youngchildrenoralhealthbirth-age12

4C

L. DubcovskyR. Prashar

TBDK. Beach george lai / rekha.prashar

3-18-2009 9:54 AM

0-12 ENGBOOK

100% of Final Size5.5 in x 8.5 in5 in x 8 in5.5 in x 8.5 in5.75 in x 8.75 in

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5.5” x 8.5”None

100%10

39-2581G 39-6914C Cyan

Magenta Yellow Black

Cossette MHPORAL HEALTH BROCHURES

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Oral HealthOral HealthDifferent Ages/Different Stages

Birth to 12 years

MouthYOU

HealthyHealthy

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TABLE OF CONTENTS

ORAL HEALTH • DIFFERENT AGES/DIFFERENT STAGES • BIRTH TO 12 YEARS2

Why is Oral Health Important? 4

What Causes Cavities? 4

When You Neglect Your Child’s Teeth 5

Taking Care of Your Child’s Teeth 6 • Brushing 6 • Flossing 6 • Fluoride 7

Nutrition and Good Dental Snacking 8

Good Dental Snacking and Drinks 9

Injury Prevention and Mouthguards 11

Dental Emergencies 12

Eruption Chart (When Teeth Come In/Fall Out) 13

Different Ages & Different Stages 14 • 0 to 6 months 14-15 • 6 to 24 months 16-17 • 2 to 5 years 19 • 6 to 12 years 20-21

Dos and Don’ts for a Great Smile 22

Good Oral Health Online Resources 23

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ORAL HEALTH • DIFFERENT AGES/DIFFERENT STAGES • BIRTH TO 12 YEARS 3

The Children in Need of Treatment Program off ers FREE dental services to babies, kids and teens, age 17 and under, who

urgently need care. It provides: fillings, extractions and sedation • preventive dental care, including cleaning and fluoride

• dental health support and information. Call or visit your local Public Health Unit today to find out if you are eligible.

Because no child should ever have to suffer.

FREEURGENTDENTALCARE.

IF A CHILD TELLS YOUTHEIR TEETH HURT, WE CAN HELP.

Queen’s Printer for Ontario, 2009

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WHY IS ORAL HEALTH IMPORTANT?In 2000, the Surgeon General in the United States wrote the fi rst ever report on Oral Health in America. He said:

“ Oral health is integral to general health. You cannot be healthy without oral health. Oral health and general health should not be interpreted as separate entities. Oral diseases are progressive and cumulative and become more complex over time. They can affect our ability to eat, the foods we choose, how we look and the way we communicate. These diseases can affect economic productivity and compromise our ability to work at home, at school or on the job.”

Healthy teeth and gums are important as your child grows to help them develop good speech, healthy eating habits and good social skills.

• Cavities are the most common chronic disease of early childhood.

• Oral diseases are infectious, often painful and expensive to treat.

• Poor oral health has been linked to diabetes, heart disease and other long-term health problems in adults.

What Causes Cavities?The most common oral disease in children is tooth decay or cavities. They are caused by bacteria in the mouth.

• Every day a sticky fi lm called plaque forms on the teeth.

• Plaque consists of bacteria and food debris that collects on your teeth day and night.

• If plaque is not removed by brushing and fl ossing on a regular basis, it will cause cavities and lead to periodontal (gum) disease. Cavities occur when food and liquids containing sugar combine with the bacteria in plaque to produce acid. This acid attacks the teeth and can cause cavities.

There’s no such thing as “Soft Teeth.” Many people believe that they suffer from cavities because they have “soft teeth.” While family history is important, most cavities develop because people eat too much sugar and do not thoroughly brush and fl oss their teeth.

SugarBacteria (in plaq ue)

+ = =Acid Cavity

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WHEN YOU NEGLECT YOUR CHILD’S TEETH...Children with poor oral health tend to struggle in school, may lack self-esteem and may have less success later in life.

This could lead to undesirable outcomes such as:• Cavities and gum disease• Pain• Infection• Loss of teeth• Poor nutrition• Lack of sleep• Lower body weight• Prolonged infection and/or swelling• Diffi culty learning and communicating• Poor self-esteem• Future serious dental problems• High cost of dental care

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TAKING CARE OF YOUR CHILD’S TEETH

Brush Your Child’s Teeth Every Day2 FOR 2 IS WHAT YOU DO...

