Children’s oral hygiene is something that we don’t give much attention to. It is definitely not a wise thing to do
The phenomenal decrease in dental caries in children, in the West, is attributed to optimum fluoridation of water and access to dental care at an early age. Unfortunately, it is the complete opposite here in Pakistan.
Dental diseases in children are so great that it can safely be labelled as an epidemic. A number of factors contributing to poor dental health of Pakistani children, include ignorance on part of the parents and health care providers of the importance of primary dentition. Also involved are consumption of “junk food” in form of candies, sweets, confectionery products, fizzy drinks, supari and even pan masala. Elaborate coverage in form of advertisements of these products on the national electronic media adds to the already sorry state of dental health in children in this country. Moreover, economic constraints also are an important factor as it prevents parents from seeking early dental treatment for their children. Nevertheless, that shouldn’t stop parents from understanding the gravity of the situation and recognizing and preventing dental disease in children and seeking dental care at the right time.
WHAT IS TOOTH DECAY? Black, brown or chalky white spots on the surface of one or more teeth characterize tooth decay. This happens when bacteria, found in a healthy mouth, feeds on sugar and starch in food residue. In the process, it produces acid that causes tooth enamel to dissolve and break down thus producing a cavitation (cavity).
Tooth decay in its early stages is symptom-less. However, once it involves the inner layer of the tooth, the dentine, the child starts to complain of sensitivity to hot and or cold. Further progression of a cavity leads to the involvement of the pulp (nerve) of the tooth resulting in severe pain and infection of the tooth bearing area as well.
If milk teeth are lost too early through decay or are taken out prematurely, the permanent teeth that follow could be late in coming through. And when they do, they may be misaligned. At the same time, infection in a milk tooth can damage the structure of the developing permanent tooth underneath. In short, milk teeth are very important as they are found on which the health and proper alignment of the permanent set of teeth depends.
PREVENTION IS BETTER THAN CURE: There is a great deal that parents can do to keep their children’s teeth healthy from an early age and to protect against problems later on. It is important to brush your baby’s teeth as soon as they appear. If your baby resists, try wiping the teeth with a clean, moist piece of gauze to which you have added a spot of fluoride toothpaste.
Choose a brush that has soft bristles and a small head that allows you to reach all parts of the mouth easily. Replace the brush every three months or as soon as the bristles wear off. Brush your child’s teeth at least twice a day with a pea-sized amount of toothpaste using a gentle scrub technique that cleans all the tooth surface and gum margins.
During the toddler years you are likely to meet resistance. Investing in two or three colourful toothbrushes may help, letting your child choose which one to use each time. This might make your child feel more in control. Your child is unlikely to have the manual dexterity to be able to brush his or her own teeth proficiently until around the age of seven years, so you will have to supervise and help until then. In short, prevention should start early in life. Maintaining good oral hygiene along with healthy eating habits can ensure a lasting smile.
DIET: As well as making sure that teeth are clean, a healthy diet is vital to protect teeth and gums. Restrict the amount of sugary food and drinks that your child has in between the main meals. Avoid putting sugar-sweetened drinks into feeding bottles and beakers. Dummies dipped in sugary water or honey may help to calm a cranky baby but it spells disaster for your child’s emerging teeth.
Feeding and/or nursing has a very important role in the initiation and progression of dental caries. ‘Nursing bottle syndrome’ or baby bottle tooth decay are terms used to describe condition which results from passive feeding. A child develops a habit of taking a bottle containing milk or sweetened liquid to bed and going to sleep with the content of the bottle pooled in the mouth, bathing the erupting deciduous teeth. Within months the sugary content of the bottle can result in caries formation and total destruction of teeth.
Acidic food and drinks, such as concentrated fruit juices and fizzy drinks, can cause thinning or erosion of tooth enamel. It is essential to limit the amount your child has. Also ensure that your child eats a snack in one sitting. If your child spends the whole day nibbling something, it is more likely to cause damage than if the same amount had been eaten in one go.
It is also worth looking out for the amount of confectionery products that a child is consuming. Pan, supari masala is not only bad for teeth but is the leading cause of cancerous and pre-cancerous lesions of the mouth.
Introduce healthy eating habits from the start. Fruits, vegetables, meat, cheese, milk, eggs and fish are not only good for teeth but are recommended by nutritionist for healthy development of bones and muscle mass.
MALOCCLUSION: A common dental problem is malocclusion, irregular positioning of teeth within the jaws. This can affect a child’s appearance, ability to bite properly and also the ability to clean teeth properly. A severe malocclusion may require prompt treatment. Teeth might have to be removed so that other teeth can be aligned with the help of orthodontic braces. Majority of the malocclusion are treated once most the permanent teeth have erupted, between the ages of 10-12 years. A small number of cases may require early intervention. Only a qualified orthodontist will be able to advise you accordingly. Orthodontics is an expensive treatment all over the world. Please do not, for the sake of saving some money, seek treatment from someone who claims to be an orthodontist. Re-treatment not only is a burden on your pocket but also burns the child’s compliance.
VISITING A DENTIST: Dentistry should be introduced to a child at an early age. Taking your child with you to the dentist from an early age helps remove much of the anxiety that a child may feel when they have their own appointment. Always be positive about dentistry. Don’t use dentistry to scare your child. This will only result in developing a fear for the dentist.
The American Academy of Pediatric Dentistry recommends that children ideally have their first dental visit by their first birthday. An infant’s first dental visit should be pleasant, non-threatening introduction to dentistry. It should include a brief but thorough oral examination and provide individualized prevention counselling to the parents.
It is advisable that a child be seen once in six months. In the meantime, if you spot any evidence of abnormality, misaligned teeth, dark spots or uneven colour, make an appointment with your child’s dentist straight away.
Children’s oral hygiene is something that we don’t give much attention to. It is definitely not a wise thing to do 
