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1. My child's front baby teeth have started dropping out and new teeth are growing in to fill the spaces. However, the new teeth appear as if they have been chipped and the biting edges seem to look jagged and uneven. How could they be damaged when they are brand new and just cutting through the gums?
Without examining the teeth, it is not possible to say whether the new teeth have in fact been damaged or not. Newly erupting incisors normally do have uneven looking incisal edges, so it is possible that what appears as chips on the biting edges could just be the normal appearance of a newly formed incisor tooth. The ridges which appear in the newly erupting incisor teeth is simply due to the way the incisors develop. In the initial stages of development, incisors begin as three tubercles which join up as the crown of the tooth forms. Consequently, when the tooth erupts, these tell-tale signs of the way the tooth developed remains. The uneven edges usually smoothen out in time as the upper and lower teeth slowly wear down. Fractured teeth usually feel sharp around the edges of the fractured areas whereas a normal undamaged tooth feels relatively smooth, even though they have uneven surfaces.
2. My child's new teeth can be seen erupting behind the baby teeth but the baby teeth still feel firmly anchored in the jaw-bone. Should anything be done about it or will the baby teeth drop out naturally eventually? It does look funny at present, like a second row of teeth is forming.
Occasionally, we encounter teeth which do not grow in the proper position or in the proper direction. When we see the new tooth starting to grow out of position, it is advisable to extract the baby tooth which does not drop out to make room for the new tooth. If the baby tooth is left alone, it will prevent the new tooth from growing into its proper position. The longer the offending baby tooth is left in position, the more crooked the new tooth will grow. This will result in a crooked set of permanent teeth and would require correction by means of braces later on. It is therefore very important, if you wish to spare your child from having to undergo a long period of orthodontic treatment, to take your child to your dentist as soon as you notice this happening, to let the dentist assess the situation.
3. I notice my child's new teetlh are much darker than the baby teeth were. No amount of brushing seems to be able to remove the dark colour. Does this show that the second set of teeth will be weaker than the first set?
We find that in practically all cases, the permanent set of teeth look darker than the primary or milk set. This is not necessarily a sign that they are any weaker as long as the teeth are within the normal colour range and have a healthy translucent appearance. The deeper colour of the permanent set of teeth is due to the fact that they are larger teeth, and have a thicker layer of hard tooth structure which contains the teeth's pigmentation. In brushing the teeth, one can only manage to remove dirt particles from the surfaces of the teeth. It is not possible to remove the pigmentation inside the tooth structure. In cases where the teeth are abnormally dark, they could be treated by various methods of teeth whitening, usually preferable when the person reaches a more mature age.
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1. My dentist told me to cut down or stop drinking soft drinks because it is damaging my teeth. Is there anything else that I should avoid? Can I drink non-carbonated drinks instead?
Your dentist is advising you to reduce taking soft drinks to avoid the issue of Acid Erosion. Acid Erosion occurs when acid dissolves the tooth enamel and dentine which insulate and protect the nerve within the tooth. If enough of the enamel and dentine is eroded away, then symptoms of pain and sensitivity may develop. It is important to appreciate that a child's primary teeth are about half as thick as an adult's and hence, only half as well protected from acid erosion.
The common sources of acid are:
- Soft Drinks, Juices, Sports Drinks
- Chewable Vitamins And Sour Candies
- Stomach Acid Due To Reflux Problems.
Non-carbonated drinks like sports drinks and juices have a low pH, which means they are acidic, as are soft drinks which contain phosphoric acid and carbonic acid outright. So the damage of acid erosion is not limited to only soft drinks, but can also arise through drinking noncarbonated liquids. To limit acid erosion you must prevent contact concentration (acidity), contact duration (exposure time) and contact occurrence (frequency) between the acid and the tooth material. If you cannot avoid these drinks then you should only take them occasionally, and when you do so, do not drink it over a long period of time and do not swish it around like tasting wine. If possible, use a straw so that the acid containing liquid is directed into your throat and away from your teeth. Also avoid Vitamin C chewable tablets which contain asorbic acid. Acid does not just have to come from substances we ingest but potentially from within. Acid reflux from the stomach can also damage teeth. The treatment of which will require medical intervention by your GP.