• We recommend that you brush your child’s teeth for two minutes twice a day.

• Bedtime is the most important time to brush to prevent cavities.

• Use a manual or power toothbrush with soft bristles.

• Use a toothpaste that contains fl uoride and is recommended by the Canadian Dental Association.

• Move the brush in a small circular motion over the teeth and gums.

• Brush all the outside, inside and chewing surfaces of the teeth.

• Gently brush the tongue to remove any germs and to make your child’s mouth feel fresh.

Floss Your Child’s Teeth Every Day• We recommend fl ossing at least once a day to clean between the teeth

and under the gums.

• Take a piece of fl oss about 45cm (18 inches) long and wrap it around the middle fi nger of each hand until you have no more than 2.5cm (1 inch) in length between them.

• With the thumb and index fi nger of each hand, guide the fl oss gently and carefully between each tooth using a back-and-forth motion, until the fl oss reaches the gum line.

• Curve the fl oss into a C-shape around each tooth and slip it under the gum line.

• Slide it up and down the side of the tooth.

• Move the fl oss to the side of the next tooth and repeat.

• Remove the fl oss and repeat the above steps for each tooth.

Let your child practice these new skills, but remember, as the adult, you are the one to do the job effectively!

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Use Fluoride Every DayFluoride is a naturally occurring substance that helps prevent cavities by strengthening the enamel, or outer layer, of the tooth. There are four main sources of fl uoride: most tap water, many toothpastes, mouth rinses and professionally applied fl uoride at the dental offi ce. Fluoride is also found in many foods.

Tap Water• Over the past 60 years, it has been

a major factor in the decline of tooth decay.

• Fluoridation of community water supplies benefi ts everyone equally and is cost-effective, as it saves money on dental treatment needs.

• The fl uoridation of drinking water supplies is a decision made by municipalities. Health Canada has recently accepted an optimum recommendation of 0.7 mg/L, which is within Ontario’s recommended range of 0.5 to 0.8 mg/L.

Fluoridated Toothpaste• Health Canada recommends that children use no more than a pea-sized

amount of toothpaste and are taught to not swallow the toothpaste. Children aged six and under should be supervised while brushing. Children under three should have their teeth brushed by an adult, without toothpaste, unless deemed high risk.

Professionally Applied Topical Fluoride• Your dental professional may suggest that your child could benefi t from

a topical fl uoride treatment at their checkup appointment, or suggest a fl uoride rinse or supplement.

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NUTRITION AND GOOD DENTAL SNACKINGGive your child nutritious meals and snacks to help develop strong bodies and healthy teeth that will last a lifetime.

Be a good role model. Healthy eating and active living are important for your children to reach their full potential.

• Choosing a variety of different foods from each of the four food groups, as recommended in the new Eating Well with Canada’s Food Guide, will help your children achieve proper energy levels, growth and overall health.

• Start the day in a healthy way! Eating a nutritious breakfast is a great start to your child’s day. Try cereals that are low in sugar, whole grain breads, fresh fruit, yogurt, milk, cheese and eggs.

Healthy Lunches and Snacks for School• Involve your child in planning lunches and snacks.

• Do not let lunch and snacks get boring.

• Offer your child a selection of nutritious foods and let them choose their favourites.

• Think like a kid. Stick to foods you know your child will like. Introduce new foods at home, instead of in the lunch bag.

What Should Kids be Eating?• Fruit and vegetables, including the following:

carrots, celery, cucumbers, peppers, broccoli, apples, oranges, bananas, kiwi, watermelon, pineapple, strawberries, blueberries, cherries.

• Grains: bread, bagels, pitas, unsweetened cereals, pasta, rice, crackers.

• Milk and alternatives: yogurt, cheese, milk.

• Meat and alternatives: fi sh, chicken, turkey, beef, ham, beans and lentils, pumpkin seeds, nuts and sunfl ower seeds.

Note: Be aware of allergy restrictions in schools and daycares.

