CHILDREN'S DENTAL HEALTH
The habits formed when a person is a child will generally be
carried on through adulthood. This means that instilling
good dental care habits in a child is a very important part
of raising a child. Teaching a child the value of brushing
his or her teeth will contribute to good dental and overall
health when that child is an adult.
When a child is a baby, there are still things that can be
done to contribute to good oral health. For starters, as
soon as a baby has teeth, it is a good idea to wipe them
down with a soft cloth or baby tooth brush. This will
prevent decay of baby teeth before the child can even feed
his or herself. In addition, it is an excellent idea never
to give a baby a bottle while in the crib. While a bottle of
water may not do damage, allowing the baby to have milk or
juice just before bed will allow the sugars in the liquid to
decay teeth all night.
Once the child is old enough, he or she should use a
fluoride toothpaste to brush his or her teeth. Fluoride has
long been shown to prevent dental decay and cavities. When a
child has fluoride toothpaste, he or she needs to be
supervised to prevent too much toothpaste from being
Healthy snacks and a low-sugar diet are also important for a
child. Providing snacks that are too high in sugar, in
addition to their overall negative effect on a child's
health, will contribute more to tooth decay. In addition,
healthy snacks will instill good eating habits in a child
from a young age.
Just like all people, children need a diet that is high in
calcium for bone and dental health. Low-fat milk is one of
the best ways to get this calcium while avoiding a high fat
content. In addition to needing lots of calcium for their
current teeth, children need calcium to help the formation
of their adult teeth.
INFANTS AND TOOTH DECAY
Infants can experience tooth decay soon after the baby teeth
erupt, which is usually between nine months and two years.
Tooth decay in infants is sometimes referred to as 'early
childhood caries' or 'baby bottle decay'.
As children often have sugary food and drinks, bacteria in
their mouth can use these sugars to produce acid that
attacks immature tooth enamel. Regular coating of the teeth
with sugary foods or drinks by sucking from bottles
containing fruit juice or sweet drinks (eg. cordial and soft
drink) or sucking on dummies dipped in sugar syrups (eg.
honey) can cause early childhood caries.
Seek treatment from a dental professional.
To avoid early childhood caries, follow these tips:
and water are the best drinks for babies - avoid
undiluted juice, cordial and soft drinks.
the cup at around six months.
the bottle at around 12 months.
bottle away once the baby is finished drinking.
sweet syrups on a dummy.
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- preventing infant tooth decay
Early childhood caries can occur in children as young as six
to 12 months of age. In infants, the upper four front teeth
(incisors) are the most commonly affected. Dental caries are
holes in teeth caused by decay. Early childhood caries can
be caused by the inappropriate use of bottles.
How to tell if your infant has early childhood caries
Early childhood caries can be difficult to detect. Its
appearance will depend on how advanced the condition is.
Early childhood caries may show up as:
white band along the gumline this is the first sign and
usually remains undetected by parents. Bacteria found in
plaque change sugars into acids, which dissolve minerals
in the tooth's enamel in a process known as
demineralisation. If untreated, this can lead to holes
(cavities or caries) in the teeth.
brown or black collar around the neck of the teeth this
indicates that the demineralisation has progressed to
look like brownish-black stumps this indicates that the
infant has advanced cavities. The upper four incisors
(front teeth) are usually involved, while the lower
incisors remain relatively unaffected. The back teeth
may also be involved.
Importance of early detection
Unfortunately, in most cases, early childhood caries is
not picked up until the child is about 20 months of age.
By this stage, many children need significant dental
treatment. This can be traumatic for both the infant and
to prevent early childhood caries
Breastfeeding is best as it carries a reduced risk of early
childhood caries. If bottle feeding is necessary:
bottle away when the child has had enough.
boiled water if the child needs a bottle for comfort or
the child to a feeding cup between six and eight months
of age. In most cases, the bottle can be discarded when
the child is 12 months old.
children to drink water rather than fruit juices or
sweet drinks when thirsty.
Toothbrushing recommendations include:
soon as the first tooth appears. Wipe the front and back
of each tooth using a finger wrapped in a face washer.
soft toothbrush at 12 months (earlier if tolerated by
toothpaste at about 18 months of age.
pea-size amount of toothpaste.
fluoride toothpaste for children under six years old.
Dental check-ups can help detect early childhood caries. The
Child Health Record recommends two dental checks before the
age of three and a half years. This may be done by a
maternal and child health nurse or a dental professional.
helps protect teeth against caries
Seventy-five per cent of Victorians have access to fluoride
in their water. If your drinking water is not fluoridated,
seek professional dental advice about the use of fluoride
toothpaste for children. A dental professional may advise
more frequent use of fluoride toothpaste, commencement of
toothpaste at a younger age or earlier commencement of use
of standard toothpaste.
