JAIVINS ACADEMY ,ATTUR

Primary Teeth
Primary teeth are also called a y teeth! "y a#e $ years, there are %s%ally &' (rimary teeth! The s(aci)# et*ee) childre)+s a y teeth is im(orta)t eca%se it allo*s e)o%#h room ,or the i##er, (erma)e)t teeth!

Primary Teeth
Primary teeth ha-e thi))er e)amel a)d a((ear *hiter .tra)sl%ce)t/ almost l%ish0 tha) (erma)e)t teeth! Disease may (ro#ress more 1%ic2ly i) (rimary teeth! The iti)# s%r,aces o, (osterior . ac20 teeth are #roo-ed a)d (itted! Perma)e)t teeth ha-e *a-y ed#es .mamelo)s0 *he) they er%(t, *hich smooth o%t *ith )ormal *ear a)d tear!

Primary Teeth
Teeth Eruption The ,irst tooth er%(tio) is %s%ally et*ee) 3 a)d 45 mo)ths o, a#e! Premat%re a)d lo* irth *ei#ht a ies ca) ha-e delayed (rimary tooth er%(tio) a)d e)amel de,ects, (%tti)# them at hi#her ris2 ,or decay! Er%(tio) is %s%ally symmetrical .lo*er teeth %s%ally e,ore %((er0 i) the ,ollo*i)# (atter) ,or (rimary teeth6 ce)tral i)cisors, lateral i)cisors, ,irst molars, ca)i)es, seco)d molars! E7,oliatio) o,te) ,ollo*s a similar (atter)! Teeth *ill sometimes er%(t e)tirely o%t $ o, the 8)ormal9 a)tici(ated se1%e)ce: $ this sho%ld )ot e a co)cer)!

Primary Teeth
Tooth Shedding/Exfoliation and Permanent Teeth Tooth loss .also 2)o*) as sheddi)# or e7,oliatio)0 %s%ally starts *ith the lo*er (rimary ce)tral i)cisors! Er%(tio) is similar ,or the (erma)e)t teeth, e#i))i)# et*ee) 5 a)d ; years a)d %s%ally ,i)ishi)# y 4$ to 43 years o, a#e! The ty(ical (atter) is ce)tral i)cisors, lateral i)cisors, ,irst molars, (remolars, ca)i)es, seco)d molars, a)d third molars .*isdom teeth0, altho%#h )ot e-eryo)e de-elo(s or er%(ts third molars! It is commo) to see (erma)e)t teeth er%(t ehi)d the (rimary i)cisor teeth i) the lo*er <a*! This ty(ically resol-es itsel, *itho%t i)ter-e)tio), altho%#h (ro,essio)al de)tal mo)itori)# is i)dicated! The ,irst (erma)e)t molars er%(t aro%)d = years o, a#e!

Early Childhood Caries

Normal Healthy Primary Teeth Teeth sho%ld e *hite *ith smooth s%r,aces! S(aci)# et*ee) teeth is desira le! >%m tiss%e .#i)#i-al m%cosa0 sho%ld e smooth, (i)2, ,irm, a)d immo ile!

Early Childhood Caries

Chalky White Spots ?irst a((ear as d%ll *hite a)ds o) the smooth s%r,ace o, the tooth at the #%m li)e, ,ollo*ed y yello* or ro*) discoloratio)! Are i)dicati-e o, early decay or *ea2e)ed e)amel! May e re-ersi le *ith e7(os%re to to(ical ,l%oride a)d (la1%e remo-al! I)dicate re,erral to a de)tal home as soo) as (ossi le! I, le,t %)treated, *ill lead to ca-itatio)! Pla1%e a)d chal2y *hite s(ots are sometimes mista2e) ,or each other! The di,,ere)ce is (la1%e ca) e *i(ed o,, a)d *hite s(ots ca))ot!

