Although it is almost entirely preventable, tooth decay is the most common chronic childhood disease. What’s more, your child’s oral healthcare habits today will have a major impact on their general health and well-being as an adult. So the behaviors we encourage (or fail to encourage) in them today, really do matter. In this week’s post, I will outline the steps you can take to help your child enjoy a lifetime of beautiful smiles.
Before your baby is born: A good and balanced diet that includes adequate vitamins A, C and D, as well as sufficient protein, calcium and phosphorous for the pregnant mother is an important step towards assuring good oral health for the child. The baby’s teeth begin to form from the second month of pregnancy and harden by the fourth month, so inadequate maternal nutrition can result in poorly-formed tooth enamel that makes the child much more susceptible to tooth decay. Decay-causing bacteria from the mother’s mouth are easily passed to her infant. This is why it is very important that mother is free of tooth decay before the birth. Poor periodontal health in the mother is associated with premature delivery and low birth weight babies. Pregnant women should visit the dentist early in the pregnancy, and pay close attention to their own oral hygiene including brushing the teeth, gums and tongue twice daily, and flossing between teeth on a daily basis.
From birth to six years: Most people think that infants have no teeth, but the truth is that their 20 primary teeth are already nearly fully formed and waiting just below the surface of the gums. These primary teeth are important for normal chewing, speaking and appearance; they also hold the space in the jaws for the secondary or “permanent” teeth. A baby’s front four teeth usually erupt by six months of age and most children have a full set of 20 primary teeth by age three, but this can vary quite a lot.
Cleaning your child’s teeth: You should begin cleaning your baby’s mouth after feeding during the first few days after birth. You can do this by using a clean, wet gauze pad or soft washcloth. This will help remove bacterial plaque and residual food, and helps the child get used to having their mouth checked. You should continue to do this after each meal once the firth teeth have erupted until about 12 months of age. Once a molar tooth has appeared, begin to brush all the teeth on a twice-daily basis with a soft, child-sized toothbrush. This is best done by seating the child in your lap and having her look up towards your face while opening her mouth. When your child is consistently able to spit and not swallow, begin using a pea-sized dab of fluoride toothpaste on the brush. Replace the brush when the bristles are frayed. You should begin to floss on a daily basis between the teeth once the adjacent teeth are touching. Flossing is very important to prevent cavities between the teeth. By age six or seven, children should be able to brush their own teeth twice a day. If you make this a habit when they are younger, it will not become a twice-daily battle when they are older! Supervise their brushing often to make sure they are doing a good job. By age 10 or 11, many children can floss their own teeth under supervision. Until that time, you will need to floss for them. As with almost everything else, if you model these behaviors, your children will follow your example!
First visit to the dentist: The first visit to the dentist office should take place around your child’s second birthday. Think of this visit as a well-child checkup. During the visit, the dentist will examine and clean the teeth, look for evidence of tooth decay, evaluate your child’s need for supplemental fluoride, and provide information on other issues such as teething, thumb-sucking and so on. If you have been cleaning, brushing and flossing your child’s teeth consistently, this first visit to the dentist will be much less stressful for your child and will help your child learn to trust- and not fear- the dentist. Older children should see the dentist one or two times per year.
Preventing decay of the primary teeth: Tooth decay, also called dental carries, are caused by bacteria that feed on sugary food residue on the teeth. These bacteria form sticky films (plaque) on the teeth and release acids that decay and weaken the tooth enamel, which is thinner and less hard than it will be in the secondary teeth. This is why it is so important to keep the teeth, and the space between them, clean. It is also why parents should discourage prolonged exposure to sweetened liquids in a baby bottle. For example, by calming a fussy baby by putting them to bed with a bottle with formula or sweet liquids. Also, you should encourage your child to drink from a cup by one year of age, and never dip a pacifier in honey or sweetened liquids.
What about Fluoride? Fluoride is a mineral that occurs naturally in many foods and water. Fluoride helps to harden the enamel and prevent decay. It can also help repair the early stages of tooth decay before it is visible. Finally, the fluoride your young child receives also helps to strengthen the enamel of the secondary teeth, so they will be less vulnerable to decay. Community water fluoridation is an extremely effective and inexpensive way of preventing dental caries. Unfortunately, we cannot drink the tap water in Bangkok, so it is important that your child receive sufficient fluoride in other ways. This can be from supplements provided by the child’s dentist, or through a treatment done in the dentist’s office. It is important not to receive too much fluoride, which can cause white sports to appear on your child’s permanent teeth. Therefore, only give your child fluoride supplements when they have been provided by your dentist and follow the instructions carefully. That’s is also why it’s important not to use too much toothpaste, especially before your child learns to rinse and spit it out. I also suggest avoiding the use of fluoride mouth rinses in children less than six years of age, and always keep these rinses well out of reach of your children.
Conclusion: I encourage you to think of dental health and physical health as one and the same. Your child cannot be fully healthy and happy if her teeth are decayed, painful or missing. So start early and be disciplined to instill positive oral hygiene habits that will give your children a lifetime of good health and big smiles!