General Anticipatory Guidance for the Young Patient (0 to 3 Years of Age)
Oral hygiene: Oral hygiene measures should be implemented no later than the time of the eruption of the first primary tooth. Cleansing the infant’s teeth as soon as they erupt with either a washcloth or soft toothbrush will help reduce bacterial colonization.
Children’s teeth should be brushed twice daily with fluoridated toothpaste and a soft, age-appropriate sized toothbrush. A “smear” of toothpaste is recommended for children less than 2 years of age, while a “pea-size” amount of paste is recommendedfor children 2-5 years of age.
Flossing should be initiated when adjacent tooth surfaces cannot be cleansed with a toothbrush.
Diet: High-risk dietary practices appear to be established early, probably by 12 months of age, and are maintained throughout early childhood. Frequent night time bottle feeding, ad libitum breast-feeding, and extended and repeated use of a sippy or no-spill cup are associated with, but not consistently implicated in ECC. Likewise, frequent consumption of snacks or drinks containing fermentable carbohydrates (e.g., juice, milk, formula, soda) also can increase the child’s caries risk.
Fluoride: Optimal exposure to fluoride is important to all dentate infants and children. The use of fluoride for the prevention and control of caries is documented to be both safe and effective. Twice-daily brushing and Professionally-applied fluoride, as well as at home fluoride treatments, should be considered a dental routine for children.
Systemically-administered fluoride should be considered for all children drinking fluoride deficient water (<0.6 ppm).Caution is indicated in the use of all fluoride-containing products. Fluorosis has been associated with cumulative fluoride intake during enamel development, with the severity dependent on the dose, duration, and timing of intake. Decisions concerning the administration of additional fluoride are based on the unique needs of each patient.
Injury prevention: Practitioners should provide age appropriate injury prevention counseling for orofacial trauma. Initially, discussions would include play objects, pacifiers, car seats, and electric cords.
Non-nutritive habits: Non-nutritive oral habits (e.g., digit or pacifier sucking, bruxism, abnormal tongue thrust) may apply forces to teeth and dentoalveolar structures. It is important to discuss the need for early sucking and the need to wean infants from these habits before malocclusion or skeletal dysplasia’s occur.