Oral Health: Children

Published on 03 May 2021

Oral Hygiene

Regular brushing helps remove the sticky film of bacteria, called plaque. If not cleaned thoroughly the bacteria in plaque can break down tooth enamel, which can cause cavities and gum disease. As your child gets older, they might want to brush their own teeth. It is important that you teach them the right way and assist your child until they are 8 or 9 years old.

  1. Once your child is 6 years old start using a pea-sized amount of fluoride toothpaste.
  2. Make sure your child is not eating or swallowing toothpaste.
  3. Encourage them to spit the toothpaste out after brushing and not to rinse the mouth.
  4. Brush twice a day, morning and night, for 2 minutes and brushing last thing at night time before bed is very important.
  5. Hold the brush at 45 degree angle to the gum line and brush gently by moving the brush back and forth in short, tooth-wide strokes.
  6. Make sure the child is brushing the outer, inner and chewing surfaces of all the teeth in upper and lower jaws.
  7. Check your child’s brush regularly and replace it every 3 months or soon after the bristles start to wear out.

Nutrition & Snacking

  1. Families should remember that snacking in small amounts at regular intervals, and in addition to 3 meals, is important to ensure the child’s energy and nutrient requirements are met. However, frequent intake of sugary foods or drinks leads to frequent acid attacks and eventual loss of tooth enamel. Hence, it is important snack choices for young children are nutritious, non-sticky and low in sugar.
  2. Food and Nutrition Guidelines for Healthy Children (ages 2-12 years old) without the addition of extra sugar, fat or salt:
  3. Breads and Cereals: Breads including whole wheat breads; crackers; rolls; toast; muffins, and loaves made with minimal amounts of sugar; and unsweetened dry cereals.
  4. Fruits and Vegetables: Raw vegetable and fruit pieces; grated vegetables and salads; vegetable juices; fresh or unsweetened, frozen or canned fruit (in own juices).
  5. Milk and Milk Products: Milk; yoghurt without added sugar; cheese; yoghurt or cottage cheese dips; cheese spreads.
  6. Meat, seafood, chicken: Hard-cooked egg; cheese; pieces of lean meat or and chicken; tuna or salmon; peanut butter and other spreads made from pureed nuts, seeds and legumes.

Fissure Sealants

Sealants are a protective plastic coating applied to back teeth to prevent decay. The chewing surfaces of back teeth have small grooves or fissures which often extend right down into the tooth itself. These fissures are very difficult to clean thoroughly and can trap food particles. Fissure sealants can seal off these grooves, preventing any food particles or bacteria from getting in.

It is best to get advice from your dentist if your child would benefit from fissure sealing the permanent back molar teeth. The first molars usually come through between 6-7 years old. If required the rest of the molars are usually sealed as soon as they appear which can be any time between 11-14 years old.

Common Problems

Sports Injury
Sports injuries can be minimized by proper prevention and adequate preparation. As your child gets older, they will start to get involved in various sporting activities. A good and effective way to protect your child’s teeth is to wear a properly fitted, custom-made mouth-guard. A good mouth-guard should be of sufficient thickness in the correct areas, resilient, well retained, comfortable, and should not interfere with speaking and breathing. Always wear a mouth-guard when playing contact sports.

Knocked Out Teeth
When accidents happen, teeth can sometimes be knocked out completely. Sometimes, they can be put back in by a dentist. Follow these injury management tips to reduce the likelihood of any long-term damage. First make sure that the injured person does not show any signs of head injury, unconsciousness, nausea, persistent headaches, or any other warning signs of a serious injury. Once this is ruled out, see a dentist as quickly as possible. The sooner the tooth or teeth is replanted in its socket, the greater the chance of retaining it for life.

