Parenting / 19 September, 2018 / Dr Saul Konviser
When it comes to our kid’s health, we are so focused on every aspect from allergies, nutrition to toilet habits, however for some reason oral health is still not considered a priority. As a Dentist and a father, the oral health of a child is simply non-negotiable and trips to the dentist should be seen as important as getting your child their routine vaccinations. An unhealthy mouth can have serious implications on a child’s general health and so it is absolutely crucial that it is well looked after.
Here are just a few pointers on things to know when looking after your kid’s oral health to give them the best start in life:
We want our kids to develop healthy habits from early on and toothbrushing is one of them that needs to last for as long as they wish to keep their teeth. You would not allow your child to stay in a dirty nappy however much they dislike having it changed, the same goes for dirty teeth and tooth brushing.
We should always try to brush their teeth twice a day, especially last thing at night before bed and one other time ideally in the morning after breakfast. I know it can be very difficult but it is extremely important to not let kids fall asleep on the bottle once their teeth come through. I found with my kids a phased approach worked best, by watering down the bedtime bottle until it was just water and they didn’t even realise we had changed it. That way they can still have their milk and bed time stories or whatever your routine is, followed by a brush and a bottle of water to bed.
Until children have the skills to brush properly on their own, we still need to help them usually until around the age of 7 years old. I always let my kids start brushing first then repeat it afterwards to show them how it’s done properly…..we play games, have fun with coloured toothbrushes, I let them try brush my teeth and we even make up a competition to see who is going to be first to let me brush their teeth…. Kids love to be competitive. Another common question I get is electric or manual toothbrush for kids – personally I find the electrics are too big for an infant’s mouth and you will get a better result by brushing manually. You also get the tactile feedback yourself when brushing telling you that you are doing it correctly – something I don’t believe any amount of technology can ever tell you.
I’m a father of two and even as a dentist, it really can be a thankless task with kicking and screaming at the end of a long day to brush my kids’ teeth and I’ve had bite marks to prove it. However, they’ll soon get over it and be reaching for the brush on their own without you having to nag them!
Going to the dentist should be a fun experience for a child as we want to avoid any negative memories for them so the earlier they start attending the better. It doesn’t matter if it’s just for a balloon, stickers or to chew the child friendly mirror at first, we just want your kids to be happy to attend the dentist for their check-ups. We don’t want their first visit to be for a filling or at worst an extraction, it can put them off for life.
More often than not, the first appointment doesn’t even involve a check-up as the kids are so young and non-compliant. However, it is an excellent opportunity for parents to discuss with the dentist about how to look after the oral health of the child from toothbrushing techniques, the appropriate toothpaste to diet advice and teething tips. If you are not sure how they will respond, just take your kids with you for your check up so they can become familiar with the dentist and the surroundings.
I do however usually advise against bringing your child to an appointment that you may require treatment at, just because for a small child seeing their parent in that situation can be quite traumatic and scare them off.
Every child should be taken to the dentist by the age of one year old or when their first tooth pops out, whichever comes first. There is no reason why you should be turned away for the child being too young, be it in an NHS or a private dental practice.
These days, it’s very difficult to avoid sugar altogether as its in almost everything we eat or drink. The important thing to remember is to limit the frequency of our sugar intake – if our kid’s teeth constantly have sugar on them throughout the day, they just never get a break and this puts the teeth at a higher risk of developing decay not to mention the acid erosion from all the citrus fruits and drinks available.
I often hear parents say their kids don’t like water and so that’s why they give them watered down juice all the time – this of course is a non-starter for me. Children should be given sugary drinks as a treat not as part of their daily intake. Again, as a parent, I know that my kids will ultimately have what they are given. Yes, there will be arguing or tantrums to start with but as I have said, some things are simply non-negotiable and that includes our kid’s health. We have to make these decisions for the benefit of our children and healthy eating and drinking is one of them.
And when it comes to fizzy drinks…… this is an absolute no no. In my opinion, children shouldn’t be allowed any type of fizzy drink, even sugar free. The sugar and acidity level in these drinks is unbelievably damaging, especially to the smaller and more fragile children’s teeth.
Of course, as the kids get older, more independent and go to parties, these things are more available, but by instilling healthy habits early on, hopefully your kids will be reaching for the water bottle instead of the can of cola at their next party.
There are many different brands on the market, with different flavours and even bright colours but what’s most important is that your child is using a toothpaste with fluoride in it. Up to the age of 3 years old we only need a smear of toothpaste with 1000ppm Fluoride content (always check the label) but thereafter a pea size amount with more than 1000ppm Fluoride is just fine. When they are old enough, we want to encourage them to spit out the excess toothpaste and avoid rinsing as this washes all the good bits in the toothpaste off our teeth – this applies to adults also!
As kids grow and become more active, so does the risk of falling over and bumping into things. Dental trauma in kids is therefore extremely common but fortunately we have very good protocols in place to help manage. If there is a trauma to a child’s mouth, there is often a lot of blood which can be very scary for both parent and child but this does usually health very quickly.
It is very important to try and check your child’s teeth to see if anything has chipped off, moved or even if the tooth has been knocked out. If there is a chip, try to locate the piece of tooth as often it can end up in the child’s lip and this needs to be removed. If the tooth has moved or been knocked out then it is very important that you get to a dentist as soon as possible. If a baby tooth gets knocked out we do not replace these however for an adult tooth, these can be reinserted into the socket from where they came. Be sure to only touch the crown (the white part you usually only see in the mouth) and not the root and then rinse the tooth under cold water. The tooth should then be stored in milk and brought to the dentist as soon as possible to re-implant. Of course, if you are happy to, you can re-insert the tooth yourself and then keep pressure on it but most people are not too keen on this.
Any type of trauma can have long lasting effects so regular reviews of the teeth are important. The teeth can sometimes discolour, become painful or even need a root canal or extraction. If the trauma happened before the adult teeth erupted, sometimes they can come out in less than ideal positions or even look different with spots, lines or little defects in them. It is therefore very important to always go to see your dentist after any kind of trauma to your child’s mouth just to keep an eye on things.
There is no ‘magic cure’ for teething as every child is different. Some can produce tooth after tooth and wouldn’t know the difference, while others bring the house down with just the sight of one. It can therefore be unbelievably stressful for both parents and kids during the teething process. The important thing is to try and help sooth your child and keep them pain free. Of course, the use of medication such as Calpol and Neurofen is very helpful as well as topical anaesthetic gels at the recommended doses however there are other alternative homeopathic remedies that some parents find helpful, however this is a personal preference.
Cold packs for kids to suck and chew on certainly do provide a great deal of relief and there are a number of different toys and products available that can help with this. It is also good to know that as the teeth begin to come through, you need to keep the gums nice and healthy as the inflammation around the erupting teeth also causes a lot of discomfort. Using a baby’s toothbrush or even some gauze on your finger to rub and clean the area can make a difference.
It is quite common during teething for children to suffer from excessive saliva production and it looks like they are drooling all the time. This can also result in sores around the mouth if it is not kept clean, especially on their chin where the saliva can dribble and irritate. Cheeks often become very red and the child can also have a very runny tummy. There are instances where kids could get a high temperature and again this should be managed with the appropriate medication and if necessary, always consult your GP.
Dr Saul Konviser BDS MSc BSc
(Clinical Days: Tuesday, Wednesday, Thursday)
Tel: +44(0) 207 935 3016
47 Montagu Mansions, Marylebone, London, W1U 6LD