7. Looking After Your Child's Teeth. When do you start?Contributed by:
Dr. Kalaiarasu M. Peariasamy
Paediatric Dental SpecialistKlinik Pergigian Pakar, Hospital Kuala Terengganu
Dental caries and gingivitis are two most common dental diseases in children. Normally parents 'discover' dental disease in children the painful way! Yet dental problems can be avoided if the oral health of the child is maintained with good eating and oral hygiene habits.
From Birth to 3 years of Age
Infant oral health and care of the child younger than age 3 has largely been dependent on the interest and ability of parents. For this reason oral health education is given to expectant mothers, so that a program of home care can be started in early infancy. Despite this, almost 80% of all pre-school children in Malaysia had experience of dental caries and significantly some had bottle or nursing caries. The primary factor is a pattern of sugar consumption that has been established early in life of the child. Other factors include feeding practices such as putting the child to bed at naptime, or bedtime with a bottle containing sweetened milk or beverages.
Parents therefore should understand their responsibility and begin a program of home care in infancy. It is important to establish good dietary habits early in the child's life. Avoid sugar right from the start so that the child doesn't get a taste for sweet things. If a bottle is necessary for naptime or bedtime, parents must ensure that after feeding the child is placed in bed without the bottle. Additionally, if the child prefers a pacifier or dummy, never dip into something sweet for the child to suck.
Oral hygiene measures are important during the first years of life. Start brushing your child's teeth at an early age. Then it becomes a habit right from the begining. Your child does not have the manual dexterity nor understanding to perform effective tooth brushing. Therefore, parents must assume the primary role of cleaning their child's teeth. Once teeth have erupted a clean cloth or a soft toothbrush can be used to gently wipe over the tooth. Find an appropriate time at least once a day to help your children learn to brush their teeth well. Make it a part of your family's daily routine. later when more teeth have erupted your child can learn to brush under your supervision. Generally, toothpaste can be introduced between 2 and 3 years of age. When this occurs, fluoridated toothpaste should be used sparingly to minimize fluoride ingestion.
Regular visits to the dentist are important for children. Dental caries may begin when the first teeth start to come through between the ages of six months and one year. As such, children should receive their initial oral evaluation by a dentist within 6 months of the eruption of the first primary tooth and not later than 12 months of age. Your child will get to know his or her dentist and get used to going for recall examinations.
This is a brief interval before the loss of the first primary tooth and the begining of permanent tooth eruption. By now an eating pattern that carry a risk of dental caries may have occurred. Many children consume sugary snacks three or four times a day Parents must reduce the number od times each day a child eats sugary things. You can do this by cutting out sweet things between meals. Encourage your child to snack on "tooth-friendly" food items like rice-crackers, cheese, peanuts, sugarless gum, fruits and vegetables. this positive dietary control is not only healthy for your child, but also prevents dental caries.
During this period, many parents assume that their pre-school child can be responsible for their own oral hygiene. However only very few children can brush well enough. Usually parents need to help with tooth brushing, at least once a day until their child is in primary school. Even when their child takes over brushing, you need to check if it is done properly. As for dental check-ups, take your child regularly to your dentist.
The Primary School Years
Children are most likely to change their dietary habits during this period. Commonly they spend a full day in school with frequent snacks and sweets. This can be avoided if parent packed lunches with fruits and other foodstuff that are not sugary. Often the first tooth to decay is the first permanent molar. The pits and fissures of this tooth are the primary sites for dental caries in children. Normally your child's dentist can help prevent this type of caries by applying a plastic coating to the pits and fissures as a mechanical barrier. This plastic coating or sealant is very effective in preventing pit and fissure caries.
Children with high risk of dental caries can benefit from fluoride therapy. Fluoride can be applied professionally by your dentist or used in conjunction with your child's home care routine.
For effective oral hygiene care, parents need to help with tooth brushing at least until their children are skilful. Twice a day brushing with a fluoridated toothpaste is routinely recommended. Further reinforcement of oral hygiene measures may be necessary for those children with poor compliance. Often encouragement and reinforcement are enough to help your child change his or her poor oral hygiene practices. If your child sees a dentist regularly, and early decay or developing gum disease can be easily treated before it can cause trouble. Usually early treatment does not require the use of local anaesthetics and therefore children would benefit from a painless dental treatment.
If you have a child with disabilities, additional assistance may be required. The nature of disability may prevent your child from achieving an adequate level of oral hygiene. Various methods are available to support your child during tooth brushing. Your dentist would be the best person to advise you on oral hygiene aids and preventive measures for your special child.