Preventing tooth decay
Last week I came across a four year old boy at my 'other job' at the GP's. He had the most awful early tooth decay. It made me sad because it's so preventable. Are we as health professionals not getting the message across?
In England it was a huge part of the 8 month developmental assessment. As Health Visitors we even gave out little goodie bags with free hard-spout sippy cups, baby toothbrushes and baby toothpaste. Maybe we should do the same in Australia?
Lift the Lip
But whatever ... we need to start the conversation. We start with 'LIFT THE LIP' - a weekly check on all your child's teeth. Lift the top and bottom lips - you can't do a proper check without doing that.
Early decay is identified by white deposits of plaque on the gumline.
Dental medicine and healthcare - human patient open mouth showing caries teeth decay
Late decay is brown in colour, starting on the back teeth and top front, then it spreads.
Stop all bottles by 6-12 months
The use of feeding bottles after 12 months vastly increases the risk of decay. Ideally a feeding beaker with a hard spout should be introduced by 6 months and all bottles should stop by 12 months.
Babies 'comfort suck' with a bottle, increasing the sugar contact on the teeth. Cup feeders have a shortened exposure, lifting the cup up and down, and out of the mouth in between sips.
- The only 'safe' liquid is water. Breast milk, infant formula and cow's milk all contain sugar. Juice and Coca-cola are a no-no.
- Watch out for hidden sugars in 'healthy' foods such as muesli bars and packets of sultanas and raisins. 4g of sugar is equal to one sugar cube of added sugar.
- Try and encourage raw fruit and veggies rather than sugary foods.
- Don't 'clean' dummies in your own mouth or share toothbrushes - you are sharing your own mouth germs and tooth decay.
- Putting honey or jam on dummies is another tooth rotting no-no.
- Even breast feeding at night can lead to tooth decay. Babies don't produce saliva at night-time, so there is less protection on the teeth.
After 6 months, aim to stop night time feeding. This should be in place by 8 months. It's all about the teeth.
First teeth appear by around 8 months and should have erupted by 12 months. If they are later than this you will need to consult your dentist.
If the milk teeth have decayed, then the second teeth will most likely be affected. It is a myth that it doesn't matter.
As soon as teeth appear, we need to clean them twice a day with a baby toothbrush. Young babies teeth can be cleaned with a damp muslin cloth.
Low-fluoride toothpaste can be used from 18 months. A pea sized amount on the morning and night toothbrush.
It's important to make your baby, friends with your dentist as soon as teeth appear. Have their teeth checked every 6 months so it becomes 'normal'.
I'd like to think that by reading this article and following these simple steps we can stop the rot.
The 4 year old boy I mentioned at the beginning of this article was using a feeding bottle with a teat and his bottle had milk in it. He'd even brought his bottle along for the 4 year old check.
The tantrum that may result from removing the bottle and giving it to the bottle fairy is a lot less painful than the resulting tooth abscesses from tooth decay.
The image that forever stays in my head is of two children in Melbourne aged 3 and 4 years. They had milk in their feeding bottles. Their tooth decay had gone as far as their gums. They had no front teeth left at all. Those teeth would not be replaced by the second teeth till 6 years. They endured months of very painful dental treatment and it it all preventable.
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