What preventive measures should the nurse teach parents of toddlers to prevent early childhood caries? (Select all that apply.)
a. Avoid using a bottle as a pacifier.
b. Eliminate bedtime bottles completely.
c. Place juice in a bottle for the child to drink.
d. Wean from the bottle by 18 months of age.
e. Avoid coating pacifiers in a sweet substance.
ANS: A, B, E
Prevention of dental caries involves eliminating the bedtime bottle completely, feeding the last bottle before bedtime, substituting a bottle of water for milk or juice, not using the bottle as a pacifier, and never coating pacifiers in sweet substances. Juice in bottles, especially commercially available ready-to-use bottles, is discouraged; these beverages are especially damaging because the sugar is more readily converted to acid. Juice should always be offered in a cup to avoid prolonging the bottle-feeding habit. Toddlers should be encouraged to drink from a cup at the first birthday and weaned from a bottle by 14 months of age, not 18 months.
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