Different Ages/Different Stages Birth to 12...

Oral HealthDifferent Ages/Different Stages

Birth to 12 years

Oral Health

ORAL HEALTH • DIFFERENT AGES/DIFFERENT STAGES • BIRTH TO 12 YEARS

TABLE OF CONTENTSA message from the Oral Health Director . . . 3

Why is Oral Health Important? . . . . . . . . . . . . . . 4

What Causes Cavities? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

When You Neglect Your Child’s Teeth . . . . . . . . . . . . . . . . 5

Taking Care Of Your Child’s Teeth . . . . . . . . . . . . . . . . . . . . 6 • Brushing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 • Flossing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 • Fluoride . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Nutrition and Good Dental Snacking . . . . . . . . . . . . . . . . 8

Good Dental Snacking and Drinks . . . . . . . . . . . . . . . . . . . 9

Canada’s Food Guide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

Injury Prevention and Mouth Guards . . . . . . . . . . . . . . . 11

Dental Emergencies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

Eruption Chart (When Teeth Come In) . . . . . . . . . . . . . . 13

Different Ages/ Different Stages . . . . . . . . . . . . . . . . . . . . 14 • 0 to 6 months . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14-15 • 6 to 24 months . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-17 • 2 to 5 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 • 6 to 12 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20-21

Do’s and Don’ts For A Great Smile . . . . . . . . . . . . . . . . . . . 22

Other Oral Health Resources . . . . . . . . . . . . . . . . . . . . . . . . 23

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Dear Reader,

Thank-you for taking the time to learn more about your child’s developing teeth . Good oral health is important for children as they grow . Healthy teeth are important for learning to talk, eating a healthy nutritious diet and smiling .

The Region of Durham supports the efforts of all residents to have good dental health . Through our partnerships with the Provincial Government and the Durham Department of Social Services we are able to help many residents access dental care . The following are some of the programs available to help:

1. CINOT - The Children In Need Of Treatment Program • Provides assistance to pay for urgent dental needs• Only for children up to 17 years• The child must be screened by Oral Health Division Staff before

treatment is done

2. HSO - Healthy Smiles Ontario• Provides regular detnal care for eligible children 17 years and

under whose families have an adjusted family net income of $20,000 or less

• There is an application process that involves completing a form and showing required documentation

3. Ontario Works (OW) Dental Benefits• Dependant children up to the age of 17 years are eligible to

receive basic dental services, including fillings and preventive care

4. Preventive Services• Children who are identified as needing care are eligible to receive

free preventive services such as fluoride and pit and fissure sealants

We hope that you find this booklet helpful . We encourage you to keep this booklet as a handy resource .

Remember a healthy mouth means a healthy you,

Dr . Patricia L . AbbeyDirector, Oral Health DivisionDurham Region Health DepartmentPhone 905-723-1365 or 1-866-853-1326

For more information, please call or visit our website at:durham .ca

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WHY IS ORAL HEALTH IMPORTANT?“A Healthy Mouth means a Healthy You”. In 2000, the Surgeon General in the United States wrote the first ever report on Oral Health in America. He said:

“Oral health is integral to general health . You cannot be healthy without oral health . Oral health and general health should not be interpreted as separate entities .

Oral diseases are progressive and cumulative and become more complex over time . They can affect our ability to eat, the foods we choose, how we look and the way we communicate . These diseases can affect economic productivity and compromise our ability to work at home, at school or on the job .”

Healthy teeth and gums are important as your child grows to help them develop good speech, healthy eating habits and good social skills .• Cavities are the most common, chronic disease of early childhood .• Oral diseases are infectious, progressive, often painful and expensive

to treat .• Poor oral health has been linked to diabetes, heart disease and other

long-term health problems in adults .

What Causes Cavities?• The most common oral disease in children is cavities . It is caused by

bacteria in the mouth . • Everyday a sticky film called plaque forms on the teeth .• Plaque is made up of bacteria and food debris that collects on your

teeth day and night .• If plaque is not removed by brushing and flossing on a regular basis,

it will cause cavities and lead to periodontal (gum) disease . Cavities (tooth decay) occur when food and liquids that contain sugar combine with the bacteria to make an acid . This acid attacks the teeth and can cause cavities .

There’s no such thing as “Soft Teeth”. Many people believe that they suffer from cavities because they have “soft teeth” . While family history is important, most cavities develop because people eat too much sugar and do not thoroughly brush and floss their teeth .

