Welcome to The Art of Patients, I’m Dr Golly and today we’re talking dental care for both baby and adult teeth – how best to care for your child’s teeth and what you should do in the event of a tooth injury. Across Australia, every year, more than 25,000 children and young people are admitted to hospital because of decay or holes in their teeth. That’s not even counting all the tooth trauma that results from sporting injuries or falls, but I’ll talk about that a little later.
To prevent tooth decay, it’s crucial to clean your teeth twice a day, from the very first moment a tooth arrives… Let’s jump to the whiteboard and take a quick look at normal dental development in children.
There’s huge variability in when a child gets their first tooth, but for most babies, it’s between 6 and 10 months – with all the baby teeth usually complete by 3 years of age. The sometimes distressing process of teething begins as the tooth travels through the gum, before it actually erupts, occasionally causing pain, swelling, drooling and a slight jump in temperature. The baby teeth – also called deciduous or primary – usually number 20 and a full set of adult – or permanent – teeth numbers 32, these include the third molars, or wisdom teeth.
Under 18 months, you only need to use a toothbrush or wet cloth – with plain water. From this age onwards, use a small amount of fluoride-free toothpaste. From the age of 3, you can begin teaching your child how to floss and encourage them to do this by themselves from the age of 10 onwards. Children should see a dentist every 6 to 12 months from 1 year of age. Taking them early and regularly helps to establish a really positive experience.
It’s very important to avoid too many sugary foods and drinks, especially right before bed. Younger children should never be left with a bottle to drink during the night, as this can lead to significant tooth damage, called dental caries.
As a newborn paediatrician, a very common question I get asked is whether or not dummies – or pacifiers – are OK to use. We call this non-nutritive sucking, it’s a normal part of early development and acts as a self-soothing behaviour in up to 90% of infants. Let’s jump to the whiteboard again and look at the possible effects (turns to whiteboard)…
Whether using a pacifier, finger or thumb, non-nutritive sucking is associated with changes to the position of the teeth, resulting in things like excessive overjet (upper front teeth are too far in front of the lower front teeth), buck teeth (upper teeth protrude so far that they go beyond the lower lip), posterior crossbite ( the upper teeth sit ‘inside’ the lower teeth, ie: the C-shape is more narrow and they don’t meet properly) as well as an increased risk of tooth decay, and ear or finger infections.
Interestingly though, studies show that babies who use dummies are less likely to continue this non-nutritive sucking than children who suck their fingers or thumbs. This is because dummies are easier to wean – and you can’t hide a child’s thumb in the cupboard! Lastly, if your child has knocked out an adult tooth, rinse it in milk – or water if your child has a dairy allergy – and if they are conscious and awake, replace it back into the socket. Get your child to bite down on some fabric to keep it in place and have them seen by a dentist as soon as possible. If you can’t replace it, store it in a container of milk – or your child’s saliva – until you can get to a dentist or local emergency department.
You’ve been watching another episode of The Art of Patients. I’m Dr Golly, I’ll see you next time.