Oral health seems very important to us in Babies and more, and that is why we wanted to bring our readers a interview with Manuella Surette, specialist in Preventive and Maternal-Child Dentistry, which has been working for 15 years with child prevention and for eight years more directly with pregnant women and babies.
In the first part of our interview we focus on the oral health of children and caries problems in babies, what they may be due to and, above all, how to prevent them.
We know that many of the consultations he attends each week are cases of babies with cavities. What can be caused by tooth decay in babies? How can they be prevented?
Caries is one of the most prevalent diseases in childhood. It is infectious-contagious, then transmissible and therefore preventable. First of all it is important to know that caries is also multifactorial, that is, to exist, it depends not on one factor, but on several. Dentre these factors have those that are determinants (without which decay is not made) and predisposing (which contribute to its development). Caries is the result of an imbalance between the three determining factors: the host (individual), the oral bacterial flora and the substrate (diet). So to exist caries it is necessary for the individual to be susceptible, have responsible bacteria in their mouths and "feed them". Let us think about how we can act in the prevention of this imbalance:
Made this small but relevant introduction, let's talk about what happens in babies. The majority of women are not aware of how important it is to go to the dentist when they are pregnant and therefore, the delay in bacterial contamination by salivary transmission already escapes us. So we have still very small contaminated babies with very aggressive bacteria.
The other factor is that they are not aware of the importance of oral hygiene of the baby and that any fermentable food (be it rice milk, breast milk, cow's milk, or cookies), can cause tooth decay. As we do not know if the baby is susceptible or not, it is receiving a bacterial load since childhood, it is feeding on fermentable substances and we are not doing good hygiene, or even none, we have destabilized the tripod (guest, bacteria, substrate) and we have Than to trust in luck. Or rather, we are taking a risk! We add to this a crucial detail: the erupting teeth, that is, when they come to the mouth, the enamel maturation is not yet finished. So they are, we would say, easy victims.
In this sense, are there differences between breastfed babies and bottle-fed babies?
Any fermentable food has the potential to generate tooth decay, what we call cariogenic food. But it is important to contextualize. From birth to six months, the baby feeds exclusively on milk. In the breast is breast milk, and in the bottle can be breast milk, cow, goat, rice, oatmeal, infant formulas, etc ... In this sense it is important to differentiate cariogenic potentials. If we are going to compare maternal, cow and artificial milk, artificial milk is the one that has the most potential for caries, followed by breast milk and cow's milk.
In its origins, Early Infant Caries (CTI) was baptized as bottle caries because they were frequent in children who took bottles containing some sweet liquid inside, including juices. It was thought at that time that this type of extremely acute caries, in such young children, was only associated with the intake of sweet liquids in bottles. With the passing of time it has been seen that infants in general could present it, even breast-fed babies.
The following factors are quite clear today: In this sense, children who are breastfeeding on demand and at night are the ones who are most at risk of developing cavities, whether breastfeeding or bottle feeding. But in general, bottle feeding usually has regulated schedules and breastfeeding is usually on demand. It is not about judging anyone and saying that it is the right thing, even because there are mothers who have not been able to breastfeed ... but it is about being preventive.
I would like to clarify that I am prolactance, and if we have a stage in which we are going to go through a situation of greater risk, we must strengthen the other side of the balance!
One last observation: although it is true that in the first months the nipple is stretched reaching almost to the baby's throat avoiding, so that the milk remains stagnant in the mouth and therefore making the possibility of decay almost null, it is also It is true that children grow up, their skull increases greatly in volume in the following months and therefore the nipple-throat ratio is altered, leaving the nipple halfway behind the upper incisors where the first lesions of STI usually appear .
From what age is it advisable to wash the mouth of children?
Having seen the above, after the first teeth are born (over six months), we should stimulate the baby's mouth. I suggest that after the bath to associate it with HYGIENE.
With the clean hand we make circular movements inside the mouthpiece and so it gets used to the touch. A few days after the initial stimulus, we can start using gauze to clean the first teeth, pressing against them. It is important to do it daily and remember that it is not a game, but a conscious hygiene, because you already know the importance of this!
Should a special toothpaste be used for children? Is it advisable to use dental floss in children?
Toothpaste is not essential and I do not recommend it if it is not necessary. The most important thing in dental hygiene, both in babies, as in older children, as in adults, is the pressure and rub that we exert on the teeth. But some children like it, so the recommendation is that until they know how to spit, the paste should NOT contain fluoride. The amount of toothpaste for children with more than two years is a grain of rice, and with more than five years a pea granite. I am used to saying that in the dentition of milk the dental floss is almost more important than the brush. The vast majority of decay in temporary dentition occurs between the teeth. So from the exit of the second milk wheels (over two and a half years), we must use the floss between all the teeth that touch each other.I recommend that even if you use fluoride-free toothpastes, let's educate you to spit to generate the habit of not swallowing.
We really liked learning about these interesting topics, and tomorrow we will return with the second part of the interview with Manuella Surette in which we delve into new issues related to the oral health of children and pregnant women.
