Dental Health Tips and Visits for Pregnant Mothers, Toddlers, and Children.

The Best Trips to the Dentist Get an "All Clear" Report!

"Dear Dr. Reifman, Thank you for making my daughter, Dharma, feel comfortable during her first visit with you. You and your staff were very personable and accommodating. I researched dentists with updated methods, while offering the least invasive, toxic treatments. What I loved about the pediatric office Dharma went to, was that it was very child-centered. However, I found that forward-thinking techniques were not to be found. My concerns about excessive x-rays and amalgams were minimalized. I look to professionals for their expertise. I welcome your input and direction for my daughter's dental health. Thank you again." Kesa Ryono — Port Hueneme, CA

Professional Dental Care — When is the best time to have dental work done if you're pregnant?

The 4th to 6th months of pregnancy may be the most comfortable time for you to visit your dentist, since few concerns of pregnancy occur during this period. A dental check-up and cleaning during your pregnancy can find and treat problems before they become serious. Women who are free of serious gum disease are less at risk for having a premature or low birth weight baby.

An Important note from Dr. Reifman... If you haven't had a dental cleaning from your dentist or hygienist for awhile, and you are pregnant, please consider making an appointment! A proper, thorough, gentle teeth and gum cleaning, especially during your 2nd trimester, will substantially reduce possible gum disease and accompanying oral gum infections to yourself, and will make your body a much healthier environment for your growing baby.

#1: How should I care for my child's teeth at home?

Start brushing your child's teeth as soon as they come in. Brush your child's teeth for the first 4 to 5 years, until the child seems able to do it alone. A good teaching method is to have your child brush in the morning and you brush at night until he or she masters the skill.

Use disclosing tablets from time to time to see if any plaque (the soft, chalky material near the tooth and gums, and which contains lots of bacteria) is left on the teeth after brushing. Disclosing tablets are chewable and will color any plaque left on the teeth. They are available at most drugstores.

When brushing your child's teeth, use only a small amount of toothpaste, about the size of a small pea. It is important that a child not swallow too much fluoride.

If your local water supply does not contain enough fluoride, your child may need fluoride supplements. Discuss this with your dentist.

Do not put an infant or small child to bed with a bottle of juice or milk. The sugar and acids in these liquids can cause tooth decay. Nursing an infant to sleep is safe, however.

Start flossing your child's teeth as soon as they touch each other. Flossing tools may be helpful.

Do not give mouthwashes that contain alcohol to children. Children with a lot of cavities may start using a mouthwash that contains fluoride when they are around 6 years old. However, they will need to be watched so that they do not swallow it.

What causes a cavity in my child's mouth?

Your mouth is a busy place. Bacteria - tiny colonies of living organisms are constantly on the move on your teeth, gums, lips and tongue. Having bacteria in your mouth is a normal thing. While some of the bacteria can be harmful, most are not and some are even helpful.
Certain types of bacteria, however, can attach themselves to hard surfaces like the enamel that covers your teeth. If they're not removed, they multiply and grow in number until a colony forms. More bacteria of different types attach to the colony already growing on the tooth enamel. Proteins that are present in your saliva (spit) also mix in and the bacteria colony becomes a whitish film on the tooth. This film is called plaque, and it's what causes cavities.

What about sugar?

Sugar plays a harmful role in tooth decay. The bacteria that form together to become plaque, use sugar as a form of energy. They multiply faster and the plaque grows in size and thickness. Some of the bacteria turn the sugar into a kind of glue that they use to stick themselves to the tooth surface. This makes it harder for the bacteria to get washed away with your saliva.

#3: Dental Care For Toddlers

Your toddler should have all of his or her first set of teeth ("baby" teeth) by three years of age. Twenty teeth should appear - 10 in the top jaw and 10 in the bottom jaw. Baby teeth are very important. When teeth first come in they are not fully hardened and may decay easily. Some baby teeth are not replaced by permanent teeth until age 12 or 13. Healthy baby teeth will help your toddler look good, eat well and learn how to speak clearly. The baby teeth also guide the permanent teeth into their correct position.

#4: Diet and tooth decay

Tooth decay is caused by bacteria on the teeth. The bacteria use starches and sugars from foods to produce acid that can break down tooth enamel and cause tooth decay. Your toddler's teeth are at risk for decay if they are still drinking from a bottle filled with anything other than water, especially during rest and sleep periods. The risk is the same if your toddler walks around with a bottle, drinking box or sipper cup during the day. Fruit juice, sweetened tea, pop and even breast milk, cow's milk and formula all contain sugars that can cause tooth decay if left in contact with the teeth for lengthy periods of time. For information on breaking your toddler's bottle habit, contact the dental staff at your local health unit.

Two of the most important factors related to tooth decay are: how often food is eaten, and how long food stays on the teeth. Offer your toddler snack foods such as vegetables, fruits and dairy products.