Need Help Planning Healthy Meals and Snacks?You can speak to a Registered Dietitian personally by calling EatRight Ontario toll-free at 1-877-510-510-2, Monday, Wednesday and Friday – 9 a.m. to 5 p.m., with extended hours on Tuesday and Thursday evenings until 9 p.m. The EatRight Ontario Call Centre provides trustworthy nutrition information free of charge to all residents in the province and has the capacity to answer questions in more than 110 languages.

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GOOD DENTAL SNACKING AND DRINKS


• Snacks that are nutritious, sugar-free, and do not stick to your child’s teeth are the best dental snacks.

• Research shows that eating cheese may help prevent tooth decay.

• Kids should drink milk, water and a limited amount of 100% fruit juice.

• Children should not be given energy drinks.

Liquid Sugars• Soft drinks or pop are mainly water, sugar and caffeine. One can of pop

(355 ml) contains 50 mls (10 teaspoons) of sugar! Drinking too much pop has been linked with tooth decay and obesity.

• Sport drinks were developed to help you recover from strenuous exercise. They should not be used as regular thirst quenchers, because they are high in sugar, calories and chemicals.

• “Fruit drinks” differ from 100% fruit juice. Think of these drinks as pop without the bubbles.

• Read your labels! Sugar comes in many disguises – dextrose, glucose, fructose, lactose, maltose, corn syrup, maple sugar and honey.

• Milk is a great drink that is loaded with vitamins and minerals. The calcium and vitamin D in milk will build strong teeth and bones in growing children.

Visit ontario.ca/eatright to access helpful meal plans, recipes and nutrition information. You can also use the “Ask A Dietitian” feature and receive answers to your questions online, courtesy of an EatRight Ontario Registered Dietitian.

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Queen’s Printer for Ontario, 2009

FREEURGENTDENTALCARE.

IF YOUR TEETH HURT, WE CAN HELP.

The Children in Need of Treatment Program provides FREE dental services to teens, age 17 and under, who urgently need

care, and includes: emergency extractions, fillings and sedation • preventive dental care, including cleaning and fluoride

• dental health support and information. If you have tooth pain, bleeding gums, cavities or a mouth injury, call or visit

your local Public Health Unit to see if you are eligible.

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INJURY PREVENTION AND MOUTHGUARDS

Once your baby is on the move…• Prevent tooth injury by using safety gates and

putting corner guards on furniture.

• DO NOT allow them to walk or run with anything in their mouth.

Once your child is on the move…• Many children begin sports early. Your child may require a mouthguard

for a number of activities. Some organizations have a mandatory mouthguard policy.

• Wearing a mouthguard is an important part of any athlete’s uniform. It will help to protect the teeth, lips, and cheeks. It may prevent concussions and jaw fractures.

There are many different kinds of mouthguards; speak to your dental professional for the correct type and fi t.


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DENTAL EMERGENCIES Your child is growing and changing every day – crawling, walking and running. Along with these new milestones, bruises, bumps and accidents can occur. The following is a guide to help you deal with a dental emergency.

Toothache• If swelling occurs, place a cold compress on the face next to the sore tooth.

• DO NOT use heat, as this can increase swelling and pain.

• DO NOT place aspirin, other pain relievers or numbing gels on gum tissue around the sore tooth.

• Take the child to the dentist immediately.

Knocked-Out Permanent (Adult) Tooth• CHECK to see if your child has any serious injuries.

• If it is a baby tooth, do not try to replace (a child under fi ve years will probably not have adult teeth).

• DO NOT clean the tooth.

• If it is a permanent (adult) tooth, try to replace the tooth in the socket.

• If you cannot replace the tooth in the socket, put the tooth in a glass of milk immediately.

• See a dentist as soon as possible.

If the tooth loss occurs at night or on the weekend, try calling your dentist’s offi ce (many after-hour messages provide resources for emergency services). Otherwise, seek urgent care immediately (even if you cannot fi nd the tooth).

Broken or Bumped Tooth• Place a cold compress on the face next to the injured tooth.

• Take the child to the dentist immediately.

Bitten Tongue or Lip• If swelling persists, apply a cold compress.

