Healthy and strong smiles don’t stop requiring care when dental services are complete. At Clearfork Pediatric Dentistry, we want parents to feel comfortable and confident when they leave our office. Let your child’s oral health flourish with these helpful hygiene tips, and don’t ever hesitate to contact our office for more resources!Contact Us
Kids are unique, and your approach to helping your child with healthy sleep and sustainable oral hygiene habits will be a journey you figure out together. Here are some helpful guidelines to help you along your journey!
Tips for Sleep
Minimize screen time prior to bedtime, try to turn off screens two hours prior to desired bedtime. The blue light emission can disrupt our circadian rhythm and make falling asleep more difficult. This can be hard! Sometimes switching over to a change of scenery (bathtime, dinnertime) can make it easier to transition away from screens.
Create and stick to a bedtime routine. Boundaries feel like love to children, and the predictability of a routine can be comforting.
Finish eating prior to two hours of bedtime if possible. This can minimize a full stomach when falling asleep, which can lead to GERD symptoms.
Warm baths or showers can be relaxing prior to changing for bed.
Sometimes a dance party to “Another One Bites the Dust, We Will Rock You, Eye of the Tiger,” etc makes it more fun to chew the appliance to a strong beat.
If your little one must have a drink, limit liquids to water only. Using a medicine cup to limit the volume of liquid can be helpful if your little one has bladder control considerations during sleep.
During the day remind your little one to keep their “tongue up in the palate, lips closed, breathe through your nose!” This posture helps with nasal breathing while we are awake and makes it easier to sustain it while we sleep. This helps us to achieve deeper levels of restorative sleep so that we can be refreshed for the next day.
Brush and floss teeth within 30 minutes of bedtime
Reading stories is a great way to wind down and promote literacy skills.
Keep bedrooms dark and free of stimulating clocks or nightlights. If you need a nightlight, try to find one with a pink/red undertone.
Tips for Oral Hygiene
Overall, the best toothbrush and toothpaste are the ones your child will use, and the best technique is whatever works for your family. Sometimes reading books about the dentist and hygiene can be helpful and engage your children. The book Sugarbug Doug is a very compelling read for children to encourage them to be effective brushers!
You can brush in the bathroom, in your child’s bedroom at night, and at the breakfast table in the morning or even have a car toothbrush to use on the way to school! Sometimes we have to be creative to make sure the job gets done. That said, here are a few tips to help your children with successful oral hygiene practices.
If your child demonstrates some resistance to your help, it may be easier to have your child lay in your lap, extend their chin toward the ceiling to open their airway and brush their teeth. If your little one is anxious it can be helpful to count. Counting to 10, or spelling their name (sometimes their full name), and giving a little break can be helpful to relieve any anxiety your child may have and help them to behave. You can repeat this as long as necessary for an effective brush.
If your little one has contact between their teeth, floss picks are often the easiest way to effectively remove stubborn plaque and particles.
Lots of praise and positive reinforcement at every step can be helpful and keep the tone positive. “You’re doing a great job of keeping your hands so still!” gives good directive guidance. “You’re such a good helper!” is praise that most children can easily relate to. “You’re halfway done/more than halfway done,” is more effective than “you’re almost done,” and “Your teeth are strong and healthy just like you!” are great motivators along the way. Negative reinforcement like “Don’t close!” or “Don’t move!” can be difficult for children to abide. Children can usually get a good brush while moving a little bit, and it might be impossible for them to stay completely still.
Foods and Tips for Picky Eaters
An important consideration regarding food and your child is that all food contributes to the nourishment of our bodies. It is not binary. There are no “good” foods or “bad” foods. Certainly, some foods contribute more to the formation of cavities, but let’s face it, we have to live! Some foods have less nutrient density, higher sugar content and are often associated with celebrations, like birthday cake, candy, etc. As long as our foods exist in a balance that promotes overall health and wellness, we don’t need to dwell on what is good or bad. Water is the drink that may best promote hydration and health of the body system, and one or two servings of apple juice a week is unlikely to throw off your child’s nutritional balance.
