Maintaining tip top levels of oral hygiene for your infant or tantrum throwing toddler is often not at the top of every young mother’s priority list. While your baby may not have any teeth yet, it does not negate the need for good oral hygiene practices. It is advisable to clean your baby’s mouth and gums with an infant toothbrush or soft wet cloth. This not only helps to keep the oral cavity clean and healthy in anticipation of the eruption of the milk teeth, it also prepares the child to be ready for the brushing of teeth to come when his first tooth appears.

We recommend caregivers to start the tooth brushing regime as soon as the first tooth appears in the mouth. The teeth and gums should be brushed in a gentle and ‘fun’ way using an appropriately sized children’s toothbrush with water , twice daily, preferably once in the morning and once before bed. Caregivers can start introducing a pea sized amount of non-fluoridated or low dose fluoridated (in areas where drinking water/milk is not fluoridated) toothpaste for children aged 2-6 years. The use of fluoridated toothpaste is advocated only under the direct supervision of an adult because for a child at that age, anything that goes in the mouth is considered food. The caregiver’s role is to limit the amount of toothpaste used and to remind the child to spit out the toothpaste after brushing.

A child that unwittingly swallows small amounts of fluoridated toothpaste over a long period may end up with permanent teeth that are mottled and discoloured, a condition termed fluorosis. Adult guidance and encouragement also ensures that the child is gradually gaining confidence and developing the dexterity needed to battle against dental decay. We hope that your child would be able to brush their teeth, using self-effort by the age of 4-5 years. The caregiver would however still need to check their work and instill awareness if the child is missing out on certain areas (e.g. the gum line etc.) or starts to get complacent.

From age 7 onwards, the child should be able to carry out tooth brushing on his own without direct supervision. A child’s who is able to tie his own shoelaces or write in cursive will have sufficient dexterity to use a toothbrush in an effective manner. The child would also be able to understand that not everything that goes in the mouth ought to be swallowed. They can start making the transition to normal, fluoridated toothpaste without any worries.

 

DIET

 

Our diet continues to play a crucial role in the development of tooth decay. Studies have shown that children who are old enough to incorporate other food or beverages into their diet and who continue to be breastfed for long periods after the first tooth appears, are at a higher risk of developing tooth decay. Also, though it may be comforting for the child to have their milk bottles filled with sweetened milk or juice within easy reach for their consumption throughout the day or night, it is actually extremely damaging for their teeth.

There is a strong body of evidence to demonstrate the association between frequency of sugar intake and dental decay. Every time the child takes a sip of that sugary goodness, it’s also meal time for the bacteria present in the mouth, as they metabolize the sugar present to form acids that eat away tooth structure, hence causing dental decay. This sugar attack is made worse when it takes place at night because salivary flow is lowered. Our saliva play an essential role in the battle against tooth decay as it acts as a buffer against initial pH changes, provide the medium for ionic exchange and contain immunoglobulin’s that defends against oral bacteria. Though your child might be sleeping better through the night when having his sippy bottle nearby within reach, the bacteria in their mouths are hard at work every time a sugar attack takes place.

The same applies as well to carbonated beverages as they are acidic and erodes tooth structure causing cavities. It is best to encourage your child to drink their milk or juices quickly when feeding, and sip plain water as a habit, to prevent early onset of dental decay. When the child is old enough to reach into cupboards for snacks, make sure those cupboards are not filled with sugar loaded food or carbonated drinks for the very same reason! It might seem like a dream come true for your child to have unlimited access to sugary treats initially, but soon enough, it will turn into a nightmarish experience of unexpected pain episodes due to dental decay, need for fillings and teeth pulling at the dentist’s office.