Follow the 3-Step Snacking Guide for snacks between regular main meals:

• Choose healthy snacks
• Offer 2-3 snacks per day
• Vary your daily snack choices

What about fluorides?

Fluoride is a proven effective and low cost cavity fighter. Fluoride is added to most brands of toothpaste, and is found naturally in some water supplies. Many major cities in the United States add a small amount of fluoride to their drinking water to raise the natural level to between 0.8 and 1.0 parts per million. This level is recommended for preventing tooth decay in all age groups. If you are unsure if your water supply contains optimum fluoride, call your dentist.
When fluoride comes in contact with the tooth surface, it makes the tooth enamel stronger and more resistant to decay. That's why using fluoride toothpaste twice a day is so important in preventing tooth decay. Although many children get enough fluoride from using fluoride toothpaste twice a day, some children who are at high risk for tooth decay may need additional fluoride. Contact your dentist or health unit staff for further information if you are concerned that your child is at high risk for tooth decay.

Preventing tooth decay

Brush your toddler's teeth for them using a fluoride toothpaste twice a day, in the morning and before going to sleep at night. Use a "pea-sized" amount of toothpaste on a soft bristled, child-sized toothbrush. It's a good idea to gently brush your child's tongue to remove bacteria that forms there. Parents need to brush their children's teeth until at least 6 years of age.

What about soothers?

Soothers are not recommended for toddlers once their complete set of primary or "baby" teeth have grown in. This usually happens by age three. Regular use of a soother after this time may affect the child's speech development and the normal development of the mouth and jaws. To “wean” your toddler off their soother, try limiting soother use to rest and sleep times and gently removing it from their mouth after your child is asleep.

When should my child go to the dentist?

Regular dental visits should begin before age 3. If you have a concern about your toddler's teeth make an appointment to see a dental professional even if your child is very young and only has a few teeth. Your child's first dental visit is a good time to discuss daily mouth care, eating habits and fluoride.

Good Food, Healthy Teeth

We have all heard that sugar is bad for teeth. Why is this so? It's because when your child eats or drinks sugars, the germs (bacteria) in your child's mouth MIX with the sugars to make a mild acid. This acid attacks the hard outer layer of teeth (also called enamel). It can make holes (or cavities) in the teeth.

Unsweetened fruit juice may have no ADDED sugar, but fruit juice has natural sugars in it. If your child is always sipping juice between meals, the teeth are being coated in sugars over and over again. Water is the best drink to have between meals. Starchy foods, like teething biscuits, break down to make sugars. If these kinds of food stay in your child's mouth long enough, they will make the acid that can cause cavities. Your job is to CLEAN your child's teeth, NOT to stop your child from having milk, juice, bread or noodles. Your child NEEDS these foods to stay healthy.

Read the labels of the packaged food you buy. By law, everything that's in the food is listed by weight. So if a sugar is listed first, you know that there is more sugar than anything else. These are sugars you can look for on labels: corn sweeteners, corn syrup, dextrose, fructose, glucose, honey, maple syrup, molasses, sucrose.

Also, check to see if liquid medicines (such as cough syrup) have sugars. Ask your doctor or pharmacist to give you medicines that are sugar-free.

Snacks

Growing children need and like snacks. Here are some smart ways to give snacks:

• Limit the number of times a day your child eats or DRINKS sugars. If your child sips juice or pop while playing, he or she will have sugars in the mouth over and over again. Water is the best drink to have between meals.
• Do not give your child sugar-rich foods that stay in the mouth for a long time like gum with sugar in it, suckers (or lollipops) and other hard candy. Stay away from soft, sticky sweets that get stuck in the mouth such as toffee, raisins and rolled-up fruit snacks or fruit leather.
• Keep good snacks handy, where your child can get them. Have carrot sticks or cheese cubes on the bottom shelf of the fridge. Children like small things like small boxes of cereal, small fruits and vegetables, and small packs of nuts or seeds (provided they are safe for your child). Keep them in a low cupboard.
• To keep your child from asking for sweets, do NOT buy them. If they are not in the house, you can't give them out. If you do serve sweets, limit them to meals. When your child is eating a meal, there is more saliva in the mouth. This helps to wash away the sugars.

Pregnancy & Oral Health

Newsflash: Good Oral Health Begins in the Womb

CHICAGO — Pregnant women can help ensure their children get a good start on their oral health by focusing on staying healthy, including a proper diet, because teeth begin developing between the third and sixth month of pregnancy, says the American Dental Association (ADA).

Taking good care of yourself during pregnancy affects not only your own health but also the health of your baby.

Did you know that... some women have sore, bleeding gums during pregnancy?

Daily brushing and flossing, a healthy diet and regular dental visits will keep your teeth and gums healthy during and after pregnancy.