Fluoride supplements in the form of drops or tablets to be
chewed or swallowed should not be used as they can affect
the development of your child's second teeth and cause
dental fluorosis (staining).
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Dummies and medicines
Avoid dipping dummies in honey, glycerine or other foods or
liquids. If your child needs medicine, ask your doctor to
prescribe a sugar-free form.
Things to remember
detection of early childhood caries may prevent the need
for dental treatment.
cleaning should begin as soon as your infant's first
Use a low
fluoride toothpaste for children under six years of age.
LOSING BABY TEETH
first teeth are the lower center teeth. They usually make
their arrival around 6 months of age. They are also the
first baby teeth to fall out. This generally occurs at 6
years of age. Children will lose the upper center teeth
Baby teeth fall out in order to make room for permanent
teeth. Children will continue to lose their baby teeth until
about 11 to 12 years of age. Typically, the teeth will fall
out in the same order they came in: center incisor teeth,
first molar, canines, and second molars.
Some children are very nervous about losing teeth, while
others become extremely excited about the process. Losing
baby teeth generally does not cause any discomfort. However,
some children do have sore gums and light bleeding. Mild
pain relievers such as ibuprofen and acetaminophen can be
given to assist with any pain.
Since permanent teeth last forever, it is important your
child learn good hygiene. Teach the child to brush his teeth
after every meal and get him in the practice of flossing
before bed. Children should visit the dentist for the first
time at age 3. If complications arise, they may need to go
When the permanent back teeth come in, the dentist will
place a sealant to help protect against decay. In addition,
sugary treats should be limited, and a fluoride supplement
should be given if your drinking water does not have
FIRST DENTAL VISIT
The first "regular" dental visit should be just after your
child's third birthday. The first dental visit is usually
short and involves very little treatment. We may ask the
parent to sit in the dental chair and hold their child
during the examination. The parent may also be asked to wait
in the reception area during part of the visit so that a
relationship can be built between your child and your
We will gently examine your child's teeth and gums. X-rays
may be taken (to reveal decay and check on the progress of
your child's permanent teeth under the gums). We may clean
your child's teeth and apply topical fluoride to help
protect the teeth against decay. We will make sure your
child is receiving adequate fluoride at home. Most important
of all, we will review with you how to clean and care for
your child's teeth.
What should I tell my child about the first dental visit?
We are asked this question many times. We suggest you
prepare your child the same way that you would before their
first haircut or trip to the shoe store. Your child's
reaction to his first visit to the dentist may surprise you.
Here are some "First Visit" tips:
with them about going to the dentist.
them what the dentist will be doing at the time of the
positively about your own dental experiences
first visit the dentist will:
your mouth, teeth and gums
adverse habits like thumb sucking
see if you need Fluoride
about cleaning your teeth and gums
schedule for regular dental visits.
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BRUSHING YOUR BABY'S TEETH
Breast milk and formula both contain natural kinds of sugar,
making infants highly susceptible to tooth decay. Some
parents do not understand the importance of caring for a
baby's teeth, reasoning that the teeth their child was born
with will fall out anyway.
The truth is that your child will use those teeth for biting
and chewing for years, not to mention the process of
learning spoken language. Baby teeth also function as "place
holders" for adult teeth; if baby teeth fall out too soon,
there may not be room for adult teeth to grow in.
Before Teeth Develop
Many dentists agree that it is important to keep your
infant's mouth clean even before he or she begins to teeth.
This will increase your child's hygiene while establish
mouth-cleaning as a nightly ritual, making it easier to
introduce your child to the concept of brushing. It is
recommended that you gently wash the gums with a wet cloth
or infant toothbrush. Be careful not to be too rough.
After your child begins teething, the method for keeping his
or her mouth clean will not change much at first. Using a
cotton swab, gently wipe down the teeth and clean the gums.
It may be difficult to get your child to sit still for this,
especially if you have waited for teeth to appear before you
began cleaning his or her mouth. With practice, however, it
should become easier.
Check with your pediatrician about the correct time to start
using toothpaste. Use a very small amount for a child's
early years; a pea-sized blob is usually sufficient.
Remember, children's teeth decay faster than adults', so do
not be too lax about enforcing regular brushing!
Tooth decay and children no longer have to go hand in hand.
At our office we are most concerned with all aspects of
preventive care. We use the latest in sealant technology to
protect your child's teeth. Sealants are space-age plastics
that are bonded to the chewing surfaces of decay prone back
teeth. This is just one of the ways we will set the
foundation for your child's lifetime of good oral health.
Most of the time cavities are due to a diet high in sugary
foods and a lack of brushing. Limiting sugar intake and
brushing regularly, of course, can help. The longer it takes
your child to chew their foods the longer the residue stays
on their teeth, the greater the chances of getting cavities.
