From Paediatric Dentist’s diaries: Proper care for children’s teeth
As a paediatric dentist and mother of twin-girls I am personally connected to children’s oral health. And as a lecturer at a future and current parents’ school and member of the Consultative Council of the “About Food” Foundation, I firmly believe that dental hygiene and nutrition are equally important for children’s general and dental health.
When teeth erupt in the mouth (whether baby or permanent) they are not fully mineralized and their enamel is not fully resistant to acidity. The full mineralization of teeth is completed within a year after they erupt, as the minerals, which the body uses for this mineralization, are microelements, contained in saliva and partially – in food, which are in direct contact with the enamel. Therefore, proper hygiene, using a toothbrush and paste, corresponding to child’s age, is of extreme importance. Mechanical removal of the layers of plaque on incompletely mineralized enamel protects it from the cariogenic effect of microorganisms. On the other hand, proper dietary prophylaxis would protect children’s teeth from cavity development, when they eat a balanced diet, with a strict eating timing and no snacks, between meals. When food requires effort while chewing, this produces extensive salivation, cheeks and tongue play an active cleaning role and this ensures minimum retention of plaque and food residues. Therefore, after a child starts eating solid food and enters the world of the “chewing people”, we must enhance chewing, and not quick eating and swallowing with minimum effort. I could say here that using tablets and phones to help the quicker and better organized eating by the children in some families, has a serious negative impact on the habits of conscious chewing, swallowing and child’s important habit to eat until full.
In order to establish a sustainable and pleasant teeth-washing habit in our children, this process must commence from a very early age, even before the actual eruption of the first teeth. Because, the earlier we implement and repeat the same action in a child’s daily routine, the easier to establish an “acquired reflex”.
You may ask “When we should start washing children’s teeth?”
You can even start before the eruption of the very first teeth in the mouth, using a SILICONE TIP. Start with massaging motions in order to eliminate the surface tension and “scratch“ the tense, swollen, red and painful teeth. When there are already 4 - 5 teeth in the mouth, start using CHILDREN’S TOOTHBRUSH AND TOOTHPASTE for ages 0-3 years. The brush must lightly sweep the teeth, with brushing or circular motion and no strong pressure. Children below the age of 3 swallow the toothpaste, they cannot spit, and therefore, when the child is aged between 6 and 12 months and still not able to sit stable or walk, you can wash its teeth on the changing-table/pad, to make sure that you have a stable support and good visibility. When the little person starts walking and is stable, you can move the teeth-washing activities to the bathroom, in front of the washbasin, as part of the bedtime routine. Before the age of 2 it is sufficient to wash the teeth in the evenings only, and when children reach the age of 2,5- 3 years and become much more independent and stable physically, you can also incorporate morning teeth-washing. The little person may want to take away from you the “working tool” at any moment. Do not let this frustrate you – on the contrary – this is a signal that the child starts mastering fine motor skills. Let them have their own toothbrush, which they will “work” with, nibble on and play with, because this is how they get to know their mouth and receptors. Your job is to properly brush the teeth with the second brush, after they finish “playing”. My advice is that the parent, spending less time with the child during daytime, takes responsibility for the oral hygiene. The reason for that is that this parent would be much more patient and responsible for that task, and the child would protest and “behave” less.
It is important to alternate and change toothpastes, so that the child does not get used to only one taste and to avoid monotony in their taste.
Parents always face the dilemma MANUAL OR ELECTRIC TOOTHBRUSH? I always prefer manual toothbrushes, because they make sure that there are no monotonous head movements, pressure can be precisely adjusted, children do not get the feeling that someone else is doing their job, but are stimulated to move their hands and develop fine motoric. Manual toothbrushes are much easier to get into the space between cheeks and the last teeth, and are much more easily controlled by the parent. In the period of tooth eruption or active tooth replacement, using electric toothbrushes is inadvisable, because gums are very sensitive and children fail to exercise sufficient pressure to clean the teeth. As for oral showers and other additional oral hygiene equipment, my usual advice is that using them must always be recommended by a dentist, and only if necessary.
All 20 teeth in children’s mouth would have erupted by the age of 3,5 years, then the main item on the agenda for us, children dentists, when carrying out prophylaxis of the deciduous dentition, is the proper articulation and positioning of the upper vs lower teeth. The lack of monitoring and managing of changes, occurring in the bite of the youngest children – aged between 4 and 6, results in severe teeth and jaw anomalies, tilted, clustered teeth, unesthetic appearance, which subsequently requires prolonged and complex orthodontic treatment, which may continue for years.
Therefore, in order to ensure the healthy teeth are beautiful smiles of our smaller and grown-up children, it is necessary to arrange visits with a children dentist, from an early age – within the first year of their birth, and then make appointments every 6 months for regular examinations and prophylaxis. Rest assured that only through adequate training and good personal example, our children will have proper habits and take responsibility for their own health.