Teeth cleaning or scaling is the process of removing the hard deposits in teeth called Dental Calculus or Tartar.
Toothpastes are like a double edged sword! Use them wrong and they will harm you.
3.Low Fluoride or Non Fluoride-containing
Milk teeth have thinner and softer enamel compared to permanent teeth. A toothpaste with higher abrasive content can easily strip away enamel. (a single use doesn’t harm. The damage is cumulative over a period of time).
While detergents like sodium lauryl sulfate are used in toothpastes to act as a surfactant to remove surface stains, it is not recommended in children less than 6 who do not yet know how to spit. They tend to swallow. (Again the damage is cumulative over a period of time).
Adult pastes usually have sodium fluoride at a floride concentration at 1100 ppm (parts per million), the recommended concentration for child formulations is less than 550 ppm. Newer research recommend even lower concentration of less than 250 ppm.
One of the most important, but least discussed aspect of a toothpaste for children is its flavour! Companies in india like Colgate design toothpastes in various attractive flavour like bubblegum and mixed fruit!! I as an adult find them irresistible to eat!! Ideally children’s toothpastes should be non flavored to discourage children from swallowing! As a pediatric dentist, I recommend ToothMin from Abott as it satisfies the above criteria. It also has a formulation that prevents cavities and repairs daily damage.Whichever paste you use for children, use only a small quantity. For children less than 3 years of age, use a ‘SMEAR SIZE’ about the size of one long grain of rice. For kids above 3, use a SMALL PEA SIZED quantity!
The white sticky gooey stuff that is hard to clean off! That stuff is called bacterial plaque or simply ‘plaque’, and is made up of millions of bacteria. Even when babies are not eating solid food, plaque can form on their teeth.Plaque is a complex bacterial ecosystem that firms adheres to teeth and can relatively easily get established in a child’s mouth as early as 9 months of age! Therefore it’s important to start brushing your baby’s teeth as soon as they appear in the mouth.
The plaque bacteria breakdown sugars in baby’s milk into lactic acid (what is food for your baby is also the food for the bacteria in the plaque!). Over time, this acid slowly dissolves the calcium in the enamel (decalcification) and erodes it away. From here, it can go downhill with the tooth necks (near the gumline) turning yellow/Brown and gradually the tooth looks like small black stumps!
In my experience as a pediatric dentist, I see children go from decalcification to caries (cavities) as fast as 6 to 8 weeks!!
Milk at bedtime! Never let the baby fall asleep with a bottle.
For babies less than a year old, use a finger brush (a soft silicone rubber sleeve that can be worn around the index finger).
For children above 15 months of age, a soft bristled baby brush should be used. For children 6 to 12 years, a junior brush is recommended and thereafter a regular adult toothbrush can be used.Children don’t have the manual dexterity to brush on their own until they are about 7 to 9 years of age. Therefore children less than 6 should be brushed by their parents and thereafter children have to brush under parental supervision.For children less than 6, use a knee-to-knee position where the parents sit facing each other on two chairs of the same height to form a cradle. This helps is good visualisation. Once a week, perform a cursory ‘lift the lip’ exam. (see images).
The knee-to-knee can also be done sitting on the floor.
In case of a single parent, a bed or a bench can be used and the baby’s head gently yet firmly supported by the parents knee (see image).
How much toothpaste? For children below 3, use a smear size (about the size of a long grain rice). For those above 3, use a small pea sized amount.
Which toothpaste? Ideally, a child’s tooth paste should be- non foaming, low abrasive, low/non fluoride and non flavoured. (check out my answer to choosing a toothpaste for your child).
1.Use a disclosing tablet/solution for kids keen on wanting to brush on their own (usually at age 4–5). Disclosing solutions are made of food dyes that stain only plaque deposits so that children can visualise the plaque in color. This motivates them to brush better.
2.Use a timer
3.Play an animation on iPad
4.Make it a game
5.Make it a fixed daily routine so that it becomes a habit and children develop positive attitudes to health and hygiene.
6.Start early. Its easy. If introduced later (say above 3), it’s difficult for children to accept it and may take a long time to get accustomed to.
7.Don’t make it seem like a punishment. Be supportive and encouraging. Also best way to do it is to do it with them. Children see – children do!