• If bleeding persists or the bite is severe, take the child to the dentist or seek urgent care.

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ERUPTION CHART


This is a guideline only; your child’s teeth may “come in” and “fall out” at different times.

When teeth“come in”

7-12 mos.

9-13 mos.

16-22 mos.

13-19 mos.

25-33 mos.

When teeth“come in”

7-8 yrs.

8-9 yrs.

11-12 yrs.

10-11 yrs.

10-12 yrs.

6-7 yrs.

12-13 yrs.

17-21 yrs.

20-31 mos.

12-18 mos.

16-23 mos.

7-16 mos.

6-10 mos.

When teeth“fall out”

6-8 yrs.

7-8 yrs.

10-12 yrs.

9-11 yrs.

10-12 yrs.

10-12 yrs.

9-11 yrs.

9-12 yrs.

7-8 yrs.

6-8 yrs.

UpperTeeth

UpperTeeth

Lower Teeth

Lower Teeth

Eruption(year)

20 Primary (Baby) Teeth

32 Permanent (Adult) Teeth

This chart is a guideline

only; children grow at their own pace.

When teeth“fall out”

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DIFFERENT AGES AND DIFFERENT STAGES


Birth to Six MonthsAs early as six weeks into pregnancy, your baby’s fi rst teeth are beginning to grow. Looking after oral health and eating nutritious foods is very important for both mom and baby. Research has linked gum disease in pregnant women to an increased risk of premature low birth weight babies. It is essential to maintain regular dental visits during your pregnancy.

Smoking and/or drinking alcohol while pregnant can have many serious side effects on an unborn child, including a condition called cleft lip and palate, which may require several operations to correct.

Early Childhood Tooth Decay• Tooth decay can occur in very young children

up to four years of age.

• This decay results when liquids that contain sugar are left in the baby’s mouth for a long time, and the teeth are not cleaned.

• These liquids include: breast milk, formulas, cow’s milk, fruit juice, sweetened tea, soft drinks and many others.

• Early cavities start on the top front teeth. Look for any chalky white or brown spots at the front and back of the teeth.

How To Prevent It!• Lift your baby’s upper lip monthly and check

the front and back of their front teeth for any of these spots.

• Never dip a pacifi er in sugar, honey or other sweets.

• When your baby is able to sit up alone, give him/her a cup to drink from.

• Babies do not have decay causing bacteria at birth. To avoid giving your baby these bacteria, DO NOT share utensils or pacifi ers with your baby. Be sure to clean forks, spoons, bottle nipples and pacifi ers if you have put them into your mouth for any reason such as testing food temperature or placing a pacifi er in your mouth to clean.

• Most liquid medications are available in sugar-free form. If not available, clean your baby’s mouth after giving the medication.

• Your baby’s bottle should not be used as a pacifi er.

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TeethingTeething is a natural process of baby’s fi rst teeth working their way through the gums.

Common Signs of Teething• Drooling, irritability, sore and

swollen gums, loss of appetite, rashes and showing a need to chew on things.

• High fever, severe diarrhea and vomiting are NOT common symptoms of teething. If these occur, take your child to their doctor.

Helping You and Your Baby Through Teething• Offer a teething ring that contains only water, cooled in the refrigerator.

• Offer a clean, damp, cooled washcloth for your baby to chew on.

• Massage your baby’s gums with your clean fi nger or a baby washcloth.

DO NOT...• Use teething gels or ointments, as they contain medicines that may

harm your baby.

• Give teething biscuits to your baby, as they contain sugar and could also be a choking hazard.

Cleaning Your Baby’s Mouth• It is important to begin the habit of cleaning your baby’s mouth,

before the teeth come in.

• Choose a convenient time to clean your baby’s mouth each day. Bath time is ideal, because your baby is happy and relaxed.

• Wipe the inside of your baby’s mouth with a clean washcloth or a fi nger brush.

• Regular mouth care makes your baby’s mouth feel fresh and develops good habits.


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6 TO 24 MONTHSBetween the ages of six and 24 months, there will be many changes in your baby’s mouth. The fi rst tooth will appear around six months of age. A total of 20 baby teeth will come in. Give your child the gift of healthy teeth for life with daily brushing, nutritious meals and snacks.