Early Childhood Caries

Brown Spots So,t ro*) or lac2 s(ots a((ear o) the tooth, *ith (ro#ressio) slo*ly to*ard the che*i)# s%r,ace o, the tooth! P%t the a,,ected tooth at ris2 ,or ,ract%re! Si#)i,y ad-a)ced or se-ere decay! De)tal re,erral is cr%cial@

Early Childhood Caries

Se ere !e"ay Re,ers to the (rese)ce o, m%lti(le ca-ities i) se-eral teeth! May lead to early tooth loss a)d a,,ects a child+s a ility to che* ,ood a)d his or her sel,Aesteem! B,te) re1%ires #e)eral a)esthesia i) the o(erati)# room to remediate! Places childre) at ris2 ,or i),ectio) a)d cell%litis!

Feeding
Breastfeeding Altho%#h reast mil2 alo)e is )ot cario#e)ic, it may ecome cario#e)ic *he) com i)ed *ith other car ohydrate so%rces! B)ce teeth are (rese)t, it is im(orta)t to im(leme)t oral hy#ie)e ,ollo*i)# ,eedi)#s: (artic%larly ,or a child *ho is ,ed o) dema)d a)d *ith hi#h ,re1%e)cy a)d d%ratio) at )i#ht!

Feeding
Bottle#feeding "ottles sho%ld o)ly e %sed *ith reast mil2, ,orm%la, or *ater! ?r%it $ <%ices, so,t dri)2s, s*eet teas, etc sho%ld )ot e (%t i) ottles! At edtime or )a( time, ottles sho%ld o)ly co)tai) *ater! I),a)ts sho%ld e held *he) ottleA,ed! I, a ottle is #i-e) *ith a)ythi)# other tha) *ater at )a( time or edtime, (are)ts sho%ld %se a cloth to *i(e the a y+s mo%th (rior to layi)# the a y do*)! "ottles sho%ld )ot e (ro((ed *ith i),a)ts i) cri s or car seats! Prolo)#ed a)d ,re1%e)t e7(os%re to s%#ary li1%ids co)tri %tes to the caries (rocess, a)d childre) *ho dri)2 ottles *hile lyi)# do*) may e more (ro)e to ear i),ectio)s!

Feeding
Sippy Cups I)trod%ce a c%( as soo) as the i),a)t ca) sit %)s%((orted .aro%)d = mo)ths o, a#e0 a)d try to elimi)ate the ottle y 4 year o, a#e! Si((y c%(s co)tai)i)# ,r%it <%ices, so,t dri)2s, s*eet teas, ,orm%la, or mil2 sho%ld )ot e #i-e) to the child at edtime or )a( time! I, the si((y c%( is o,,ered et*ee) meals, it sho%ld co)tai) o)ly mil2 or *ater! I, <%ice is o,,ered, it sho%ld e restricted to mealtimes! Bther s%#arAco)tai)i)# dri)2s sho%ld e a-oided!

Feeding
$ood %uidan"e Pro-ide the child *ith healthy alter)ati-es s%ch as ,r%its a)d -e#eta les c%t i)to small (ieces .to a-oid cho2i)#0 or *hole #rai) s)ac2s! PreAtasti)#, (reAche*i)#, a)d shari)# o, %te)sils sho%ld e a-oided eca%se acteria is tra)smitted thro%#h sali-a! A-oid stic2y ,oods li2e raisi)s, ,r%it leather, a)d hard ca)dies! Disco%ra#e #raCi)#!

Feeding
&aternal#'nfant Transmission Cario%s acteria ca) e tra)smitted ,rom a mother to her child y shari)# %te)sils, clea)i)# o,, (aci,iers *ith the mo%th, a)d (reAche*i)# ,ood! Mothers *ith caries history sho%ld im(leme)t oral hy#ie)e ,or themsel-es, see a de)tist re#%larly, a)d ta2e care to )ot share %te)sils or (reAche* ,ood!