Dental caries (cavities) is the most prevalent childhood disease, with a prevalence higher than chicken pox, mumps and typhoid put together!.It is also the most common untreated medical condition in India!!.It is also one of the most common reason for loss of school hours for children!!!.It is also preventable!.So… yes. Regular oral healthcare checkups go a long way in identifying oral diseases early and in preventing and managing them more effectively.That was the short answer. For details, read on…
The AAPD (American Academy of Pediatric Dentistry) defines caries as “Biofilm-mediated Acid-demineralization of enamel and dentine”. Caries is currently considered to be caused by the bacterial plaque (biofilm) that forms on the teeth which has a complex structure and consists of several types of bacteria that are suspended in a matrix. This biofilm is sticky and adheres to the enamel and dentine of the teeth. They consume the simple carbohydrates (sugars) in our diets and lead to the formation of acid (lactic acid is produced as an end product of bacterial glycolysis). This acid gradually dissolves the enamel and dentine (acid demineralization) to form ‘cavities’. Once the surface of a tooth is breached, the bacteria can gain access to the soft tissue of the tooth (dental pulp which contains blood supply and nerve supply of the tooth) and cause an infection.
Yess! Good oral hygiene and educating children and parents about healthy dietary choices can go a long way in preventing caries. Further, even after a cavity ‘just starts’, its progress into an infection can be completely repaired or arrested (depending on the stage of the cavity) by following adequate preventive means!
1.Primordial prevention –
The disease is prevented from ever occuring in the first place! This can be done by educating kids early about oral hygiene practices and use of adequate preventive measures such as fluorides and dental sealants.
2.Primary prevention –
The disease is identified early and it’s spread is halted. Early stage cavity is called a ‘white spot’ as the surface looks chalky white in colour due to loss of mineral (calcium and phosphate) from the tooth enamel. This can be prevented by early diagnosis and measures like surface sealing in addition to good home care and hygiene practices.
3.Secondary prevention –
The disease process is identified after the surface is breached, but the nerve involvement has not yet occurred. In this case, management will involve cleaning out the decayed portion of the tooth and replacing with a restoration or a ‘filling’
4.Tertiary prevention –
The disease is identified quite late in the progression. However a full blown infection has not set in. In such cases a ‘root canal treatment’ is performed and tooth is ‘saved’ from being pulled out.
This is more like disability limitation where an extraction of the tooth is avoided!
Obviously, the most ideal form of prevention is the primordial and primary prevention modalities.
A periodic (ideally once in 6 months) checkup will help identify dental disease early and achieve higher levels of prevention. The old adage – an ounce of prevention is better than a pound of cure holds good!
A typical check up and preventive education costs about 200 to 500 rupees in an average urban setup in India. [Depending upon the location and whether the dentist is a a general dental surgeon or a Specialist Pedodontist]
Twice-a-year check up – INR 1000 per child. (on an average Rs. 500 per visit)
A simple cavity ‘filling’ – INR 500 to 2000! (Per tooth)
A root canal treatment and crown – INR 5000 to 7000!! (Per tooth)
Extraction and Space maintenance – INR 6000 to 8000!!! (Per tooth)
[These prices are indicative of an average Indian urban setup. They may vary vastly based on your surgeon’s experience and expertise, techniques and materials of choice]
As we go down the road of prevention, the procedures get progressively lengthy, progressively uncomfortable and progressively more expensive.
With a sharp rise in school are population, rise in consumerism and negative urban food practice trends, dental caries incidence is on the rise. A good national programme is a need of the hour and will go a long way in bridging the disparity in the public-private health gap that exists today.
Without it, the gap is only bound to rise with devastating consequences.
Oral health is a gateway to Medical health. Untreated cavities can lead to early tooth loss, Mal aligned permanent teeth, speech impediments, psychological and behavioural impact, low height/weight gain during growing years, poor school performance, loss of school hours, inability to chew, infections in rare cases spreading to lungs/sinuses/brain etc.
Dental health is often under appreciated.
A school programmes can involve a pediatric dentist and a public health dentist to specifically formulate strategies to prevent childhood oral and dental disease depending on regional and local variables in consideration. Based on the variables, simple strategies can be designed in schools at various levels of prevention.
Such a programme can be very effective in lowering costs needed to otherwise treat children in private setups. It can drastically improve the quality of life of our children.
