As dental professionals we believe in Preventative dental care and encourage our patients to bring their children to the practice from an early age (ideally from 12 months of age). Regular check-ups from a young age will ensure children don't suffer from untreated dental decay with devastating effects to their growing dentition.
An accident [trauma] that involves injury to the teeth, mouth and face are particularly common in childhood. Just over one third of all five-year-olds will have suffered an injury to their first [primary] teeth. By 12 years old, 20-30 per cent of children will have suffered injuries to their teeth. Boys are one third more likely to be affected.
Rapid action by parents, carers and teachers can save a child's teeth, so it is important to know what to do if an accident should happen. With some injuries there is a much better chance of good recovery if treatment is given immediately, rather than waiting for professional assistance [see below] Any trauma or injury to first teeth (baby teeth) can affect the developing second teeth. Children who have had injuries to first teeth need to be monitored regularly by their dentist.
Injuries to the teeth can include a fracture of the tooth or root. The fracture can go through enamel only, through the enamel into the dentine (sensitive yellow tissue under the enamel), or into the pulp in the middle of a tooth (nerve and blood vessels).
Injury to the tissues that hold the tooth in place (periodontal ligament)
The tooth can be loosened or knocked out of its socket completely.
Severe injuries may include head injury and fractures of the jaw and facial bones. If severe injury is suspected, or there has been any period of loss of consciousness, the patient should be taken to hospital immediately
Patients who have had an accident to either first or second teeth need to be monitored by a dentist. Teeth may appear fine at first, but some teeth can show reaction to damage months, or even years, after the event. A dentist will be able to advise on the necessary follow-up period
Toddlers and young children, when they begin to explore their surroundings, are often unsteady on their feet. Furniture is used to support awkward first steps, and falling on to a coffee table is common. Making the home as safe as is possible before a child begins to walk (9-12 months) and not allowing children to walk with cups or bottles (or other objects) in their mouths can prevent many injuries.
Sport results in many injuries to the teeth. A thorough check-up at the beginning of each season to identify teeth at risk and the provision of a mouthguard, fitted by a dentist, provide the best protection possible. Anyone involved in contact sports [e.g. soccer, rugby, hockey, boxing and wrestling] should have mouthguard protection. Even non-contact sports [e.g. basketball, squash, skateboarding, and cycling] can cause damage to the teeth and participants would benefit from the use of mouthguards.
Patients with physical disabilities or conditions that may cause them to fall [e.g. epilepsy] are more prone to accidents that involve the teeth. A dentist can give advice in these cases.
Prominent front teeth (anterior), especially if not covered by the lips, are much more likely to be fractured. Orthodontic treatment (aligning the teeth with braces) reduces this risk.
Seat belts, appropriate child restraints, and car seats all prevent trauma to teeth, mouth and face, as well as the rest of the body.
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.
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.
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.
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.
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.
|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|
|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.
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 12 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.
Plain still water and milk are the best choices of drink for a child. Sweetened drinks should be avoided for as long as possible. They encourage a 'sweet tooth', leading to problems later on.
Sugar-free squashes, if totally sugar free, are the safest alternative to water or milk for the protection of children's teeth. They should be diluted as much as possible - there should only be a hint of colour in the water when the drink is made up. Some of these drinks contain artificial sweeteners, which should not be given to a young child (check with a dentist/health visitor).
The dilution of natural fruit juices with water minimises the risk of tooth damage. Dilute one part juice/squash to 10 parts water.
If children are genuinely thirsty they will always drink water! It can be made more exciting to drink by giving it in a special cup, adding ice or using a straw.
Squashes, fizzy drinks (whether diet or regular), fruit drinks, cocoa and milk shakes all cause harm to teeth. The sugar in them causes decay while the acid in both normal and diet drinks dissolves the enamel on the teeth.
Comfort feeders and bottles containing sugary drinks given to young children for prolonged periods of time cause severe dental problems because they bathe the teeth in sugar. When using feeding bottles, hold the child until the feed is finished. Never leave a baby propped up with a bottle. Apart from the increased risk of damage to their teeth, the baby could choke.
Never leave a sweetened bottle or feeder cup by a child's bed overnight.
Milk or water is the only drink that should be given in a baby's bottle.
Sugared liquid medicines for children are very effective but, if taken regularly, they have a significant risk of causing dental decay. If possible try giving them at mealtimes and not last thing at night. Better still, ask the GP or pharmacist for a sugar-free medicine.
The more often that a child has sugary drinks, the more likely they are to get dental decay. Therefore it's best to give such drinks at mealtimes only.
When buying drinks look at the labels. Manufacturers often describe sugars as ''added' or ''natural''. Natural sugars are just as damaging to teeth as refined sugars.
Honey is a source of natural sugar but acts as a concentrated solution of glucose and fructose (these are both 'hidden sugars'). Sugars in fruit juices are also natural but are more rapidly absorbed than those in the whole fruit; also, natural fruit juices can be acidic.