Non-nutritive Sucking
Thum( and $inger Su"king "a ies *ho s%c2 their th%m s %s%ally co)ti)%e the ha it lo)#er tha) (aci,ier %sers! Prolo)#ed th%m s%c2i)# may ca%se (ro lems *ith (ro(er #ro*th o, the mo%th a)d the ali#)me)t o, teeth! It also ca) ca%se cha)#es i) the roo, o, the mo%th! The most commo) de)tal e,,ect o, )o))%triti-e s%c2i)# is a)terior, %(*ard mo-eme)t o, the ma7illary ce)tral i)cisors a)d (alatal o)e, *hich may res%lt i) a) a)terior o(e) ite! Bther (ossi le e,,ects i)cl%de ma7illary co)strictio) a)d (osterior cross ite! Childre) sho%ld e e)co%ra#ed to disco)ti)%e their )o))%triti-e s%c2i)# ha its y 3 years o, a#e!

Non-nutritive Sucking
Pa"ifier )se Paci,iers sho%ld )e-er e di((ed i) s%#ary s% sta)ces s%ch as ho)ey a)d s%#ar! Paci,ier %se d%ri)# slee( is associated *ith a decreased i)cide)ce o, s%dde) i),a)t death sy)drome! Paci,iers sho%ld )e-er e %sed to re(lace or delay meals a)d sho%ld e o,,ered o)ly *he) the care#i-er is certai) the child is )ot h%)#ry! Paci,iers sho%ld ha-e -e)tilatio) holes a)d a shield *ider tha) the child+s mo%th .at least 4D i)ches i) diameter0! Paci,iers sho%ld e o)e (iece a)d made o, a d%ra le material, re(laced *he) *or), a)d )e-er tied y a stri)# to the cri or aro%)d a child+s )ec2 or ha)d! Physiolo#ic (aci,iers are (re,era le to co)-e)tio)al (aci,iers eca%se they may ha-e less de)tal e,,ects!

Non-nutritive Sucking
Teething Teethi)# is the emer#e)ce o, the ,irst (rimary . a y0 teeth thro%#h a a y+s #%ms! Teethi)# e#i)s as early as $ mo)ths a)d co)ti)%es %)til the child is a((ro7imately $ years o, a#e! Some a ies may ha-e te)der a)d s*olle) #%ms *he) teethi)#! Diarrhea, rashes, a)d a ,e-er are )ot )ormal ,or a teethi)# a y!

Non-nutritive Sucking
Tips for Parents
Remo-e the drool o) the a y+s ,ace to (re-e)t rashes ,rom de-elo(i)#! >i-e the a y somethi)# hard or cold to che* o), ma2i)# s%re it is i# e)o%#h that it ca)+t e s*allo*ed or rea2 i)to small (ieces! E7am(les i)cl%de re,ri#erated teethi)# ri)#s, (aci,iers, s(oo)s, clea) *et *ashcloths, a)d ,roCe) a#els or a)a)as! >e)tly r% the a y+s #%ms *ith a clea) ,i)#er! I, the a y seems irrita le, acetami)o(he) ca) e %sed! To(ical teethi)# #els sold o-er the co%)ter .BTC0 are sometimes %sed ,or teethi)#! Eo*e-er, these #els ca) carry serio%s ris2s, i)cl%di)# local reactio)s, seiC%res .*ith o-erdose0, a)d methemo#lo i)emia! Pare)ts sho%ld e i)str%cted o) (ro(er dosi)# o, BTC a)al#esic medicatio)s! Re#%larly disi),ect teethi)# ri)#s a)d o <ects a)d *ash ha)ds to a-oid #astroi)testi)al dist%r a)ces a)d i),ectio)s!

Fluoride Modalities
$luoridated Water It ca) e ,o%)d i) comm%)ities that s%((leme)t ta( *ater *ith ,l%oride! The Ce)ters ,or Disease Co)trol a)d Pre-e)tio) .CDC0 My Fater+s ?l%oride Fe site .htt(6//a((s!)ccd!cdc!#o-/MF?/I)de7!as(0 allo*s co)s%mers i) c%rre)tly (artici(ati)# states to lear) the ,l%oridatio) stat%s o, their *ater system! ?l%oride ca) e ,o%)d i) some ottled *ater! Goo2 ,or ,l%oride co)te)t o) the la el!