2. My child has bad breath. What can I do about it?
Bad breath (halitosis) usually originates from one of two sources: the types of food we eat which contain sulphur compounds or the production of sulphur compounds by bacteria in our mouths that feed on leftover food particles. You should avoid food types that contain sulphur compounds, which are eliminated from our body via our lungs. These food types include garlic, onion and cabbage. Persistent bad breath is most likely caused by bacteria releasing volatile sulphur compounds as a by product of their metabolism. Hence, you could reduce the degree of bad breath by reducing the amount of bacteria in your mouth by proper brushing, flossing and rinsing. Don't forget to brush your child's tongue as bacteria are also found there. Sometimes, despite these efforts, the bad breath may remain. This may indicate other issues like gum disease, gastric reflux and dry mouth. Seek a dental opinion as these will require dental or medical practitioner intervention.
3. How do I ensure my child can keep his teeth for life and minimise the need for any dental treatment?
Follow these three simple rules:
- Diet: To minimise tooth decay, you need to understand that everybody has bugs (bacteria) in their mouth and it is the bacteria which converts sugar into acids which ultimately damages the tooth. Hence, if you maintain a low sugar and carbohydrate diet, it is almost impossible to get tooth decay.
- Cleaning: Aside from a proper diet, you must reduce the bacteria and remove the plaque from your mouth. Brushing and flossing twice a day is minimal. Children can have their teeth flossed by an adult as soon as there are teeth that are in contact with one another.
- Regular visits: Aside from catching up with your dentist, these visits allow them to address issues before they become complicated and often costly to deal with. Regular visits will also help in re-enforcing and motivating proper home care and technique, much perrsonal trainer aids in that of your physical health.
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1. Should I visit the dentist when pregnant?
Absolutely! It is a popular myth that the dentist should be avoided during pregnancy when the truth is that pregnant women should maintain as good oral health as possible for reasons which will be outlined below.
Generally, pregnant women can safely receive the majority of dental treatments-including dental prophylaxis and filling if required during the the second trimester when the developing foetus is less susceptible to local anaesthetics or antibiotics (though tetracycline should not be prescribed at any time during pregnancy).
2. What is pregnancy gingivitis?
This is a condition caused by increase in certain hormones-notably oestrogens and progesterones during pregnancy characterizes by swollen, red and tender gums, often accompanied by bleeding when the teeth are brushed. Studies suggest that about 50 per cent of pregnant women suffer from pregnancy gingivitis.
Another effect of gingivitis during pregnancy is the occasional development of pyogenic granulomas or 'pregnancy tumours' seen in up to 10 percent of pregnancies; these are non-cancerous growths caused by an immune response to an irritant-in this case, dental plaque. They normally spontaneously resolve after pregnancy but may have to be surgically removed if they persist.
3. Why is oral hygiene so important during pregnancy?
Recent evidence has shown that good oral hygiene during pregnancy could also be important to the developing foetus. Studies have established a link between the late stages of gums disease, periodontitis, and both premature birth and low birth weight. One study found that women with severe gum disease were up to seven times more likely to delivery prematurely than equivalent women with healthy gums whilst another demonstrated that a similar poor gum condition increased the likelihood of low birth weight babies by three times.
4. What about x-ray during pregnancy?
The American Dental Association advises avoiding routine or elective dental radiographs during pregnancy but that, if absolutely required, a lead apron with additional collar to provide protection to the thyroid gland be used. The reality is, however, that the x-ray dose used for dental radiographs is extremely low and very safe.
5. Will I lose the calcium from my teeth during pregnancy?
NO! This is a common dental myth. The calcium in dental enamel and dentine is bound and not available as a source of metabolic calcium, A small amount of calcium may be utilised from that stored in the bones but, in the absence of any underlying periodontal disease, the amount lost from the jaw bones is minimal and will not cause tooth loss.
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1. My teenage girl used to have a set of perfect teeth. However, I've been told by her dentist lately that her oral hygiene is poor and that some of her teeth are decayed. How can I encourage her to pay more attention to her teeth? She hates me nagging at her everyday.
A teenager should be managed differently from a child. Nagging at her to brush her teeth everyday may not help. Check on her time management. Is she overloaded with work or activities? If this is the case, advise her on time management. Some of the teenagers I know study till they fall asleep without brushing their teeth. I normally advise them to brush their teeth immediately after dinner or supper. They are then permitted to fall asleep with their books any time after that.
