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Recommendations for the Infant’s Oral Health
Oral health risk assessment
Every infant should receive an oral health risk assessment from his/her primary
health care provider or qualified health care professional by 1 year of age. This
initial assessment should evaluate the patient’s risk of developing oral diseases
of soft and hard tissues, including caries- risk assessment, provide education on
infant oral health, and evaluate and optimize fluoride exposure.
Dental visit
Parents should take the infant to the dentist by 1 year of age.
The initial visit should include thorough medical (infant) and dental (parent and
infant) histories, a thorough oral examination, performance of an age-appropriate
tooth rushing demonstration and prophylaxis and fluoride varnish treatment if indicated.
In addition, assessing the infant’s risk of developing caries and determining a
prevention plan and interval for periodic reevaluation should be done. Infants should
be referred to the appropriate health professional if specialized intervention is
necessary. Providing anticipatory guidance regarding dental and oral development,
fluoride status, non- nutritive sucking habits, teething, injury prevention, oral
hygiene instruction and the effects of diet on the dentition are also important
components of the initial visit.
Teething
Teething can lead to intermittent localized discomfort in the area of erupting primary
teeth, irritability and excessive salivation; however, many children have no apparent
difficulties. Treatment of symptoms includes oral analgesics and chilled rings for
the child to “gum”.
Use of topical anesthetics, including over-the-counter teething
gels, to relieve discomfort are discouraged due to potential toxicity of these products
in infants.
Non-nutritive habits
Non-nutritive oral habits (eg, digit or pacifier sucking, bruxism, abnormal tongue
thrust) may apply forces to teeth and dentoalveolar structures. It is important
to discuss the need for early sucking and the need to wean infants from these habits
before malocclusion or skeletal dysplasias occur.
Oral hygiene
Oral hygiene measures should be implemented no later than the time of eruption of
the first primary tooth.
Cleansing the infant’s teeth as soon as they erupt with a soft toothbrush will help
reduce bacterial colonization. Tooth brushing should be performed for children by
a parent twice daily, using a soft toothbrush of age-appropriate size. Flossing
should be initiated when adjacent tooth surfaces can not be cleansed with a toothbrush.