Thinking about food as good or bad promotes guilt and shame, and those sentiments are far more damaging than a pack of Starburst. Guilt and shame manipulate our boundaries, and our boundaries exist to keep us safe physically, mentally, and emotionally. When boundaries are breached, we are more likely to be stressed, and when we are stressed, we are more likely to choose foods with less nutrient density and higher sugar content.
In addition, some of our children have certain feeding considerations that make a wide variety of foods challenging for their personal diets. It can be exceptionally challenging for the reality of those parents to have added pressures of what their children “should” be eating. For those of us who are fortunate enough to not have that frame of reference, it *is* possible to continue feeding your child food that has never touched the inside of a package without telling everyone about it. Certainly, that is a tremendous accomplishment and one that can be bolstered by exerting grace and kindness on others who are not living the same experience. If your child is exhibiting difficulty at mealtimes, slow or messy eating, picky eating, food aversions, reflux, food allergies, or GI disturbances, it can be related to oral dysfunction, particularly a disordered swallow pattern. If you have concerns regarding this issue, please reach out, we are happy to evaluate your little one and assess oral function. We are quick to connect to resources that can significantly improve quality of life, like feeding therapy, bodywork, and myofunctional therapy.
A lot of our patients have feeding considerations that they are working through and eat five foods or less. We thought it might be of value to assemble everyone’s five foods or less list so that while families are working on increasing variety with their therapists, we can provide a larger, more comprehensive list that parents may be able to draw from.
Healthy Smiles At Home
Hygiene tips and food tips come in handy, but being able to chew, smile, and speak comfortably are also critical for your child’s development. Additional recommendations and resources, like myofunctional therapy, can encourage optimal oral health for your child. Our team at Clearfork Pediatric Dentistry is always here to help your child achieve a healthy smile.Contact Us
Nasal Clearing Protocol
Nasal clearing can open the nasal passageways and promote nasal breathing. It can be especially helpful if our little ones are chronically congested due to seasonal allergies. Also, when our little patients are chronically congested and breathe primarily through their mouths, the brain will tell the nose to secrete more mucus to slow the offset of CO2. This contributes to congestion and proliferates the mouth breathing cycle.
For our infants and babies under two years old, we recommend saline spray and the Nose Frida or suction bulb to clear the nose.
For our children two years old and older, we recommend the use of Flonase for two weeks and then transition to a nasal saline spray like Xlear (that is xylitol-based) or Neil Med Saline Mist. Flonase is a steroid, and we do not recommend its use after two weeks. You will do one puff of Flonase in each nostril about an hour before bedtime for two weeks. After two weeks you will have your little one blow their nose, then one to two puffs of saline, plug their nose, and lubricate the nostrils by gently cocking their head side to side, then blow their nose again. Repeat as necessary. Repeat with saline only.
There are many wonderful brands and products available to help you and your child achieve great oral health. We’re always happy to consult with you should you have any questions about what solutions are right for your situation. Here are a few products that may be worth your consideration.
Myofunctional therapy aims to achieve four goals:
- The tongue in the palate at rest
- Good lip seal at rest
- Effective swallow
- Nasal breathing
That’s it! Myofunctional therapy has four goals. Believe it or not, those four objectives are critical to the optimal growth and development of the face and relate to a cascade of responses in the body to maintain its natural balance.
When the tongue is in the palate, we see appropriate expansion of the upper jaw from its naturally strong muscular presence. This helps us accommodate our permanent teeth when they erupt. When the tongue is not in the palate, we see certain compensations that can have detrimental effects. The tongue in the palate also stimulates the “rest and digest” response in our body. When the tongue rests low in the floor of the mouth, children may try and compensate by thumb sucking, with pacifiers, or chewing and biting behaviors. Often, we will see crowding of the teeth, or even downward growth of the maxilla/upper jaw as it looks for that opposition from the tongue, which can translate to showing more of our gums when we smile. The tongue is our natural expander!
