How can pregnant women take care of their oral health and that of their baby?

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Nowadays, as well as prenatal care with a gynecologist, prenatal care with a dentist specializing in babies and pregnant women is recommended. This care should start after the third month of pregnancy and should continue until the ninth. The dentist will guide how to help develop the baby's taste buds, how to maintain the mother-to-be's gums and teeth health. There is no point in “losing a tooth with every pregnancy”. You will receive the proper guidance on breastfeeding position, the importance of breastfeeding for the baby's correct oral development, pacifier and bottle nipples, how and when to use, eruption of baby teeth, cleaning of these. Types of brushes and toothpastes specific for babies and for early childhood, teethers, fluoride, diet, habits, etc. All this information will help prevent caries and gum problems in the mother and baby and also prevent orthodontic, respiratory and motor development problems.

Should I sanitize the baby's gums, tongue and teeth?

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If the baby has no teeth, there is no need to clean the mouth. When there are teeth, brushing should be started with soft brushes specific for babies  and with 1000 ppm F fluoridated toothpaste in small amounts (one grain of raw rice) . Our guideline is to use fluoride pastes as long as there is a minimum amount of paste on the brush. Fluoride is very important to prevent decay from developing. We do not recommend the use of cotton swabs or gauze for brushing. The child is motivated to brush by seeing an adult brushing. As adults brush with a brush and not with cotton swabs or gauze, using baby brushes from an early age helps to develop the habit of correct and real brushing.

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What is the relationship between breastfeeding and baby teething?

Breastfeeding will provide better alignment of the baby's teeth due to the development of the jaws, reducing the future need for orthodontic appliances:  

– Breastfeeding prepares the baby for chewing and nasal breathing.
– If it is not possible to breastfeed your baby, it is important to advise the dentist on the proper nipple for a bottle

Be careful with the bottle. It favors the appearance of rampant caries or bottle decay. This decay can occur in all of the child's teeth and is associated with a feeding or sweet food given mainly at night. The 6 to 8 month old baby can already have decay if he has teeth.

At soup time, the  Mom should avoid blowing, trying the flavor, or the temperature of the food in the baby's spoon or cup, as it can carry bacteria from your mouth to your child's mouth, transmitting diseases to the child.

How should the pacifier be used?

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If the child is breastfed, we should not force the use of a pacifier. If the child, after breastfeeding, still needs suction, we can offer a pacifier. In general, the child uses the pacifier until he falls asleep, then lets go during sleep.  You should prevent your baby from having habits such as pacifiers and finger sucking, which affect the development of teeth and bring

also harmful consequences to speech and breathing;

What is the best toothpaste?

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All pastes on the market are good. All contain enough fluoride to prevent cavities. However, some care is needed. Only use anti-tartar pastes, bicarbonate, calcium, chlorhexidine or desensitizers, if your dentist advises you to do so. These medicated pastes should only be used with professional guidance for as long as your dentist recommends. For children under 3 years old, use minimal amounts of toothpaste on the brush. Any paste can be used, as long as it has minimal amounts of dentifrice. It is best to use fluoride pastes on children under 3 years old so they get the fluoride benefit. It is difficult to brush babies' teeth (mechanical hygiene), so fluoride works to compensate for this difficulty (chemical control). Attention: it is very important to use minimal amounts of dentifrice (“dirty” on the brush).

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What is the best toothbrush?

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The best brush should have the following characteristics: small head (as small as possible). The smaller the head, the easier it is to reach the bottom teeth and the better we sanitize tooth to tooth. This is true for both children and adults. The brush should have soft bristles. The soft or extra-soft bristles massage and don't hurt the gums. Also, they don't wear out the teeth near the root. All bristles should be the same size, so they fit better over the teeth and gums, making for more adequate cleaning. It is currently recommended to start brushing right after the eruption of the first little tooth in the baby's mouth. There are several baby brushes on the market and all are suitable for every age group. We do not advise the use of finger cots, cotton swabs or gauze for cleaning, as these do not develop the correct habit of oral hygiene for the baby. The child learns by watching, and no one brushes their teeth with finger cots, gauze or cotton swabs. An adult should supervise brushing until the child is able to do it alone. Electric brushes are excellent brushing aids, especially for children with motor problems or those of motor development age, as they facilitate brushing. Ideally, they should be used at night or at times of greater availability for cleaning teeth. In other periods the conventional brushes can be used. There are specific brushes for various purposes. For example: for the hygiene of fixed orthodontic appliances, for dentures, for mobile or fixed bridges in the mouth, for those who have gum problems, etc. A professional can define the moment and the best indication of them.

Can fluoride harm your health?

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If used in excess, it can be harmful to health. Therefore, it must be administered correctly and with professional guidance. In Brazil, where public water supply is piped, the population receives the benefit of fluoride. The presence of fluoride in the water associated with brushing with fluoride toothpaste is an important aid in reducing tooth decay, as every time we drink water or brush our teeth, we give a fluoride bath to the tooth enamel. The dentist should always be consulted regarding fluoride applications in the office. These should be done when the patient shows signs of developing caries. Fluoride applied in the office can be in the form of gel, mousse or varnish. Mouthwashes can be important in preventing caries, however, their use should be advised by the dentist, as well as the amount of toothpaste in the brush for children under 3 years old. Ingesting too much mouthwash or toothpaste can cause fluorosis (staining of teeth during their formation phase).

What do I need to know about oral habits?

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Oral habits, that is, the systematic repetition of some act such as, for example, biting nails, sucking fingers, pacifiers, bottles, dental clenching, bruxism, etc., can cause dental problems or joint changes. In children, these habits can interfere with their oral development. In the case of prolonged use of pacifiers, bottles, finger sucking, mouth breathing, the child may present poor positioning of the teeth, open or crossed bites, projection of anterior teeth, etc. In adults, it can cause tooth wear, pain or joint problems. The guidance of a professional is essential to diagnose the problem and help resolve it. In the case of childhood habits, the pediatric dentist is able to guide how to adapt the habit so that it does not become an addiction. The sucking habit is natural until the age of two to three years, after this period the habit must be removed. Even if there are already oral changes due to these habits, these can resolve naturally. When not, the solution of these disorders may involve several professionals such as the orthodontist or the speech therapist. Often the help of a psychologist may be needed as these habits can be related to anxiety, stress or other emotional problems.

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What is the function of toothpaste?

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Toothpaste is very important for brushing and the fluoride contained in it is even more important to prevent cavities. In Brazil, all pastes contain fluorine around 1100 to 1500 ppm (in the form of NaF or MFP). There is a difference in abrasiveness in the folders. There are more and less abrasive ones. There are also several types of pastes: for gingival sensitivity, anticaries, anti-tartar, with bicarbonate, etc. Pastes for specific purposes must be prescribed by the dentist and for a defined period of time. If there is no oral alteration or dentist prescription, conventional or basic pastes are the best and most suitable.

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