Lift the Lip• Babies can get cavities as soon as teeth erupt.

• Once a month, lift your child’s upper lip and look for chalky white or brown spots on the front and back of their upper front teeth.

• If you notice any spots or anything unusual, take your child to their dentist.

Thumb Sucking• Sucking is a natural urge which comforts and relaxes.

• Thumb sucking usually stops by four or fi ve years of age.

• If this habit continues after the permanent teeth have erupted, it could affect the positioning of your child’s teeth or jaws.

• You should seek the advice of a dental professional if you have any concerns.

Pacifi ers are Safe to Use• Pacifi ers satisfy your baby’s natural need to suck.

• It is easier to stop pacifi er use than thumb sucking.

• Choose a pacifi er that is the right size for your child’s mouth.

• Use an approved pacifi er that meets safety standards.

• Wash with soap and water before fi rst use and on a regular basis.

• NEVER clean a pacifi er in your own mouth. This could spread bacteria.

• Check often for signs of wear and replace the pacifi er if it is sticky, cracked or torn.

• DO NOT attach a string to a pacifi er – use a proper clip.

• DO NOT dip a pacifi er in sugar, honey or anything sweet, as this could cause cavities.

• Use of a pacifi er should be stopped as soon as possible, as it may affect the positioning of your child’s teeth.


•

•

•

•

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First Dental Visit• Take your child to the dentist for a quick checkup by their fi rst birthday.

• Start dental visits early, so your child will learn the importance of good oral health care and feel comfortable visiting the dental offi ce.

• Your dental professional will then advise you about future visits.

Bottle Feeding• A bottle should be used ONLY to give a nutritious meal. • DO NOT let your child use the bottle as a pacifi er.• Wean your child from the bottle by 12 to 14 months of age.

Introducing Your Child to a Cup• Start giving your child a cup at approximately six months of age or when

your child is able to sit up.• Frequent drinking or sipping on milk, juice or anything sweetened with

sugar could cause cavities.• DO NOT substitute a bottle with a sippy cup.

Cleaning Your Child’s Mouth• Daily cleaning of your child’s mouth is important.• Wipe the inside of your child’s mouth with a clean

washcloth or a fi nger brush.• When a few baby teeth have appeared, you can start using a small

soft toothbrush to clean them.• Use WATER ONLY on the toothbrush until your child can spit out. • Brush in a circular motion.• Brush twice a day and especially after the baby’s nighttime feeding.

Snacking• Healthy snacking plays an important role in oral health.• Encourage healthy choices such as cheese, soft cooked or canned

vegetables, fruit and yogurt.• If your child needs a drink between meals, water is best.

Be aware of foods that could cause choking:• Grapes, berries or raisins • Nuts • Potato chips and popcorn


ance of tal offi ce.

visits.

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2 TO 5 YEARSHealthy baby teeth are extremely important for eating, smiling, talking and keeping the space for adult teeth. Regular dental checkups are important to maintain good oral health.

Home CareWe recommend that you brush your child’s teeth for two minutes twice a day using a manual or power toothbrush with soft bristles.

1. Brush your child’s teeth for two minutes twice a day.

2. Bedtime is the most important time to brush to prevent cavities.

3. Unless your child is high risk, you should begin to use a fl uoride toothpaste once your child is three years of age, and can spit the toothpaste out.

4. Health Canada recommends that children use no more than a pea-sized amount of toothpaste and brush under adult supervision until the age of six.

5. Daily fl ossing of your child’s teeth is important.

6. DO NOT let your child swallow or eat the toothpaste.

Regular Dental VisitsStart regular visits between two-and-a-half and three years of age, or as advised by your dental professional.


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6 TO 12 YEARSYour child will experience many changes during these years. Their baby teeth will fall out and their adult teeth will appear. Adult teeth are usually larger and more yellow in colour than baby teeth. This is sometimes called the “ugly duckling stage” because their teeth can sometimes be crowded and may not look ideal. Remember, their jaw is still growing!

