Build oral-care habits from young

With so many aspects of an infant's or toddler's well-being to fuss over, parents, sometimes, ignore early oral care. They may, for instance, neglect to take their young child to the dentist.

But it is important to do so.

"Failure to care for the baby teeth may result in cavities, pain and infection," said Dr Elizabeth Tan, a dental specialist in paedodontics with Specialist Dental Group.

Dr Mavis Tan, a dental surgeon at Raffles Dental, added that "the early loss of baby teeth, such as due to decay, may affect the subsequent eruption of adult teeth, and this may result in crooked teeth".

Dr K Vijaya, director of the youth preventive services division at Health Promotion Board, said it is a good idea for children to visit the dentist at least once a year.

One's diet plays a big part when it comes to healthy teeth, too. Avoid overly sweet and sticky food; carbonated and sweetened soft drinks; and frequent snacking, especially on sweetened snacks, said Dr Vijaya.

Limit sweet treats to mealtimes, rather than eating them as in-between meals. Parents should also avoid using sweets as rewards, she said.

THE FIRST DENTAL VISIT

The first trip to the dentist can take place when a child is one year old, or as early as when his first tooth erupts, dentists say.

This is to ensure that the child's dental development is normal, said Dr Tan from Raffles Dental.

"In addition to monitoring the pace of baby teeth eruption, the child's oral hygiene can be assessed and advice can be given to the parents."

Parents can choose a paediatric dental specialist (paedodontist) or a general dentist who has an aptitude for child patient management, she said.

Paedodontists have special training in the dental management of children (from infants to those under 18). They are also trained in child development, psychology and behaviour management, explained Dr Tan, the paedodontist.

"A child dental specialist usually practises in a child-friendly design treatment clinic or room, which helps in the management of the child's anxiety," she said.

A first visit can take as long as 30 to 45 minutes and should ideally take place when there is no major treatment to be done, Dr Tan added.

"If the first visit is made when your child is in pain and more extensive treatment is required, dental visits may become associated with pain or discomfort," she said.

"During the first visit, it is important for your child to feel comfortable with the dentist. That is why the paedodontist will normally converse with your child before starting any treatment."

ORAL CARE AT HOME

Apart from dental visits, parents have to make the effort to take care of their young child's teeth at home. Toothbrushing should not be left to very young children, said Dr Vijaya.

"Parents should supervise or undertake the brushing of teeth for children below six years old, as they do not have the dexterity to do a thorough job," she said.

"Brush the child's teeth at least twice a day, especially just before bedtime (after eating or drinking anything, except water); and after every meal, if possible," she said.

Brush all three surfaces of each tooth thoroughly - the inner, outer and chewing surfaces - and brush in an orderly manner so that none of the teeth will be missed out on, added Dr Vijaya.

It is also important for parents to buy the right products. For instance, there may be an attractive selection of organic flouride-free toothpaste on the shelves, but these may not be ideal for your child.

Choosing fluoride-free toothpaste exposes the child to a higher risk of tooth decay, as fluoride has been strongly proven to be effective in strengthening teeth and reducing the incidence of tooth decay, said Dr Tan from Raffles Dental.

The fluoride content of kids' toothpaste tend to be around 500ppm (parts per million) while that of adult toothpaste is higher at 1,000 to 1,400ppm, she said.

Always keep the amount of toothpaste used to a thin layer to minimise the accidental ingestion of flouride, she said.

Ingesting too much flouride toothpaste can give rise to permanent tooth discolouration (dental fluorosis).

"Baby teeth are not less important than adult teeth. Caries in young children under three years old tend to be more difficult to manage due to poorer co-operation of children, so reducing the risk of caries cannot be overemphasised," she said.

Kid-friendly products

ToothbrushesChoose one with soft bristles and a small head which can reach the back teeth and areas between the tongue and the lower back molars, said Dr K Vijaya, director of the youth preventive services division at Health Promotion Board.

Replace it every three months or as soon as the bristles wear out.

Toothpaste

Children above two years old should use toothpaste that has an optimal amount of 1,000ppm (parts per million) flouride, which is found in adult-strength toothpaste, said Dr Vijaya.

Toothpaste marketed for children tend to have less or no fluoride. These are suitable for those who have yet to learn how to spit, so that they do not ingest too much fluoride, she said.

Parents should start brushing their children's teeth with fluoride toothpaste as soon as their first tooth erupts at around six months of age, said Dr Elizabeth Tan, a dental specialist in paedodontics with Specialist Dental Group.

Many authorities support the following recommendations: A flouride concentration of 500ppm for those aged six months to two years; 1,000ppm for those aged two to six; and 1,450ppm for those aged six and up.

A smear of toothpaste the size of a rice grain is sufficient for three- to four-year-olds while a pea-sized amount is advised for children aged five to six. If the child does not know how to spit, consult a dentist on the use of fluoridated toothpaste, said Dr Vijaya.

Dental floss

Brushing can be supplemented with flossing by the time the child is about three years old, when all the baby teeth would have erupted, said Dr Tan.

Cleaning cloths or fancy products

A baby of up to about six months old does not need a toothbrush.

Parents can use a damp, thin flannel towel or a gauze to clean his gums, tongue and roof of mouth, as well as the lining of the cheeks after every milk feed, said Dr Tan.

When outside, xylitol wipes can be used, she said.

Silicon finger brushes are a bit too stiff and stubby. So, once the child's first tooth emerges, parents should switch to a small, slim neck-bristled toothbrush, she said.

Tongue scrapers

Kids do not need to use tongue scrapers, said Dr Tan. A toothbrush can be used to clean the tongue at least two times a day, she said.

Some studies suggest that tongue scrapers may help adults with bad breath. But these are not recommended for young children as they may cause accidental injury, said Dr Mavis Tan, a dental surgeon at Raffles Dental.

Instead, get toddlers with bad breath to take more frequent sips of plain water to clear the milk residue in their mouths and the bacteria at the back of their throats, she added.

joyceteo@sph.com.sg

This article was first published on March 26, 2015.
Get a copy of Mind Your Body, The Straits Times or go to straitstimes.com for more stories.