Samiksha Choithani

Cleft is a split in the lip that can be immediately identified during the birth of a baby. A cleft lip is a split in the lip. Cleft lip and cleft palate can affect one or both sides of the mouth. Cleft lip and cleft palate can occur independently of each other or can occur together. A cleft lip is caused due to many reasons - it can be hereditary, exposure to substances like cigarettes, alcohol or medications, diabetes or obesity during pregnancy. Babies having cleft lip can breastfeed comfortably, however babies with a cleft palate may have difficulty in sucking.&nbsp;Consider this while feeding a baby with cleft lip (Without cleft palate):<ul><li>The baby may find it difficult to seal nipple with the mouth. If there is a hissing sound, it indicates that air is entering in the mouth.</li><li>Try to reposition the breast and baby’s mouth to form a vacuum.</li><li>The nipple should be behind the tongue; this will help the baby to hold the nipple in its mouth.</li><li>You can adjust and change positions to identify the one that works the best for your baby</li></ul> A cleft palate is a split or opening in the roof of the mouth. A cleft palate can involve the hard palate (the bony front portion of the roof of the mouth), and/or the soft palate. Consider this while breastfeeding a baby with cleft palate:<ul><li>Hold your breast in such a way that baby can get a good grip and latch properly.</li><li>The cleft can be repaired with surgery after 6-12 months but before that do not stop breastfeeding your child.</li><li>Breast milk is very helpful as it does not cause irritation on delicate tissues of the nose and throat and can help to reduce ear problems. Try to avoid formula milk.</li><li>Take help from nurses or specialists to feed the baby with a cleft palate. There are alternate methods like bowl and spoon-feeding, use a breast pump to get the milk in a bowl and feed the child with a spoon.</li></ul>

A cleft occurs because the tissues of the baby’s face and mouth don’t fuse (link) properly.

Breastfeeding a child with cleft lip/palate

Lip tie is a condition where the underside of the upper lip tethers to the top of the gum with a skin tag. The piece of tissue behind your upper lip is called the frenulum. When these membranes are too thick or too stiff, they can keep the upper lip from moving freely. This condition is called a lip tie. Lip tie isn’t dangerous for babies, as long as they’re gaining weight according to their paediatrician’s guidelines. But lip tie, once diagnosed, is easy to correct. A baby with a tongue tie may not necessarily have a lip tie. Babies with lip tie may face challenges to breastfeed or bottle-feed, as it restricts the baby from stretching the lips to open the mouth wide. Causes: The causes of lip tie are still unknown. Lip tie symptoms:<ul><li>Difficulty in breastfeeding is one of the most common indications that your child may have a lip tie or tongue tie.</li><li>Struggling to latch on to the breast</li><li>Difficulty breathing during feeding</li><li>Making a clicking sound while nursing</li><li>Falling asleep often during nursing</li><li>Acting extremely fatigued by nursing</li><li>Slow weight gain or lack of weight gain</li><li>Colic</li></ul> If a child has a lip tie and you’re a breastfeeding mother, you may experience:<ul><li>Pain during or after breastfeeding</li><li>Breasts that feel engorged even right after nursing</li><li>Blocked milk ducts or mastitis</li><li>Fatigue from breastfeeding constantly even though your child never seems to be full</li></ul> Babies who have a severe lip or tongue-tie may go on to have difficulty eating from a spoon or eating finger foods, according to the American Speech-Language-Hearing Association. Lip ties don’t have as many complications later in life. Some paediatricians believe that an untreated lip tie can lead to a higher likelihood of tooth decay for toddlers. Diagnosis: A lip tie is diagnosed through a physical exam. Most paediatricians can diagnose a lip tie based on its appearance. Treatment:A lip tie can be treated on the basis of the class of lip tie. Whether it is a class 1, class 2, class 3 or class 4. It can also be fibrous, fleshy, thick or thin depending upon the texture of the skin fold. Manual treatment: For class 1 and class 2 lip ties, the baby doesn’t need any formal treatment. Parents have to gently slide the finger underneath the upper lip to stretch frenulum tissue. This type of manual practice can gradually release the tightness of the tissue and the child will have normal mobility of the upper lip. Frenectomy: This is a small surgical procedure where the frenulum is cut through an operation. A frenulum is a small fold of tissue that prevents an organ in the body from moving too far. Doctors usually use laser technology to cut the frenulum and so it is called laser frenectomy. General anaesthesia is not used; instead, a local topical numbing agent is applied to the frenulum. In this procedure, a child may or may not require stitches. The procedure hardly takes a few minutes to complete. Babies can experience mild pain post the procedure. Stay vigilant for any signs of swelling or bleeding from the lips and contact the doctor immediately. Prevention: Lip tie cannot be prevented.