Steps to follow:

  1. Find the tooth and hold it by the smooth white part that is usually visible in the mouth – the crown NOT root.
  2. Do not scrub or rinse the tooth in anything except water or milk.
  3. If the tooth is clean, hold it by the crown, making sure it is the right way round, gently push it into its socket.
  4. If it is dirty, rinse it in milk, or for not more than 1-2 second in cold water, gently push it back into its socket.
  5. Hold the tooth in place by biting on a piece of cloth and go to a dentist immediately.

If you are not comfortable putting the tooth back in:

  1. Do not let the tooth become dry and do not place it in disinfectant.
  2. Either place it in a cup of milk or if milk is not available, keep it in the mouth between the cheeks and gums.
  3. Go to the dentist immediately.

This advice is only for managing knocked-out permanent teeth. If a baby tooth is knocked out, do not try to put it back in its socket, as this may damage the unerupted permanent tooth. Always seek advice and treatment from a dentist.

Mixed Dentition
This is the period when the baby teeth begin to fall out and permanent teeth start to come through. During this period the jaws grow to make room for the permanent teeth and the roots of the baby teeth begin to be absorbed by the tissue around them. At the same time the permanent teeth under them prepare to come through. When a baby tooth is lost early before the permanent tooth beneath that is ready to erupt, the nearby tooth may move into that space. This will later make the permanent tooth to erupt out of its position, creating crooked or crowded teeth. When a baby tooth does not fall out when it should, it is good to remove them as this may also make the permanent tooth to erupt out of its position. Your dentist can advise you on this.

The first permanent molars usually erupt between 6-7 years old and they do not replace any baby teeth. This erupts at the space next to the back baby teeth. While the first permanent molar should not be mistaken for baby teeth, the last set of baby teeth is lost only around 12 years old. To avoid future problems with permanent teeth, ensure that you follow effective home care routine and limit the frequency and amount of sugary food and drink intake.

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  • Dental plaque is a soft, sticky coating of bacteria that forms on teeth. If not removed by brushing and flossing, bacteria in dental plaque can cause tooth decay and gum disease.

  • Tooth decay is the gradual destruction of the tooth. Bacteria in dental plaque turn sugar on your teeth into acid. This acid attacks the enamel of your teeth and after repeated attacks creates cavity. Early stages of tooth decay do not cause pain so it is necessary to have regular check-ups to detect cavities caused by decay and get the cavities repaired before they cause pain. If your child is particularly prone to decay, the dentist can apply fluoride to make the teeth stronger against decay and place sealants to protect the chewing surfaces of the teeth from decay.

  • Fluoride helps prevent dental decay by both strengthening and protecting the teeth. Firstly, fluoride helps strengthen baby teeth by building fluoride into their structure. This is most effective when teeth get exposed to small levels of fluoride when they erupt through gums. Secondly, fluoride helps protect both children and adults’ teeth by early stages of dental decay.

  • Yes, provided that you only use sugar-free chewing gum. Chewing gum makes extra saliva and this helps clear food from your teeth, and quickly neutralizes acids produced by bacteria. Make sure that the chewing gum doesn’t contain sugar as this could cause more tooth decay.

  • A normal mouth has a pH of 6.2 to 7, which is close to neutral with no damage done to the teeth. Though enamel is the hardest substance in the body, it begins to dissolve at pH levels below 5.5. Fizzy drinks are very acidic with an average pH of 3.5. This acid dissolves the tooth enamel and makes it prone to decay. Diet or sugar-free drinks may not have sugar, but they usually contain harmful acid. Some also contain caffeine which reduces the salivary flow into the mouth and reduces the benefits of saliva.

  • Bacteria in your mouth use carbohydrates as energy and produces acid as a by-product. Some carbohydrates, especially sucrose as found in sweets and soft-drinks, cause more acid to be produced and are bad for your teeth. Avoid eating sugary, sticky and crispy snacks in between meals. Replace these with healthy snacks such as fresh fruit pieces, cheese, chopped vegetables and sandwiches. Stick to water and milk especially between meals.

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