Oral care as a baby for our children is pretty much the same as for any baby. There may be issues of secretions, swallowing and inability to have anything by mouth at any age. Speak with your pediatrician or other specialists about the best way to care for your child's teeth and when to start seeing a dentist.
Even if your child does not eat by mouth, they will still need oral care. Again, follow the recommendations of your dentist, pediatricians, specialists and therapists. But most of our kids tolerate having their teeth brushed. Some families use a toothette swab to clean the inside of the mouth, these are available flavored and unflavored and can also be dipped in mouthwash if ok'd by your professionals.
It is also helpful to use oral stim such as nook brushes to help your child tolerate things being in their mouth to build up to/maintain oral feeds, and it can also be used to help get stuck food from thier mouths during feeding. Nook brushes are also helpful for wetting the inside of the mouth several times a day for kiddos who do not take anything by mouth.
My son gets oral stim four times a day, we usually do it before each of his four tube feeds, he gets his mouth swabbed with a nook brush dipped in water and we use a gentle washcloth as well as our fingers to massage his cheeks and mouth gently.
Some of the biggest issues families face with oral care, especially as their child gets a little older would be secretions, and biting. Some kids bite down on anything you put in their mouth such as food, a spoon or toothbrush. If this is an issue, never yank it out, just massage their cheeks and/or jaws very gently and they will usually let go. Many kids need to have suctioning done during tooth brushing. There are also toothbrushes that are specifically designed for use with suction machines. Most doctors recommend using only a small trace of toothpaste, if any at all. Some families use baking soda, again ask your doctors and therapists what is safest for your child. Some families use the toddler toothpaste that is safe to swallow, but still only use a small amount.
Drooling and secretions can be a huge issue with our hydran kiddos. Drool can cause rashes, and become quite smelly very quickly. Sometimes our kids produce excessive amounts of drool and they cannot handle it and choke on it a lot. There are various medications and treatments available to help with this. Speak with your doctors to find out what they recommend and what options are available to you. Many families find it helpful to keep bibs, or other clothing protectors, on their child to help manage the drool. These can be changed as needed throughout the day. The excess should be wiped from their little face gently on a regular basis to help prevent rashes and smell to develop.
For children with a lot of problems handling secretions, suction machines are a common piece of equipment. Suction can be done just orally inside the mouth, it can be used with a special attachement to suction nose secretions and also deeper suctioning into the throat can be done. A medical professional will show you how to use the suction machine and what type of suctioning you should do on your child. Remember when you are suctioning that you are also suctioning breath from your child. Speak with your doctors about how long it is safe to suction at any given time. For example we were told not to suction for more than 10 seconds at a time orally. Suction machines should be cleaned regularly according to manufacturer's directions and the canisters and hose should also be changed regularly.
One of our families recommends using a small amount mouthwash in the suction canister to help keep it clean and odor free. Also keep a bottle of water in your suction machine bag to suction a small amount water each time you use the machine to keep the tubing and suction device clean.