Here are Lip Tie Symptoms, Causes, Diagnosis, Treatment, and Prevention.

All about Lip tie

A 'tongue-tie' (also known as ankyloglossia) limits the tongue's mobility due to an unusually short/thick frenulum (a piece of skin) that connects the tongue tip to the floor of the mouth. As the mouth parts develop in the fetus during the 1st trimester, a failure of the frenulum to separate completely from the base of mouth results in tongue tie. The severity ranges from being mild to a complete loss of mobility of the tongue. Causes: The causes of tongue tie are still unknown. Symptoms:<ul><li>Baby can’t latch well</li><li>Baby tends to chew more than suck</li><li>Baby doesn’t gain weight</li><li>Baby is fussy when trying to feed</li><li>Baby makes a clicking sound while feeding</li><li>Tongue can’t move far from side to side</li><li>Tongue can’t reach the upper gums or roof of the mouth</li><li>Tongue can’t stick out past the gums</li><li>Tongue has a V shape or heart shape at its tip when it’s sticking out</li><li>Older children may have difficulties pronouncing certain words with 't; 'th; 'd', 'dh', 's', 'Z', 'r', or 'II in it.</li><li>There is a higher possibility of dental problems (tooth decay, gingivitis, space between the bottom front teeth) in older children.</li><li>Gagging or choking on foods as your child starts to eat solids.</li><li>A hard time with basic things, like licking an ice cream cone.</li></ul> Diagnosis:A physical exam is all it takes to see what’s going on. The doctor will:<ul><li>Ask how feeding is going.</li><li>Check your child’s tongue, mouth, and teeth.</li><li>Use a tongue depressor, which is like a big popsicle stick, to look under your child’s tongue and check the range of motion.</li><li>The doctor may ask older kids to move their tongue around and make certain sounds, like of an r or l</li></ul> Treatment:The lingual frenulum generally loosens over time and it can be cured on its own most of the times. But if the problem persists, a lactation consultant can help with breastfeeding and a speech-language therapist can help with speech therapy. If there is any severe complication, then your doctor may suggest some surgical procedures like frenectomy or frenuloplasty. Frenectomy: This is a simple surgical procedure wherein the doctor uses sterile scissors to cut the frenulum free. It is a quick procedure. The baby hardly feels any pain during or after the surgery as there are few blood vessels in the lingual frenulum. The procedure can be done with or without sedation. Frenuloplasty: If the lingual frenulum is too thick, the doctor might need to do some additional repair and this is an extensive procedure known as Frenuloplasty. General anaesthesia is given by the doctor. The wound is usually closed with sutures. Complications are similar to frenectomy - Bleeding, infection, damage to tongue or salivary glands. In this procedure, the doctor will:<ul><li>Give your child drugs so they sleep through the whole thing</li><li>Use special tools to cut the frenulum</li><li>Put in a few stitches that dissolve on their own as the wound heals</li><li>After the surgery, the doctor might suggest a few tongue exercises to increase the movement of the tongue.</li></ul> Prevention: Tongue tie cannot be prevented.

Here are Tongue Tie Symptoms, Causes, Diagnosis, Treatment, and Prevention.

