Oral Hygiene and Diet
Prevention is always better than cure. Therefore, maintaining good oral hygiene habits greatly reduce the likelihood of having cavities and of contracting periodontal disease. We encourage parents to continue to learn about their child’s oral health. Click here for a list of suggested dental professionals.
All dentists recommend following the guidelines set forth by the American Dental Association (ADA) to prevent dental caries. Dental caries, also known as cavities or tooth decay, is the leading cause of tooth loss and tooth-related pain. According to the ADA, all children should follow these general oral healthcare guidelines:
- Eat a healthy, balanced diet and reduce between-meal snacks.
- Brush twice a day with ADA-approved toothpaste that contains fluoride.
The process of cleaning your child’s mouth should start even before the arrival of any teeth. The ADA recommends that you “wipe” your infant’s gums, tongue, and inside of their cheeks after each feeding or at least twice a day. Once the teeth erupt, start using a small, soft-bristled tooth brush. For most infants and toddlers, the recommend using a “smear” of non-fluoridated toothpaste. Your dentist will recommend use of fluoride toothpaste based on your child’s risk of developing cavities.
Dental Caries (Cavities)
According to the Centers for Disease Control, “tooth decay (dental caries) affects children in the United States more than any other chronic infectious disease. Untreated tooth decay causes pain and infections that may lead to problems such as difficulties in eating, speaking, playing, and learning.”
Caries is an infection of the teeth. The cause is a specific bacteria such as Streptococcus mutans. These bacteria invade the oral cavity (mouth) and use sucrose (sugar) present in certain types of foods to produce damaging products (acids). These acids cause destruction and break down tooth structure. When a baby is born, he or she is normally free from infection from these bacteria. They can however get infected very quickly if they are exposed to the saliva of the mother/caregiver who has a high level of these bacteria in his/her mouth due to the presence of poor oral hygiene and/or cavities. This exposure can occur when a parent kisses the hands of the child who then puts the hand in their mouth, or tasting the child’s food, pacifier contamination, etc. It is therefore important for the main caregiver of the child to maintain good oral health, too.
It is very important to brush and clean your child’s teeth, especially after night time feeding.
It is very important to brush/clean your child’s teeth, especially after night time feeding. In addition, it is important to not allow your child to go to bed with a bottle. Baby bottle syndrome, or rampant caries, frequently affects the front teeth of children with poor oral hygiene and prolonged exposure to sugary drinks. This is especially important for children with Down syndrome due to the delayed eruption of permanent teeth. Your child may retain their primary (baby) teeth for several years past the typical time frame.
Baby Bottle Syndrome and Rampant Caries
A well-balanced diet is optimal for your child’s tooth development and overall wellness. According to the American Academy of Pediatric Dentistry, night time bottle feeding with juice, repeated use of a sippy or no-spill cup, and frequent in between meal consumption of sugar-containing snacks or drinks (e.g., juice, formula, soda) increase the risk of caries. Frequent ingestion of sugars and other carbohydrates (e.g., fruit juices, acidic beverages) and prolonged contact of these substances with teeth are particular risk factors in the development of caries. Along with increasing caries risk, increased consumption of sugar-sweetened beverages and snack foods also has been linked to obesity.
Children with Down syndrome may require daily medications. Numerous over-the-counter and prescribed oral liquid medications have a high sugar content to increase acceptance by children. If given at bedtime, it is important to give these medications before brushing your child’s teeth.
To motivate children to consume vitamins, numerous companies have made “jelly,” “gummy,” and “candy-like” chewable vitamin supplements. These are a source of sugar, and parents should perform oral hygiene after consumption. Additionally, cases of vitamin A toxicity have been reported as a result of excessive consumption of candy-like vitamin supplements.
Periodontal Disease (Gum Disease)
Research has shown that individuals with Down syndrome are more prone to gum disease. It is therefore extremely important to maintain excellent oral hygiene at home. Also, discuss with your dentist the option of more frequent “preventive” appointments for your child.
The use of fluoride helps reduce cavities. A small pea-sized amount of fluoride toothpaste is sufficient for children between the ages of 2 and 6 years. Children under 2 years should not use fluoride toothpaste prior to consulting their dentist and performing a caries risk assessment. Most water systems are fluoridated, and fluoride works both systemically (drinking) and topically (brushing). Therefore, it is very important to be aware of your child’s fluoride intake. As with anything, too much of a good thing can be harmful.
Too much fluoride can cause dental fluorosis, which is a permanent discoloration of otherwise healthy teeth. The discoloration occurs during the formation of the tooth, which is well before eruption. According to the CDC, children over 6 years old are past the age that fluoride ingestion can cause cosmetically objectionable fluorosis. This is because only certain posterior teeth are still at a susceptible stage of enamel development, and these will not be readily visible. In addition, the swallowing reflex has developed sufficiently by age 6 years for most children to be able to control inadvertent swallowing of fluoride toothpaste and mouth rinse.
Fluoridated Drinking Water
Studies show that water fluoridation reduces tooth decay by about 25% over a person’s lifetime.
Fluoride therapy reduces tooth decay and strengthens the existing tooth structure. The fluoridation of drinking water has had a strong impact on the reduction of caries. Water fluoridation prevents tooth decay mainly by providing teeth with frequent contact with low levels of fluoride throughout each day and throughout life. Even today, with other available sources of fluoride, studies show that water fluoridation reduces tooth decay by about 25 percent over a person’s lifetime. New moms need to read the label of infant formulas to determine the amount of fluoride in the formula and if fluoridated or non-fluoridated water should be added.
Most community water systems are fluoridated and information regarding fluoride levels can be obtained from the billing office. Some bottled water has fluoride added and some do not. Single-family well owners can have their water tested for fluoride at a laboratory. Local health departments can usually guide you in this process. Click here to visit the CDC’s website that can be used to determine your water fluoride level.