Healthier alternatives to these sweet treats should be considered instead and a great alternative would be cheese. Cheese now not only come in fanciful packages that appeal to children, they are also packed full of calcium and phosphorous, excellent for your child’s developing dentition and bones. They also stimulate salivary flow when eaten and hence can help neutralize acids produced by bacteria as well as clear away food debris that bacteria would be glad to feast on. You can help make your child’s visit to the dentist way more pleasant and cheaper too, if you keep those sugary treats for special occasions.

 

DENTAL VISIT

 

The appearance of the child’s first tooth is an excellent occasion to celebrate with a child’s first dental visit. Cultivating good oral hygiene practice from a young age goes a long way. Studies have shown that children who attend for dental checkups from a young age tend to have fewer cavities and lower levels of dental disease compared to those who do not. The visit provides your dentist with the opportunity to check if the timing of the eruption of your child’s dentition are as expected, identify and advice against practices that may cause damage to the child’s teeth, as well as dispense appropriate instruction to cultivate the correct oral hygiene habits from a tender age. Also, it will be a more pleasant experience for the child if his first visit to the dentist is not during an emergency situation, where throbbing pain from a toothache or reeling from the after effects of having a tooth pulled is all they remember of the visit. While we can try to minimize the trauma and go on about the tooth fairy’s visit later on but that traumatic first visit to the dentist will more than likely remain etched in your child’s memory and manifest as some form of dental phobia for many years to come. Prevention is better than cure and getting your child to the dentist early also allows the child the opportunity to get acquainted and accustomed to the clinic’s environment as well as build a rapport with the dentist, making future visits more pleasant and fruitful.

 

FLUORIDE

 

Low dose fluoride has been shown to be beneficial in the development of teeth that are more resistant to dental decay. It also has the potential to reverse the decay process during its early stages. Some countries, including Singapore, fluoridates its water supply as a preventive strategy against dental decay. Another convenient source of fluoride would be from toothpastes currently available in the market. Though most toothpastes sold have a fluoride content of between 1100-1500ppm, it is advisable to read the labels to be sure. In geographic areas that do not receive fluoridated drinking water, fluoride can be added to milk, consumed as a supplement or applied on the teeth by the dentist. The need for such forms of delivery will be dependent on a dental decay risk assessment by your dental practitioner.

 

SEALANTS

 

It is common misconception that since milk teeth will eventually be replaced by permanent teeth, there is less need to be as meticulous with regards to their care. This is definitely not the case and getting this right will bring significant benefits to your toddler’s wellbeing.

The milk teeth features prominently in a child’s first twelve years of live. They allow the child to chew food, learn to speak and ultimately act as space guardians for the developing permanent teeth. Early loss of milk teeth often results in the loss of space for the permanent successors. Space loss complicates the teeth eruption pattern and sequence of the child’s permanent dentition, causing a variety of issues such as dental crowding, crossbites due to tooth displacement and in severe cases, tooth impactions.

Deep dental decay in milk teeth will require some form of restorative procedure, or even extraction in severe decay, and the memory of this unpleasant experience may put your child off any form of dental treatment for many years to come. Not only does decay of milk teeth cause poor appearance, it can also result in much agony for your child should the decay extend all the way to the nerve in the tooth. Infections can arise as a result and can interfere with the development of permanent teeth below the milk teeth. Unfortunately, the problem does not end there.

Dental sealants are thin layers of resin (a type of plastic) coating that are applied over deep fissures that are commonly found on molar and premolar teeth. Deep fissures are common starting points of decay in young children as it easily accumulates food debris and cavity forming bacteria besides being located at hard to reach areas. The placement of sealants is a quick, simple and painless procedure. We recommend sealants to be placed on the biting surfaces of your child’s permanent molars, which start to erupt at about 6 years of age. Children whose milk teeth are at risk of decay can also have sealants placed on them, especially the baby molars. Not only do sealants serve the purpose of protecting your child’s teeth, allowing your child to experience uneventful and pleasant dental visits will ultimately provide him with an excellent opportunity to build self-confidence, get comfortable and acquainted with the dental environment and staff.