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WHEN YOU NEGLECT YOUR CHILD’S TEETH...Children with poor oral health tend to struggle in school, may lack self esteem and may have less success later in life.

This could lead to undesirable outcomes such as:

• Cavities and gum disease• Pain• Infection• Loss of teeth• Difficulty learning and communicating• Poor nutrition• Lack of sleep• Lower body weight• Prolonged infection and/or swelling• Poor self esteem• Future serious dental problems• High cost of dental care

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TAKING CARE OF YOUR CHILD’S TEETHBrush Your Child’s Teeth Every Day2 FOR 2 IS WHAT YOU DO . . .

• We recommend that you brush your child’s teeth for two minutes twice a day .

• Bedtime is the most important time to brush to prevent cavities .• Use a manual or power toothbrush with soft bristles .• Use a toothpaste that contains fluoride (recommended by the

Canadian Dental Association) .• Move the brush in a small circular motion over the teeth and gums .• Brush all the outside, inside and chewing surfaces of the teeth .• Gently brush the tongue to remove any germs and to make your

child’s mouth feel fresh .

Floss Your Child’s Teeth Every Day• We recommend flossing at least once a day to clean between the

teeth and under the gums .• Take a piece of floss about 45cm (18 inches) long and wrap it

around your middle fingers until you have no more than 2 .5cm (1 inch) in length between them .

• With the thumb and index finger of each hand, guide the floss gently and carefully between each tooth using a back-and-forth motion until it reaches the gum line .

• Curve the floss into a C-shape around each tooth and slip it under the gum line .

• Slide it up and down the side of the tooth .• Move the floss to the side

of the next tooth and repeat .

• Remove the floss and repeat the above steps for each tooth .

Let your child practice these new skills, but remember as the adult, you are the one to do the job effectively!

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Use Fluoride Every DayFluoride is a naturally occurring substance that helps prevent cavities by strengthening the enamel (outer layer) of the tooth. There are four main sources, most tap water, many toothpastes, rinses and professionally applied fluoride at the dental office. Fluoride is also found in many foods.

Tap Water• Over the past 60 years it has been a

major factor in the decline of tooth decay .

• The water in Durham Region is fluoridated at the provincial standard of 0 .5-0 .8 p .p .m .

• Areas in Durham Region with fluoridated water include:1 . Pickering2 . Ajax3 . Whitby4 . Brooklin5 . Oshawa6 . Parts of Courtice (if on Oshawa water)

• Fluoridation of community water supplies benefits everyone equally .

• Fluoridation is cost effective because it saves money on dental treatment needs .

Fluoridated Toothpaste• We recommend the use of toothpaste that contains fluoride and has

been approved by the Canadian Dental Association .

Fluoride Rinses and Supplements• Sometimes your dentist or hygienist might recommend your child

use a fluoride rinse or supplement . This is not for everyone . Your dental professional should review all sources of fluoride your child is already receiving .

Professionally Applied Topical Fluoride• Your dental professional may suggest that your child could benefit

from a topical fluoride treatment at their check-up appointment .

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NUTRITION AND GOOD DENTAL SNACKINGGive your child, nutritious meals and snacks that will develop strong bodies and healthy teeth that will last a lifetime.

Be a good role model. Healthy eating and active living are important for your children to reach their full potential .

• Choosing a variety of different foods from each of the 4 food groups (Canada’s Food Guide) will help your children achieve proper energy levels, growth and overall health .

• Start the day in a healthy way! Eating a nutritious breakfast is a great start to your child’s day . Try cereals that are low in sugar, whole grain breads, fresh fruit, yogurt, milk, cheese and eggs .

Healthy Lunches And Snacks For School• Involve your child in planning lunches • and snacks . • Do not let lunch and snacks get boring .• Offer your child a selection of nutritious • foods and let them choose their • favourites .• Think like a kid . Stick to foods you know • your child will like . Introduce new foods at • home instead of in the lunch bag .

What Should Kids Be Eating?• Fruit and vegetables- carrots, celery, cucumbers, peppers,

broccoli, apples, oranges, bananas, kiwi, watermelon, pineapple, strawberries, blueberries, cherries

• Grains- bread, bagels, pitas, unsweetened cereals, pasta, rice, crackers .

• Milk and Alternatives- yogurt, cheese, milk• Meat and Alternatives- fish, chicken, turkey, beef, ham, beans and

lentils . Pumpkin, sunflower seeds and nuts

Note: Be aware of allergy restrictions in schools and daycares.

