Healthy teeth for children

Healthy teeth for children

When will my baby’s teeth appear?

Healthy teeth are an important part of your child’s overall health. Helping your child develop good oral health begins at birth.
The first primary (or “baby”) tooth usually comes at about 6 months, but it isn’t unusual for teeth to appear as early as 3 months or late as 12 months.
Every child is different, but most will have all 20 primary teeth by 3 years. At around 5 or 6 years, your child will start to lose his primary teeth to make room for his permanent teeth.

Primary teeth give shape to your child’s face, help guide permanent teeth into the right position and are crucial for learning to eat and to speak. It’s important to care for them well. Primary teeth have a thinner outer enamel (a thin, hard, white substance that covers the tooth) than permanent teeth. This puts them at risk for early childhood tooth decay, which can begin even before the first tooth appears. Decay is caused by bacteria and happens more easily if teeth keep coming into contact with sweet liquids—such as formula, milk, juice, and even breast milk (which contains sugar)—and are not cleaned regularly. Early childhood tooth decay can affect your child’s health and cause pain, making it hard for her to sleep, eat or speak. It can also affect her ability to concentrate and learn. Children who develop dental decay at an early age are more likely to suffer from it throughout childhood.

From birth to 12 months
  • Wipe your baby’s gums with a soft, clean, damp cloth twice a day.
  • As soon as the first teeth appear, clean them at least once a day (usually at bedtime) with a soft bristle toothbrush designed for babies. Lay your baby on a flat surface or with his head cradled in your lap to brush teeth.
  • Avoid leaving your baby in bed with a bottle.
  • After 6 months:
    • Introduce a sippy cup.
    • Avoid juice. If you do offer it, limit juice to no more than 125 to 175 mL (4 to 6 oz) per day, in a cup rather than a bottle and only as part of a meal or snack.
    • If a bottle is needed at nap time, offer water rather than milk or juice.
    • If you breastfeed before naptime, be sure to clean your child’s teeth before he goes to sleep.
  • Never sweeten a soother.
  • Don’t put a soother or bottle nipple in your own mouth for any reason. Bacteria (including those which cause tooth decay), viruses and yeast infections can be passed between you and your child this way.
From 1 to 2 years
  • Take your child for a first dental visit at 12 months.
  • Brush your child’s teeth daily (using non-fluoridated toothpaste).
  • Check for signs of early childhood tooth decay once a month. Lift your child’s upper lip and look for chalky-white or brown spots on the teeth or along the gum line. If you see any, take your child to a dentist as soon as possible. Your dentist may suggest you start using a small amount (the size of a grain of rice) of fluoridated toothpaste.
  • Switch to a regular cup for all drinks between 12 and 15 months.
  • Limit soother use to nap and bedtime.
From 3 to 4 years old
  • Teach your child “2 for 2,” which means brushing twice a day for 2 minutes each time.
  • Start using fluoride toothpaste, the amount of a green pea, and teach her to spit rather than swallow.  Supervise your child while he/she is brushing teeth.
  • Encourage her to do some brushing with you completing the job, making sure that all tooth surfaces have been cleaned.
  • Be a role model by brushing your teeth at the same time.
  • If your child continues to suck her thumb as permanent teeth begin to appear, talk to your doctor or dentist.
For all ages
  • Wash your hands before and after brushing teeth.
  • Rinse toothbrushes thoroughly after brushing and ensure that each one can dry without touching others.
  • Replace toothbrushes every few months, when the bristles become flattened with use.
  • Between meals, quench a child’s thirst with water. Do not offer candy, dried fruit (including raisins) and sugared drinks or juices.
  • Take your child for regular dental visits (every 6 months, unless otherwise suggested by your dentist).

When your child is getting her teeth, her gums may be swollen and tender.

Do:

  • Rub the gums with a clean finger.
  • Offer her something to chew on. A wet facecloth placed in the freezer for 30 minutes can be helpful, or a teething ring made of firm rubber.

Do not:

  • Use gel that can be rubbed on your child’s gums. Your child may swallow it.
  • Give her teething biscuits, which may contain sugar.
  • Ignore a fever. Getting new teeth does not make babies sick or give them a fever. If your baby is younger than 6 months call a doctor. Older children can be treated at home, as long as they get enough liquids and seem well otherwise.

