Imagine your child’s preschool graduation picture, she is beaming with pride but all you see is a wide toothless grin! While the thought of it may seem funny and possibly endearing, the fact is that it’s a high reality, and actually really worrying.
A study by the National University of Singapore published in 2009 found that as many as 40 per cent of the 1,782 pre-schoolers in Singapore aged 3 to 6 had early childhood caries or tooth decay before the age of 6.
More dentists are also seeing an increased number of young patients with cavities. With the National Dental Centre Singapore, the largest dental specialist centre in Singapore, treating over 1,000 children with early childhood caries in 2011 and 2012 as opposed to only 500 in 2000. The School Dental Centre at Outram Road also states that the most common condition they see for young patients is early childhood caries. It makes up 73.8% of 4,424 cases in 2013.
And these are only the cases that get treated. According to the NUS survey, up to 90% of children who develop caries never get treated for their condition.
But I brush my kid’s teeth
This comes as a surprise to many parents as their kids regularly brush their teeth. However regular brushing alone will not help prevent caries especially if kids still drink from the bottle in the middle of the night. Worse still if they fall asleep while drinking, allowing the milk to percolate in their mouth.
Milk, both formula and breast, contain sugar and can cling onto an infant’s teeth for long periods of time. Drinking milk from a bottle at night, when the saliva flow is low, is worse as the milk does not get washed away by the saliva and has contact with the teeth for a longer time.
The bacteria present in the mouth react with the sugar, producing acid that attacks the teeth causing your children’s teeth to slowly decay.
But it’s just their milk teeth
Many parents don’t seek treatment because they feel that their kid’s baby teeth are going to drop anyway so there is no point to remedy any tooth decay that happens to it.
Unfortunately this is not the best attitude to take. According to Dr Elizabeth Tan, a Paedodontist with Specialist Dental Group, “although baby teeth will eventually fall out, it is important that young children do not develop tooth decay as the milk teeth are placeholders for permanent teeth.
Dr Tan adds that “premature loss of milk teeth can have long-term implications such as causing the nearby teeth to tip or shift into the space left unoccupied. When a permanent tooth subsequently grows into this space, there may not be enough room for the tooth to grow properly. The new tooth may then emerge tilted, causing crooked or misaligned teeth that can result in a range of problems – from chewing abilities to speech problems, poor eating habits and a loss of self-esteem”.
Early childhood caries may also result in infection, spreading from the confines of the tooth to the surrounding soft tissue and presents itself as a gum abscess. There is commonly acute pain. If infection travels deeper into the tissue planes; it can result in ‘Cellulitis’, which is a medical emergency.
“Having problem-free teeth will also result in a greater likelihood of a child having a positive experience visiting the dentist, and in the long term, result in healthier teeth and gums as an adult,” she adds.
Prevention better than cure
The good news is that early childhood caries can be prevented. Here are some of the things you can do to help prevent early childhood caries developing in your kids.
1. Ideally expectant mothers should be alerted on good oral hygiene practices during their prenatal check-ups.
2. Try not to share saliva with your baby through common use of feeding spoons or licking pacifiers as you can transfer your oral bacteria to their mouths.
3. Plaque control by regular and proper tooth brushing
4. A diet that is low in sticky, starchy and sugary foods
5. After each feeding, wipe your child’s gums with a clean, damp washcloth
6. When your child’s teeth come in, brush them gently with a child-size toothbrush and water. It is not encouraged to use a fluoride based toothpaste before the age of 2
7. Brush the teeth with a ten-cent sized amount of toothpaste from the ages of 2 to 6
8. Supervise brushing with your child until they can be trusted to spit out and not swallow the toothpaste. This usually happens when they reach primary school
9. Place only formula milk or breastmilk in bottles. Avoid filling the bottle with sweet liquids such as juice or soft drinks
10. Infants should finish their bedtime and naptime bottles before going to bed – never let them sleep with bottles still in mouth
11. If your child uses a pacifier, provide one that is clean and don’t dip it in any sugar or honey
12. Wean your child from the bottle when they turn one and encourage them to start drinking from a cup
13. Encourage healthy eating habits and stay away from sugary drinks
14. Regular dental visits twice a year
