Dental Care at Home

We welcome the opportunity to thoroughly explain at-home care recommended for your child when you visit Camp Smile, and in the meantime, check below for brief explanations of the most routine at-home dental procedures.

We are pleased to offer comprehensive infant oral exams for infants less than 18 months of age and feel this is a great way to get your baby off to a lifetime of healthy smiles. Cleaning your baby’s mouth is very important.

• Clean your infant’s gums after feeding. This can be easily done by cradling your baby in one arm, wrap a moistened washcloth around the index finger of your free hand, and gently massage their gum tissues.
• Try not to put your baby to bed with a bottle.
• Infants normally begin teething between four and six months of age. His/her gums may be red and swollen which may increase the saliva flow. Help ease these symptoms by giving your infant a clean teething ring or cold, wet washcloth. Cold temperatures are soothing, so you may want to chill the teething ring.
• Remember that dental decay is an infectious, transmissible disease. Avoid testing the temperature of your infant’s bottle with your mouth, sharing utensils, or cleaning a pacifier or a bottle nipple by putting it in your mouth. Help stop the transmission of bacteria that cause tooth decay (cavities) by practicing these tips.
• Begin to wean your baby from the bottle as your infant begins to eat more solid foods and drinks from a cup. Gradually begin to offer a cup for water. By age 12 to 14 months, most children can drink from a cup. Promote healthy habits now by limiting the frequency and amount of sweetened beverages and foods you give your child. Prevent your baby from walking around with his/her bottle or sippy cup.

• Brush your child’s teeth as soon as they come in with a soft bristle brush twice a day. You are welcome to use training toothpaste or a smear (grain of rice) of regular or kid fluoridated toothpaste.
• PM brushing is extremely important to remove any food or drink in the form of plaque off the teeth prior to sleeping as the saliva does not move through the mouth while sleeping leaving your child at an increased risk for tooth decay.
• It is extremely important to limit the carbohydrate or prolonged sugar exposures your child has in a day’s time. It is best to keep your child’s mouth sugar and acid free for as much of the day as possible that is why water is best for in between meal and snack hydrating.

There are three important concepts to understand about oral wounds:

1. Any open oral wound likes to contract towards the center of the wound as it is healing
2. If you have two raw surfaces in the mouth that are in close proximity, they will naturally reattach
3. ***Starting several days after the procedure, the wound(s) will look white and/or yellow and will look very similar to pus. This is a NORMAL inflammatory response. If you have concerns about the wound(s) please call our office first.

The key to getting the optimal result is post-procedure stretches. These stretches are NOT meant to be forceful or prolonged. It’s best to be quick and precise with your movements.

Tylenol may be used for pain control. The following are dosages for Tylenol Oral Suspension (160mg/5mL):

• 6-11 pounds -1.25mL
• 12-17 pounds -2.5mL
• 18-23 pounds -3.75mL
• 24-35 pounds -5mL

For children 6 months of age and older, you may use ibuprofen instead if you would like. Please follow the dosing instructions on the package.

Please refrain from using Orajel if your child is Under 2 years of age, as it may cause a significant medical emergency if too much is ingested.

The main risk of a frenectomy is that the mouth heals so quickly that it may prematurely reattach at either the tongue site or the lip site, causing a new limitation in mobility and the persistence or return of symptoms. The stretching exercises are best done with the baby placed on your lap (or lying on a bed or flat surface) with the feet going away from you.

A small amount of spotting or bleeding is common after the procedure, especially in the first few days. Using a laser does minimize bleeding though. Wash your hands prior to stretches.

It is recommended that stretches be done 4x a day for 3 weeks and then 2x a day the 4th week.

The upper lip is the easier of the 2 sites to stretch. If both sites have been treated and need to be stretched, it is recommended that you start with the lip. Typically, babies do not like either of the stretches and will likely cry, so starting with the lip allows for better access under the tongue when your baby starts to cry. To stretch the upper lip, simply place your finger under the lip and move it up as high as it will go (until it bumps into resistance). Then, gently sweep your finger between the raw, opposing surfaces of the lip and gum so they can’t stick together.

To stretch the tongue, insert both of your index fingers into the mouth (insert one in the mouth and go towards the cheek to stretch out the mouth, making room for your other index finger). Then use both index fingers to dive under the tongue and pick it up towards the roof of the mouth. The tongue needs three separate stretching motions:

1. Once you are under the tongue, try to pick the tongue up as high as it will go (towards the roof of the mouth. Hold it here for 1-2 seconds, relax it and do it once more. The goal is to completely unfold the diamond so that it’s almost flat in orientation.
2. With one finger propping up the tongue, place your other finger in the middle of the diamond and do a gentle circular motion for 2-3 seconds to dilate the diamond.
3. The final motion is turning your finger sideways and use a roller pin motion to try and keep the diamond as deep as possible. Make sure your finger starts within the diamond when doing this stretch. Once it’s done, repeat the motion on either side of the diamond (outside the diamond) to loosen up the musculature of the remainder of the floor of the mouth.

It’s important to remember that you need to show your child that not everything that you are going to do to the mouth is associated with pain. Additionally, babies can have disorganized or weak sucking patterns that can benefit from exercises. The following exercises are simple and can be done to improve suck quality.

1. Slowly rub the lower gumline from side to side and your baby’s tongue will follow your finger. This will help strengthen the lateral movements of the tongue.
2. Let your child suck your finger and do tug-of-war, slowly trying to pull your finger out while they try to suck it back in.
3. Let your child suck your finger and apply gentle pressure to the palate, and then roll your finger over and gently press down on the tongue and stroke the middle of the tongue.

Content is courtesy of Dr. Bobby Ghaheri | Photos are courtesy of Bright Kids Bright Futures

An additional YouTube reference can be found by searching, Dr Lawrence Kotlow’s Fenectomy Aftercare Video.