1. © The National Training Institute for Child Care Health Consultants, UNC-CH, 2011 1 Healthy Smiles: Oral Health of Young Children

2. © The National Training Institute for Child Care Health Consultants, UNC-CH, 20112 n Your Name n Your Agency n Date

3. © The National Training Institute for Child Care Health Consultants, UNC-CH, 20113 Training Objectives n Know why good oral health for infants and young children is important n Identify ways to improve childrens oral health n Be able to promote oral health in the classroom for all children, including children with special health care needs

4. Why is oral health important? n The health of the mouth affects the overall health of the body. n Early childhood caries is the most common infectious disease affecting young children in the United States. © The National Training Institute for Child Care Health Consultants, UNC-CH, 20074

5. Tooth decay can cause: n Increased risks of caries in permanent teeth n Increased hospitalizations and emergency room visits n Increased expenditures on dental health care n Insufficient physical development (from dehydration and under-nutrition associated with chronic mouth pain) n Loss of school days n Diminished capacity to learn n Lowered self-confidence and self-image (AAPD, 2010c) © The National Training Institute for Child Care Health Consultants, UNC-CH, 20115

6. 6 When Do Teeth Develop? n Primary teeth (baby teeth): in utero n 1 st tooth: 5-7 months n All 20 primary teeth: 2-3 yrs n Permanent teeth: 5-6 yrs n Last primary molar:12-14 yrs

7. © The National Training Institute for Child Care Health Consultants, UNC-CH, 20117 Teething 1. When does teething begin? 2. How can you tell if an infant is teething? Before the first tooth erupts Gums become red, swollen and tender. The infant is fussy, has excess saliva, and wants to chew on something semi-firm.

8. © The National Training Institute for Child Care Health Consultants, UNC-CH, 20118 TRUE OR FALSE? Since the primary teeth get replaced by permanent teeth, it is not important to take care of the primary teeth. FALSE!

9. © The National Training Institute for Child Care Health Consultants, UNC-CH, 20119 Caring for Primary Teeth n Tooth Decay is common! n Baby teeth allow children to: l Chew properly l Develop speech l Maintain space for permanent teeth l Develop a healthy smile

10. Key Prevention Strategies 1. Cleaning Teeth 2. Fluoride 3. Nutrition 4. Dental Visits © The National Training Institute for Child Care Health Consultants, UNC-CH, 201110

11. 1. Cleaning Teeth n Child care providers can help improve childrens oral health by setting aside time to brush teeth in the classroom (with children seated on the floor or at tables or taking turns near a sink). n A small amount of toothpaste should be distributed to each child on wax paper or in paper cups to prevent cross-contamination (University of Iowa, 2004). n Brushing together provides an opportunity for children to model behavior of teachers and other children, and allows staff to supervise. © The National Training Institute for Child Care Health Consultants, UNC-CH, 201111

12. © The National Training Institute for Child Care Health Consultants, UNC-CH, 201112 Age-Appropriate Cleaning Cleaning Teeth and Gums of Infants and Children InfantsCaregivers should wipe gums with a clean, damp cloth Before Age 2Caregivers should brush for the child At about age 3Children should begin to learn to brush their own teeth By age 4Children should brush their own teeth At least until age 6Caregivers should continue to ensure that teeth are thoroughly cleaned

13. © The National Training Institute for Child Care Health Consultants, UNC-CH, 201113 Proper Care of Toothbrushes n Each child's toothbrush should be clearly marked with his or her name. n Toothbrushes may not be shared. n Toothbrushes should be air-dried and stored with bristles up so they do not touch or drip on one another. n If a toothbrush becomes contaminated through contact with another brush or child, it should be thrown away.

14. © The National Training Institute for Child Care Health Consultants, UNC-CH, 201114 2. Fluoride n Fluoride helps protect the teeth from harmful bacteria that can cause cavities. n Fluoride can also help reverse tooth decay that has already begun, although only in the early stages. n A child can receive fluoride in two ways, systemically or topically. l Children receive fluoride systemically by drinking fluoridated water or chewing fluoride tablets. l Children receive fluoride topically when Includes fluoridated water washes over the teeth, fluoride by when using toothpastes and mouthwashes, and during fluoride treatments applied by a dental professional. Photo courtesy of the Oregon Oral Health Program

15. © The National Training Institute for Child Care Health Consultants, UNC-CH, 201115 3. Nutrition n Provide a healthy, balanced diet consisting of a variety of foods. n Visit www.choosemyplate.gov for tips and ideas. n Prior to age 5-6, a diet rich in calcium (dairy products) is especially important to strengthen permanent teeth while they are forming, and to keep the gums and mouth healthy as they emerge.

16. Nutrition (continued) n Foods and drinks containing sugars are the most harmful. n All sugars promote tooth decay, even the sugars and starches in foods that are essential to a healthy diet. n The longer sugars remain in contact with the teeth and gums, the greater the risk for decay. © The National Training Institute for Child Care Health Consultants, UNC-CH, 201116

17. Nutrition (continued) n Baby-Bottle Decay can result from the long- term exposure to sugar that occurs when infants given a bottle of milk, juice, or sweetened liquid as a pacifier or comforter at bedtime. n A small amount of 100% fruit juice (4 oz.) should only be allowed at meal times, and water should be available to children in child care at all times. © The National Training Institute for Child Care Health Consultants, UNC-CH, 200717

18. © The National Training Institute for Child Care Health Consultants, UNC-CH, 201118 4. Dental Visits n Many children dont have dental insurance, which may limit access to care. n The AAP and AAPD recommend that every infant receive an oral health assessment by a qualified health professional by six months of age. n The first dental appointment should take place within 6 months after the first tooth appears and no later than 12 months of age. n Regular dental visits should occur twice yearly, or more often if need is greater.

19. © The National Training Institute for Child Care Health Consultants, UNC-CH, 201119 Dental Emergencies n Some injuries need immediate attention: l Dislodged, chipped, or loosened teeth l teeth pushed through gums l toothache l tissue injuries l broken or dislocated jaw n Keep emergency contact information readily available.

20. Injury Prevention n Young children are most likely to suffer injury from falls. n Prevent tooth damage from falls by: l Installing bumper guards around furniture with sharp edges l Placing baby gates at both the top and the bottom of stairs © The National Training Institute for Child Care Health Consultants, UNC-CH, 201120

21. © The National Training Institute for Child Care Health Consultants, UNC-CH, 201121 Children with Special Needs n Children with special needs have a higher incidence of untreated oral disease. n Other health needs may take priority, or it may be more difficult to find care. n The same preventive strategies that work for all children can be used with children with special needs.

22. © The National Training Institute for Child Care Health Consultants, UNC-CH, 201122 Review Training Objectives n Know why good oral health for infants and young children is important n Identify ways to improve childrens oral health n Be able to promote oral health in the classroom for all children, including children with special health care needs

23. © The National Training Institute for Child Care Health Consultants, UNC-CH, 201123 Learning Assessment Bag O Tricks

24. Action Items Write one thing you will do to promote oral health in your classroom or home. © The National Training Institute for Child Care Health Consultants, UNC-CH, 201124

25. © The National Training Institute for Child Care Health Consultants, UNC-CH, 201125 Evaluation Please take a few minutes to complete the training evaluation. Thank you!