Dr Bien Lai, Head and Senior Consultant of Paediatric Dentistry at National Dental Centre Singapore (NDCS), answers your queries about tooth decay in children and infant oral health.
Child tooth decay and infant oral health
Almost one in two children in Singapore has tooth decay by the time they enter kindergarten.
Tooth decay, formally known as
early childhood caries (ECC), is the most prevalent chronic disease in children. Untreated tooth decay can lead to pain, swelling, affecting growth and development of adult teeth. Unlike other chronic diseases, ECC is preventable.
It is recommended that children go for their first dental visit by one year old. This gives dentists an opportunity to educate parents and caregivers on the risk factors of ECC before ECC happens.
In this "Ask The Specialist" forum,
Dr Bien Lai, Head and Senior Consultant of
Paediatric Dentistry at
National Dental Centre Singapore (NDCS), a member of the
SingHealth group, is here to answer your queries about tooth decay in children and infant oral health.
This Ask The Specialist forum has closed. Thank you for your interest and participation.
1. Question by ZY
Dear Doctor Lai,
My questions are:
1.What happens if children has too many cavities? Does it lead to any health issues?
2.My son's teeth is very yellow. Why is that so? We make sure he brushes teeth everyday. He does not take any staining food or drinks.
3.He dropped his first baby tooth when he was in nursery 2. Is that way too early? He upper and lower front tooth is adult teeth even before he hit P1 and the changing or dropping of milk teeth has stopped. Is that normal?
4.What is a normal time frame for children to drop their baby teeth or to change to adult teeth?
Thank you.
Answered by Dr Lai:
Thank you for your questions!
1.When the child has too many cavities, it may be difficult for him/her to brush the teeth well, resulting in food trap and causing tooth decay to worsen. Untreated tooth decay may result in pain, swelling, bad breath, missed school days due to pain or need to go for dental appointments, affecting diet and sleep, and growth and development of the child.
2.Yellow teeth may be due to plaque deposition as a result of poor oral hygiene, tooth decay, or possibly a visual colour difference when baby and adult teeth are in contrast. Adult teeth usually appear to be more yellow than baby teeth. You should bring your child for a dental visit to rule out tooth decay.
3.Baby teeth usually start exfoliating at 6 years old. Some children may be faster or slower.
4.Baby teeth start to exfoliate at 6 years old. The set of baby teeth will slowly fall out one by one and new teeth will grow from 6 to 12/13 years old.
You’re welcome!
2. Question by Stacey
Hi,
My 2-year-old tod has 4 teeth.. thinks he's currently teething w some fever till 39*C.
What age should I bring him to see a dentist? Till he finishes growing all 10?
Read that low grade fever not to give panadol. Can I have a range for teething issues like this?
Answered by Dr Lai:
We recommend first dental visit by one year old. This is to equip parents with oral health knowledge and guidance for dental growth and development. We also hope to better inform parents with tooth decay prevention tips before tooth decay happens.
Studies have shown that teething is usually not associated with high fever, and that fever is a result of concurrent infections such as upper respiratory tract infections or other childhood illness. You should bring your child to see a paediatrician to rule out viral causes.
Teething is usually associated with drooling, irritability, tendency to chew, and child keeps putting his fingers into the mouth. You should bring your child for his first checkup and the dentist should cover all these topics in detail!
3. Question by Marwarni
Hi Doctor,
Based on the photo of my child's teeth (as shared), what is happening to my child’s teeth and how do I manage? Thanks.
Answered by Dr Lai:
From the limited view, it looks like your child may have tooth decay at the upper front teeth. This is not a definite diagnosis. You should bring your child for a proper consultation in a dental clinic.
4. Question by Sukhmander
Hi,
My 12-yr-old son does not believe in brushing his teeth in the morning once he wakes up as he says that he has already brushed in the night before he sleeps.
As he is not consuming anything throughout the night, there should not be a need to brush once he is awake in the morning.
Please revert this opinion. Also he is wearing braces just so you know.
Thanks.
Answered by Dr Lai:
Toothbrushing helps in caries prevention because of 2 factors:
1.Mechanical removal of substrates/food debris
2.Use of >1000ppm fluoridated toothpaste
It is not just the toothbrushing action that helps, but the use of toothpaste that can help to prevent tooth decay.
In fact, children on braces should brush diligently especially before sleep and after each meal. Intra-oral appliance can make it harder for him to keep his teeth clean. For his case, he should be brushing after each meal (e.g. after breakfast and lunch), and once at night before he sleeps. He should consider an adult fluoridated toothpaste and possibly fluoridated mouthwash. Please check with his orthodontist for more information.
Hope this helps!
5. Question by Ellie
Dear Dr Lai,
My questions as below:
1.With COVID-19, is it safe to bring a 14-month to dentist for his first visit or is it better to delay?
2.How to get a 14-month old into the routine of brushing teeth? How often to brush a day? When to introduce toothpaste?
Thank you.
Answered by Dr Lai:
1.We recommend the first dental visit by 1 year old so that we can pick up disease if there is, and to assess a child’s risk of getting decay. The Ministry of Health has established guidance for dental services during this COVID-19 period, in terms of patient scheduling and management and infection prevention and control measures. At NDCS, we have implemented various measures to ensure the safety of our patients and staff. Some of these include safe distancing measures throughout the whole centre, 15-minute intervals between each patient for proper disinfection of the operatories, and reduction of number of people in the clinic by limiting one accompanying person for each patient.
2.Children learn best by following a routine. You may consider establishing a bedtime routine e.g. book-brush-bed, or milk-brush-bed etc. For a 14-month-old, we recommend toothbrushing by an adult 2 times daily, including brushing after last night feed. A smear amount of fluoridated toothpaste is recommended when the first tooth erupts. Recommendation may differ depending on caries risk.
6. Question by Hazel
Hello Dr Bien, I would like to ask the following questions:
1.I have a 2-year-old toddler. He always get food stuck between his front bottom teeth. The gaps are not exceptionally wide. I am concerned that when his baby teeth drops and the adult teeth starts to grow, they will also have such gaps. Is there any way to make sure the adult teeth grow nicely, without the need for braces?
2.Is it okay to brush my toddler's teeth after dinner, but yet feed him milk before he sleeps?
3.I sometimes hear my son grinding his teeth when he is not eating, why does he do that? is there any way to stop him from doing it?
Answered by Dr Lai:
1.Baby teeth with gaps usually indicate that adult teeth will be well aligned. However, it also depends on growth of the jaw and size of the adult teeth, which cannot be determined or controlled. It is good for your child to see a dentist regularly, not just for routine check for tooth decay, but also for growth and development. If early intervention is needed, it can be given in a timely manner.
2.We recommend toothbrushing after last night feed, and no food/drinks after toothbrushing. Milk sugar can stay on teeth and potentially cause tooth decay. Do consider seeing your dentist for advice on how to wean off milk bottle or change the habit.
3.One in two children grinds teeth and most will grow out of it on their own when they reach mixed dentition. The cause is unknown in majority of cases, a small percentage is linked to other causes. Treatment is usually not warranted unless there is significant damage to teeth or muscles. Do bring him for a checkup at the dentist to rule out need for treatment or medical causes.
About Dr Bien Lai
Dr Bien Lai is Head and Senior Consultant of the Paediatric Dentistry Unit at National Dental Centre Singapore (NDCS), a member of the SingHealth group.
Because #healthiswealth #healthforgood
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