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GOOD DENTAL SNACKING AND DRINKS• Snacks that are nutritious, sugar-free, and do not stick to your child’s

teeth are the best dental snacks .• Research shows that eating cheese may help prevent tooth decay .• Kids should drink milk, water and a limited amount of 100% juice .

Liquid Sugars• Pop is mainly water, sugar . and caffeine . One can of pop (355ml)

contains 50 mls (10 teaspoons) of sugar! Drinking too much pop has been linked with tooth decay and obesity .

• Sport drinks were developed to help you recover from strenuous exercise . They should not be used as regular thirst quenchers, because they are high in sugar, calories and chemicals .

• “Fruit drinks” are different from 100% juice . Think of these drinks as pop without the bubbles .

• Read your Labels! Sugar comes in many disguises - dextrose, glucose, fructose, lactose, maltose, corn syrup, maple sugar and honey .

• Milk is a great drink that is loaded with vitamins and minerals . The calcium and vitamin D in milk will build strong teeth and bones in growing children .

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REFER TO CANADA’S FOOD GUIDE FOR MORE RECOMMENDATIONS

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INJURY PREVENTION AND MOUTH GUARDSOnce your baby is on the move . . . • Prevent tooth injury by using safety gates

and putting corner guards on furniture . • DO NOT allow them to walk or run with

anything in their mouth .

Once your child is on the move . . .• Many children begin sports early . Your child may require a mouth

guard for a number of activities . Some organizations have a mandatory mouth guard policy .

• Wearing a mouth guard is an important part of any athlete’s uniform . It will help to protect the teeth, lips, and cheeks . It may prevent concussions and jaw fractures .

There are many different kinds of mouth guards, speak to your dental professional for the correct type and fit.

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DENTAL EMERGENCIES Your child is growing and changing everyday, crawling, walking and running. Along with these new milestones, bruises, bumps, and accidents can occur. The following is a guide to help you deal with a dental emergency.

Toothache• If swollen, place a cold compress on the face next to the sore tooth .• DO NOT use heat as this can increase swelling and pain .• DO NOT place aspirin, other pain relievers or numbing gels on

gum tissue around the sore tooth .• Take the child to the dentist .

Knocked-Out Permanent (Adult) Tooth• CHECK to see if your child has any serious injuries .• If it is a baby tooth, do not try to replace (a child under 5 years will

probably not have adult teeth) .• DO NOT clean the tooth .• If it is a permanent (adult) tooth, try to replace the tooth in the

socket .• If you cannot replace the tooth in the socket, put the tooth in a

glass of milk immediately .• See a dentist or go to the nearest urgent care immediately (even if

you cannot find the tooth) .

Broken Or Bumped Tooth• Place a cold compress on the face next to the injured tooth .• Take the person to the dentist immediately .

Bitten Tongue Or Lip• If swelling persists, apply a cold

compress .• If bleeding persists or the bite is

severe, take the child to the dentist or urgent care .

Possible Fractured Jaw• Take the child to the hospital

immediately .

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ERUPTION CHART

This is a guideline only, your child’s teeth may “come in” and “fall out” at different times

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DIFFERENT AGES AND DIFFERENT STAGESBirth to 6 MonthsAs early as 6 weeks, into your pregnancy your baby’s first teeth are beginning to grow. Looking after your oral health and eating nutritious foods is very important for both you and your baby. Research has linked gum disease in pregnant women to an increased risk of premature low birth weight babies. It is essential to maintain regular dental visits during your pregnancy.

Smoking while pregnant can have many serious side effects on your unborn child including a condition called cleft lip and palate, which may require several operations to correct .

Early Childhood Tooth Decay• Is tooth decay that occurs in very young

children up to four years of age .• This decay results when liquids that

contain sugar are left in the baby’s mouth for a long time, and the teeth are not cleaned .

• These liquids include: breast milk, formulas, cow’s milk, fruit juice, sweetened tea, soft drinks and many others .

• These cavities start on the top front teeth . • Look for any chalky white or brown spots,

at the front and back of the teeth .

How To Prevent It!• Lift your baby’s lip monthly and check the front and back of their

front teeth for any of these spots .• Never dip a pacifier in sugar, honey or other sweets .• When your baby is able to sit up alone, give him/her a cup to • drink from .• Babies do not have decay causing bacteria at birth . To avoid

giving your baby these bacteria, DO NOT share utensils (testing temperature of their food or place their pacifier in your mouth to clean)

• Most liquid medications are available sugar-free . If not available, clean your baby’s mouth after giving the medication .

