Avoiding tooth decay
The importance of diet
Avoiding giving a baby or a young child unnecessary sugars is a good way to establish healthy eating patterns to protect every child’s teeth for life. Milk and water are the only drinks that should be put into a baby’s bottle. Don’t give a child sugary drinks in bottles or pacifiers (dummies) dipped in a sugary substance.
Babies should be introduced to a feeding cup as soon as possible. Fruit juice given to children, should be diluted (1 part juice to 10 parts water) and given in a cup. Restrict juices to mealtimes only. If the child tends to snack between meals, remember that cheese is a very tooth friendly food – avoid sweets, cakes and biscuits.
The importance of cleaning teeth
Plaque will start to form on a child’s teeth and gums as soon as the first tooth appears (erupts). So, it is very important to begin a suitable toothbrushing routine as soon as possible. The brushing routine that is established with a child at an early age should continue throughout their life.
Use a toothbrush that is appropriate for the child’s age and stage of tooth development. A small-headed soft brush should be used as soon as the first tooth erupts. Character toothbrushes are an excellent way to make brushing fun for young children. A small smear of a children’s fluoridated toothpaste should be used on the brush. As the child gets older a slightly larger brush with medium bristles may be used.
The importance of fluoride
Fluoride occurs naturally, at some level, in the water in most areas and helps to prevent tooth decay when at the optimum concentration. Fluoride is present in most toothpastes but special children’s toothpastes are better for babies and infants because the amount of fluoride is controlled specifically for their needs. The amount of fluoride in any area’s water supply can be found out by contacting the Local Water Authority. Fluoride supplements come in tablet form and may be prescribed by the dentist if active decay is identified during routine dental examinations. A varnish can be applied by the dentist or hygienist in the surgery. Although fluoride is a valuable protective agent, like many things it is important to have just the right amount, not too much or too little. To avoid excess fluoride from toothpastes, children under six years should be supervised when toothbrushing and only use a small smear of toothpaste. Children over seven years can use the family fluoride toothpaste but only a pea sized amount on their brush.
Changes over time
Weaning & Teething
The timing of the eruption of the first teeth can vary widely from three months to as late as 11 or 12 months. This is perfectly normal but, if there are any concern about late eruption of teeth, this should be discussed with the dentist. The first teeth to appear are usually the central lower teeth (incisors).
Sugars should not be added to weaning foods. When buying prepared foods always read the labels to ensure that hidden sugars are not present.
Try to introduce babies to ‘savoury’ foods, such as pureed vegetables and fruit. During teething babies may look a bit flushed and dribble more than usual. Babies often find comfort from the use of teething rings. Teething does not usually cause symptoms such as high temperatures. However when babies are distressed and have a slightly raised temperature they often respond very quickly to a dose of paracetamol suspension.
Teething and eruption dates
The exact dates will vary from child to child, but the following guide will give some idea of what to expect. Permanent tooth development in girls maybe more advanced than in boys.
|Primary, baby or deciduous teeth|
|3-6 months||Central lower incisors erupt|
|9-12 months||All front incisors now present|
|12 months||First primary molars|
|18 months||Primary canines|
|2 years||Second primary molars|
|Adult or permanent teeth|
|About 6 years||Lower central incisors replaced. First lower permanent (adult) molar erupts (6 year molar). These appear behind the primary molars at the back of the mouth|
|9 years||Canines replaced|
|11/12 years||Permanent pre-molars replace primary molars|
|12 years||Second molars erupt|
|16 years +||Wisdom teeth erupt|
With all children it is important to establish good oral hygiene practice as early as possible to prevent the development of common gum diseases (such as gingivitis) in later childhood and teenage years.
Fizzy drinks (whether diet or regular), artificial fruit squashes, cocoa and milk shakes can all cause harm to teeth. The sugar in them can lead to decay whilst the acid in both normal and diet drinks attacks the enamel covering the teeth (this is called erosion). Try to get children to drink only milk or water between meals. Dilute drinks, when applicable, as much as possible. Give sugary drinks at meal times only. Limit fizzy drinks to treats for special occasions only. After brushing teeth before bedtime, only let chldren drink water. Liquid medicines – always try and get sugar free formulas from the pharmacist.
Visiting the dentist
It is a good idea to get babies and young children used to the idea of having dental examinations by taking them along to the dentist when adults are having dental check-ups. Dental visits by infants should begin at 18 months if only to become familiar with the dentist and to have a ‘ride’ in the dental chair. Once confidence is gained by two years of age it will be possible to examine the deciduous teeth, which should all be present. While for the majority of children the teeth will develop normally, for some children there are variations in the number of teeth, their size, colour and shape. If you have any concerns about your child’s teeth, you should consult your dentist as soon as possible.