Oral Hygiene and Dental Care

Assessment of oral hygiene and dental care may be considered in response to concerns regarding feeding safety, and adequacy, feeding as a positive experience, development, and efficiency.

Preventing Poor Oral Hygiene (Coating and Debris) and Early Childhood Caries (Dental Decay)

All children should receive their first dental visit within six months after the first teeth appear or by 12 months of age, whichever comes first.

Poor oral hygiene should be readily visible on visual examination; there may be visibly damaged or diseased tissue, or foreign material in the oral cavity such as food particles.

Early childhood caries (ECC) is a dental disease occurring in the preschool years; from eruption of the primary (baby teeth) dentition until secondary (adult teeth) dentition erupts. Treatment often requires hospitalization and general anesthesia. ECC can lead to poor eating and there can be adverse effects on the development of secondary teeth. ECC begins with white lesions or lines which become larger turning yellow or brown (Centre for Oral Health Strategies, 2008).

Children at risk:

  • with poor general hygiene
  • who do not brush their teeth regularly or parents who do not brush their child’s teeth regularly
  • with poor diets (high incidence of sugary or acidic food and drinks)
  • who are enterally fed
  • with poor oromotor skills
  • with lingual ankyloglossia (tongue-tie)
  • with disabilities or with sensory preferences may have challenges performing tooth brushing or oral care
  • with medical conditions, e.g. gastroesophageal reflux (GER), eosinophilic esophagitis (EoE)
  • receiving certain medications, e.g. inhaled corticosteroid

Refer to:

Oral Health Screening
AHS Oral Health
Everyday Care for Your Child
MyHealth.Alberta.ca: Dental Care From 6 Months to 3 Years

AHS Insite Oral Health (AHS Staff Login Required)

Identifying Oral Candida (Thrush)

Oral candida is an overgrowth of the fungus Candida albicans in the oral cavity. It can spread to all surfaces in the oral cavity, tonsils, and into the pharynx. Symptoms include white lesions or coating, redness, pain, and/or bleeding.

Children at risk:

  • with poor oral hygiene, or who use oral appliances, bottles or pacifiers which have been poorly sterilized
  • receiving medications that cause, or with medical conditions known to lead to, increased incidence of the growth of Candida, e.g. inhaled corticosteroids, antibiotics, immunosuppression, nutritional deficiencies
  • lacking access to dental care (Carman, et al., 2012)

Refer to: MyHealth.Alberta.ca: Thrush

Identifying Sialorrhea

Sialorrhea refers to drooling or excessive flow of saliva as a result of limitations in a child’s ability to control and swallow oral secretions. Sialorrhea can result in perioral chapping, maceration of skin, dehydration, odour, or social isolation. A history should include questions about snoring, noisy breathing or poor sleep patterns.

Children at risk:

  • with a neurological condition with associated low oral tone or poor sensation, dysphagia, or with upper airway obstruction such as enlarged adenoids

Refer to:
Sialorrhea in Cerebral Palsy
Nationwide Children’s Hospital: Sialorrhea