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Key Points
 
With eruption of the first tooth, parents should begin brushing with a soft-bristled, small-head brush.
 
The most important time to brush is at night, after the last feeding, with children being allowed to consume only water afterwards.
 
To prevent fluorosis, parents should make efforts to minimize the swallowing of toothpaste, or consider using only water or a non-fluoridated toothpaste.
 
Parents should begin flossing the child’s teeth as soon as the tooth surfaces touch each other.
 
Eating and drinking supply bacteria in the mouth with the carbohydrates they need to produce acid and destroy tooth enamel.
 
The type of food and pattern of ingestion both impact caries development.
 
Caregivers should decrease the frequency and duration of sugar intake, promptly remove carbohydrates from the teeth, and choose less cariogenic foods.
 
Night feedings should be discouraged once a child's teeth begin to erupt.
 
The American Academy of Pediatrics recommends no juice for children younger than 1 year of age and limiting juice consumption in older children.
 
A diet of fresh fruits, vegetables, and whole grains is best in the prevention of Early Childhood Caries.
 
Frequent snacking and drinking throughout the day increases a child's risk of caries.
 
Families should be encouraged to avoid sticky foods such as dried fruits, fruit roll-ups, and candies.
 
Decreased saliva production is a known risk factor for the development of caries.
 
Causes of limited saliva production include systemic diseases and salivary gland damage.
 
Decreased saliva production is most commonly a medication side effect.
 
When a child is at risk or is known to have xerostomia, he or she should be more closely screened for caries by a dentist.
 
Dental caries is an infectious process, so delaying bacterial colonization will delay caries development.
 
Because modifying the primary caregiver's dental flora can significantly affect a child’s caries risk, physicians should promote improved parental oral hygiene.
 
Anticipatory guidance includes recommending that parents brush their teeth twice daily with a fluoridated toothpaste, as well as floss daily.
 
Parents can decrease transmission of oral bacteria to children by minimizing the passage of saliva.
 
The American Academy of Pediatrics recommends that children with risk factors for caries be seen by a dentist within 6 months of eruption of the first tooth or 12 months of age, whichever comes first.
 
Risk factors such as special health care needs and sleeping with a bottle warrant referral to a dentist. It is recommended that, whenever possible, all children be referred to a dentist by 12 months of age.
 
It is important to create relationships with local dentists to allow for “emergent” referrals.
 
Risk factors such as special health care needs and sleeping with a bottle warrant referral to a dentist.
 
It is recommended that, whenever possible, all children be referred to a dentist by 12 months of age.
 
It is important to create relationships with local dentists to allow for “emergent” referrals.
 
Dental sealants provide a physical barrier to bacterial invasion of pits and fissures and should be applied to all high-risk children around the ages of 6 and 12.
 
Sealants can be applied at any time; however, ages 6 and 12 are ideal because that is when the permanent molars erupt.
 
Sealants are cost-effective because they typically last 5 to 10 years and cost less than half that of a filling.
 
Fluoride is effective in the prevention of caries, but primarily benefits the smooth surfaces of the teeth.
 
Parents of infants should be counseled to begin brushing once teeth erupt.
 
Recommend that families discontinue bottle use by 12 months
of age.
 
Parents of toddlers should be advised to limit sippy cup use and to keep snacks to one time between meals.
 
Cariogenic snacks should be limited for all children, with fresh fruit, vegetables, and whole grains being the snacks of choice.
 
Parents of infants should be counseled to begin brushing once teeth erupt.
 
Adolescents have unique issues that need to be addressed, such as oral piercing and tobacco use.
 
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