• Your baby’s bottle should not be used as a pacifier .

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TeethingTeething is a natural process of baby’s first teeth working their way through the gums.

Common Signs Of Teething• Drooling, irritability, sore

and swollen gums, loss of appetite, rashes and showing a need to chew on things .

• High fever, severe diarrhea and vomiting are NOT common symptoms of teething . If this occurs take your child to their doctor .

Helping You And Your Baby Through Teething• Offer a teething ring that only contains water, cooled in the

refrigerator .• Offer a clean, damp, cooled wash cloth for your baby to chew on .• Massage your baby’s gums with your clean finger or baby wash

cloth .

DO NOT . . .• Use teething gels or ointments as they contain medicines that may

harm your baby .• Avoid giving teething biscuits to your baby as they contain sugar

and could be a choking hazard .

Cleaning Your Babies Mouth• It is important to begin the habit of cleaning your baby’s mouth,

before the teeth come in .• Choose a convenient time to clean your baby’s mouth each day .

eg . bath time is ideal because your baby is happy and relaxed .• Wipe the inside of your baby’s mouth with a clean wash cloth or a

finger brush . • Regular mouth care makes your baby’s mouth feel fresh and

develops good habits .

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6 TO 24 MONTHSBetween the ages of 6 to 24 months there will be many changes in your baby’s mouth. The first tooth will appear around 6 months of age. Twenty baby teeth will come in. Give your child the gift of healthy teeth for life with daily brushing, nutritious meals and snacks.

Lift The Lip• Babies can get cavities as soon as teeth erupt .• Once a month lift your child’s lip and look for chalky white or

brown spots on the front and back of their upper front teeth .• If you notice any spots or anything unusual take your child to their

dentist .

Thumb Sucking• Sucking is a natural urge which comforts and relaxes .• Thumb sucking usually stops by 4-5 years of age .• If this habit continues after the permanent teeth have erupted it

could affect the positioning of your child’s teeth or jaws .• You should seek the advice of a dental professional if you have any

concerns .

Pacifiers: Are safe to use• Satisfies your babies’ natural need to suck .• Easier to stop using pacifier than thumb sucking .• Choose a pacifier that is the right size for your child’s mouth .• Use an approved pacifier that meets safety standards .• Wash before first use and on a regular basis in soap and water .• NEVER clean a pacifier in your own mouth . This could spread

bacteria .• Check often for signs of wear and

replace it if it is sticky, cracked or torn .• DO NOT attach a string to a pacifier –

use a proper clip .• DO NOT dip a pacifier in sugar, honey

or anything sweet, this could cause cavities .

• Use of a pacifier should be stopped as soon as possible, it could affect the position of your child’s teeth .

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First Dental Visit• Take your child to the dentist by their first birthday for a quick look . • Start dental visits early, so your child will learn the

importance • of good oral health care .• Your dental professional will then advise you about

future visits .

Bottle• A bottle should be used ONLY to give a nutritious meal . • DO NOT let your child use the bottle as a pacifier .• Wean your child from the bottle by 12 to 14 months of age .

Introducing Your Child To A Cup• Start giving your child a cup at approximately 6 months of age or

when your child is able to sit up .• Frequent drinking or sipping on milk, juice or anything sweetened

with sugar could cause cavities .• DO NOT substitute a bottle with a sippy cup .

Cleaning Your Child’s Mouth• Daily cleaning of your child’s mouth is important .• Wipe the inside of your child’s mouth with • a clean washcloth or a finger brush .• When a few baby teeth have appeared you • could start using a small soft toothbrush to clean them .• Use WATER ONLY on the toothbrush until your child can spit out . • Brush in a circular motion .• Brush twice a day and especially after the baby’s night-time feeding .

Snacking• Healthy snacking plays an important role in oral health .• Encourage healthy choices such as cheese, soft cooked or canned

vegetables, fruit and yogurt .• If your child needs a drink between meals, water is best .

Be aware of foods that could cause choking:• Grapes, berries or raisins• Nuts• Potato chips and popcorn

• Raw vegetables• Hot dogs• Peanut butter

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ORAL HEALTH • DIFFERENT AGES/DIFFERENT STAGES • BIRTH TO 12 YEARS 18


2-5 YEARSHealthy baby teeth are extremely important for eating, smiling, talking and keeping the space for adult teeth. Regular dental check-ups are important to maintain good oral health.

