**[GIO3 Preventing Baby Bottle Tooth Decay]{.underline}**

**Who:** WIC parents and their children

**Why:** To encourage parents to help children establish good dental
habits and avoid foods that may cause decay.

**When:** Designated class times (20-30 minutes in length)

**Where:** SCHD auditorium, Richland Outreach, Live Oak Outreach

**What:** Prevention of baby bottle tooth decay due to improper use of
bottle and/or sippy cup with valve.

**What for: (by the end of the class participants will have)**

1.  Listened to the steps that are needed to prevent baby bottle tooth
    decay

2.  Viewed pictures of examples of baby bottle tooth decay

3.  Listed why baby teeth are important.

4.  Listed what foods to avoid to help prevent tooth decay.

**How:** PowerPoint presentation and using appropriate props. Props
include baby washcloth, sippy cup and child's tooth brush. Short
interactive quiz at end of presentation.

**Handouts:** *Time for a cup*, *Healthy Teeth for Happy Smiles* (purple
sheet), Medi-cal accepting dentist list

**Incentive:** Prop 10 parent kit which includes child's toothbrush.

"*Lift the Lip*" video can be played during set up time previous to
class starting.

Introduction:

Good morning/afternoon. My name is \_\_\_\_\_\_\_\_\_\_\_. We are going
to talk about keeping your baby's teeth healthy today. Please feel free
to ask questions or make comments during the presentation.

The information contained in this class are general recommendations. If
you have any doubts about feeding your baby, please call your baby's
doctor.

Slide 1 (Title page)

Preventing baby bottle tooth decay is important for all babies and
children.

Slide 2

Why do you think baby teeth are important? Pause 5 seconds for any
discussion. Baby teeth hold a place for permanent teeth. Decay and loss
of baby teeth too early can deform the mouth permanently. The first
teeth are needed for many years to chew and bite foods. Early loss can
interfere with good nutrition. First teeth are also needed for speech
development and appearance. Inability to form words correctly and teeth
that are missing or decayed can affect a child's self confidence
negatively. What are your questions? Pause 5 seconds before advancing
slide.

Slide 3

Here are three different examples of baby bottle tooth decay. The mild
case has some decay in between the front teeth. The other two views have
obvious decay. What are your questions? Pause 5 seconds before advancing
slide.

Slide 4

Baby Bottle Tooth Decay (BBTD) can be painful for the child and
traumatic if surgery is required to cap teeth. Surgery to cap teeth is
expensive and requires a one day stay in a hospital. Protect your child
from preventable decay and help them have good looking teeth so they can
feel good about themselves and their smile! What are your questions?
Pause 5 seconds before advancing slide.

Slide 5

The good news about baby bottle tooth decay is that it is 100%
preventable.

Slide 6

So how do you think we can prevent BBTD? Pause 5 seconds for any
discussion. (read info from slide) Following these simple rules can
reduce chance of decay that can be caused by liquids like breast milk or
formula in the mouth. Once we fall asleep the swallowing reflex and
saliva production are reduced. Any liquid other than water will sit in
the mouth and bathe the teeth for hours letting decay begin. This also
applies to breastfeeding. Letting a baby stay latched on for hours can
help start tooth decay in the same manner as a bottle used in bed. A
side benefit to no bottles or cups of milk in bed is a reduction in ear
infections. When baby relaxes and goes to sleep the milk may actually
enter the middle ear and cause an infection. What are your questions?
Pause 5 seconds before advancing slide.

Slide 7

It is also important to wean from the bottle around 12-14 months and
start giving your baby a cup to use and practice with around 6 months.
The cup can be empty or have a very small amount of water or formula in
it for baby to practice with. Also assist your baby with the cup so he
gets used to drinking from something else besides a bottle. Drinking
from a cup is very different than sucking from a bottle or breast. (Show
example of WIC cup fro baby here.) This is the correct type of cup to
teach your baby to drink from. It does not have a valve to keep liquids
from spilling out of it. Cups with the valve are okay once the baby
learns to drink from a cup without a valve if you are worried about
spills. What are your questions? Pause 5 seconds before advancing slide.

Slide 8

So do you have any ideas about what is the best way to clean your baby's
teeth? Pause 5 seconds for any discussion or comments.

Slide 9

Before teeth come in you can get baby ready for tooth care by wiping the
gums with a soft, thin cloth like a baby wash cloth. Then when the teeth
come in, teeth should be brushed twice a day using a small, soft child's
toothbrush. You don't have to use toothpaste, wetting the toothbrush
with water will work fine. (If question is asked about using toothpaste,
recommend to not use toothpaste until an age when child learns to spit
out toothpaste and not swallow it. Then only use a pea sized amount.
Fluoride free toothpaste is fine, too.) What are your questions? Pause 5
seconds before advancing slide.

