Current evidence indicates that a woman's oral health can have an impact on obstetrical outcomes such as premature birth and the development of pre-eclampsia (Boggess & Edelstein, 2006). Given the ramifications of poor oral health, what better time to establish good oral health practices than during infancy and early childhood? Past topics in this column have particular relevance to the topic of this column: both juice consumption (Morin, 2006a) and fluoride use (Morin, 2006b) play a significant role in an infant or child's oral health. This column builds on previous information to provide a more comprehensive approach to infant oral health.
Why Such Emphasison Oral Health?
There are several reasons for emphasis on oral health. Fostering good oral health habits is a behavior that can be incorporated easily into activities of daily living, and good oral health can decrease the incidence of dental caries, which are the most common chronic childhood disease (Douglass, Douglass, & Silk, 2004). Reinforcing oral health behaviors certainly falls within the purview of our nursing practice. Moreover, nurses' interactions with parents focus on health-promoting behaviors, regardless of setting.
What Assessments Should You Perform?
You might begin by assessing the parents' own degree of oral health and their knowledge of good oral health behaviors. If you notice missing teeth or untreated cavities, that could indicate poor oral health caused by a lack of sound health behaviors or lack of dental care, either through choice or personal circumstances. These findings place an infant or toddler at risk for the development of dental caries (Douglass, Douglass, & Silk, 2004). Once you have a general idea of the state of parental oral health, you can assess their knowledge of oral health for their infant or toddler. When the focus of your attention is on the infant, consider the following in your assessment:
* Type of infant feeding. When parents choose to formula-feed, then reinforce that bottles should not be propped and that only breast-milk or formula should be placed in the bottle.
* Type of formula. Formulas that contain sucrose, such as some soy-based ones, may increase the incidence of cavities.
* Use of juices. Infants under the age of 6 months should not be offered juices.
* Sources of fluoride. This information can be obtained when the infant is as young as 4 months of age. Remember that the presence of fluoride in drinking water varies by municipality.
* Use of a toothbrush. Think about this specific point when interacting with parents whose infant is older than 6 months. Suggest that parents brush use a small, soft brush and that they brush their infant's teeth twice a day with a small amount of fluoridated toothpaste.
Once the infant is a toddler and finger foods are introduced, emphasize that "sugar-containing foods should be limited to meal times, and a regular pattern of means and set snacks should be developed, rather than 'grazing'" (Douglass, Douglass, & Silk, 2004). Nurses can play a key role in establishing and maintaining the oral health of infants and toddlers. Although one of the major culprits of dental caries is mutans streptococci, which is passed to the infant via mother's saliva, the other culprit is frequent consumption of sugar. Encourage parents to examine their infant and toddler feeding behaviors critically. Doing so will start their children off on the road to good oral health.
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