Some people believe that a tooth is lost for every pregnancy. This is not true.

Professional dental care — When is the best time during a pregnancy?

The 4th to 6th months of pregnancy may be the most comfortable time for you to visit your dentist, since few concerns of pregnancy occur during this period. A dental check-up and cleaning during your pregnancy can find and treat problems before they become serious. Women who are free of serious gum disease are less at risk for having a premature or low birth weight baby.

Are x-rays safe?

If you are pregnant, you can postpone routine dental x-rays until after your baby is born, to reduce radiation exposure. If x-rays are needed, our dental office will provide a leaded apron to shield you.

Are local anesthetics and medicines safe?

It is wise to avoid taking drugs or medications of any kind while you are pregnant. However, if you need emergency dental treatment, certain drugs may be required. They are generally considered safe, but you should discuss their use with your dentist and physician.

Diet and dental health for you and your unborn child

The amount of food you need every day depends on your age, body size and activity level. Remember, your baby's first teeth begin forming in the 5-6th week of pregnancy, so...

• Enjoy a variety of foods from the four food groups: grain products; vegetables and fruit; milk products; meat and alternatives.
• Eat regularly: three meals and two or three healthy snacks every day.
• Eat a balanced diet. The four food groups provide the necessary nutrients for you and your unborn baby need.
• Talk to your doctor or health unit staff about choosing a prenatal vitamin and mineral supplement.
• Brush your teeth at least twice a day with a fluoride toothpaste. Tooth decay is affected by how often you eat, and how long the food stays on your teeth.
• For further information consult the dental staff and nutritionist at your health unit.

Morning sickness and Dental Problems

Nausea and vomiting can happen during pregnancy, caused by hormonal action, tension and/or fatigue. This feeling usually occurs during the 8th to 12th week of pregnancy. Frequent vomiting can leave stomach acids in your mouth. If this acid is not cleared away quickly, it can damage the surfaces of your teeth and promote tooth decay.

Some helpful suggestions

Try eating unsalted crackers or dry toast as a snack before getting out of bed in the morning. It may also help to get out of bed slowly. Rinse your mouth with water, or use a fluoride mouth rinse after vomiting, to freshen your mouth and protect your teeth from the damaging action of stomach acids. Notify your doctor if vomiting persists or if you become concerned.

Tender or bleeding gums

Hormonal changes occur during pregnancy that can affect the gums. The gums may become swollen and inflamed in response to bacteria along the gum line. This is called "pregnancy gingivitis". It usually appears during the third to ninth month of pregnancy. To prevent pregnancy gingivitis, it’s important to brush your teeth at least twice a day and to gently brush along the gum line.

What can you do to help:

• Keep your mouth squeaky clean.
• Brush your teeth at least twice a day using a fluoride toothpaste.
• Floss daily to remove plaque and food debris from between the teeth.

Other ways to stay healthy

Don't smoke or drink alcohol during pregnancy. The more you smoke, the more likely you are to experience problems with your pregnancy. Scientific evidence links smoking to miscarriages and low birth weights for infants.

There is no known safe level of alcohol use during pregnancy. It has been shown that women who drink while pregnant can have babies with physical and mental defects.

Women who find it difficult to stop smoking or drinking alcohol can contact their physician or their local health unit for assistance.

Eating Disorders

These are more prevalent in women. People with bulimia make themselves vomit up stomach acid that erodes enamel surfaces, weakening and discoloring tooth structure. Usually most of the damage is done to the back of the front teeth. Thinning of enamel by the acid makes tooth color appear gray or brownish as opposed to white and creamy. While frequent brushing and rinsing the mouth with water helps, it does not neutralize the acid exposure if frequent.

A neutral fluoride mouth rinse or antacid may be recommended by your dentist. Women with such disorders need to seek professional help (though a dentist can help treat certain among the physical symptoms).

Diet pills reduce salivary flow that can lead to tooth decay and gum diseases. Without saliva lubricating and neutralizing the mouth, the teeth and the gums are exposed for a longer time to food particles that stick to them. To minimize this risk, increase flossing and brushing, and drink extra water along with using a daily fluoride mouth rinse.

Dental Procedure May Reduce Risk Of Premature Birth

CHICAGO – A non-surgical dental procedure may reduce the risk of preterm birth in pregnant women with periodontal disease,* according to new study findings. Nearly 12 percent of babies in this country are born preterm (before 37 completed weeks of pregnancy), which increases their risk of death and lasting disabilities, such as mental retardation, cerebral palsy, lung and gastrointestinal problems, and vision and hearing loss.

*Periodontal disease, also known as gum disease can include bleeding or swollen gums, manifests itself as more pronounced in women who are pregnant. Dr. Reifman's dental office is very proud to have Jodi Greene, a registered dental and perio hygienist who gently and carefully treats pregnant women who may have gum disease.