By Olivia Miwil
Pictures courtesy of Patrick Tie.
Chan Jui Yan, 67, was shocked when a dentist told her granddaughter had to be put under anaesthesia for multiple teeth extractions.
The two-year-old kid had cried in pain for several days before the grandmother brought her to paediatric clinic and had been referred to dental clinic.
“The thought of having her going through surgery at such young age was frightening as there are always risks in that.
“Luckily she pulled through from the surgery, and it gave great lesson to us to look after more of her dental hygiene practices after that,” she said.
The grandmother from Kuching in Sarawak, who takes care of the child when her parents working, said she skipped tooth brushing, allowed toddler to drink milk to sleep and eat sweet things.
Chan had been advised by dental nurses on the importance of oral cares but she thought they were unnecessary as children will eventually lose their baby teeth.
General anaesthesia is also indicated for other complex dental procedures such as children allergic to local anaesthesia, moderately traumatic or complex extractions, biopsy of a hard or soft tissue lesion or debridement and suturing of orofacial wounds.
Doctor of Dental Surgery Dr Patrick Tie, who had five years of working experience in government and running a private clinic in Kuching, said it was common among parents and caregivers not to take seriously in caring for the primary teeth for its short life span.
The set of 20 milk teeth, with the first erupts when baby is about six-month-old or earlier, will be replaced with permanent teeth when children reach six-year-old.
Tie added the transition or mixed dentition period was crucial as early oral care could prevent bacterial infection which would affect children’s development.
“Childhood caries lead to toothache causes loss of appetite among children and disrupt their daily activities.
“Besides that, some of them will have low self-esteem due to dental caries (which will affect their appearance among peer),” he said.
Research indicate early tooth loss caused by dental decay has been associated with lower body weight, impaired speech development, absence from and inability to concentrate at school.
Unhealthy milk teeth will also cause another problem to the permanent teeth in life later known as “crowding”, a condition which space is limited for all teeth to be fitted within the jaws. Teeth might be rotated or displaced.
The condition occurs with early or late loss of primary teeth, improper eruption or a genetic imbalance between jaw and tooth size.
Crowding has to be corrected as the structure causes inadequate cleaning of all the surfaces of teeth.
Tie added that good oral hygiene is a habit or life pattern that should be developed since young. Parents and caregivers have to lead by examples so the kids will adapt the good practices.
“Once the baby start teething around three to six months, massage their gum and clean the residual milk.
“Start dental visit at around that time to develop good rapport with the dentist, early treatment for problem tooth, and to monitor oral hygiene status,” he explained.
The first visit will have fluoride applied to erupted teeth and parents will be given advice on oral care and food intakes. It is recommended to schedule next appointment within six months.
Parents can use any suitable sizes brush for their children’s teeth but it is important to pay attention on the brushing techniques, duration and frequency.
He suggested Bass technique with a brush placed at 45 degree angle to the teeth and gum line, and make gentle, back and forth strokes along the gum line. Reposition to other spot after making several strokes on same group of teeth.
For the inner surface of front teeth, tilt the brush vertically and use its front half brush and make the up and down strokes to clean the area. The biting surface has to have brush against them and to be scrubbed with back and forth motion. Lastly, brush the tongue from back to front.
Stillman method uses the same stroke of Bass's except the placement of the bristles move towards the root of the teeth and in contact with gum.
A pea-sized non-fluoride toothpaste can be introduced to children below age of six, while baby can omit it.
Ideally every brushing should takes place between two to four minutes for every session. It is also recommended to clean the mouth two to three times per day especially before sleep.
“Thumb sucking, tongue thrusting and nails biting should be monitored and stopped as both may interfere teeth development and alignment.
“Prevent them from eating too much cariogenic food including grains, fruit and diary, as well as products with added sugars could also save the teeth,” he added.
Other habit that adults should avoid is not to share drinking straw and utensils with children as it will pass oral bacteria to them.
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