organisms, plaque and tartar from teeth and gums.

8. Can I transmit harmful bacteria that may affect my baby's teeth? • Yes. • Cavity-causing germs can be transmitted through contact — like when baby puts hands in your mouth, and then in his/her own mouth. That's why it's so important to keep your own teeth and gums healthy.

9. Children’s tooth formation • Your baby’s first teeth will begin to develop about three months into pregnancy. • At birth, a full set of baby teeth has begun to form underneath the gums. • Crown formation is not complete until well after birth. • Root formation takes even longer. • During the last trimester, the mother provides all minerals needed to calcify the baby´s teeth. • The best source of minerals is from an increased intake of calcium-rich food and drink by the mother. • The healthier your diet is, the greater the likelihood that your baby’s teeth and gums will be healthy too.

10. Anatomy of a tooth

11. Teething • A baby's first tooth usually comes through the gum between 6 to 9 months of age. • A full set of 20 primary teeth is usually present by 3 years of age. • Symptoms of teething are variable and may include: • Irritability • Mouthing of objects • Dribbling may increase • Food fussiness or refusal • Redness on cheeks • Swelling on gums • Restlessness by day, sleeplessness by night • Rashes on faces or buttocks • Management is based on symptoms shown

12. Emerging teeth

13. Eruption and loss of baby teeth

14. Tooth decay in childhood • Baby teeth can decay from the time they appear in the mouth. In fact, teeth decay more readily when they first erupt. • Babies are born sterile. They have no decay causing bacteria in their mouths. Bacteria is transferred to babies via contact. • Decay causing bacteria use sugars from foods to produce acid attacks. Each acid attack can last up to 20 minutes. • The very early stages of mineral/enamel loss are reversible. • One of the best ways to ensure your child stays decay-free is to ensure that your own teeth and gums are clean and healthy.

15. Is breastfeeding better than bottle feeding in preventing early childhood decay? • Many experts recommend breast-feeding over bottle-feeding for the overall health of your child. • However, breast-feeding can lead to Early Childhood Cavities in the same way that bottle-feeding can. • To prevent early childhood cavities: • Avoid overnight feeding, • Avoid letting baby walk around with a bottle • The Dental Association recommends that you encourage your child to drink from a cup by his/her first birthday

16. Baby bottle decay early decay moderate decay severe decay

17. Who checks children’s teeth? • Dentists - qualified to treat diseases and oral conditions that affect the teeth and gums. • Dental Hygienists – work co-jointly with the dentist. They are qualified to treat diseases of the gums and soft tissues. • Dental Therapists - work co-jointly with the dentist. They treat diseases of the teeth and gums in pre-school, primary and secondary school aged children. • You – availability means you are first line of defence.

18. Checking children’s teeth • Lap to lap technique

19. Checking children’s teeth • Lift the lip tehcnique

20. Prevention Prevention Prevention! • Take your child for regular dental visits from the first signs of teeth. Familiarization can begin even earlier. • Protect children’s teeth with fluoride. • Prioritize oral health at least twice each day. • A balanced diet is necessary for children to develop strong, decay-resistant teeth. • If you are, or planning to be, pregnant get prenatal dental care and eat a healthy diet. • Talk to your child’s dentist/therapist about sealants. They protect teeth from decay.

21. What is the best way to brush children’s teeth? • If your baby won't open their mouth when it's time to brush their teeth, then try putting a brush in YOUR mouth - babies love to mimic whatever Mum is doing! • Open your mouth wide and sing a song. They will either try to copy your singing - or they will laugh - but either way, they will have opened their mouth! • Sit your baby in the most comfortable position for both of you - try standing or sitting behind your baby as they look up. • Be gentle - it isn't necessary to brush firmly at this stage and it may just put your baby off having their teeth brushed altogether!

22. How to brush

23. Should Children Floss? • YES! • Flossing removes food particles and plaque between teeth that brushing misses. • Children should begin flossing by age 4 with assistance. • At age 8, most kids can begin flossing for themselves.

24. How to floss

26. What is fluoride and how do I know my child is getting enough? • Fluoride is one of the best ways to help prevent against tooth decay. • A naturally occurring mineral, fluoride combines with the tooth's enamel to strengthen it. • In many municipal water supplies, the right amount of fluoride is added for proper tooth development. • If your water supply does not contain any (or enough) fluoride, or your child has weakened enamel, your child's pediatrician or dentist may suggest using fluoride drops or a mouthrinse in addition to a fluoride toothpaste.

27. When should I start using fluoride toothpaste for my child? • When your child is able to spit. • Fluoride is safe and necessary to keep teeth strong, but only at appropriate levels. • Younger toddlers tend to swallow toothpaste in excessive amounts, and this may lead to fluorosis, which causes discoloration of the teeth. • And remember — even if your water is fluoridated, you still need to use fluoride toothpaste. Fluoride is necessary in both "topical" forms — like toothpaste, and "ingested" forms - like water or fluoride supplements.

28. What Should I Do if My Child Chips, Breaks or Knocks Out a Tooth? • Contact your dentist immediately. • If your child is in pain give a pain reliever. • Keep any broken pieces. • If a tooth is completely knocked out, handle the tooth as little as possible — do not wipe or clean the tooth. Ideally put the tooth back into the child’s mouth, have them tuck it into their cheek. Alternatively, store the tooth in water or milk until you get to your dentist.

29. Is it ok that my child sucks his/her thumb? • Thumbsucking is normal for infants • Most stop on their own by age 2 • If your child sucks his/her thumb beyond age 2, try to discourage it by age 4 • Thumbsucking beyond age 4 can lead to crooked, crowded teeth and/or bite problems

30. Dental concerns facing children born prematurely • Evidence shows that children who are born prematurely are more prone to develop dental problems. • Baby teeth are most vulnerable however, secondary teeth can also be affected. • Most often seen are: • Delayed tooth eruption • Enamel defects • Tooth discolouration • Greater risk of tooth decay • Palatal grooves • Over crowding

31. Dental advice for children born prematurely • Let your dentist/therapist/hygienist know that your child was born prematurely. • Visit your dentist/therapist/hygienist religiously • Like with all children (and adults) it is all about PREVENTION • Incorporate fluoride • Provide a nutritious diet • Minimise snacks between meals • Clean or brush children’s teeth/mouth after meals • Follow your dentists recommendations • Don’t share eating implements

32. How do I encourage kids to be partners in their oral health? • http://www.youtube.com/watch?v=2QMogM6TRIQ&feature=related • Kids love to mimic what their parents are doing • Make it fun with games • http://www.colgate.com/app/BrightSmilesBrightFutures/US/EN/Kids/Games.cvsp • Positive reinforcement • http://www.colgate.com.au/app/Colgate/AU/OC/Information/InteractiveGuides/EveryAge.cvsp

33. My advice to you • All women, either pregnant or considering pregnancy should have a full oral health examination. • The guidelines maintain that diagnosis and treatment, including x-rays, can be undertaken safely during pregnancy. • Dental treatment should be co-jointly managed by prenatal and oral health care providers. • Elective treatment can be deferred until after delivery. • Don’t delay in obtaining necessary treatment, it could result in significant risk to you and baby alike.

34. Use a gentle toothbrush • Brush teeth twice daily • Use a fluoride toothpaste • Floss daily • Limit foods containing sugar to mealtimes only • Choose water or low-fat milk as a beverage • Choose fruit rather than fruit juice • Use a teaspoon of baking soda in a cup of water as a rinse or a mouthwash after vomiting • Chew sugarless or xylitol-containing gum after eating