Red Flags Bermuda
EARLY INTERVENTION
BIRTH TO AGE SIX
Nutrition & Oral Health
Dental
Poor oral health care can result in the development of Early Childhood Caries (ECC). ECC is a severe form of cavities with tooth decay in the baby teeth of children up to six years of age. It is considered to be a chronic disease which affects more than 10 per cent of preschool-age children in Canada. ECC often begins on a child’s upper front teeth just under the lip. Chalky white or brown spots may be signs of caries (tooth decay/cavities). ECC can lead to pain, infection, difficulty eating and sleeping, speech problems, poor health and higher risk of tooth decay in later years. Dental problems in early childhood have been shown to impact general growth and cognitive development and cause poor school behaviour and negative self-esteem. Therefore, access to dental care and early development of good oral hygiene habits are important for children.
…the presence of any of the following risk factors should be considered a red flag:
Exposure of teeth to fermentable carbohydrates (foods/liquids that can easily break down into acids) through:
► Too much sugar in diet
► Going to sleep or walking around with a bottle or sippy cup containing anything but water
► Retaining the nipple in an infant’s mouth
► for prolonged periods when not actively breastfeeding
► If using pacifiers, dipping them in anything sweet such as syrup, sugar or honey
► Long-term use of sweetened medication
Physiological Factors
► Sharing toothbrushes or utensils or intimate contact such as kissing (this can transfer oral bacteria from parent/caregiver to the child)
► Lack of exposure to fluoridated water
► Factors associated with poor enamel development, such as prenatal nutritional status of mother, poor prenatal health and malnutrition of the child
► Prematurity or low birth weight (possible enamel deficiencies)
Other Risk Factors
► Lack of routine infant oral health care i.e. not wiping baby’s mouth and gums after each feeding
► Poor oral hygiene i.e. ineffective or infrequent brushing less than twice per day
► Parent/caregiver not performing tooth brushing or oral health care for child (children up to six years of age are not able to brush or floss effectively, so parent/caregiver has to do it for them)
► Sibling history of early childhood caries
► Parent/caregiver with untreated dental disease
► Lower education level of parent/caregiver
► Lower socioeconomic status
► Limited access to dental care
► Deficit in the parental/caregiver dental knowledge
► Use of bottle or sippy cup beyond 18 months
► No dental visit by age one or shortly after primary teeth begin to erupt
Note: The Canadian Dental Association recommends that the first visit to a dentist should occur within six months of the eruption of the first tooth or by one year of age.
Problem
Signs