Q&A: 2 Year Old Using a Bottle and is Leading to Tooth Decay

CME WebsitesChild Routines, Mealtime

blockquote_bgI work with a child who has just turned two. The child receives early intervention services. The child prefers soft foods and still uses a bottle. This has led to dental/oral complications such as tooth decay. One of the child’s IFSP goals is to reduce mouth stuffing. What are some ways to help teach the child not to stuff his mouth when eating? (The child does not like spicy or tangy foods).

I would definitely work on also weaning this child from the bottle and onto a straw cup (not a sipper which will also promote tooth decay) if possible. I would guide the family to only present meals in small portions or even present foods one bite at a time instead of giving the child a whole chicken nugget to bite into, give him one bite sized piece and begin to work on a pattern of chew and swallow before he is allowed a second bite. If his teeth are poor, he may be having extreme difficulty chewing, and possibly due to poor dental hygiene his teeth (oral cavity) may be very sensitive, which could be one reason he does not like spicy or tangy foods. I would also add oral motor play with a Nuk brush, vibrating toys, etc to wake up his mouth before eating. I would definitely teach the child some tooth brushing skills, and a vibrating tooth brush may be helpful.

Brushing the tongue and cheeks can stimulate tongue lateralization. Mouth stuffing sometimes occurs when children are under-sensitive in the mouth and need all that food in there for them to be able to sense where food is within the oral cavity. Some children may have difficulty with lateralizing foods by using their tongue or having trouble chewing in a rotary fashion. If he does not tolerate spicy foods, use crunchy foods, cold foods, ice chips, or sips of carbonated water to wake up the mouth. You can use a mirror during eating so he can watch himself chew and eat and let him look into his own mouth to see and feel it is empty before he takes another bite. I’d also try to persuade the family to get him to a pediatric dentist.