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Infant Oral Health Programme

​Dental caries is the most common chronic disease in children. 1 in 2 preschool children has early childhood caries (ECC).

While ECC is prevalent, it is a preventable disease. Early dental visits allow preventive advice to be given to caregivers before the occurence of dental caries. If present at a young age, early interventions can be made to prevent dental caries from spreading and causing further damage.

The objective of the Infant Oral Health Programme (IOHP) Clinic is to help the child develop good oral health and oral health behaviours at an early age. It is recommended for a child to have his/her first oral assessment at 1 year old or 6 months after the first tooth erupts.

IOHP is run by paediatric dentists who will:

  • Assess the risk of infants developing early childhood caries
  • Conduct an oral examination for your infant
  • Help you manage your infant's risk of dental caries by customising a preventive plan with close follow-up
  • Provide individualised advice on fluoride use, oral habits, trauma prevention, the growth and development of teeth and jaws
  • Manage age-specific problems (e.g. natal and neonatal teeth)
  • Monitor the oral development of infants in relation to teething and oral habits
  • Teach parents appropriate feeding and oral hygiene practices

Your child is eligible for IOHP if he/she has had the first birthday, or if it is within 6 months after the eruption of the first tooth.

For enquiries on IOHP, please contact us at iohp@ndcs.com.sg.


How will the dentist examine my infant’s teeth?

Children below age 3 are considered pre-cooperative. Examination of a 1-year-old child using the knee-to-knee positionAs they are too young to understand and cooperate for a dental examination, some crying and/or struggling is anticipated.

A knee-to-knee approach is often used to examine young children. This involves the dentist and parent sitting facing each other with their knees in contact, and the child’s head is placed on the dentist’s lap. From this view, the dentist will be able to examine all the teeth. The parent should help to hold the child’s hands to prevent any unexpected movements. The knee-to-knee position can also be used by parents when brushing an infant’s teeth. The examination typically takes less than 2 minutes.

 



                                                                                                                                                                                              Examination of a 1-year-old child using the knee-to-knee position

COMMON DENTAL ISSUES RELATED TO INFANTS

Teething

The first primary tooth usually erupts at the age of 6 months. However this can vary, and it is not unusual to find some children who do not have a single primary tooth until the age of 10 months and onwards. By age 3, all primary teeth are present in the mouth.

Teething babies may show signs of mild irritability, drooling, and tendency to chew more. Babies with diarrhoea, vomiting, high fever, ulcers and decreased appetite should consult a medical doctor as it is a myth that these symptoms result from teething.

So what can parents do to help alleviate the mild discomfort in the gums when the baby is teething? Try a chilled teething ring or massage the gums with your finger wrapped in a cold towel. These can help the teeth to cut through and alleviate the need to bite on things. Avoid using teething gels as inappropriate use may result in accidental overconsumption.


Oral Habits
In the first year, infants usually explore things by putting them into the mouth. This includes sucking on digits or pacifiers. However, prolonged use of pacifiers or thumb-sucking can result in misaligned anterior teeth (i.e. an open bite). Parents are encouraged to wean children off these habits early, before age 3, as there is a higher chance of spontaneous correction.

Child sucking on pacifier Thumb-sucking

(Left) Child sucking on pacifier                                                             (Right) Thumb-sucking


CARING FOR YOUR INFANT'S TEETH

  
Oral Hygiene

Toothbrushing in babies may be daunting, but establishing an oral hygiene routine early in life will help your child gets used to having his/her mouth cleaned. For babies without teeth, a toothbrush isn’t necessary. Simply wrap a clean damp washcloth around your index finger, and gently wipe the gum pads, cheek mucosa and tongue to remove any residual milk curds. Toothwipes can be used, but are not necessary. While most toothwipes contain xylitol, the xylitol concentration in the toothwipes has not been consistently proven to be effective in preventing early childhood caries.


An age appropriate bristled toothbrush should be used for toothbrushing once the first tooth erupts.


Fluoridated toothpaste containing a minimum of 1000 parts per million (ppm) fluoride is recommended. For children who cannot spit, use only a smear of toothpaste and wipe it off with a cloth after brushing. For older children who can spit well, a pea-sized amount of toothpaste should be used. Do consult a paediatric dentist if you need a demonstration or more information on oral hygiene in infants/babies.

Toothbrushing for an infant

Toothbrushing for an infant

 
Feeding Practices
Avoid filling your child’s bottle with sweetened liquids and never allow your child to fall asleep with a bottle containing milk, formula, fruit juices or sweetened liquids. Such practices increase your child’s risk of developing early childhood caries. If your child needs a comforter between regular feedings at night or during the day, give him/her a bottle of plain water instead. You should aim to wean your child off the milk bottle by age 1.

Picture of infant bottle feeding to sleep
Bottle feeding to sleep is not recommended