My child doesn't need to see a dentist, does he?

Seeing your child's first baby tooth emerge is one of the highlights of your career as a young parent.

But the joy of seeing your little one grow from baby to toddler also comes with a whole host of responsibilities towards his teeth, if you want to leave him with a set of pearlies that will see him through from childhood to adulthood. Contrary to what the old folks tell you - "Don't worry if her milk teeth fall out before the adult ones grow out", or "Crooked teeth will right themselves sooner or later" - strong and healthy teeth starts with caring for them the moment his baby teeth emerge.

Dr Sarah Ok, a dental surgeon at T32 Dental Centre, tells parents why they need to help their young ones develop good dental habits at an early age.

Q: I never visited the dentist as a child until I had a toothache. Similarly, my child does not need to see a dentist until either her milk teeth drop off, or she gets a toothache.

A: Most babies get their first tooth between the ages of six and 12 months. Baby teeth play an important role in speech development, proper nutrition, proper spacing for permanent teeth, and the overall health of the child.

Most dental and medical associations recommend a child’s first dental appointment to be before their first birthday even before their milk teeth erupts. This is because tooth decay can begin as the teeth are erupting.

Q: Why is there a need for children to care for their teeth at such a young age?

A: Teeth are important for feeding, speech and appearance, etc, and the last primary (baby) tooth naturally leaves the mouth at 12 years old. The primary teeth also hold the spaces for the adult teeth and losing them too early can lead to crowding of the succeeding adult teeth.

The first adult teeth begin erupting at 6 years old and these teeth should ideally last them their whole life. Hence dental care is important for children to have a healthy set of primary as well as adult teeth.

Misconceptions

Q: What are some of the dental issues that young children face and how will that affect them as they grow into their teens?

A: Dental issues would be mainly cavities and gum disease. 16 per cent of children aged three to six years old have large numbers of large cavities.

16.5 per cent have rampant caries, which is defined as decay on smooth surfaces where you would not usually find decay, such as the facial surfaces of their front teeth.

70 per cent of school children have some form of gum disease, such as gingivitis, which is usually not as serious as caries (cavities), but this can lead to periodontitis, or severe gum disease, if left untreated for too long.

Q: Milk has calcium, and so is good for very young children. It should be fine if my child falls asleep with a bottle of milk.

A: Some parents leave their kids asleep with a bottle of milk or fruit juice. This should not be the case as both milk and juices contain high amounts of sugar and thus may cause Baby Bottle Tooth Decay or Early Childhood Caries.

Some kids have extremely severe decay that their teeth cannot be repaired and need to be removed. It generally affects the upper front teeth, but other teeth may also be affected. It can reversed and prevented just by substituting with water in the bottle or slowly weaning the child off the sweet content in the bottle.

Q: Since my child will eventually grow out her permanent set of teeth, it should be alright even if she loses her milk teeth earlier.

A: If a child's baby teeth are lost too early, it may disrupt the proper spacing and cause misalignment as other baby teeth may drift into the gap. This may lead to overcrowding when the permanent teeth finally emerge.

Q: Can my two-year-old toddler be left to brush her teeth without my help?

A: Many kids have limited manual dexterity and might not be able to reach certain corners and grooves. Parents should supervise their kids till they are at least six years old and even after that parents should also continue to observe them now and then to see if they are brushing correctly.

Flossing?

Q: When should children begin to floss their teeth?

A: There are often spaces in between the front baby teeth. However, the molars are often contacting each other and that is a potential food trap and at risk of subsequent decay.

As long as teeth are in contact with each other, it is advisable for parents to floss for their children every night before brushing. But children at age eight should be able to floss by themselves.

Q: How often should a child brush, and does it matter if he misses brushing them sometimes?

A: The frequency is the same as for adults - that is, at least twice a day.

Missing a session puts the child at risk of allowing tooth decay to set in, so it is not advisable to miss brushing them.

Q: If my child's baby teeth are crooked, does that mean that his adult teeth would be crooked as well?

A: One issue that children often face is misalignment of the baby teeth, which usually carries into the adult teeth.  This problem is often caused by a bad habit, such as the prolonged use of pacifiers, sucking on fingers, and such. 

Maintaining regular visits to the dentist can help the parents stop bad habits either by behavioral methods or by use of an appliance. 

Misaligned teeth can also happen naturally, but dentists can often reduce or correct the minor misalignment while the child is growing and reduce or eliminate the need for braces in future.

Dentists may also recommend sportguards or mouthguards for children who are more prone to bumping and fracturing their teeth due to the alignment of their teeth.

Q: My child hates visiting the dentist and kicks up a fuss even before we leave the house. How can I make dentist visits less traumatic for him?

A: There are a few things parents can do to make sure their child's first experience is not as bad.  I actually have a 'dos and don'ts' list I will give to my patients if they have a particularly fearful child.  I ask the parents to try a few of the 'dos', and don't do any of the 'don'ts'.

Q: What is the difference between a regular dentist and a paediatric dentist?

A: A regular dentist is competent enough to handle most cases - both adult and children - but a pediatric dentist usually handles more complex cases involving children, such as special needs children or those with severe medical problems.

General dentists usually are the front line and screen these cases and refer them to the appropriate specialty where needed.

Dental care for kids

Dental care for kids

A visit to the dentist can leave even the bravest adult shuddering with fear. More dentists recognise this, but with growing awareness that dental care is important even at a young age, more parents find themselves searching for a dentist who is sympathetic with their young patients.

T32 Dental Centre recently launched its own pediatric wing, T32 Junior with a dental programme designed especially for kids. The programme looks after a child's teeth from birth to 12 years of age.

Dr Chin Shou King and Dr Sara Song Ok, T32 Junior's resident dental surgeons have years of handling children and putting them at ease. They will also give advice to patients and their parents on caring for teeth. The newly set-up T32 Junior for kids offers a suite of treatment options as well for young patients, from caries detection, screening and prevention to orthodontic treatments such as braces for older children.

There are also dedicated 'boys' and 'girls' treatment rooms, as well as a room equipped with a CCTV camera for parents to observe their kids during treatment to set both young patients and parents at ease.

T32 Junior is located at Camden Medical Centre, 1 Orchard Boulevard, 17th Floor.