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Cavity Risk

Prematurely born babies

Prematurely born babies can expect to have dental complications as they grow older. About 6 percent of babies are born before their due date and below 7.2 pounds, and of these, up to 70 percent will have enamel hypoplasia when their teeth erupt.

Enamel hypoplasia causes teeth to appear brownish and less smooth, as well as to be softer and more prone to decay or chipping. You won't discover this until your child is about 6 months old, because that's about the time when the baby's first tooth would erupt. Prematurely born children should see a dentist when their first tooth erupts to avoid any dental complications.

Children with the lowest birth weight and shortest gestational ages have the lowest rates of dental development, particularly before 6 years of age. Children who are born prematurely can have delays in the eruption of their baby teeth and even their permanent teeth.

The front teeth are the first to erupt at 6 to 8 months and the back teeth erupt between 18 and 24 months. Prematurely born children should visit the dentist regularly, even at this early stage, because they are more likely to be candidates for cavities than children born at term.

Cavity risk assessment

Children who develop cavities in their baby teeth are more likely to develop cavities as an adult.

So how can a parent determine if their child is at risk for cavities? It all begins with that first trip to the dentist.

• The first dental visit should include an exam to determine if the child is at low, moderate or high risk for cavities and will help decide which oral hygiene programme best suits them. Your dentist will be able to explain to you how often your child should be brushing, as well as provide flossing instructions for the child.
• Children whose parents are prone to cavities and tooth decay need to be extra careful as there's a genetic predisposition to tooth decay.
• Children at high risk for cavities should be discouraged from eating starchy snacks such as crackers and chips. In fact, one good way to determine if a snack is good for a child is to check their teeth 20 minutes after consumption. If the teeth are still filled with food, the snack should be discontinued.
• Regardless of what food is eaten, regular efforts have to be made to clean the teeth before decay can begin. This means things like brushing, flossing, rinsing after snacks and using non-sugary beverages in bottles or sippy cups.
• Essentially all children are at risk for cavities to some extent or another. So the same basic principles apply – control of exposure of cavity-inducing food and thorough cleaning of the teeth. Even if decay is a low risk for an individual child, they can still develop gingivitis or other problems if home care is inadequate.

Early childhood tooth decay risk

• Parents are aware of baby bottle tooth decay but may not know that the long- term and regular consumption of sugary liquids in a bottle or cup puts children's growing teeth at increased risk for decay.
• Fruit juice causes tooth decay if children are allowed to hold a bottle, cup or box of juice in their mouth through the day.
• If left untreated, baby bottle tooth decay can result in pain and infection. Baby teeth are important because they hold the place for permanent teeth and help guide them into correct position. Severely decayed teeth may need to be extracted, which could effect the development of permanent teeth, speech and chewing.
• Caring for children's teeth beginning in infancy promotes good oral health care habits for a lifetime and increases the chances of a child maintaining healthy permanent teeth.

• Wean a child from the bottle or breast by age 1.
• Use spill-proof cups as a transitional step in the development of children, not a long-term solution.
• Don't allow children to use spill-proof cups throughout the day. Save spill-proof cups for snack and mealtimes when increased salivary activity helps clean teeth.
• Drink sugary beverages through a straw. The best spill-proof cups to protect against decay are those with collapsible rubber straws.
• Introduce oral health care habits early. Wipe baby's gums with a damp cloth after every feeding. Introduce brushing with a soft-bristle brush and water when the first tooth appears. Parents can add a pea-sized dab of fluoridated toothpaste to the toothbrush by age 2.