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Children and Oral Care
Dental Care
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Teething
You may be wondering what to expect when your baby starts teething. For newborns, some teeth may appear as early as six months after birth. During the first three years of life all 20 baby teeth will erupt. These primary teeth are important in normal development and hold space for the permanent teeth.
The four front teeth usually erupt first at 6 to 14 months. Around 14 to 19 months the child’s canines and first molars will erupt. Then finally between age 2 and 3 years the second molars will erupt. As the child grows, their jaw will grow to make room for the future permanent teeth, which will erupt around age 6.
Tooth decay in children
Some parents and other caregivers do not realize that a baby’s teeth are susceptible to decay as soon as they appear in their mouth. Decay in infants and toddlers are sometimes called early childhood caries. It can lead to pain, infection, and premature exfoliation of baby teeth, which can lead to complication in the development of adult dentition.
This occurs when the child’s teeth are exposed to cariogenic liquids for long periods of time. It can include: milk, cordial, formula, fruit juice and soda. But this is preventable!
Here are a few tips to help keep your infant’s teeth clean and decay free:
- Never allow your baby to fall asleep with a bottle that has milk, formula or juice.
- Begin oral care early! Wipe the baby's gums with a wet washcloth or baby finger brush after each feeding.
- Begin to brush their teeth with a little water and toothbrush as soon as the first tooth appears.
- Always help brush a child's teeth until they can do a proper job by themselves.
- Be vigilant and do regular at home visual teeth checks for your child.
- Schedule a child's first check-up around their first birthday.
Start the habit of brushing your baby’s teeth twice a day when the first tooth comes in. Use a soft-bristled toothbrush for a baby with some water and toothpaste (non-essential at this stage). Around age two is when you can use a pea size amount of baby toothpaste, because the child should be able to spit by that time.
Why do we need to brush a baby’s teeth?
Even though children do not tend to eat the variety of foods that adults eat, bacteria still occupies the oral cavity. The byproduct of these bacteria is acid, which is what attacks and destroys our tooth surface leading to a filling.
If your child does not like brushing, just be persistent and patient while continuing to give proper care. Don’t be too rough. It takes very little pressure to remove bacteria and food. With time they will appreciate the gentle attention. So, how do we brush?
First of all, it takes two to three minutes to properly brush your teeth but most people do not get anywhere close to that amount of time.
Teach your child to brush
- Brush twice a day - after breakfast and before bedtime. If they can, additional brushing such as a brush after lunch or after any sweet snacks.
- Use a pea-sized amount of toothpaste.
- Use a low fluoride toothpaste for young children under 6 years of age.
Get your child to gently brush the inner surface of their teeth using short circular motions. Then using the same motion, move to the outer surface and then the biting surface on top.
Use the tip of the brush to clean behind each front tooth – both top and bottom (particularly the inner surface of the bottom teeth).
Be gentle! It takes only a small force to remove bacteria and food and being too rough can harm the gums. Make sure your child spits out the toothpaste after brushing.
Habits that affect dental development - Thumb Sucking
Sucking is a natural reflex for infants. It makes them feel safe and happy and provide a sense of security. And since it is relaxing, it can help induce sleep. Most children stop thumb sucking and dummies at two to four years of age. But the problem exists when dummies or thumb sucking persist beyond the first few years. If your child continues to use their thumb or dummies beyond age four, they can develop misaligned teeth, malformed jaws, and potential speech defects (due to lack of lip seal). The frequency, duration, and intensity will determine whether or not problems will form.
Here are some helpful hints on breaking the habit:
- Praise and reward them when they are not sucking.
- Children often suck when insecure. Focus on correcting the cause of anxiety (sleep environment?), instead of the thumb sucking.
- Wait until the time is right.
- Dental appliances can be made to assist in breaking the habit.
- During your dental visit, we can encourage the child to stop sucking and explain what could happen if they continue.
Prevention of dental issues in children - Regular Check-ups
Visiting the dentist for a regular check-up can be easily forgotten or postponed but is vital in maintaining good oral health.
Prevention and early treatment prevents larger issues. Children who have regular examination and checks tend to have fewer dental related problems, and required treatment tends to be simpler, which means happier children and parents.
If your child hasn’t seen a dentist in over twelve months – book them in for a check-up and clean and polish.Fluoride Application
Fluoride helps make teeth strong and prevent tooth decay.
Fluoride is a natural mineral that strengthens tooth enamel and protects against decay.
In Australia, most capital cities have optimal amounts of fluoride added to tap water. Studies have positively demonstrated over long periods of time the benefit to teeth of having fluoride in water. (Evans RW, Hsiau AC, Dennison PJ, Patterson A, Jalaludin B.)
Water fluoridation in the Blue Mountains reduces risk of dental decay. (Aust Dent J. 2009 Dec;54(4):368-73.)(Arora, A., Evans, R. Dental caries in children: a comparison of one non-fluoridated and two fluoridated communities in NSW. New South Wales Public Health Bulletin.2010; 21:257-262. [Abstract])
It is important to note that many children are now drinking bottled water, which most do not contain fluoride. While some bottled water naturally contains fluoride, it is usually not enough to offer sufficient protection. Some home water filters also remove fluoride from tap water.
The choice of toothpaste is also important for children. Make sure you choose low fluoride toothpastes specifically for children. Too much fluoride during tooth development can cause mild white marks or mottling of permanent teeth (enamel fluorosis). There are other causes of discolored or malformed enamel such as childhood malnutrition, chronic illness, trauma, long term use of some medications or radiation therapy.
To prevent dental fluorosis
Choose a low-fluoride child toothpaste for children younger than six years.
- Apply a pea-sized amount to the toothbrush.
- Encourage your child to spit out the toothpaste after brushing.
- Store all toothpastes out of your child’s reach.
If your children do have white spots or mottled enamels, please consult us as many current techniques can lessen or completely remove the unsightly discolourations.
Fissure Sealants
Another key to preventing decay in childhood are sealants. Sealants are fluid material that becomes hard, like plastic after it is applied to the chewing surfaces of adult molar teeth.
Sealant placement is simple and painless and doesn’t require a local anaesthetic.
The pits and fissures on teeth can be really difficult for anyone to clean. So these areas tend to build up plaque and eventually lead to cavities. The purpose of the sealant is to reduce the harder to clean food traps on teeth. However, not everyone needs fissure sealants, as some children have shallow pit and fissures and some just have excellent oral hygiene.
The first and second adult molars are the most common teeth to have sealants placed on—these erupt around age 6 and 12 and are placed at about those ages.