All about Tongue tie

Are root canals good for a 5 year old?Root canals can be safe for 5 year old child if performed properly by an expert. The procedure and materials used for performing root canal is safe and suitable for child and does not cause any harm. Do Pediatric dentists do root canals?Yes, Pediatric dentists do root canal for babies. Your family dentist may address the problem but a child’s specific dental needs can be treated by a pediatric dentist. Hence, it is good to visit a pediatric dentist to do the procedure of root canal How long does it take to do a baby root canal?Root Canal treatment for babies usually takes around 30 mins to an hour, however you might have to spend around 90 mins at the dental clinic for a complete entire treatment.

Frequently asked questions about root canal treatment

All you need to know about root canal

Good dental health includes cleaning teeth regularly.<ul><li>For an infant, using a soft cotton cloth is a better option. Wrap the cloth around your finger and clean the teeth and mouth using your finger. Get started with a soft toothbrush when the child turns 2. Use only rice-sized fluoride toothpaste.</li><li>Brush your child’s teeth twice a day, in the morning and before going to bed. For the babies of 6-9 months offering water to drink between the feeding is considered to be a better choice to keep their mouth clean.</li><li>After the age of 3, start using pea-sized toothpaste to clean the teeth. This amount of fluoride toothpaste is considered safe for children and helps to prevent tooth decay.</li></ul> Brushing properly:<ul><li>Get a small, child-sized, soft-bristled toothbrush. Soak the brush in warm water for a few minutes before brushing to make the bristles softer.</li><li>Apply a rice sized paste on the brush and get started with proper brushing habit, gradually increase the amount of toothpaste.</li><li>Brush the teeth for 2 minutes; concentrate on space between the teeth and black portion on the tooth. This is an area where cavities often first develop.</li><li>Replace toothbrush after 3 to 4 months and never share it with others.</li></ul>&nbsp;If your child does not like to brush his/her teeth try this:<ol><li>Become a role model and start the practice in early years of childhood. If you want your child to develop good dental care routine start brushing your teeth in front of kids twice a day.</li><li>If toothpaste is the cause of concern, try to eliminate it for a few days. Let the child brush the teeth with a wet brush, this is just to develop the habit of brushing once they get used to it you can get started with a small amount of toothpaste.</li></ol> Never lose your patience, remember this will make things difficult for both you and your child. Narrate stories and try to make it a fun loving activity rather than a daily practice.

Brushing habits should start in early years of childhood.

When and How to get started with brushing?

Ravina Sewani

Cavities are tiny openings or holes that develop in the hard surface of the teeth. Cavities are also called tooth decay or caries. The main cause of tooth decay in children is unhealthy food habits. Causes:<ul><li>Excess intake of sugary food</li><li>Retaining sweet food for a long time in the mouth</li><li>Bacteria in the mouth</li><li>Not keeping teeth clean</li></ul> Symptoms of tooth decay or cavities:<ul><li>Toothache, mostly spontaneous</li><li>Tooth sensitivity</li><li>Mild to sharp pain when eating or drinking something sweet, hot or cold</li><li>Visible holes in the teeth</li><li>Brown, black or white staining on any surface of a tooth</li></ul> Diagnosis: Your child’s dentist can often diagnose tooth decay based on:<ul><li>A complete history of your child</li><li>An exam of your child’s mouth</li><li>Dental X-rays</li></ul> Treatment:Routine dental check-ups are very important because your child might not complain about the pain until the cavity has spread too much. So if your child feels fine about his/her teeth, take them for routine check-ups. In case your child experiences a toothache or mouth pain, see your dentist at the earliest. The dentist will suggest the treatment for your child depending on the intensity of the tooth decay. Your child's dentist may suggest one of the following: <ol><li>Early-stage treatment: If the tooth decay gets detected in its early stage, a fluoride treatment can restore the tooth enamel and prevent further decay.</li><li>Tooth fillings: A dentist uses a drill and removes decayed material from the tooth. The dentist will then fill the tooth with a substance, such as silver, gold, or composite resin depending on what is appropriate.</li><li>Crowns: For more severe decay, the dentist will place a custom-fit cap over your child's tooth to replace its natural crown.</li><li>Root canal: When tooth decay causes the death of your nerves, the dentist will perform a root canal to save the tooth. They remove the nerve tissue, blood vessel tissues, and any decayed areas of the tooth. If there is any infection, the dentist will apply a medication. Finally, they fill the tooth and place a crown on it. Root canals are usually very painful hence it is better to take precautions early on.</li></ol> Precautions:<ul><li>Reduce the frequency of sugary acidic foods, limiting it to mealtimes.</li><li>Opt for fresh fruit instead of dried fruits which are high in sugar.</li><li>Avoid feeding drinks containing sugars, including fruit juices, between meals.</li><li>Choose to give water or milk over sugary drinks.</li><li>Avoid adding sugar to their drinks/food while introducing your baby to solid food.</li><li>Avoid giving sugar-laden processed baby food.</li><li>Cleanse baby's teeth regularly to help prevent cavities.</li><li>Ask them to gargle regularly and drink enough water.</li><li>Develop the habit of brushing the teeth twice a day.</li></ul>

