Questions :

20. Looking After Your Child's Teeth: When Do You Start?

Contributed by:

Dr. Roslan Saub

Department of Community Dentistry, University of Malaya Kuala Lumpur

Do you have a child? If you do, I'm sure you would want your child to be healthy. wouldn't you? It is your responsibility to look after your child's health. This should also include their oral health because it is part of total health. Often, many parents ignore their children's oral health. If your child has a toothache, for instance, it will not only disturb your child's daily activities but also yours as well. Your child couldn't sleep, couldn't eat well and will be crying all day and night. Why wait until they have these problems? Why can't you prevent it from happening. Dental caries and gingivitis are two most common oral diseases in children. They can easily be prevented if you can inculcate in them good oral hygiene habit and dietary practice.

Why healthy teeth are important?

Human beings need to eat in order to stay alive. Food that we take need to be broken up into smaller pieces to enable our digestive system to absorb all its nutrients We need teeth to do this. If food have not been chewed well, there is a possibility that your child will suffer from constipation and perhaps malnourishment.

Children are in the process of development; physically, psychologically and socially. Proper eating is important to ensure that they are getting all the nutrients necessary for growth. Besides that they need teeth to speak properly. Healthy teeth are also important in the development of self- image. In addition primary teeth (baby teeth) are important to ensure that permanent teeth erupt into their correct position. Hence it is important to maintain good dentition, both primary and permanent throughout life.

When do teeth develop?

There are two sets of teeth in life. The baby teeth are the first set of teeth, which will then be replaced by the permanent teeth. Baby teeth begin to grow during the early stages of pregnancy. The first teeth will appear in the mouth from the age of 6 months and by 3 years old all 20 baby teeth are in place The permanent teeth starts to erupt at 6 years old and by 12 years old all baby teeth have been replaced by permanent ones. A child is in a mix dentition state between the age of 6 and 12 years old.

When do you start?

Dental care of the child should begin as soon as pregnancy starts. This is because, as mentioned earlier, the development of baby teeth begin in the first trimester of pregnancy and continues until the teeth appear. Therefore to ensure normal development of the teeth, mothers should take good diet. Vitamin supplements such as calcium and vitamin D will benefit the baby's developing primary teeth. Taking drugs such as tetracycline should be avoided during pregnancy to avoid permanent discoloration of the baby teeth.

Oral care for infant should starts at birth. The infant's oral cavity has to be cleaned using a clean cloth by wiping all around the month. By doing so, it will avoid infection of the soft tissue. Breast feeding is encouraged among mothers. It increases mother-infant bonding and gives the child contentment, security and protection. However prolonged on-demand breast feeding, especially at night can cause detrimental effect to the milk teeth due to the lactose in breast milk which has been shown to produce lactic acid when fermented. When the mother is unable or unwilling to breast feed, and bottle feeding is used, make sure that you do not add sweeteners to the milk. Babies should not be allowed to sleep with a propped bottle or given reservoir comforters. It in advisable to wean off the bottle by the age of I year to avoid inevitable rampant caries.

Diet, especially sugary food, is one of the factors that cause dental caries. A study in Klang found that the total amount of sugar intake among the 12 years old school children was estimated at 72 grams per day per person or 26 kilograms per year per person which is much higher than recommended sugar intake that is 15 kilograms per year per person. They also found that the amount of sugar intake was higher at home than at school. Hence it is important for the parents to instil good dietary habits among their children as young as possible. Children should he given satisfying well-balanced meals so that they do not need to supplement them with snack food or drinks in between. If your child wants to eat between meals, avoid giving them sweet and sticky foods, you can always replace them with fruits, milk nuts, savoury biscuits, and low calories drinks which are safe snacks.

Start brushing your child's teeth as soon as they appear. However children below 10 years old who does not have the skill to clean his teeth properly, need help from you, the parents. Parents play a primary role in cleaning their child's teeth until their children are able to brush their teeth effectively by themselves. The very young child ( 6 months - 6 years ) must have his teeth brushed by the parents at least once a day especially before putting them to bed. This may be best achieved by sitting your baby on your knees and using a small toothbrush with soft bristles. At first use only water, but as the baby gets used to having his teeth cleaned, a small amount of fluoride toothpaste can be used. However it must be used with caution. Studies have shown that children at the age of 5 years old tend to swallow toothpaste and hence the amount placed on the brush each time much be carefully limited, generally to a pea-size quantity. Train your child to spit after brushing. To make brushing for you and the baby much easier, let the baby play with the brush and he will learn how it feels in his mouth. This will not only help in developing the brushing skills but also will help in developing the motor skill of your child. However supervision from an adult is necessary.

As the child gets older he will start to attempt this oral hygiene himself but will still need the additional help and supervision of an adult until he has developed the skill. The habit of brushing teeth should he made part of daily routine.

Once your child has teeth, you should take the initiative to make an appointment to see a dentist. It is advisable to bring your child to dental clinic as early as possible. This will help your child to become familiarized with the set-up of the dental clinic and to detect early dental diseases. Moreover it also helps in reducing fear towards dentist which is very common among young children. As a Malay proverb said "Kalau melentur buluh, biarlah dari rebungnya". It means that if we want to train people, start them early in life. So in maintaining good oral health for life it should be started from the womb and continued throughout life. Hence preferable health behaviour such as good oral hygiene practices and healthy diet should be instilled as early as possible.


Malaysian Dental Association shall ensure that the collection, use and disclosure of your personal data is consistent with the Malaysian Personal Data Protection Act 2010 ( 'PDPA' ). It is acknowledged that personal data collected and processed is obtained voluntarily and with your consent.

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