TODDLERS / INFANTS
Some two year-olds are ready for a ride in the dental chair while some three year-olds are still only able to cope with a “knee-to-knee” examination. Individual variations must be taken into account and this can be done through observing your child during the consultation phase of the appointment.
The appearance of primary teeth is commonly called “teething”. Many babies experience some discomfort during teething. Most babies are irritable when new teeth break through their gums. Signs and symptoms of teething can include:
- Frequent crying and crankiness
- A mild fever
- Reddened cheeks and drooling
- Loss of or reduced appetite
- Mild diarrhoea
- Sucking or gnawing on toys
- Pulling the ear on the same side as the erupting tooth
It is extremely important not to ignore symptoms such as fever and diarrhoea in your child. If these symptoms occur, seek medical advice to eliminate other reasons for the symptoms. To help relieve the discomfort of teething, here are some recommendations from the ADA:
- Wash your hands and gently rub your baby’s gums with a clean finger
- Give your baby a teething ring or wet washcloth to bite. Teething rings can be chilled in the refrigerator before being used to help manage discomfort associated with teething (do not put teething rings in the freezer)
- Give your baby non-sweetened rusks to chew on
Signs and symptoms may appear and disappear over several days. Please feel free to ask your paediatric dentist for advice before using any pain relief specifically created for babies and toddlers. Never give aspirin to a baby or young child.
Brushing Baby Teeth
Even before your baby’s teeth appear, you should gently wipe their gums with a moistened soft cloth once a day. Once your baby’s primary teeth start to appear, you should use a toothbrush specially designed for babies, with a small head and soft, rounded bristles to gently massage their teeth and gums. Up to the age of 18 months, your baby’s teeth should be brushed with plain water, twice a day, especially after their last feed in the evening.
Tooth brushing for your baby can be done more easily with them lying on a bed or change table. The time taken to brush can be increased slowly until the baby is able to tolerate a two minute brushing as a toddler.
There are special low-fluoride toothpastes that have been developed for young children. These can be introduced from around the age of 18 months – read the directions on the toothpaste for age suitability. Only a smear of toothpaste is needed, and encourage your child to spit out the excess toothpaste.
If your child isn’t able to spit out after brushing, continue using a smear of low fluoride toothpaste and wipe their mouth with a washer or tissue. It’s really important to keep brushing their teeth and there is variability in the age at which children learn to spit out.
Store all toothpastes out of your child’s reach. Some small children love the taste of toothpaste and will eat it if given the chance. Consuming toothpaste can cause dental fluorosis, which is why you need to keep toothpaste out of reach of young children.
The one-year old dental check
In order for an intervention to be successful, it must be both timely and relevant. At the 1-year-old visit, an oral health risk assessment is made through a structured consultation with you and your child. Age appropriate and individualised preventive information is discussed. The time spent talking to you allows your child time to become accustomed to the environment as well as to me and my staff, and may allow for an easier examination.
Thumb sucking is a natural reflex in babies and young children. Most children lose interest in thumb sucking and dummies at two to four years of age.
Children who continue to suck their thumb or fingers after their permanent teeth have increased risk of developing crooked teeth, particularly if the sucking is forceful or frequent. Speech defects may also arise, especially with ‘s’ and ‘th’ sounds.
Learning to brush
From around the age of four or five, your child should begin to learn how to brush and care for their own teeth. Children do not have the skills to properly clean their own teeth until around eight years of age, so until then, tooth brushing should be a combined effort between you and your child. Teeth should be brushed in the morning and at night.
Choose a position where you can easily see your child’s mouth. For example, sit your child on your lap or stand behind your child with their head tilted back slightly.
Move the toothbrush gently in small circles to clean the front surfaces of your child’s teeth. To reach inner surfaces, tilt the toothbrush. Avoid side-to-side scrubbing, which can damage your child’s teeth and gums. Brush the biting and grinding surfaces of back teeth with a firm back and forth motion, and be sure to clean every surface of every tooth.
It will take time for your child to allow you to clean their teeth, however, it’s important that their teeth are brushed twice a day, working up to two minutes as they get older.
Replace toothbrushes every three months or when bristles appear frayed. Frayed bristles are not effective at removing plaque and may scratch your child’s gums.
Did you know?
Plaque-disclosing tablets or drops (available from your dentist or pharmacist) contain food dye that turns plaque pink or red. Using these can be a fun way to help you and your child to see if the brushing technique you are using removes plaque from every tooth surface.
The teenage years and early twenties are exciting times of many changes – starting high school, first jobs, many new relationships, finishing high school, technical training, university, moving out of home, starting careers, engagements, weddings and young families. These are years of exploring new interests and testing boundaries. These changes and challenges can affect conditions in the mouth and can form habits that have long term effects on oral health.
More tooth decay!
Studies have shown that young adults (18-24 year olds) in Australia have more tooth decay compared to Australian children at 12 years of age. Similarly in New Zealand oral health gains made during school years are not continued into adulthood. It is thought that the many changes in the lives of young adults may result in less frequent tooth brushing, new eating patterns and less regular dental check-ups – These changes can increase the risk of tooth decay.
What to do – remember the basics!
- Fluoride is needed DAILY throughout life to protect teeth against decay
- Fluoride is most easily applied DAILY through brushing with fluoride toothpaste and drinking fluoridated water
- Brushing twice a day with fluoride toothpaste reduces the risk of tooth decay much more than brushing only once a day
- The most important time to apply some fluoride is before bedtime as the flow of saliva (which protects teeth against decay) is lowest during sleep
- Use floss to remove plaque between teeth
- Have regular dental check-ups
- Don’t share toothbrushes – bacteria that causes tooth decay can be spread from person to person!