Observe whether there is a change in her eating habit and in her diet. If she is snacking mare frequently, then advise her to at least rinse her mouth more often. If she is taking more fizzy drinks lately, then advise her on a healthier choice of drinks.
Lastly, but not least, have a chat with her dentist. Request for the dentist to teach her the proper brushing and flossing techniques. Take her to the dentist more often if her oral hygiene remains poor.
2. It is so difficult to brush my child's teeth. I always end up screaming at him or caning him. Can brushing be less of a chore?
Yes, brushing should not be a chore, but it should be a habit for both you and your child. If you think that brushing is a chore, then your child will inevitably perceive it to be so.
I do agree that it is almost, if not, always a challenge to inculcate the daily habit of brushing in children. Nonetheless, you can succeed to do so with a little patience, persistence and creativity.
You may find the following suggestions helpful :
- Make brushing fun for your child - Put him in a bathtub filled with floating rubber ducks or boats. Give him a colourful and attractive toothbrush. Hold his hand with the toothbrush and start brushing the toys. Next, slowly proceed to brush his fingers and then his teeth. This lets him feel the bristles of the toothbrush first before putting it into his mouth. Hence, he will find it less "threatening" to brush his teeth. At the same time, this helps him to learn the action of brushing.
- Make brushing a family activity - Set aside some time after dinner or supper to brush your teeth together with him. To make it more interesting, your family members can compete with one another to see who has the cleanest teeth after tooth brushing.
- Use the reward system - You can keep track of your child's good behavior by marking on the calendar together with him, each time he brushes his teeth well. Reward him with stickers, ice-cream or an outing if he brushes his teeth well without kicking a fuss for a week. The reward will give him a sense of achievement and will encourage him not to miss any tooth brushing session.
- Focus on telling him about the advantages of keeping his teeth clean - Praise him for looking so handsome with his teeth cleaned. Cook his favourite dish and tell him that he can enjoy eating with a good set of teeth.
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1. There are so many dental products on the market. As my child goes to school, what should I be using to help prevent decay?
There are many excellent dental products that your child can utilize to help prevent dental decay. When your child begins to go to school, it will often coincide with the eruption of their adult teeth. Prevention is the best form of treatment, and it is important to encourage good oral hygiene habits, as well as regular six monthly dental checkups. Fluoride is still an important preventive constituent. As your child reaches their early schooling years (approximately 6 years old), they can begin to use adult toothpaste. Adult toothpaste contains a higher level of fluoride in comparison to children's toothpaste. It is necessary to use only a smear or pea-sized amount. Supervise your child while they brush their teeth to ensure that they are using the correct techniques and not swallowing the toothpaste residue. Your dentist can demonstrate to your child how they should brush their teeth. This will provide positive reinforcement to the methods you have taught them at home.
Another excellent product that you can incorporate into your child's preventive dental routine is Tooth Mousse. Tooth Mousse is a water based product which contains casein phosphopeptide stabilized amorphorous calcium phosphate (CPP-ACP). Tooth Mousse uses a milk protein to enhance the bioavailability of calcium and phosphate, two of the constituent minerals that make up our teeth. This product is particularly useful if your child has had previous dental decay, and is at high risk of developing decay in their adult dentition. Tooth Mousse comes in a variety of different flavors, is easy to use, and is generally readily accepted by children. Tooth Mousse is not suitable for children who have allergies to milk or dairy products. Tooth Mousse is only available to purchase at your dentist. Your dentist will advise you as to your child's suitability for use of this product and provide a personalized usage regime.
2. So many foods seem to contain sugar. What snacks and drinks do you recommend I give to my children at school?
Many foods contain excessive amounts of sugar and can cause dental decay in children. It is best to avoid sticky, chewy products, as these commonly lodge in the pits and fissures of the teeth's chewing surface and can remain there for extended periods of time. It is also important to promote regular meal times and avoid snacking in between meals. The mouth needs time to neutralize the acids formed during eating, and a constant intake of food inhibits this natural process. Teeth friendly snacks include; fresh fruits, vegetables, unsalted popcorn and cheese. It is also important to remember that many drinks contain high levels of sugar and acids. Fizzy drinks (diet and non-diet) and sports drinks are examples of these. Teeth friendly drinks include milk and water.