Tooth decay or cavities are very common among kids and teenagers.

Tooth decay - Symptoms, Causes, Treatment and Prevention

Children experience toothache because the nerves and the blood vessels are very sensitive in the teeth and gum area. Causes:<ul><li>Diet of the child</li><li>Cavities</li><li>Bacterial infection</li><li>Broken teeth</li><li>Infected gums</li></ul> Symptoms:<ul><li>Swelling, painful gums</li><li>Bad taste in the mouth (from an infection in a tooth)</li><li>Fever or headache</li><li>Bleeding from gums</li><li>Pain while chewing</li><li>Hot or cold sensitivity</li><li>Tooth pain that only occurs when pressure is applied</li></ul> Diagnosis:A check-up by dentist leads to an appropriate diagnosis. Sometimes, dentists carry out dental X-rays to diagnose the problem properly. Sometimes, X-rays Various ways of handling the teething pain at home are:<ol><li>Use a cold pack: Apply a cold pack against your child’s cheek where there is painful sensation. If you don’t have a cold compress, you can wrap a few pieces of ice in a cloth and use it.</li><li>Make your child rinse their mouth with warm water and a teaspoon of table salt.</li><li>You can also use a clean finger or moistened gauze pads to rub your child’s gums, this might help to ease the discomfort.</li><li>Rinse with warm saline water: Add a teaspoon of table salt in a warm cup of water. Ask your child to swish it in mouth for 30 seconds and spit.</li></ol> Medical Treatment:<ul><li>Visit the dentist when your child develops a fever or there is an increase in discomfort.</li><li>The doctor might give an injection around the tooth if the pain is severe. If there is swelling in the gums or face, or if your child have fever, antibiotics may be prescribed.</li><li>For more severe cases like tooth decay, root canal may be performed.</li></ul> Prevention:<ul><li>Help your child to maintain the oral hygiene.</li><li>Ask them to properly gargle after eating.</li><li>Make a habit of brushing teeth twice in a day.</li><li>Avoid sugary foods.</li></ul>

Toothache is quite common among children as they like to munch on anything and everything.

Treating Toothache

Palak Vyas

Begin brushing your baby’s teeth from the time they start appearing. Even in the absence of teeth you can wipe their gums with soft clean cotton cloth carefully. Brush their teeth with clean small soft bristled toothbrush using small circular movements. Change their brush every 3 months. Cause of bad breath could vary:<ul><li>Sometimes, infections can cause bad breath. If your toddler has an infection at the back of his throat, such as tonsillitis, this can make his breath smell foul. Other symptoms of tonsillitis include a sore throat and coughing. Your toddler’s bad breath will disappear when the infection clears up.</li><li>It’s also possible that the smelly breath is because your little one has a blockage in his nose. That could be because he has a cold or sinus infection.</li><li>If your toddler sucks or chews on a blanket, or sucks thumb, it could lead to developing bad breath.</li><li>If your toddler has persistent bad breath, take him for a check-up at the dentist.</li></ul>

It is important to maintain proper oral hygiene since day 1. Bad breath is an indication of poor oral hygiene.

oral care health concerns

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