BABY TEETH ARE IMPORTANT
They are important for chewing foods, speech, and development of adult
teeth. Baby teeth can also affect the growth and appearance of your child. At times,
infants and toddlers may have trouble-sleeping or eating solid foods. During these
stressful times, parents sometimes use bottles to pacify children or to help maintain
their weight. Overuse of bottles may cause tooth decay (cavities) which can lead to pain,
infection, malnourishment and poor weight gain. These are serious problems for a child
with HIV infection.
CAVITIES, SUGARS, BLEEDING GUMS
In the mouth, sugars are broken down by germs (bacteria) into acids. It is
these acids that cause tooth decay. Sugars are in milk, formulas, juices and many
medications. The liquid and pudding foods your doctor recommends to maintain your child's
weight have sugars. It is important to clean your child's mouth to prevent cavities and
ABOUT ORAL LESIONS/THRUSH
Children with HIV infection may suffer thrush (candidiasis) and other
infections in their mouth. Cleaning your child's mouth and limiting sugars may he
important in controlling thrush. Thrush is most often seen as white patches or reddened
areas that appear on the roof of the mouth and/or tongue. Tell your pediatrician if you
see sores or thrush in your child's mouth.
TO PREVENT PROBLEMS, START RIGHT AFTER BIRTH
Clean your child's mouth each day, even before you can see the first baby
tooth. As often as possible, clean the mouth after each feeding and before bed. Be sure to
wash your hands before and after cleaning your child's mouth.
HOW TO CLEAN A CHILD'S MOUTH
- Sit your child on your lap, facing away from you. Support your child's head with your
arm and hand.
- Use the index finger and thumb of your supporting hand to gently open the mouth and
support the lower jaw.
- Wrap a piece of gauze or clean washcloth around the index finger of your other hand.
Moisten it with water. Be sure to wipe the roof of the mouth, tongue, cheeks, and pocket
areas between the jaw and cheeks, as well as the tooth bearing areas.
- You can use a children's soft toothbrush to clean the teeth.
For children who can stand or sit:
- Position yourself behind the child and clean the entire mouth as described above.
- Use only a "pea-sizes" amount of toothpaste on the gauze pad, washcloth, or
toothbrush. If your child doesn't like the flavor, try another brand of toothpaste.
- Offer encouragement for toddlers and older children to clean their own teeth and mouth,
and offer praise each step of the way as they learn how to do it.
- Be a role model and clean your teeth after each meal. Children often like to imitate
adults. If they watch you brush, they will be more likely to brush too.
- Explain why it is important to clean their teeth and mouth. Help your child until he or
she can do it alone.
- For a fussy child, consider asking another person to help you clean the child's mouth.
- It may be helpful to use a distraction such as music or the TV while cleaning your
child's teeth and mouth. Try to use the same routine daily.
- If you still have trouble after trying these suggestions, consult your child's dentist
or pediatrician for additional help.
HOW TO PREVENT PROBLEMS
- Try not to leave a bottle of milk, formula, or juice in the crib or bed with your child.
- If you child needs a bottle to go to sleep, give the bottle to the child in your lap.
- If you must leave your child in the crib with a bottle, thin the contents with water.
You can get your child used to water in two or three weeks if you add a little more water
to the bottle each night until it is all water.
- All non-feeding bottles (bottles used to keep your child calm) should be diluted with
water and gradually converted to water.
- If you give medicines by mouth while your child sleeps, follow with a little water in
the same way that you give the medicine. You can also use a plastic or bulb syringe to
give a little water along the side of each cheek.
- Aim to top bottle feedings by your child's first birthday. This is the ideal, but may be
difficult for a sick or disabled baby. It is important that the baby gets enough fluids.
Ask your pediatrician for advice on use of the bottle for ongoing feeding problems.
- Your child's first dental visit should be before the first birthday.
ADVICE ABOUT SNACKS
- Never give your child a pacifier moistened with a sweetened liquid.
- Avoid sweetened cereals, especially when eaten dry.
- Offer water or apple juice diluted with water as in-between meal snacks, instead of
juice-ades such as punch or other sugary liquids, unless told by your child's pediatrician
to use these.
- As often as possible, follow snacks with water or brushing.
As often as possible, clean or rinse your child's mouth with
water after bottles, foods, or medicine.
THE IMPORTANCE OF FLUORIDE
If your water system is not fluoridated, then fluoride should be
included in your child's vitamins. Ask your pediatrician about fluoride.