In recent years the American Academy of Pediatric Dentistry has been the passionate advocate for the early infancy dental examination. This is a major step forward in putting teeth into the old saying, “An ounce of prevention is worth a pound of cure.“
In truth, counseling expectant moms and dads would probably be the best time to institute prevention of dental disease in children. Alerting pregnant women to the importance of proper diet, not smoking, limiting alcohol and drugs would certainly be timely.
Few expectant parents are aware that the (primary) teeth begin forming in the first trimester. Nor do they realize that the tooth calcification process that takes place during the pregnancy, in addition to the overall well-being of the fetus, can be negatively affected if an expectant mom neglects or abuses herself.
Also, by the time a baby is 1-year old, there may already be habits in place that could have been avoided with earlier counseling. Cautionary information about not going to sleep with a baby bottle, not breast feeding in bed at will, wiping the gums to clean the mouth, acclimating the child to hands in their mouth, how to deal with teething, etc.
Think of the 1-year baby-parent consultation as an opportunity to educate the parents, examine the baby, and most of all as the beginning of a wonderful relationship. When examining the baby, place the child in your lap, back to you with the baby facing the parent.
**Point: Do not worry about the baby crying, Your gentle touch, soft voice and calm and friendly bedside manner, despite the infant’s crying will be very impressive to the parents. GUARANTEED!**
Insert your fingers in the mouth gently and quickly assess the general character of the mouth, shape of the arches, and stage of tooth eruption (which ones and how many). Feel the ridges with your fingers to verify anticipated eruption sites. Check the labial and lingual frenums. Ask the mother about any feeding problems. (Breast fed? Baby bottle?)
Also, ask, “Is the baby using a pacifier?” If so, is it intermittent, infrequent, or constant? Parents have questions and you have the answers. “Should I be brushing with a toothbrush?” “What about toothpaste?”
What if the baby has evidence of decalcification or the dreaded nursing bottle syndrome? What are the treatment options? Make certain when discussing your diagnosis that you cast the situation in the most positive light possible, without being accusatory. Under these circumstances parents are already feeling guilty about having “neglected” their baby.
If everything is normal, give the parents an array of items that you feel are appropriate, such as instructive literature, toothbrushes, toothpaste, teething rings, mouth wipes, etc. Don’t forget to set up a communication mechanism with the parents -- a hotline, so to speak -- and make plans for a future visit.
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Dr. Marvin Berman has been a pediatric dentist for more than four decades. He serves on the Council of Dental Practice and is a Consumer Advisor for the American Dental Association, as well as a spokesman for the American Academy of Pediatric Dentistry. He is a renowned lecturer and shares his expertise at dental meetings throughout the world. He has published numerous articles and his instructional videotapes are part of the curriculum of many dental schools. Music and theater are his other passions but he's particularly proud of his wife Joyce and their four children and seven grandchildren. Visit Dr. Berman's practice page at http://www.dentistry4kids.net/team and Facebook page at https://www.facebook.com/pages/Dentistry-for-Kids-Ltd-Dr-Furusho-Dr-Kollmann/293517314003627.
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This article is a part of the Dental Economics "Spotlight on Pediatric Dentistry," with exclusive content posted on the Dental Economics Facebook Page and archived at http://www.dentaleconomics.com/pediatric-dentistry-spotlight.html. The spotlight runs February 1st - 28th, 2014, in recognition of National Children's Dental Health Month, and is sponsored by Dentsply Professional and Nupro White Varnish.
