Preventing Baby Bottle Tooth Decay
Bonnie Headley, Project Director, Alaska Head Start Health
Improvement Initiative Dental Project, Anchorage, Alaska
Home visitors in the Alaska Head Start Health Improvement Dental Project have developed a number of strategies for helping parents protect their young children's teeth from Baby Bottle Tooth Decay. Younger siblings of Head Start children, or children enrolled in birth-to-three programs, can be spared pain and suffering by timely prevention. The areas of feeding and weaning young children are very personal, and require tact and sensitivity on the part of Head Start staff to support parents in making good choices.
First, share the information that tooth decay is catching. The bacteria that cause decay are passed from mother or other family members to the baby through tasting a spoonful of food, cleaning a pacifier in the mother's mouth, or the baby putting her fingers into a parent's mouth then into her own. If parents have good oral health, the chance of passing germs to the baby is less. Head Start's family focus should be to help parents establish good health habits for themselves as well as their children. Children will easily imitate their parents in such things as tooth brushing.
The value of fluoridated water in preventing tooth decay is also important. Fluoride causes stronger enamel to form as teeth grow and strengthens teeth already in the mouth. If fluoridated water is not available, prescription drops or tablets are available.
Next, help parents develop the habit of cleaning the baby's mouth, even before teeth appear. Using a clean gauze or cloth to rub the baby's gums after feeding cleans the mouth, stimulates the gums, and lets the baby get used to having her mouth cleaned. Holding the baby in a cuddle hold feels cozy to the child. When four teeth have appeared, switch to a soft toothbrush. If this habit is started early, children will cooperate more easily.
Bottles should always contain only formula, milk, or water. When a child begins to eat solid foods, night-time bottles of milk are usually no longer necessary. When a child is ready for juice, give it in a tippee cup.
When a child learns to walk, a "weaning window" appears. For several weeks to months, the new walker is so excited about his new height and ability to get around that he loses interest in the bottle or breast At this time, a child can very easily switch to a tippee cup for milk as well as juice. If the switch does not happen soon after walking, the child then becomes re-attached to the bottle, and weaning becomes much harder. For walkers who are still nursing, gradually diluting the bottle with more and more water is often effective.
The value of pictures in sharing information with parents is tremendous. The American Society of Dentistry for Children has published an excellent pamphlet entitled "Baby's Bright Smile." This pamphlet has clear photos that help parents see the risks of poor feeding practices. The American Dental Association and the American Academy of Pediatric Dentistry also have useful pamphlets on this topic, as do many State offices of Maternal and Child Health.
Sharing information with parents rather than giving advice or direction is the most effective and empowering approach to preventing Baby Bottle Tooth Decay. Stressing parents' roles as good models for their children also builds parental self-esteem, and strengthens families.