Fluoride Modalities
$luoride Supplements *!rops and Ta(lets+
S%((leme)ts ca) e %sed as early as = mo)ths o, a#e i, a child at hi#h ris2 ,or caries does )ot ha-e access to a) ade1%ate amo%)t o, ,l%oride i) the comm%)ity *ater s%((ly! ?or childre) at lo* caries ris2, s%((leme)ts are )ot recomme)ded! Bther so%rces o, ,l%oride sho%ld e co)sidered to (re-e)t caries! Fhe) ,l%oride s%((leme)ts are (rescri ed they sho%ld e ta2e) daily to ma7imiCe e)e,it! I, a ,amily %ses *ell *ater, e s%re to order *ell *ater ,l%oride testi)# e,ore (rescri i)# s%((leme)ts! S(eci,ic #%ideli)es are %sed to determi)e the amo%)t o, ,l%oride )eeded ased o) a child+s a#e! Dro(s come i) '!5 m#/mG! The to(ical e,,ect o, ta lets is the (re,erred ro%te! Ma)y childre) ca) e tra)sitio)ed to che* ta lets as early as 45 to 4H mo)ths o, a#e!

Fluoride Modalities
$luoride Toothpaste
It may e recomme)ded y a (ediatricia) or de)tist that ,l%oridated tooth(aste e %sed ,or a child %)der the a#e o, & i, the child is at hi#h ris2 ,or de)tal caries! Ca%tio) is ad-ised *he) %si)# ,l%oridated tooth(aste ,or yo%)# childre) eca%se they may s*allo* e7cessi-e amo%)ts o, tooth(aste! A smear o, ,l%orideAco)tai)i)# tooth(aste .sho*) o) o((osite side i) (hoto o, a a y+s tooth r%sh0 has the recomme)ded amo%)t o, ,l%oride .a((lied & times a day0 ,or a &AyearAold child! Childre) & A = years o, a#e sho%ld %se o)ly a (eaAsiCed amo%)t o, ,l%oridated tooth(aste! Chec2 the ,l%oride co)te)t o, tooth(astes: almost all tooth(astes ma)%,act%red i) the U)ited States (ro-ide to(ical ,l%oride, %t )ot all )at%ral tooth(astes do!

Baby toothbrush with a smear of toothpaste

Childs toothbrush with a pea-sized amount of toothpaste

Fluoride Modalities
$luoride ,arnish Most ,l%oride -ar)ishes are lac1%ers co)tai)i)# 5I sodi%m ,l%oride i) a colo(ho)y/resi) ase! ?l%oride -ar)ish is (ai)ted o) a child+s teeth y a de)tist or child health care (ro,essio)al i, the child is at hi#h ris2 ,or caries! The -ar)ish (rotects teeth ,rom decay a)d ca) arrest the (ro#ressio) o, a chal2y *hite s(ot lesio) to a ,%llA lo*) ca-ity!

Toothbrushing
-d i"e for Parents
Clea) or r%sh a yo%)# child+s teeth t*ice daily! "e#i) *i(i)# the #%ms o, e-e) a -ery small i),a)t *ith a so,t *ashcloth or so,t tooth r%sh, e-e) (rior to tooth er%(tio), to esta lish a daily oral hy#ie)e ro%ti)e! Tooth r%shes ,or i),a)ts a)d toddlers sho%ld e so,t *ith a small head a)d a lar#e ha)dle! Tooth r%shi)# sho%ld e s%(er-ised %)til the child ca) relia ly ri)se a)d s(it o%t e7cess tooth(aste .%s%ally = years o, a#e0! Yo%)#er childre) do )ot ha-e the ha)d coordi)atio) )ecessary ,or i)de(e)de)t tooth r%shi)# (rior to that a#e! Electric tooth r%shes are es(ecially %se,%l i) sit%atio)s o, limited mo-eme)t! They do the *or2 ,or yo%, they (ositio) *ell, a)d the small head ca) hel( limit the amo%)t o, tooth(aste to *hat is a((ro(riate ,or childre)! All accessi le s%r,aces o, each tooth )eed to e r%shed! Remi)d (are)ts to )ot allo* their child to s*allo* ,l%oridated tooth(aste!