Every time someone eats, an acid reaction occurs inside
their mouth as the bacteria digests the sugars. This
reaction lasts approximately 20 minutes. During this time
the acid environment can destroy the tooth structure,
eventually leading to cavities.
Consistency of a person's saliva also makes a difference;
thinner saliva breaks up and washes away food more quickly.
When a person eats diets high in carbohydrates and sugars
they tend to have thicker saliva, which in turn allows more
of the acid-producing bacteria that can cause cavities.
Tips for cavity prevention:
Frequency of meals and snacks.
brushing, flossing and rinsing.
part of meals.
The first baby
teeth that come into the mouth are the two bottom front
teeth. You will notice this when your baby is about 6-8
months old. Next to follow will be the 4 upper front teeth
and the remainder of your baby's teeth will appear
periodically. They will usually appear in pairs along the
sides of the jaw until the child is about 2 1/2 years old.
At around 2 1/2 years old your child should have all 20
teeth. Between the ages of 5 and 6 the first permanent teeth
will begin to erupt. Some of the permanent teeth replace
baby teeth and some don't. Don't worry if some teeth are a
few months early or late as all children are different.
Baby teeth are important as they not only hold space for
permanent teeth but they are important to chewing, biting,
speech and appearance.
For this reason it is important to maintain a healthy diet
and daily hygiene.
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What is the best time to start orthodontic treatment?
This all depends on the specific dental problem and the way
the teeth and jaws are developing, we are all unique, even
siblings. The American Association of Orthodontists
recommends that every child first visit an orthodontist at
age 7. The reason for this early examination is to allow the
specialist to determine when is the ideal time (if any) for
the child to be treated for optimal improvement. Early
treatment can give the orthodontist the chance to: - Lower
the risk of trauma to protruded front teeth. - Guide the
facial and dental growth. - Correct harmful oral habits. -
The best time to start is just before, or immediately after,
all the permanent teeth (excluding the wisdom teeth) erupt,
as this would coincide with maximum growth activity of the
child. Maximum orthodontic response is seen at this stage.
This is generally between the ages of 10 and 14 years.
Sometimes treatment is started as early as 7 or 8 years,
especially when the child needs what is known as 'functional
therapy'. It is best to seek your dentist's advice.
Wisdom teeth appear between the ages of 16 and 25 and are
considered an individual's third molars. They are often
extracted as they can interfere with the other teeth. In
general, people have 4 wisdom teeth. However, some people
may have fewer or more.
Impacted wisdom teeth are classified into several
categories. Mesioangular impaction is where the tooth is
tilted forward and is the most common form. When it is
tilted towards the back, it is known as distoangular
impaction. If the tooth simply does not erupt but is in the
traditional vertical form it is referred to as vertical
impaction. Lastly, the least frequent impaction is
horizontal, in which the tooth is at a 90 degree angle and
is growing towards the second molar. When in the maxilla,
the upper jaw, distoangular impactions are the easiest to
remove, while mesioangular impactions are the most
difficult. It is the opposite for the mandible, the lower
jaw, in which mesioangular impactions are the easiest, and
distoangular being the hardest.
Occasionally, the wisdom tooth does not erupt completely and
a soft tissue flap, known as an opercalum, extends over the
teeth. Teeth with an overcalum are very difficult to clean
properly, and debris and bacteria have easy access. This can
result in periocoronitis, which is a common infection in
young adults. Symptoms include swelling of the gum, pain,
and bad taste in the mouth. If untreated, it can lead to far
more severe infections.
Learning about Wisdom Teeth
They grow in when you are older and wiser, that is why they
call them your Wisdom Teeth. Also known as third molars,
wisdom teeth are the last teeth to grow in your mouth. They
can come in at any time, typically between the ages of 17
and 25 years old. Some would consider them a product of
evolution that has become an inconvenience in modern times.
Why We Have Them and the Problem
Early humans had a rough diet that caused excessive wear on
their teeth. The teeth would compensate by shifting, leaving
enough space for most wisdom teeth to grow in by
adolescence. Today, a combination of our softer diet and a
desire for straight teeth often leaves us without the room
for our wisdom teeth to grow in. This creates a problem when
our final four molars enter the mouth, making it necessary
for many people to have their wisdom teeth removed.
When Wisdom Teeth Should be Removed
An absence of symptoms does not mean that your wisdom teeth
are not going to cause you problems in the future. As wisdom
teeth grow, their roots become longer and they become more
difficult to remove. Damage can actually be occurring while
there is no pain or visible signs. One survey estimated that
85% of third molars will eventually need to be removed.
Removing wisdom teeth is a lot easier to do when you are
younger because the roots are not completely formed. The
procedure becomes more complicated at a later age because
the roots have fully developed and the jawbone is denser.
Earlier removal, as in before your wisdom teeth start to
bother you, is best and has a less complicated healing