Wiggly Teeth... your child will lose their baby teeth... it is a milestone in their lives! • The fi rst baby tooth to be lost is usually a lower front tooth at around

six years of age.

• Don’t be surprised when only the top of the tooth (the crown) falls out. The roots have disappeared.

• Adult teeth will continue to erupt into their teenage years. Some children may experience discomfort.

• Encourage your child to keep the area clean even when the tooth is wiggly.

• SOMETIMES the new tooth will come in before the baby tooth has fallen out. DO NOT WORRY! The baby tooth normally falls out within a few weeks and the adult tooth will usually slip into the space.

• Children should be encouraged to wiggle the baby tooth until it falls out (it is not usually necessary for your dentist to remove baby teeth).

• BE HAPPY for your child. It is a normal and healthy part of growing up.

Permanent (Adult) Teeth• The fi rst adult tooth to appear is usually a lower front tooth at around

six years of age.

• The fi rst adult molar to come in is called the “six-year molar.” It comes in behind the last baby molars and does not replace a baby tooth.


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Orthodontics (Braces) • During your child’s growing years, through different stages, the appearance

of their teeth will continue to change.

• Some children will need to see an Orthodontist to straighten crooked teeth and correct teeth and jaws that do not fi t together correctly.

• Ask their dentist for a recommendation.

Brushing/Flossing• Your child will continue to need your help with brushing until eight

or nine years of age.

• Flossing is a more diffi cult task, and they will need your help until the child can fl oss effectively on their own.

Injury Prevention• REMEMBER: Mouthguards can prevent injuries during this very active

time in your child’s life, BUT ONLY IF THEY WEAR ONE!


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DOs AND DON’Ts FOR A GREAT SMILE

Do...• Lift the lip. Once a month, check your baby’s teeth for white or brown

spots and anything unusual. Take your child to their dentist if you have a concern.

• Brush your child’s teeth for two minutes twice a day.

• Brush at bedtime. It’s the most important time to brush to help prevent cavities.

• Floss their teeth every day. Parents need to assist younger children.

• Visit the dentist regularly. Babies should have their fi rst visit by their fi rst birthday, with continued visits as recommended by their dental professional.

• Make healthy eating and snacking a priority. Be a good role model.

• Ensure your child wears a mouthguard while playing sports.


Don’t...• Put your child to bed with a bottle or sippy cup. Use only plain water

if you must give your baby a bottle in bed.

• Put sugary liquids such as pop, fruit drinks and sweetened milk in a bottle or sippy cup.

• Share germs. Cavities are caused by bacteria (germs). These germs are passed to babies through saliva. Avoid sharing of toothbrushes and spoons; DO NOT place baby’s pacifi er in your mouth.

• Expose your child to second-hand smoke. Be a good role model. DO NOT smoke or use spit/chewing tobacco in your child’s presence.

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GOOD ORAL HEALTH ONLINE RESOURCES

Ontario Association for Public Health Dentistry oaphd.on.ca

Canadian Dental Association cda-adc.ca

Canadian Dental Hygienist Association cdha.ca

EatRight Ontario ontario.ca/eatright

Healthy OntarioHealthyOntario.com

Eating Well with Canada Food Guidehealthcanada.gc.ca

Health CanadaHc-sc.gc.ca

U.S. Centers for Disease Control and Preventioncdc.gov

About Kids Health Canadaaboutkidshealth.ca


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MARCH 2009

Family Dentist:

Name:

Number:

Family Doctor:

Name:

Number:

Telehealth Ontario Info Line: 1-866-797-0000

Poison Control: 1-800-268-9017

ServiceOntario INFOline 1-866-532-3161Hours of operation: 8:30 a.m. – 5:00 p.m., Monday to Friday

EatRight Ontario 1-877-510-510-2Hours of operation: Monday, Wednesday and Friday – 9 a.m. to 5 p.m., with extended hours on Tuesday and Thursday evenings until 9 p.m.

IMPORTANT NUMBERS

Special thanks to the Durham Region Health Department and the Oral Health Division for permission to reprint previously published materials. We appreciate their collaboration, which made this publication possible.

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Documents

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longterm health problems

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