Perinatal and Infant Oral Health

Pregnancy is an exciting time. It is also a crucially important time for the unborn child’s oral and overall health.  The “perinatal” period begins approximately 20-28 weeks into the pregnancy, and ends 1-4 weeks after the infant is born.  With so much to do to prepare for the new arrival, a dental checkup is often the last thing on an expectant mother’s mind.

Research shows, however, that there are links between maternal periodontal disease (gum disease) and premature babies, babies with low birth weight, maternal preeclampsia, and gestational diabetes.  It is of paramount importance therefore, for mothers to maintain excellent oral health throughout the entire pregnancy.

Why are perinatal dental checkups important?

Maternal cariogenic bacteria is linked with a wide range of adverse outcomes for infants and young children.  For this reason, the American Academy of Pediatric Dentistry (AAPD) advises expectant mothers to get dental checkups and counseling regularly, for the purposes of prevention, intervention, and treatment.

Here are some perinatal oral care tips for expectant mothers:

• Brush and floss – Be sure to use an ADA approved, fluoridated toothpaste at least twice each day, and floss at least once each day, to eliminate harmful oral bacteria.  In addition, an alcohol-free mouthwash should be used on a daily basis.
• Chew gum – Xylitol, a natural substance, has been shown to reduce infant and toddler caries (cavities) when chewed 3-5 times daily by the expectant mother.  When choosing gum, check for the “xylitol” ingredient – no other sugar substitute has proven to be beneficial in clinical studies.
• Diet evaluation – Maintaining a balanced, nourishing diet is always important, but particularly so during pregnancy.  Make a food eating diary and look for ways to cut down on sugary and starchy foods.  Sugars and starches provide food for oral bacteria, and also increase the risk of tooth decay.
• Make regular dental appointments – When seen regularly, the dentist can bolster homecare preventative efforts and provide excellent advice.  The dentist is able to check the general condition of teeth and provide strategies for reducing oral bacteria.

How can I care for my infant’s gums and teeth?

Many parents do not realize that cavity-causing (cariogenic) bacteria can be transmitted from the mother or father to the child.  This transmission happens via the sharing of eating utensils and the “cleaning” of pacifiers in the parent’s mouth.  Parents should endeavor to use different eating utensils from their infants and to rinse pacifiers with warm water as opposed to sucking them.

Parents should also adhere to the following guidelines to enhance infant oral health:

• Brush – Using a soft-bristled toothbrush and a tiny sliver of ADA approved non-fluoridated toothpaste (for children under two), gently brush the teeth twice each day.
• Floss – As soon as two adjacent teeth appear in the infant’s mouth, cavities can form between the teeth.  Ask the pediatric dentist for advice on the best way to floss the infant’s teeth.
• Pacifier use – Pacifiers are a soothing tool for infants.  If you decide to purchase a pacifier, choose an orthodontically correct model (you can ask the pediatric dentist for recommendations).  Be sure not to dip pacifiers in honey or any other sweet liquid.
• Use drinking glasses – Baby bottles and sippy cups are largely responsible for infant and toddler tooth decay.  Both permit a small amount of liquid to repeatedly enter the mouth.  Consequently, sugary liquid (milk, soda, juice, formula, breast milk or sweetened water) is constantly swilling around in the infant’s mouth, fostering bacterial growth and expediting tooth decay.  Only offer water in sippy cups, and discontinue their use after the infant’s first birthday.
• Visit the pediatric dentist – Around the age of one, the infant should visit a pediatric dentist for a “well baby” appointment.  The pediatric dentist will examine tooth and jaw development, and provide strategies for future oral care.
• Wipe gums – The infant is at risk for early cavities as soon as the first tooth emerges.  For young infants, wipe the gums with a damp cloth after every feeding.  This reduces oral bacteria and minimizes the risk of early cavities.

If you have further questions about perinatal or infant oral care, please contact your pediatric dentist.