Flossing
-d i"e to Parents ?lossi)# sho%ld e#i) *he) & teeth to%ch, ty(ically et*ee) & a)d &J years o, a#e! Some childre) may o)ly )eed a ,e* ac2 teeth ,lossed a)d others may )eed ,lossi)# et*ee) all their ti#ht teeth, de(e)di)# o) de)tal s(aci)#! Childre) %s%ally )eed assista)ce *ith ,lossi)# %)til they are H to 4' years o, a#e! ?lossi)# tools, s%ch as (reAthreaded ,lossers or ,loss holders, may e hel(,%l ,or childre) *ho are <%st lear)i)# ho* to ,loss! Some childre) may ,i)d it easier to %se a loo( o, ,loss, *hich is created y ta2i)# a (iece o, ,loss a o%t 4' i)ches lo)# a)d tyi)# the e)ds to#ether i)to a circle! Pare)ts .a)d older childre)0 ca) hold the ,loss ti#htly et*ee) the th%m s a)d ,ore,i)#ers to ,loss!

Fluoride Varnish
$a"ts Co)ce)trated to(ical ,l%oride! ?i-eA(erce)t sodi%m ,l%oride i) a resi) ase! E,,ecti-e i) (re-e)ti)# early childhood caries a)d red%ci)# caries (ro#ressio)! ?l%oride a((licatio) y (hysicia)s may e a illa le (roced%re! Chec2 *ith the local Medicaid (ro#ram ,or more i),ormatio)!

Fluoride Varnish
-pplying $luoride ,arnish # 'nstru"tions for Pro ider Ea-e e-erythi)# ready! B(e) -ar)ish (ac2et a)d mi7 it *ell! Fi(e child+s teeth dry *ith a clea) #a%Ce! Pai)t child+s teeth *ith -ar)ish %si)# dis(osa le a((licator! I)str%ct (are)ts! Do not brush the childs teeth until the next day. The childs teeth may be slightly yellow until they are brushed.

The child can eat and drink right away but should avoid hot liquids.

Fluoride Varnish
-pplying $luoride ,arnish # 'nstru"tions for Parent Do not brush the childs teeth until the next day. The childs teeth may be slightly yellow until they are brushed. The child can eat and drink right away but should avoid hot liquids. Fluoride varnish may be applied to your childs teeth at a dentists or pediatricians office or by another type of health care professional.

Fluoride Varnish
$re.uen"y of -ppli"ation ?or moderate caries ris2, a((ly e-ery = mo)ths! ?or hi#h caries ris2, childre) may e)e,it ,rom i)creased a((licatio) ,re1%e)cy o, e-ery $ to 3 mo)ths! Payme)t codes may o)ly e allo*ed ,or & to $ a((licatio)s (er year! .Chec2 *ith the local Medicaid (ro#ram ,or i),ormatio) a o%t (ayme)t!0

Fluoride Varnish
Children -ged / to 0 1ears Who Will Benefit $rom $luoride ,arnish All childre) eli#i le ,or Medicaid Si li)#s *ith ca-ities e,ore = years o, a#e Premat%re childre) Childre) *ith s(ecial health care )eeds Childre) *ho %se a ottle a,ter 45 mo)ths or ha-e s*eet or starchy s)ac2s more tha) $ times a day Childre) *itho%t a de)tal home

C ONC !S"ON
childhood caries is the )%m er o)e chro)ic i),ectio%s disease o, early childhood! >ood oral health starts early@ Childre) sho%ld recei-e (re-e)ti-e oral health care ,rom a de)tist or their (ediatricia) i, )o de)tist is a-aila le! Childre) sho%ld e e7(osed to ade1%ate le-els o, ,l%oride ,rom *ater, tooth(aste, a)d other so%rces! Childre) at hi#h ris2 ,or ca-ities sho%ld recei-e ,l%oride -ar)ish ,rom their de)tist or (ediatricia) i, de)tist is )ot a-aila le! No ottles to ed, %)less they o)ly co)tai) *ater@ ?eed childre) healthy ,oods that are lo* are s%#ar! Gimit s)ac2i)# a)d dri)2i)# a)ythi)# %t *ater et*ee) meals!