Do newborns need oral care?

September 05, 2022

The first tooth in a child's mouth erupts by 6 months of age. This is the time when the parent should take the child for his or her first dental visit. However, it should be kept in mind that oral care is not restricted to teeth. A dentist deals with all oral structures in the mouth, including the tongue, gums, ridge, floor of the mouth, and palate. In an infant, even before the teeth erupt, parents should at least once schedule an appointment with a pediatric dentist (pedodontist) who would guide them in maintaining appropriate oral care before the eruption of teeth. This is done in order to avoid the growth of decayed teeth and to ensure that the parents are well-educated about the importance of their child's oral hygiene.

Education of the parents regarding their child's oral cavity from infancy to adulthood is called anticipatory guidance. This education for the parents starts even before the birth of the child. It is well established in dental science that the mother's oral hygiene status is transmitted to the child. If the mother has multiple teeth with high caries,  the causative organism can be transferred to the child during pregnancy and lead to subsequent caries when the child develops his/her dentition. In order to avoid this,  apart from the usual oral hygiene measures,  the mother is asked to consume products containing xylitol. This sugar-substitute reduces the levels of the main causative organism responsible for caries.

Following the birth of the child, the parents are advised to maintain proper oral care of the child's mouth. The ridge on which the future dentition will erupt is to be wiped or cleaned with a cloth regularly. Even the gums should be cleaned with this technique. Wipes Co training xylitol can also be used. In order to reduce the spread of bacteria, parents are advised to keep the child's utensils and cups separate from theirs.

In some cases,  a tooth is already seen in the baby's mouth after birth. Sometimes this particular condition can be seen within 30 days of the child's birth. Extraction of this tooth should be deemed appropriate after 10 days. This is because the child might swallow the tooth as they are usually loose in the mouth and also because it is only after 10 days the factors responsible for the blood's clotting are adequately produced in the body.

When the first tooth erupts in the oral cavity, it is called teething. Teething might be irritating or painful for the child for some days. The child may act restless and there might be itching near the ears. Cold teethers can be used to temporarily reduce the pain. Parents can use gentle pressure by applying the surrounding gums to relieve pain. Application of local anesthetics and consumptions of pain killers should be done only after the pediatric dentist's consent.

Soft silicon toothbrushes can be used to brush the child's teeth. A smear of fluoridated toothpaste should be used for this. Cavities on deciduous teeth can occur if there is improper maintenance of oral hygiene or insufficient nutrition provided to the child. Weaning, or the switch from mother's milk to semisolid foods should take place at approximately 6 months. Feeding through bottles at night time before the child goes to sleep should be strictly prohibited. Bottle feeding should be discontinued after 1 year and consumption should occur through cups. Parents should be told about the detrimental effects of sugar and balanced diet. Consumption of soda can cause erosion of primary teeth and thus their intake should be minimal.

As the other deciduous teeth erupt,  parents are counselled about the ill-effects of prolonged abnormal oral habits. These include to tongue thrusting, thumb sucking, mouth breathing, lip biting, etc. These habits can lead to malocclusion of teeth and change in facial morphology if continued for a longer period of time. Pacifier sucking is discouraged.

It has been a practice to add sweeteners or flavoring agents to make the medicines acceptable for the child's taste. Most of these syrups are consumed at night as well. Sweetening agents when left in the oral cavity for a prolonged period add to the activation of the carious process. Hence,  these medications should be avoided. Parents are advised to wipe their child's oral cavity once he or she consumes these medications.

Oral care for the newborns is thus not restricted to teeth. It is important to bring to the parents' notice regarding the ill-effects of detrimental and neglected oral care in the young infant.

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