A dentist who caters to the above is known as a Pedodontist, or a Pediatric Dentist.
With such a detailed and structured program into managing children can go a long way in rendering a better quality of care for children.
Your oral health is more important than you might realize. Get the facts about how the health of your mouth, teeth and gums can affect your general health.Did you know that your oral health can offer clues about your overall health — or that problems in your mouth can affect the rest of your body? Understand the intimate connection between oral health and overall health and what you can do to protect yourself.
Like many areas of the body, your mouth is teeming with bacteria — most of them harmless. Normally the body’s natural defenses and good oral health care, such as daily brushing and flossing, can keep these bacteria under control. However, without proper oral hygiene, bacteria can reach levels that might lead to oral infections, such as tooth decay and gum disease.
In addition, certain medications — such as decongestants, antihistamines, painkillers and diuretics — can reduce saliva flow. Saliva washes away food and neutralizes acids produced by bacteria in the mouth, helping to protect you from microbial invasion or overgrowth that might lead to disease.
Studies also suggest that oral bacteria and the inflammation associated with periodontitis — a severe form of gum disease — might play a role in some diseases. In addition, certain diseases, such as diabetes and HIV/AIDS, can lower the body’s resistance to infection, making oral health problems more severe.
Your oral health might affect, be affected by, or contribute to various diseases and conditions, including:
• Endocarditis. Endocarditis is an infection of the inner lining of your heart (endocardium). Endocarditis typically occurs when bacteria or other germs from another part of your body, such as your mouth, spread through your bloodstream and attach to damaged areas in your heart.
• Cardiovascular disease. Some research suggests that heart disease, clogged arteries and stroke might be linked to the inflammation and infections that oral bacteria can cause.
• Pregnancy and birth. Periodontitis has been linked to premature birth and low birth weight.
• Diabetes. Diabetes reduces the body’s resistance to infection — putting the gums at risk. Gum disease appears to be more frequent and severe among people who have diabetes. Research shows that people who have gum disease have a harder time controlling their blood sugar levels.
• HIV/AIDS. Oral problems, such as painful mucosal lesions, are common in people who have HIV/AIDS.
• Osteoporosis. Osteoporosis — which causes bones to become weak and brittle — might be linked with periodontal bone loss and tooth loss.
• Alzheimer’s disease. Tooth loss before age 35 might be a risk factor for Alzheimer’s disease.
• Other conditions. Other conditions that might be linked to oral health include Sjogren’s syndrome — an immune system disorder that causes dry mouth — and eating disorders. Because of these potential links, be sure to tell your dentist if you’re taking any medications or have had any changes in your overall health — especially if you’ve had any recent illnesses or you have a chronic condition, such as diabetes.
To protect your oral health, practice good oral hygiene every day.
Does your kid hide under the bed or stammers after hearing the word “dentist”? Or remember something important during that instance? If so; then there is a need to prepare your child for a dental visit by following these simple tips.
The earlier a child visits the dentist, the earlier his fear will vanish. Once your child has visited the dentist, he will experience that there is nothing to fear. However, you have to take him there first, and it can be done by preparing with minimal drama.
Tell them convincingly that dentist might tickle their teeth while checking or cleaning them. Don’t make them familiar with use of needle or drilling by the dentist as it will instill fear.
You can easily prepare your child in a friendly way just by playing games of “you” being a dentist and your child a “patient”. Just take a toothbrush, and begin counting their teeth one by one. Don’t make harsh sounds that might scare them, use positive words like clean, strong and healthy teeth instead. Be nice so that they will feel no apprehension in visiting the dentist.
Begin preparing them for the visit few days before the appointment. Many parents due to lack of time make this mistake without understanding the after effects of it on a child.
Some parents take their kid to clinic during their own appointment, and as a result the child may get exposed to some of the painful processes performed in the clinic. Remember, children dentistry is different than adults, so don’t let your kids confuse it by making them accompany you for your appointments.
It is normal for a child to cry, whine or wiggle during the treatment. Don’t fret; and let the experts handle the situations because they have experience in working with children and handling their tantrums.
Experts do not recommend you to promise your child something special for the sake of behaving nicely at the dentist. In fact, it only increases their fear. So, the better way would be to praise your child after a dental treatment instead.