Child Dental Care

Child Dental Care – Good oral health is vital from the start

As printed in the Supermum supplement/The mail on Sunday

Tooth decay is very common in Ireland but it is fully preventable if parents can get babies and children into good oral hygiene routines — know what signs to look out for to spot early decay and when to get professional advice.

James began teething at around two and a half months and to be honest, he hasn’t stopped since. When he was around five months old, you couldn’t help but laugh because when he smiled, a full set of choppers were staring back at you. It got me thinking though about his dental hygiene as he was eating and drinking, so did I need to clean his teeth at such a young age?

I was introduced to Rosemarie Daly, a paediatric dentist based in Tralee, Co Kerry. Dr Daly is also a consultant in paediatric dentistry at the Bon Secours Hospital in Tralee. Her research interests include infant nutrition and tooth decay, developmental defects and oral health in obese children. She is passionate about the promotion of children’s oral health.

Paediatric dentists are specially trained dentists capable of taking care of children’s oral health. A paediatric dentist is responsible for the oral health of a baby, like a paediatrician is responsible for its health in general. The first visit to the paediatric dentist should take place as soon as the first tooth comes through. During this first visit, the paediatric dentist will organise and give you a complete preventive dental programme to follow. He or she will also examine the dental development of your child, giving you advice concerning its nutrition and informing you on how to avoid possible problems.

I decided to take a trip to Kerry to find out exactly how I should be taking care of James’ teeth. We received a lovely warm welcome and the surgery was full of toys and books. It was bright and colourful and James was in his element. The whole experience focused on fun and positivity. Rosemarie’s nurse Siobhan Walsh played with James while I discussed James’ health with the doctor.

How seriously do we take our dental health as adults? Most of us fear the experience and will most likely pass this fear onto our children. Personally I’ve let aches and pains go until I’ve needed so much work, my bank account was cleared out!

Instilling good habits in children from an early age is vital for their future health and wellbeing. We met ‘Freddy Flosserous’, a big purple teddy with beautiful teeth and a giant toothbrush to show kids how to clean teeth properly. James loved him and kept giving him hugs.

James behaved quite well considering his age (10 months). He sat on my lap and lay on a cushion on the dentist’s knee. He was given a full check-up and Dr Daly showed me the correct way to take care of his teeth. I left with full instructions on cleaning and nutrition and also a going home pack which included: a toothbrush, toothpaste for babies, spiffies (baby tooth wipes), smiley stickers and a toy.

What’s important here is that the child has a positive memory of the visit and won’t be afraid to return. The most important things I learnt were that it is the number of snacks and not the amount of sugar that counts, and that teeth need fluoride toothpaste twice a day to prevent decay.

I asked Dr Daly why she thought decay was such an important topic and she told me that dental decay is the most common chronic disease of childhood in Ireland. Approximately 50 per cent of five-year-olds will have experienced decay by the age of five years, and more than 50 per cent of those affected will have experienced pain and symptoms as a result of decay.

effects of tooth decay in children:

The visit to the paediatric dentist should take place as soon as the first tooth comes through

÷ Distress for children and parents
÷ Missed days at school
÷ Disturbed sleep
÷ Delayed growth and development
÷ Poor self-esteem and socialisation
÷ Facial swelling and hospital admission
÷ Development of dental anxiety
÷ Early loss of primary teeth leads to shortage of space for the developing adult teeth
÷ Higher risk of decay in the adult teeth
÷ Negative attitudes towards oral health in the long term
÷ Worst case scenario — hospital admission with potentially serious facial swelling
÷ Dental decay is more difficult to treat in children due to their sometimes limited capacity to accept treatment under local anaesthetic and can require specialist services and facilities
÷ General anaesthetic and hospital admission is frequently necessary to treat dental infection related to decay

What I find sad and shocking about this is that decay is a fully preventable disease. Educating parents would alleviate so many future problems. If, like me, you have a baby who developed teeth early, it becomes even more important. Breast milk is very sweet and if you’re feeding on demand or during the night, then the milk is left sitting on their teeth leaving them wide open to developing cavities. Juice is particularly bad, so try to encourage water.

I was fascinated to learn that a foetus starts to develop milk teeth as early as seven weeks in utero. The crowns of primary teeth are complete by 10 months postnatally. Certain adult teeth start to develop as early as three months in utero and the crowns of the adult teeth are complete by the age of eight years, with the exception of the wisdom teeth which finish during the mid-teens.

Many mothers are surprised to hear that an illness during their pregnancy or birth complications can lead to developmental defects in a child’s teeth,’ says Dr Daly. Examples of illnesses that can affect the teeth include kidney disease, rubella, malnutrition, anaemia, diabetes and urinary tract infections. Complications of birth that can affect the developing teeth include prematurity, prolonged labour and Caesarean sections.Tooth defects can range from chalky looking teeth, to discoloration or even missing enamel, but early detection dramatically improves the outcome. Decay starts as a white spot, which can sometimes be reversed with preventive care and advice from a dentist. If a white spot progresses, it can develop into a cavity and turn yellow, brown or black.

‘If parents notice discoloration or marks on baby’s teeth, they should seek professional advice without delay,’ says Dr Daly. Early childhood decay is aggressive and can destroy multiple teeth in only a few months. Dr Daly would like to raise awareness for children’s oral health in Ireland. ‘I want parents to know how common dental decay is in young children and what unwanted consequences that can have,’ she says.

TEETHING FACT AND FICTION

The first tooth appears during the first six to eight months and by the age of three, 20 teeth should appear in a child’s mouth. Both the earlier and the delayed appearance of teeth are usually hereditary and are not necessarily related to any problems. If your baby however, does not have any teeth by the 12th month of its life, consult your paediatric dentist.
symptoms of teething Facts:
– Red, swollen gums
– Disturbed sleep
– Increased salivation or drooling
– Anxiety and grumbling
– Altered appetite
In general teething symptoms are mild.

 
symptoms of teething fiction:
– Fevers
– Diarrhoea,
– Rashes
– Vomiting.
These are not related to teething. If these symptoms persist, you should contact your doctor.
 
 
Teething Tips
÷ To relieve your baby from discomfort, clean its mouth two or three times a day with a wet gauze
÷ Use cold objects — MAM and Nuby have great products made especially for this
÷ Try a cold clean cloth to bite
÷ Try a cold spoon
÷ Teetha — both the sachets and gel.
÷ Calpol or Nurofen — but never a product that contains aspirin
÷ Dry the drool to prevent skin irritation
÷ Don’t forget patience and hugs