2023-09-10 09:39:29
by Chiara Daina
Not only with attention in the first years of life, but already starting from pregnancy, the mother can be decisive for the oral health of the child
Baby’s oral health begins in the womb. Your first thousand days, which go from conception to the second year of life, are the basis for having healthy teeth and gums in the future. But to protect the mouth of the unborn child, the mother must learn to take care of her oral situation, clean her teeth correctly and have a healthy eating style, even before pregnancy. In fact, her behaviors will influence the oral health of the child.
Unfortunately there is little awareness about oral prevention for future mothers and children from the first months of life. It is therefore essential that dentists, dental hygienists, gynaecologists, obstetricians and paediatricians instruct women on the rules to follow to maintain a healthy mouth before, during and after gestation and on the oral hygiene to be practiced in the child from birth to the appearance of the first tooth up to two years, a phase in which the cleaning of his oral cavity is still neglected. Just as the genitals should not be left dirty after a diaper change, the gums should be cleaned after feedings and the first teeth after meals, underlines Luigi Paglia, director of the Department of Maternal and Child Dentistry at the Italian Stomatological Institute in Milan. .
The gums
Pregnancy is a delicate period for your teeth. Due to the increase in estrogen and progesterone levels, the gingival tissues are more vascularized and often show an exaggerated inflammatory response towards the microorganisms of bacterial plaque – explains Maria Grazia Cagetti, director of the School of Specialization in Pediatric Dentistry at the University of Milan . During pregnancy, the risk of gingivitis and periodontitis is more frequent (when the inflammation extends to the deep tissues, i.e. the periodontal ligament and the alveolar bone that supports the tooth, ed.) – continues Maria Grazia Cagetti -. According to studies, at an international level, gingivitis affects up to more than 60% of pregnant women, and the prevalence of periodontitis reaches approximately 40%. also demonstrated that maternal periodontal infections, especially in the presence of other factors, such as smoking, alcohol and diabetes, are associated with adverse effects of pregnancy, such as miscarriage, preterm birth and low birth weight.
Enamel erosion
Furthermore, nausea, vomiting and esophageal reflux often present in pregnant women, and the consumption of sugary foods and drinks between meals, predispose to the erosion of the enamel and then to the onset of tooth decay without adequate oral hygiene. The bacteria responsible for tooth decay, which are commonly found in the mouth, metabolize sugars and produce acids that cause demineralization of the enamel, which over time leads to the formation of a carious cavity, explains the expert.
Oral hygiene on hold
It is important for the expectant mother to brush her teeth after every meal, preferably with an electric toothbrush for more thorough and uniform cleaning, with a fluoride toothpaste and use dental floss or a toothbrush at least once a day. Do not drink water immediately after cleansing so as not to nullify the effect of fluoride in blocking the reproduction of bacteria and mineralising the enamel – Cagetti continues -. Also remember about professional dental hygiene: when you discover you are pregnant you should book a session if not done in the previous six months or in case of gingivitis, to remove the tartar and resolve the inflammation. The signs are: spontaneous bleeding or when brushing, blood-stained pillow upon waking, swelling, redness and pain in the gums.
it is useful to chew chewing gum with xylitol after meals. Xylitol – explains the dentist – limits the growth of the bacteria responsible for tooth decay and helps control the pH of the plaque which damages the enamel. If correct oral hygiene of the pregnant woman is encouraged, the cariogenic bacteria in her mouth are reduced and the colonization of the newborn’s mouth is delayed – underlines Paglia -, which can occur through small gestures that involve an exchange of saliva, from kisses on the mouth to cleaning of the pacifier falling to the ground with one’s own saliva, tasting baby food with the same spoon with which the child is fed, breaking a piece of fruit or bread with the teeth.
The checks to be done
The Recommendations for the promotion of perinatal oral health (2014) of the Ministry of Health suggest a dental check-up if not carried out in the last six months and, in general, every time a problem arises. Postponing treatment can lead to complications – warns Cagetti -. Untreated gingivitis can lead to periodontal disease. An untreated carious lesion can cause contamination of the dental pulp, which contains the nerve endings, causing acute inflammation, called pulpitis. In turn, pulpitis, if not treated well in a short time, can cause abscesses that can extend to neighboring tissues: cheekbone, chin, around the eyes.
Treatments (per quarter)
In the first trimester, it is the most delicate (because the implantation of the embryo takes place), and in the third it is advisable to treat only emergencies (pulpitis, abscesses, dental trauma). The second trimester is considered the safest for any treatments (fillings, root canals, extractions). During pregnancy, the use of anti-inflammatories or antibiotics is absolutely not contraindicated, as long as they are prescribed by your doctor, Cagetti points out. Oral hygiene in newborns Prevention of tooth decay begins before the eruption of the teeth.
It is a good habit to clean the gums, tongue and mouth of the newborn at the end of each feeding to eliminate milk residues by delicately massaging with a glove or a silicone finger or a gauze moistened with water and wrapped around a finger. Especially after night feedings because the cleansing mechanisms of the saliva and tongue fail – informs Paglia -. In this way the child becomes familiar with the practice of hygiene and has less difficulty accepting it after tooth eruption. Parents, siblings, grandparents, uncles, babysitters must be careful not to transfer bad bacteria through kissing on the mouth, using the same cutlery, cleaning the pacifier with their own saliva. The child, having an immature immune system and a developing oral microbiota, easily acquires these microbes, which in the absence of teeth are removed through swallowing but will stably colonize the surfaces of the milk teeth when they emerge, continues Cagetti.
The first visit
The Ministry’s Clinical Recommendations in odontostomatology (2017) recommend a first visit with the pediatric dentist at 18-24 months regardless of the presence or absence of problems. However – says Paglia – it would be useful to bring forward the visit within 2-3 months after giving birth to explain to the parents how to carry out oral hygiene immediately and what behaviors to adopt to avoid transferring the cariogenic bacteria to them. You will also have the opportunity to check the frenulum of the tongue. If short, it prevents normal lingual mobility and correct sucking of milk from the maternal nipple, using excessive force with the gums and lip muscles and creating pain in the breast.
The first tooth
The first teeth to emerge, around six months, are the central incisors. With the eruption of the teeth, the risk of tooth decay in children becomes real, recalls Paglia. If only the incisors are present, gauze or gloves can continue to be used. With the appearance of the molars, between 14 and 18 months, it is essential to start using the toothbrush, with soft bristles and small head, to clean both the smooth surfaces and the occlusal grooves, 2 or 3 times a day, particularly in the evening because the The self-cleaning action decreases. The parent can lay the child down on the changing table or after the year make him sit on a chair to have a good view during cleaning, recommends Paglia. Finally: do not dip the pacifier in sugar or honey and remove it at 2-3 years of age. Prolonging the time – warns the doctor – can create deformations of the bone growth of the palate and an alteration of the dental arches with dysfunctions in swallowing and breathing.
September 10, 2023 (modified September 10, 2023 | 09:39)
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