Citiraj:
Because he felt the frequency of nursing was a factor, Dr. Hale asked whether I could group breastfeeding sessions together. I'm sure Dr. Hale didn't realize the practical impossibility of this since he had never breastfed! With a clear understanding that William was going to continue to nurse on demand day and night, Dr. Hale suggested a routine in which we would try to keep his teeth immaculately clean, wipe them with a cloth after every breastfeeding, brush his teeth three to four times a day, and apply a small amount of topical fluoride (being sure to wipe off the excess fluoride). Upon hearing this I immediately felt relief. This was a solution that would allow us to continue breastfeeding as much as we needed to and have healthy teeth for William as well. Fear followed right behind. The proposed "program" sounded like far too much work. With two children and a busy schedule, would we be able to fit this in as well? William screamed through the once-a-day brushings I was already doing. But I was determined not to have William experience any more trauma from having more cavities filled. Since I was also very upset during those fillings, I did not want to go through it again either.
So we started on this experimental program—wake up, brush his teeth, apply topical fluoride, nurse throughout the day, keep a dry cloth handy, wipe his teeth after every nursing (which he didn't like), go to sleep, nurse at night. I must confess that I did not wake up at night to wipe his teeth with the dry cloth. Other mothers who may have more stamina than I, go to it! But one of the reasons William is in bed with us is so he can nurse and I don't even have to wake up.
We continued this routine for three months, had a checkup and no cavities. Then another three-month checkup and no cavities. Six months with no cavities! Both Dr. Hale and I were so happy it was as if we had won the lottery! Everyone in the office was happy for us, and even William managed a smile.
I am convinced that honest communication in which values were mutually respected made it possible to arrive at a solution. We were successful beyond my wildest dreams, and I can only hope our story helps other families in similar situations. While the solution or technique to resolve dental caries may not be the same in every situation, communication that respects everyone's values is an essential ingredient in the resolution process.
I na koji nacin se boriti s karijesom u ustima:
Citiraj:
The management of a micro-ecosystem of a mouth gone bad involves the control of three components. Those are the diet of the oral flora, hygiene, and fluoride exposure. As we discussed earlier, frequency of feeding becomes an issue because increased feedings increase the overall amount of time the bacteria in the mouth are exposed to sugars. Therefore, as far as the teeth are concerned, it would be better for an infant to consume a large amount in one fast feeding rather than graze on small amounts all day long. Reality usually places a nursing child somewhere in the middle of these extremes. When trying to control simple carbohydrate exposure, we normally attempt to negotiate a movement toward optimized feeding patterns rather than change them completely. Our experience has been that infants are usually recalcitrant about changing their feeding schedules.
All this means that of the three components to be controlled in a breastfeeding infant, diet or frequency is probably not going to change significantly. Therefore, paramount efforts must be placed on hygiene and fluoride. Hygiene is the simpler of the two. Teeth should be brushed as soon as they erupt. Since the bacteria are being fed constantly, they are capable of creating large amounts of plaque (their house), acid (bacterial poop), and many other bacteria. An infant who feeds throughout the day and night needs to have his teeth brushed frequently. This can be accomplished with a small head, soft bristle brush, and a damp washcloth. The brush will do a better job of breaking up and removing the plaque, but at a minimum the teeth should be wiped with a washcloth after each feeding, if possible.
The last component to be considered are fluorides. Some caution must be exercised with these agents. If a child swallows any form of fluoride it is quickly absorbed and a corresponding spike in fluoride blood levels will occur. These relatively short lived elevations in plasma fluoride are usually harmless to the child but repeated exposures have been linked to dental fluorosis, which can cause a chalky speckling on the front, permanent teeth. We have found the best way to optimize topical fluoride exposure is for an adult to massage a small amount of fluoride gel onto the child's teeth with their fingers and wipe out the excess upon completion. The effect of increasing the fluoride exposure is twofold. First, it greatly enhances remineralization of the starts of little cavities. Second, fluoride disrupts the enzymes that the "bad" bacteria use to move sugars intracellularly. This action makes it tough for them to live and reproduce. Therefore, topical fluoride will actually select for the "good" bacteria while inhibiting the "bad" bacteria.
Imajuci ovo sve u vidu, djetetu koje je sklono karijesu SIGURNO nije dosta oprati zube i navecer. A isto tako, sklona sam vjerovati da tom djetetu nece niti pomoci puno prestanak dojenja po noci, jer je ocigledno problem u prevelikoj kolicini bakterija u ustima (koje uzrokuju karijes). Al nisam ni zubar, niti strucnjak, samo moje skromno misljenje.