Chapter 21

Parents of pre-11 year olds

INTRODUCTION

Parents will often ask for help on the care of their children’s teeth, and parents of pre-11-year-old children is an important target group for the oral health educator (OHE) in which good habits can be established early on in life.

GENERAL ADVICE FOR ALL AGE GROUPS

Sugar-free medicines

Advise parents to buy/request sugar-free medicines from supermarkets, pharmacies and doctors to help prevent caries (see Chapter 10).

‘One hour before bed’ rule

Encourage a ‘one hour before bed’ rule (i.e. no snacks or drinks 1 hour before bed). Toothpaste should be the last thing on the teeth before sleep. Only water should be provided if children require drinks through the night.

Passive smoking (see Chapter 13)

Passive smoking is especially dangerous for children and can increase the risk of:

• Childhood cancers, including leukaemia.
• Sudden infant death syndrome (SIDS), also known as cot death.
• Otitis media – middle ear infection, also known as glue ear.
• Poor lung function.
• Respiratory infections, such as asthma, bronchitis and pneumonia.
• Mental retardation and behavioural, psychiatric and cognitive problems.

Visiting schools and clubs

Talking to children in schools or uniformed groups (e.g. Brownies, Cubs) often works well. Teachers will especially welcome dental talks as health care is included in the UK National Curriculum, and the OHE can build links with local schools to promote oral health.

A visit to a school on a parents’ evening would provide an opportunity for parents to receive information, as well as children, as would an article about oral health education in the school newsletter. Schools are also an excellent place to set up an exhibition or display (see Chapter 18), and the OHE could also link in with other health professionals in giving advice.

ADVICE TO PARENTS OF 0–3 YEAR OLDS

Parents of 0–3 year olds are often bombarded with advice from health professionals, friends and family. However, much of this advice concerns the general well-being of the infant, and parents usually welcome specific information on the following topics.

Babies born with teeth

Natal teeth are teeth that are already present at birth, and are different from neonatal teeth, which appear during the first 30 days following birth.

Natal teeth are rare. They generally develop on the lower gum, where the central incisor teeth will appear, have little root structure, and are often wobbly and not well formed. They may cause irritation and injury to the infant’s tongue when nursing and may be uncomfortable for a nursing mother. Natal teeth are often removed shortly after birth while the newborn is still in the hospital, especially if the teeth are loose and the child runs a risk of aspirating (breathing in) the tooth.

If natal teeth are not removed, the parent should be advised to keep them clean by gently wiping the gums and teeth with a clean, damp cloth. The baby’s mouth should also be inspected frequently to make sure the teeth are not causing injury.

Eruption dates and teething advice

Parents should be advised that most teeth erupt from around the age of 6 months, but times are only approximate and will vary from 4–12 months plus (see Chapter 1).

Teething symptoms

Some teeth grow with no pain or discomfort at all, but at other times the parent may notice any of the following symptoms [1]:

• Sore, red gums where the tooth is coming through.
• A flushed cheek.
• Dribbling.
• Gnawing and chewing.
• Fretful behaviour.

You may have heard of other perceived symptoms, such as diarrhoea and fever, however, there has been no conclusive research to prove that these symptoms are linked to teething.

Advice on relieving pain

Each child responds differently to pain relief and parents may find that they have to experiment with some of the following measures before finding what works for their baby [1]:

• Teething rings – to chew on. Can ease pain/provide a distraction. Some can be cooled in the fridge, but should not be put in the freezer (which can damage gums). A wet flannel is an alternative to a teething ring.
• Teething gels (sugar free) – for babies over 4 months old. Available from pharmacies, they are rubbed onto gums and often contain a mild anaesthetic to numb pain. May also contain antiseptic ingredients to help prevent infection in a sore/broken skin. For teething gel options for babies under 4 months old, the parents should consult their GP.
• Chewing – chew healthy snacks, such as raw fruit and vegetables (e.g. carrot and apple), breadsticks, bread crusts and Bickiepegs®, which are sugar free, vegetarian and kosher. Parents should stay close by to avoid choking. Avoid rusks (and other foods which contain sugar).
• Painkilling medicine (containing paracetamol/ibuprofen) – to relieve pain/temperature. Should be sugar free and be specific to the age group.
• Cool drinks (sugar free) – can help soothe gums and excessive dribbling (cool water is best).
• Comfort – comforting/playing with baby to distract them from pain.
• Preventing rashes – if baby is dribbling excessively, wiping their face and chin will help prevent rashes.

If a parent thinks their child’s behaviour is particularly unusual or symptoms are very severe they should be advised to consult their GP or call NHS Direct.

Effective cleaning of newly erupt/>