Pediatric Dentist, Dr. Premila Naidu on early dental health in children

This is the first part of a series of interviews with Dr. Premila Naidu where she talks about the importance of Dental health in children. In this part, she addresses the frequently asked questions on dental health along with the precautionary methods one must take.

Here is the transcript of our interview with Pediatric Dentist, Dr. Premila Naidu. Please note that the transcript has been edited for clarity and brevity and is not verbatim.

Dental health during pregnancy

Now a days usually couples plan ahead for their child and hence i’d like to advise the ladies especially before they plan to conceive to get their complete dental check-up and treatment done during that time. As not only the child’s dental health but also the general health is proved to be related to mother’s oral health.

When should the child’s first dental check-up be scheduled?

According to the American Academy of paediatric dentistry the child’s first dental check-up should be when the first tooth erupts or at 6 months but shouldn’t be later than the child’s first birth day.

Importance of treating milk teeth

Milk teeth play a very important role for a child:

  • Child’s nutrition: It is most important that a child’s milk teeth is healthy as it helps a child to chew and eat his food properly.
  • Speech: The front teeth helps in speech as well as aesthetics.
  • They maintain the space for the new teeth.
  • They help in proper alignment of new teeth.

It’s important for parents to understand that though milk teeth start falling by the age of 6 years, which are usually the lower front teeth, the upper front teeth start to fall by around 7 years, the molars fall only by 9 to 11 years and canines by 12 to 13 years. Hence it is important to keep them healthy till then.

What parents can do

  1. Maintain a healthy diet: We can take care of whatever we feed our children, we can eat it first. As adults we will instantly know where the food is stuck. So if it is sticking in our mouth its going to stick in a child’s tooth and for much longer which can causes cavities.
  2. Good brushing habits: However difficult it is you should make it a habit to brush their teeth at least twice a day and rinsing their mouth after every meal. The earlier you start the better it is.
  3. Regular check-ups: If the child has a cavity or not its is advisable to get the child checked once in 3 to 4 months.

What dentist’s can do

  1. Diet analysis: A thorough diet analysis is done where we go through a child’sdiet for over a period of a week and see if there is anything given at any particular time that can cause cavities and explain it to the parents so that they can change the time or clean the child’s teeth after.
  2. A regular fluoride application: Which is better if it is done in a child around 4 yrs old onwards. Fluoride application has to be done twice in a year which makes the tooth stronger and more resistant to cavity.
  3. Sealant application: Sealant is a dental material which flows into the grooves of the molars. It sets there preventing the food from sticking and causing cavity. No drilling is required for this procedure and can be done in children as young as 3 years as soon as the molars erupt.

What school’s can do

Apart from having a routine check-up and talk at the school, they should take care of the snacks and juices that they provide to the children. They could train their ayyas to completely rinse and clean up the child’s mouth after their snack.

Managing an Emergency

Mouth guards should also be made mandatory as how it is in most countries especially during contact sports. During these sports there is a high chance where during play if the child falls, the whole teeth can fall out which is known as avulsion. The 2 most important rules in the case of avulsions is how do you carry the tooth to the dentist and how soon can they set the tooth back.
It is best to carry the tooth in a container of cold milk, and head to the dentist immediately in order to set it back provided you reach the dentist in time.
Chipped tooth:  In this case too an immediate treatment plan is very important in order to avoid extensive treatment at a later stage.

Which paste and brush should we use for our children?

It is most important to select the brush and paste depending on the child’s age. For babies before the teeth erupt it’s better to clean the gums with clean cloth or gauge. Once the teeth start coming it’s time to move on to finger brush. When there are more teeth in the mouth it’s time to introduce the baby brush. As far as the paste are concerned the main determining factor is the fluoride.

6 months to 6 years: zero fluoride paste
5 years to 6 years: minimally fluoridated paste of about 300 to 600 ppm
10 years to 12 years: above that age they can safely use an adult paste.

Though more than the brush and the toothpaste the most important aspect is the brushing techniques.

Brushing techniques

Brushing techniques mainly depends on the age of the child.

For a child who’s below 3 years of age:

It is best to follow the back-to-back technique. Where 2 adults can sit facing each other with the child on one adults lap while the other can brush. This technique gives the adult/parent good control of the child and most importantly good visibility. It is very important that the parent must get complete visibility of all the surfaces of the teeth while brushing.

Incase, your partner is unavailable then you can place your child on your lap. Though please make sure you are holding your child properly, so that incase your child moves suddenly you don’t end up hurting them.

For 3 years to 8 years:

By now your child would be really enthusiastic to brush their own teeth, which is fine, though you must brush their teeth again especially their Upper molars, behind their teeth which most kids are unable to reach.

For 10 years to 12 years:

You can supervise their brushing by then though it’s best to train them to brush their upper molars, back of their teeth, lower teeth – inside and out, as well as their tongue. This will help them in gaining a good habit while brushing.

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