Slide 10

Do you have any ideas about when should you start to brush your baby's
teeth? Pause 5 seconds for any answers or discussion. Well, the earlier
the better to get the baby used to brushing. You absolutely must start
when the first tooth comes in! The first tooth usually comes in between
3-7 months, but sometimes will come in earlier or later. What are your
questions? Pause 5 seconds before advancing slide.

Slide 11

There are some foods that are important to try to stay away from for at
least until your baby is one year of age if possible! The foods listed
here are high in sugar and can stick to the teeth making decay more
likely. (If a question is asked about what processed cheese is.....
example of processed cheese slice would be individually wrapped cheese
slices that are called "Kraft singles" or "Velveeta singles".) What are
your questions? Pause 5 seconds before advancing slide.

Slide 12

Fluoride also plays a part in reducing the occurrence of BBTD and is
needed in the diet for strong teeth and bones. Babies under 6 months of
age do not need fluoride supplementation. Babies 6 months and older need
fluoride in diet which is usually supplied by drinking tap water or
making formula with tap water. Gallons of fluoridated water are
available in the store on the baby isle near formula. This is another
source of fluoride for your baby if needed. Find out if your water is
fluoridated by calling the local water authority. If your water is not
fluoridated, ask your doctor for a fluoride supplement. What are your
questions? Pause 5 seconds before advancing slide.

Slide 13

Too much fluoride is damaging to teeth. It can cause white spots in
teeth and cause pitting putting the child at risk for decay. So do not
give a fluoride supplement to your baby if your water is fluoridated. If
you have doubts about fluoride levels in your water, call the local
water authority. If you use well water, ask your pediatrician if a
supplement is needed. Also be careful about fluoridated tooth paste use.
Use a very small amount to make sure the child is not swallowing excess
fluoride or buy toothpaste that does not contain fluoride or just use
water to brush. If using fluoridated toothpaste, be sure to put it out
of reach to protect child from eating it and getting too much fluoride!
What are your questions? Pause 5 seconds before advancing slide.

Slide 14

Good tooth care consists of introducing your baby to mouth care early by
starting before teeth erupt and setting a good example for your child as
she grows. Brush your child's teeth for her and as she gets older let
her practice brushing your teeth as well as her own. Letting your child
see you brushing your teeth sets a good example. Be consistent about
brushing. Children like routines. Brush at the same times each day. For
example in the morning, brush right after breakfast and in the evening
brush right after dinner so your child will know when she is expected to
brush her teeth.

Slide 15

Has anyone here weaned their child from a bottle before? Okay, what did
you do? (discussion) Okay, those were great examples. I also have some
examples here that I have used and people that I know have used. There
are many methods that can help wean child from a bottle. It doesn't
matter what method you use. The main thing to successful weaning with a
minimum of crying and complaining is **consistency!** Try to wean around
12-14 months. Weaning around 12-14 months will be easier than doing it
later when your baby is more attached to objects like a bottle. Do not
wean when there are changes happening in you and your baby's life like
divorce, moving, illness, new daycare situation or other stressful time.
What are your questions? Pause 5 seconds before advancing slide.

Slide 16

If desired by the child and the mother, breastfeeding past one year is
fine and is recommended by the American Association of Pediatrics. Just
don't allow baby to stay latched onto the breast for long periods of
time which can start decay. Baby should be using a cup at meal times as
well beginning at the 6th month. What are your questions about this
slide? Pause 3-5 seconds before advancing slide.

Slide 17

Trouble falling asleep now that bottle is gone from crib? What do you
think you could try to help your baby fall asleep? Pause 5 seconds for
discussion. Try music, rocking, pacifier or reading a story. What are
your questions? Pause 5 seconds.

Slide 18

To start good habits for a lifetime, your child's first trip to the
dentist should be between 2 and 3 years of age. Trip can be just for
child to observe mom or dad getting teeth checked or cleaned. This can
help alleviate fears and make dentist visits easier on everyone. What
are your questions? Pause 5 seconds before advancing slide.

Slide 19

Next I have a task for you. I invite you say your ideas about the
reasons why baby teeth are important. Who would like to answer? Take a
few answers from the audience. What are your questions? Pause 5 seconds
for discussion.

Slide 20

Task number two is to please list the foods that may cause tooth decay
up here on this flip chart. Have a flip chart set up and a marker for
participants to use. Who would like to answer? Take volunteers from the
audience to come up and write down ideas. What are your questions? Pause
5 seconds for discussion.

Slide 21

What are your questions about today's topic? Pause 5 seconds for any
discussion.

Slide 22

Let's do a summary of today's class. What were some of the most
important points? Pause 5 seconds for discussion to start. What feeding
dangers did we talk about today? Pause 5 seconds for discussion to
start. What did you learn that was new? Pause 5 seconds for discussion
to start.

Slide 23

Great! Thank you for all your participation and for attending today's
class. There are handouts about today's class on the back table and I
will get your vouchers ready. Please come for your vouchers as I call
your name. Thank you!

Sutter County WIC March 2004