What is fluoride?

Fluoride is a natural mineral that is found in soil, water and in various foods. It is necessary for tooth mineralization (a process that helps to harden and protect the teeth). Many communities in Canada add fluoride to the local water supply to help prevent tooth decay. It can also be found in many types of toothpaste, mouthwash and varnishes (polish applied to the teeth by a dentist).Children who start using products with fluoride from an early age have fewer cavities than those who don’t.

How does fluoride work?

Fluoride helps prevent cavities and decay by coming in direct contact with the tooth enamel (the outside of the tooth) and promoting mineralization.If you consume fluoride from sources such as drinking water, it gets absorbed in your bloodstream. Then it becomes part of the enamel on the inside of the tooth.If too much fluoride gets into the inside of the tooth, it can cause a condition called fluorosis

What is fluorosis?

Too much fluoride in the early years can damage teeth as they are forming, and can lead to a condition called fluorosis. Fluorosis causes white spots or blotches on teeth.  But white spots on teeth can also be a sign of early cavities. Your dentist will have to look at your child’s teeth to know for sure.

In more severe cases of fluorosis, these spots can stain or become dark. The teeth can become brittle, chipped or “pitted”.

Cases of fluorosis are quite rare, and most cases are mild.

How much fluoride does my child need?

The right amount of fluoride will prevent cavities, but not cause fluorosis.

  • The best way to prevent cavities is to add fluoride to drinking water.
  • The right amount is about 0.7 parts per million (ppm) in drinking water, which is enough to prevent cavities but not too much so as to cause obvious fluorosis. You can check with your local municipality to find out how much fluoride is in your drinking water supply.
  • Natural sources of water may also have fluoride. If your water comes from wells or springs, you can have it tested. If it contains 0.7 ppm of fluoride or less, it is safe.
  • If the level of fluoride in your water supply is 0.3 ppm or less, ask your dentist or doctor whether a supplement is needed.
  • If the amount of fluoride in the water is more than 0.7 ppm, there is more chance that a child will develop fluorosis. Children younger than three years of age should not drink water with fluoride levels of much more than 0.7 ppm.
What about fluoride from toothpaste & supplements?

Start brushing your children’s teeth with a pea-sized amount of fluoridated toothpaste by the time they are 3 years old. If your child is under 3 years of age and you think she may be at risk for early childhood tooth decay, talk to your dentist to find out if it is a good idea to start using a small amount (the size of a grain of rice) of fluoridated toothpaste.

Fluoride is available as drops or lozenges, but most children don’t need extra fluoride.
If there is a reason to give your child fluoride supplements, your dentist or doctor will recommend them. If you use drops, dilute them with water (follow instructions on package) and squirt them on the teeth. Tell your child not to swallow the drops.

Attachment: A connection for life

Attachment: A connection for life

Why is attachment important?

Attachment is the deep emotional bond between a baby and the person who provides most of his care. Just as most parents feel a strong connection with their newborn after birth, babies also become attached to their parents. Attachment takes place throughout a child’s development, but this document focuses on babies.

Attachment develops as you respond to your baby’s needs in warm, sensitive and consistent ways. This is especially important when your baby is sick, upset or distressed. Attachment also builds as you go about your daily routines with your baby, caring for her and interacting with her.

The early signs that a secure attachment is forming are some of a parent’s greatest rewards:

  • By 4 weeks, your baby will respond to your smile, perhaps with a facial expression or a movement.
  • By 3 months, she’ll smile right back at you.
  • By 4 to 6 months, she will turn to you and expect you to respond when she’s upset.
  • By 7 or 8 months, she’ll have a special response just for you when her visual memory shows marked development (she may also be upset by strangers). Your baby may also start to respond to your stress, anger or sadness.
  • If your baby doesn’t respond to you, show interest in people or make eye contact, make an appointment with her doctor.

Babies can develop secure attachment with more than one important adult in their lives, including a child care provider. This doesn’t affect the special relationship babies have with their parents.

If you think you are depressed, or feel that you cannot take care of your baby, it’s important to tell someone. If you’re the partner of a mother who seems depressed, or is having trouble taking care of her baby, it’s also important to reach out. Talk to your doctor, nurse, midwife, or contact your local public health office for a listing of services in your area.

