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Ask Dr. Sears: Nursing Caries

Brush his teeth frequently. The two most important times to cleanse those pearly whites is right after the first feeding in the morning and after the last feeding at night. Try a soft-bristle brush or wrap gauze around your index finger and use it as a toothbrush. Nursing carries are most prominent in the front teeth, especially along the gum lines. Be sure to curve your finger, or the brush, enough to cleanse behind the teeth. It often takes two people to brush a baby's teeth, so you and Dad sit facing one another knees to knees and stretch baby across your laps, with his head on your lap. Then you can brush his teeth from above, which helps you get better access to the teeth. Dad can hold the squirming baby while you brush the teeth. You can also give your toddler his own toothbrush and capitalize on his natural desire to mimic. While you are brushing your teeth, encourage him to do likewise.

Consider a fluoride supplement. Since babies usually don't drink enough water, especially if you drink unfluoridated bottled water, ask your dentist for the appropriate dosage of a fluoride supplement for your baby. This could be in the form of daily fluoride drops or you could use no more than a pea-sized dab of fluoridated toothpaste. Concerning fluoride, be sure not to give more than your dentist prescribes, since too much fluoride can weaken the enamel instead of strengthen it.

Avoid sticky stuff. Because of the choking hazard, baby is too young to suck on hard candy anyway, but with toddlers, avoid caramel and sweets that stick to the teeth.

Substitute night "nursings." The term "nursing" does not mean only breastfeeding; it implies any method of comforting. A father can "nurse," too. If your baby needs a middle-of-the-night sucking to soothe him back to sleep, let him suck on your finger or knuckle. Sometimes a lullaby will do just that -- lull a baby back to sleep. For babies who want a nighttime bottle, try the trick I call "watering down" -- each night gradually dilute the formula with increasing amounts of water until your baby's bottle is 100 percent water.