Home Care1 . Brush your child’s teeth 2 times a day especially at bedtime .2 . Daily flossing of your child’s teeth is important .3 . You may begin using a fluoride toothpaste, (recognized by the4 . Canadian Dental Association) only if your child can spit out . 5 . DO NOT let your child swallow or eat the toothpaste .6 . Use a soft bristled toothbrush, with a small amount of toothpaste .

(the size of your child’s baby fingernail) .

Regular Dental VisitsStart regular visits between two and a half and three years of age, or as advised by your dental professional .

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6 TO 12 YEARS OF AGEYour child will experience many changes during these years. Their baby teeth will fall out and their adult teeth will appear. Adult teeth are usually larger and more yellow in colour than baby teeth. This is sometimes called the “ugly duckling stage” because their teeth can sometimes be crowded and may not look ideal. Remember, their jaw is still growing!

Wiggly Teeth . . . your child will lose their baby teeth . . . it is a milestone in their lives! • The first baby tooth to be lost is usually a lower front tooth at

around 6 years of age .• Don’t be surprised when only the top of the tooth (the crown) falls

out . The roots have disappeared .• Adult teeth will continue to erupt into their teens . Some children

may experience discomfort .• Encourage your child to keep the area clean even when the tooth is

wiggly .• SOMETIMES the new tooth will come in before the baby tooth

has fallen out . DO NOT WORRY!! The baby tooth normally falls out within a few weeks and the adult tooth will usually slip into the space .

• Children need to be encouraged to wiggle the baby tooth until it falls out (it is not usually necessary for your dentist to remove baby teeth) .

• BE HAPPY for your child . It is a normal and healthy part of growing up .

Permanent (Adult) Teeth• The first adult tooth to appear is usually a lower front tooth at

around 6 years of age .• The first adult molar to come in is called the “6 year molar” . It comes

in behind the last baby molars (it does not replace a baby tooth) .

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Orthodontics (Braces) • During your child’s growing years, there will be different stages and

the appearance of their teeth will continue to change .• Some children will need to see an Orthodontist to straighten

crooked teeth and correct teeth and jaws that do not fit together correctly .

• Ask their dentist for a recommendation .

Brushing/Flossing• Your child will continue to need your help with brushing until 8 or 9

years of age .• Flossing is a more difficult task and they will need your help until the

child can floss effectively on their own .

Injury Prevention• REMEMBER: mouth guards can prevent injuries during this very

active time in your child’s life BUT ONLY IF THEY WEAR ONE!

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DO’S AND DON’TS FOR A GREAT SMILEDo . . . • Lift the lip. Once a month check your baby’s teeth for white or

brown spots and anything unusual . Take your child to their dentist if you have a concern .

• Brush their teeth. At least twice a day and especially at bedtime . • Floss their teeth every day. Parent’s need to assist younger

children .• Visit the dentist regularly. Babies should have their first visit by

their first birthday with continued visits as recommended by their dental professional .

• Make healthy eating and snacking a priority. Be a good role model .

• Wear a mouth guard while playing sports .

Don’t . . .• Put your child to bed with a bottle or sippy cup. Use only plain

water if you must give your baby a bottle or sippy cup in bed . • Put sugary liquids in a bottle or sippy cup. eg . pop, fruit drinks,

sweetened milk . • Share germs. Cavities are caused by bacteria (germs) . These germs

are passed to babies through saliva . Avoid sharing of toothbrushes, spoons and DO NOT place babie’s pacifier in your mouth .

• Expose your child to second-hand smoke. Be a good role model . DO NOT smoke or use spit/chewing tobacco .

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ADDITIONAL RESOURCESFor additional information please see the following websites

Region of Durham www .durham .ca

Ontario Association for Public Health Dentistry (OAPHD) www .oaphd .on .ca

Hospital for Sick Children www .sickkids .on .ca

About Kids Health Canada www .aboutkidshealth .ca

Canadian Dental Association (CDA) www .cda-adc .ca

Canadian Dental Hygienist Association (CDHA) www .cdha .ca

American Dental Association (ADA) www .ada .org

Health Canada Food Guide www .healthcanada .gc .ca

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EMERGENCY NUMBERS

Family Dentist: Name: __________________________________________

Number: ________________________________________

Family Doctor:Name: __________________________________________

Number: ________________________________________

Telehealth Ontario Info Line: 1-866-797-0000

Durham Health Connection Line: 1-800-841-2729

Poison Control: 1-800-268-9017

Hospital for Sick Children: 416-813-1500

If you require this information in an accessible format, contact 1-866-853-1326 Oct15

Different Ages/Different Stages Birth to 12...

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