3. What are fissure sealants and will my child need them?
When your child turns six, generally their 6 year old molar teeth will begin to erupt. The chewing surfaces of these teeth contain many pits, grooves and fissures. Depending on the individual tooth anatomy, the grooves may be so narrow that the toothbrush bristles may be too wide to effectively clean out the area. A fissure sealant provides an effective way of filling these areas with a plastic material, ultimately preventing plaque accumulation and subsequent decay. Fissure sealants will not last forever, and a fractured sealant can leak and lead to dental caries. Regular dental visits will ensure that your dentist can observe the quality of your sealants and inform you if they need to be replaced. |
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1. Is it necessary to use a tongue-scrapper to clean the tongue of my 5 year old?
There is no hard and fast rule. If your child is comfortable with using the tongue-scrapper, then by all means use it. However, if he does not like using it, then it is good enough to just brush his tongue with a toothbrush. The tongue-scrapper may be a little too harsh for his tongue. In fact, it may cause him to dislike brushing his teeth.
If your child tends to retch easily, then I would suggest that you go slow with brushing the tongue. Perhaps, you can start by brushing the tip of his tongue first before proceeding a little further inwards with every brushing session.
2. My child has ulcers quite often. Is it a cause for concern?
Mouth ulcers are quite common in both children and adults. They can be of traumatic, dental or medical origin. Often than not, mouth ulcers are usually seen as a result of trauma like cheek-biting, lip-biting, being hit on the cheeks or lips, fishbone pricking the gums and burns from hot food and drinks.
Mouth ulcers can also be due to grazing from a toothbrush, sharp teeth or braces, dental abcesses and poor oral hygiene. Take your child to a dentist for advise if you suspect any dental causes for mouth ulcers.
Mouth ulcers usually do not raise much concern unless they do not heal within 2-3 weeks. Seek a medical doctor's advise if you have eliminated the traumatic and dental causes of mouth ulcers. Food allergies, stress, anxiety, hormonal changes, lack of iron or folic acid and an immune-suppressed system can cause mouth ulcers too.
3. Our 4 year old daughter has some decayed teeth. She is not cooperative on the dental chair. Can we delay treatment and not subject her to treatment under general anaesthesia?
Dental treatment under general anaesthesis is generally a safe procedure. It is also a faster and less traumatic way to solve your daughter's dental problem, especially if she is already experiencing dental pain.
You may be able to delay her treatment if the cavltles are small In this case, help her to keep the cavfiles as clean as possible. Apply toothmousse dally on her teeth, concentrating more on the cavities. The toothmousse helps to slow down the rate of decay. Ask your dentist for more lnformation about this dental product.
Continue to take her back to the dentist in an attempt to treat her on the dental chair.
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1. I'm a nervous patient and parent at the dentist. I do not want my children to be like me. Is there really a way to help?
Yes, there are many excellent ways to start your children off the right way at the dentist.
Firstly, try to ensure they visit the dentist when they are still very young so they have good habits early on and not just go when there is a toothache. The right age is debatable but sitting on your lap and having a ride in the chair can start around six months old. Avoid any negatlve talk to your children before the visit, they will pick up on your anxiety.
Try finding a dental practice, which is highly recommended by a friend or co-worker Ths cuts out the element of guesswork. Next, check the practice website to see If you get a good impression and if indeed they welcome children. Not all practices are family-orientated.
Call the practice to confirm your impression. Do you get a prompt answering of the phone? Do they have time for you or they appear hurried and stressed?
When you find a practice that feels right, you may want to visit them on your own to confirm your favourable impression. You could inquiry about your concerns and then hopefully schedule an appointment. Your children would feel better if you are booked in to visit the dentist too!
2. I would also like my children to have perfectly healthy and natural hoking teeth. How can I ensure this?
Ths is really a repeat of previous advice and is worth the most to repeat. Early first visit to the dentist and regular visits, ot just when there is a problem. We call this approach Preventive Maintenance. Use of dental sealants, brush and floss tance a day, low frequency sugar in diet and orthodontic checks to avoid crowding problems later. The New Composite Revolution sweeping the world means that all children can benefit from tooth coloured fillings; unlike the older generations who had the old unsightly mercury black fillings. In future articles, further information will focus on the Hi Tech aspects of dental care and how you can benefit.
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