Secure or healthy attachment is the foundation that lets your child explore the world and have a safe place to come back to. Attachment is the first way that babies learn to organize their feelings and their actions, by looking to the person who provides them with care and comfort. Attachment is essential to long-term emotional health.

Healthy attachment will help your child handle situations as she grows older, such as separating from you (starting child care or school), cooperating with other children, and developing self-control. Attachment also helps your child learn how to trust other people, so it’s an important part of developing healthy relationships later in life.

Healthy attachment will help your child

While a baby’s first attachment is usually with her mother, the bonds that babies form with their fathers are just as important. Though babies form attachment relationships with other adults who care for them, the bonds with their parents are the most important ones.

Secure or healthy attachment is the foundation that lets your child explore the world and have a safe place to come back to. Attachment is the first way that babies learn to organize their feelings and their actions, by looking to the person who provides them with care and comfort. Attachment is essential to long-term emotional health.

A baby’s first attachment

A baby’s first attachment usually happens quite naturally. Your baby cries, and you try to give him what he needs: a feeding, a cuddle, a diaper change, or just holding him. When you respond, your baby learns that he can trust you, and depend on you for comfort and to feel safe. As you get better at knowing what your baby is telling you and meeting his needs, your baby feels less stress.

Responding quickly to a baby

Responding quickly to a baby’s cries is the best way to show her that she is safe and loved. It should not be confused with “spoiling”. Babies cannot be spoiled. When they’re sick, upset or distressed, they need to know that you are there for them.

What Attachment involves

Attachment involves two people interacting, sharing, and connecting. So as you respond to your baby’s needs, your baby will respond to you. You’ll notice that it becomes easier to soothe her, that she wants to be near you, and that she reacts to you even from a distance. Holding, rocking or talking softly to your baby all promote attachment.

Footwear for children

Footwear for children

When should my child start wearing shoes?

If your child isn’t walking yet, she doesn’t need to wear shoes. If she has just started walking, shoes can help prevent accidental injuries. Shoes with higher ankle support don’t necessarily offer better support than shoes with low-cut ankles. However, a shoe with a higher ankle might help at this stage since they are harder for your toddler to remove.

Some people think that shoes are needed to support a child’s developing leg and foot muscles and bone structure to help prevent future problems with walking. Your child’s feet will develop naturally and will almost never require any special footwear.

Shoes have become softer, wider, lighter and more comfortable. Your child’s shoes should:

  • Protect his feet.
  • Offer some grip on smooth surfaces.
  • Ensure comfortable walking on different types of surfaces (e.g., pavement, gravel and sand).

When choosing shoes for your child, make sure they:

  • Fit snugly at the heel to stop the foot from moving forward while walking.
  • Allow room for the toes – approximately 1.25 cm (a thumb’s width) between the longest toe and the tip of the shoe while your child is standing up.
  • Have a 5 mm space between the edge of the shoe and all toes.
  • Have a small crease in the material if you pinch the shoe while your child standing.
  • Your child should always try on shoes before you buy them.

Shoes used to fix problems such as flatfoot or intoeing are called corrective footwear. Most children don’t need special footwear. Your child’s feet and legs will change naturally as she grows.

The arch of the foot between the heel and the big toe (the natural curve at the bottom of the foot) develops before 6 years of age. Almost all children younger than 18 months of age have flat feet. This can also be common until your child is 6 years of age. A small number of children still have flatfoot by the time they are 10 years of age. If your child continues to have flatfoot but it doesn’t cause any pain or discomfort, corrective shoes or orthotics are not necessary. If your child complains of pain while walking, contact your doctor to discuss your choices

Intoeing

Intoeing happens when the feet turn inward instead of pointing straight ahead when walking or running. It is common in children and usually gets better as your child gets older, without the use of corrective shoes

Growing

Your child’s feet will change quickly as he grows. Before 18 months of age, his feet will probably grow by more than one-half a shoe size every two months. A toddler’s feet grow an average of one-half a size every three months. Once your child is 3 years of age, his feet will grow by about one size every year.

Frequently Asked Questions

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