When we have a good lip seal, our teeth constantly are bathed in saliva and the pH of the mouth remains neutral. The lips also provide a good muscular boundary for our growing upper and lower arches. When our lips are parted and air passes through the mouth instead of our nose, the mouth becomes drier and more acidic. This increases the risk of getting cavities because the bacteria that causes tooth decay thrives in an acidic environment. It can also make our gums in the front of our mouth more sensitive because they are constantly stimulated and irritated by the air. This can lead to painful brushing, and some children will avoid this area with their toothbrush, which allows plaque to accumulate, and contributes to a cycle of plaque and gingivitis. In addition, mouth breathing can contribute to crowding because the teeth are not opposed by the strong circular muscle around the mouth to help keep them in place. The lips are our natural braces!
When we have an effective swallow, our tongue and saliva wash particles from our teeth. This clears food, bacteria, and plaque from our teeth surfaces. When we do not have an effective swallow food and bacteria remain on dental surfaces. This increases our risk for cavities if bacteria have increased access to food. Often children who do not have an effective swallow will be “cavity prone,” and have several cavities between their baby molars when the teeth come in contact or all erupt by around 3-5 years old. Often these children will continue to be cavity prone and continue to get new cavities or some around existing white fillings. These patients often think they just have “bad teeth,” because no matter what they do, they have cavities every time they visit the dentist. An effective swallow is our natural mouthwash.
Nasal breathing promotes optimal oxygenation for our body. It provides warmed, filtered, and humidified air. It is important to note that it also facilitates the appropriate volume of air. When people cannot breathe through their nose or have gotten off course and started breathing through their lips, the body receives a higher volume of more turbulent air. This can result in irritation of the airway, namely enlarged and irritated tonsils. It makes us more susceptible to seasonal allergens or conditions like asthma. It can also negatively affect the balance of oxygen and carbon dioxide in the body. When we breathe out through our mouth, we lose too much carbon dioxide, and as a result, the brain will attempt to slow the offset of CO2 by stimulating the nose to secrete mucus. This can lead to chronic nasal congestion and fuel the cycle of breathing through our mouth. A strong exhale through the mouth during sleep can pull gastric juices from the gut and create silent reflux symptoms and is related to a host of sleep difficulties such as grinding, bedwetting, frequent waking, sleep walking, and night terrors, just to name a few! And poor sleep quality relates to many behavioral considerations in our pediatric and adult patients, specifically ADHD and anxiety. Nasal breathing is critical to maintaining adequate oxygenation of our bodies and is the most essential aspect of our existence. Facilitating nasal breathing is critical to optimal growth and development. Our nose is our natural air filter.
Myofunctional therapy helps to redirect habits and treat the underlying cause of many symptoms that we didn’t realize were all connected! It can not only optimize our growth and development, but greatly improve the quality of life for our patients.
What is a frenectomy and when is it necessary?
The four objectives of myofunctional therapy are interconnected and the improvement in one area often leads to progress in another. In some cases, the tongue position and swallow pattern (which in turn affects lip seal and nasal breathing,) are limited by a structural restriction, like a short lingual frenum. In those cases, it may be that an intervention like a frenectomy is needed to release or “clip” the tongue to improve the range of motion. A frenectomy alters the tissue that connects the tongue to the floor of the mouth, and the lip to the gums. A new frenum attachment will form, and the goal of the procedure is for the new frenum attachment to allow better range of motion and function of the associated structures, i.e. better tongue or lip movement.
If a frenectomy is a necessary aspect of treatment, the procedure will be scheduled at an appropriate point of therapy to make sure the patient has the best possible outcome. Therapy must come before a frenectomy procedure so that it can improve, train, and tone the tongue. We swallow over 1000 times a day, and the muscle memory of the tongue is very strong. The tongue is not spring loaded and will not go up into the palate just because the frenum is released. Without therapy the original ineffective swallow pattern will continue, and the tissues will likely reattach. The frenectomy procedure is necessary in some cases to improve the ability to achieve myofunctional therapy. It is the therapy that changes and improves the behaviors that contribute to the goals of treatment.