Clean your young children's teeth for them, Singapore dentists advise

SINGAPORE - Dr Tan Wee Kiat remembers well the devastation she felt when her only child developed a tooth cavity at the age of five.

After all, she is a dentist and had been taking very good care of her son's teeth - or so she thought.

"I kept asking myself, 'What did I do wrong?'" said the senior consultant at the paediatric dentistry unit of the department of restorative dentistry at the National Dental Centre Singapore (NDCS).

Dr Tan sat her son down on her dental chair and immediately went to work fixing the hole in his tooth.

She never did find out what caused the cavity.

But she brushed her son's teeth for him till he was eight years old. Her son, now aged 26 and a doctoral student in the United States, has not had another cavity since.

Dr Tan, 58, a self-confessed fanatic when it comes to the dental health of children, is on a mission to cut the number of dental cavities in young children, which is growing.

And her target - the parents.

In a survey on close to 70 parents that the NDCS carried out at its public forum last month, 91 per cent said they did not think that parents in Singapore had the right knowledge and capability to care for their children's oral health.

Seven in 10 of the parents polled said they had not taken their children to see a dentist before and more than half were also unsure about when to do so.

The survey also found that getting the child to brush his teeth and dealing with an uncooperative child during a dental visit were among the most challenging tasks for parents.

Dr Tan and a team of paediatric dental specialists at the NDCS have introduced a new concept of "dental parenting", which aims to get parents to raise their children to possess the right dental habits and be unafraid of dental visits.

The NDCS held a public forum on childhood tooth decay last month, as part of its drive to promote dental parenting.

The interest from parents has been strong.

More than 700 people were left on the waiting list after the 180 slots for the forum were filled, said Dr Tan.

During the forum, many parents talked about their limited knowledge in caring for their children's oral health and their keenness to learn how to do so.

To help parents, Dr Tan set up a Facebook page last October at to provide information and tips for parents and to allow them to ask any questions on how to care for their children's teeth.

"It has garnered more than 2,700 likes. I also use it as a platform to answer questions parents may have," said Dr Tan.

The NDCS has also been giving some parents tips on preventive oral health for infants through its infant oral health clinic, launched in 2010.

It has also been training health-care workers at the polyclinics to encourage parents to take their children to the dentist.

Parents as role models

A good dental parent is a good dental role model and a good teacher, Dr Tan said, as habits practised by the parent are observed and practised by the child.

It does not help that adults are also often unsure of how to take care of their own dental health.

An oral health survey of 6,000 adults in 2006 showed that 45 per cent visit a dentist once a year, 31 per cent visit only when there is pain and 69 per cent think that dental treatment is always painful.

"If the adults think like that, what will they impart to their children?" said Dr Tan.

Although the parent may not be confident at first, especially if he is a new parent, he can enlist the help of a paediatric dentist and read up on the subject, she added.

Confident dental parenting means passing on the three "ideals" of good dental habits, good eating habits and a good attitude towards dental health professionals.

Both parents should brush their teeth twice a day and visit the dentist twice yearly.

"Introduce brushing for the child the moment the first tooth erupts and persist even if the child struggles," said Dr Tan.

Parents should help to brush their children's teeth until the children can manage it on their own.

Parents should also avoid giving sweets to their children frequently and stay away from giving them sticky snacks in between meals.

"Do not stock the fridge with freely available snacks. Do not use sweets as a reward for good behaviour," said Dr Tan.

And parents should prepare their children for each dental visit by talking about dentistry and dental treatment in a positive manner.

This is because research has shown there is a high level of dental fear among children here.

A survey of 505 students aged 10 to 14 in 1990 regarding fear of the dentist showed a prevalence rate of 177 fearful children per 1,000. Girls were 2.64 times more fearful than boys.

But regular dental visits are important in maintaining good oral health.

Dr Tan said: "Visits should start at the age of one."

Reaching out to children

This outreach to parents comes on top of current outreach programmes aimed at children by the Health Promotion Board's (HPB) School Dental Service (SDS).

For pre-schoolers, dental therapists from the SDS reinforce key oral health messages through teaching them an interactive song.

In addition, dental therapists may use activity sheets and ask the pre-schoolers to identify hidden food items that are good and bad for their teeth.

Dr Eu Oy Chu, senior deputy director of the SDS, which is under the youth health division of the HPB, said: "Through interactive activities and presentations, the pre-schoolers are taught the importance of oral health and how to prevent dental caries."

Parents are also given dental health education resource materials. These include the MyToothbrushing Diary and stickers, which they can use to reinforce what their children have learnt in school, she said.

The existing programmes have had an impact, resulting in more parents taking their children for check-ups than, say, five years ago. More are also taking their children in when the children are younger, said Dr Tan.

But it is still not enough, she said.

In her practice, eight in 10 young children that she sees have severe tooth decay.

"And the overall number of patients coming is still very low," she said.

The number of children being treated at the NDCS, the largest dental specialist centre here, for early childhood caries - tooth decay before the age of six - has doubled from about 500 in 2000 to 1,000 a year in 2011 and last year.

At School Dental Centre at Outram Road, run by the SDS, the most common condition is early childhood caries, making up 73.8 per cent of 4,424 cases last year.

Figures from the SDS show that the rate of severe dental caries has not improved over the last 10 years among Primary 1 pupils.

About 50 per cent of this cohort, aged between six and seven, have dental caries. Of these children, about 10 per cent have severe caries, said Dr Eu.

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