Teeth: they’re vitally important to our health and well being. If things are fine with our teeth we take them for granted. At times, when family life is busy, it can be easy to think, “Nah, the kids don’t need to clean their teeth every single morning and every single night, missing out from time to time won’t kill them.” While occasionally missing a cleaning session isn’t the end of the world (depending on exactly what your child has been eating), maintaining brushing as a regular habit, usually in the mornings after breakfast and in the evenings before bed, is vitally important. In the case of teeth, prevention is definitely better than cure and far less painful or costly. Starting regular, effective teeth cleaning early creates positive life time habits. As adults, we can role model these habits by caring for our own teeth. In our house we frequently all clean our teeth together and the kids like the song:
When you wake up in the morning
At quarter to six
And you’ve just had
A plate of Weetbix
You brush your teeth
Shh shh shh shh
Shh shh shh shh shh
You brush your teeth
Shh shh shh shh
Shh shh shh shh shh…
(For the full version of this song Google: “You brush your teeth”– there are lots of different versions out there. Our family like the “Weetbix” one, because that’s one of our breakfasts foods and it gives the song a bit of a kiwi feel. You could adapt the song to your own breakfast foods/ country/ culture).
I spoke with Esther Walker, a second year University of Otago Dental School Student about some of the issues (and misunderstandings) we parents have when caring for our children’s teeth.
Oral health care for babies, Walker says, should begin as soon as the first teeth begin to appear. A small very soft brush can be used with only a tiny sliver of toothpaste or, alternatively, even just getting a wet flannel and gently rubbing the teeth will help with exfoliation and clearing food remains. As they grow older most children will resist having their teeth cleaned by an adult, so encouraging them to watch us and making sure we have good brushing techniques ourselves is important. Walker says traditionally (perhaps because of wanting to “get the job done in a hurry”) lots of adults scrub their teeth hard and fast (I know I was guilty of doing this). Our kids tend to copy us and this quick, abrasive brushing, especially if done with a hard brush, can traumatise the gums and cause them to recede. The best method of brushing, Walker says, for adults or children, is the “rolling bass technique”: to brush with a rolling motion, flaring the bristles out, especially at the point where the teeth meet the gums. She says brushing gently in circles is more effective than hard, straight brush strokes. Cleaning plaque off the tongue is also important during a daily routine and Walker emphasises that for anyone of any age a soft brush is best. “The regularity and duration of teeth cleaning is important,” she says. “Although most children aren’t keen on having adults to clean their teeth for them, the kids still need to be supervised and encouraged to brush all their front, back, top, bottom, outer and inner teeth. If you haven’t had your brush for very long and the bristles are all splayed out, you’re scrubbing too hard. Fissures [deep recesses in the centre of the larger, back teeth, which are prone to decay] are common in children, so brushing along the tops of the side and back teeth, top and bottom, is very important.” Sometimes kids just can’t reach dental fissures with a toothbrush alone, so regular visits to a dentist, oral hygienist or dental therapist are essential. Dental professionals can also apply fissure seals where necessary. Dental visits are free in New Zealand for children under the age of eighteen years. Some children will be more nervous than others of “sitting in the chair”, so encouragement and praise are helpful. Younger children often feel reassured if a parent or caregiver sits the dental chair with them (I’ve done this before). Walker also recommends “GC Tooth Mousse” for rubbing over the top of back teeth where fissures are more likely to occur.
Mothers should care for their own teeth. During pregnancy the gums swell which can cause plaque issues, leading to gingivitis (inflamation of the gums) and peridontitis (inflammation of the tissue around the teeth, often causing shrinkage of the gums and loosening of the teeth).If a woman has gingivitis or peridontitis during pregnancy, it is more common for the child to get these same problems later on. Also, during the baby and early childhood years, such things as kissing and sharing spoons can pass gingivitis and peridontitis from mother to child. The most common cause of cavities, also known as “caries”, in very young children is “bed time bottling”. The worst culprit for this is juice. Milk, Walker says, is not so bad as it contains calcium. If this is combined with a prolonged lack of brushing and oral hygiene, things can turn very unpleasant inside the child’s mouth very quickly.
I’ve seen some kids’ teeth in a terrible state,” Walker says. “Neglecting to care for children’s teeth causes them a lot of discomfort and it can be hard to come back from severe neglect, even with hours spent in the dentist’s chair.” Some people mistakenly have the idea that the “milk teeth” or “baby teeth” are not so important, as they are later replaced by adult teeth. This combined with “old wives tales”, such as that it’s good for children to have a teaspoon of honey before bed, can lead to the importance of dental care for kids being overlooked. The results are issues with the adult teeth such as problems with spacing (teeth move more if the first teeth have been removed early) and, flowing on from this, increasing rates of orthodontic care. Good oral health is essential for children with diabetes as bacteria feeds off sugar producing acid which can then throw off blood sugar levels. This can be managed with the right dental care plan. Awareness is the key, Walker says, and this goes hand in hand with a regular brushing routine and eliminating bed time bottling.
Another issue, Walker says, is “Kiddie toothpaste” (you know, the ones with Dora or Spiderman or other popular children’s characters which younger children in particular are attracted to). These toothpastes are not recommended by dental professionals because they do not contain enough fluoride to be beneficial. “Anything with less fluoride than 1000 ppm (parts per million) is not going to help your kids maintain strong teeth,” Walker says. “It’s true that these toothpastes have cool characters on them and kids like the flavours. But the Colgate range of kids’ toothpastes, for example, contain only 0.76 ppm. When young children use “adult” toothpaste, they should use only a tiny amount, just a sliver on the brush. Those over ten can use a pea-sized dollop of toothpaste. Swallowing the toothpaste and water mix made in the mouth after cleaning is not bad for kids, so long as there’s not too much toothpaste. It’s not necessary to rinse teeth with water too much after cleaning as this can take away the fluoride coating protection provided by the toothpaste.”
It’s also interesting to note, here, that not everyone necessarily gets a full set of adult teeth. My husband still has his baby eye teeth and his father’s adult eye teeth never grew in either. In this case it is clearly hereditary– I already know that one of my sons has two adult teeth missing. If your child has Down Syndrome, they have a higher chance of not having all their adult teeth. Those “milk teeth” or “baby teeth” should not, then, be taken for granted.
As kids grow older, a good way Walker recommends of helping them take responsibility for their teeth is to use “plaque exposing tablets”. These are basically pink dye tablets which, after being sucked, stick to plaque in the mouth– you can get them from your dentist and they are a great way of showing kids (or anyone) the areas they are missing when they brush. Walker says plaque exposing tablets are also good for young people with braces and the pink comes off again easily with brushing (although the dye may cause your tongue to remain pink for a few hours afterwards). We tried plaque exposing tablets at home and my children thought it was fun and interesting. Just a word of warning though: my youngest two kept sticking their fingers in their mouths while they were still sucking the tablet and ended up with bright pink finger tips too.
Oral hygiene continues to be important as children move into their teens. For those who have braces, it is important to be aware that food and plaque are even more prone to get around the wires and hooks in the mouth. Walker says that “Superfloss” is a good product, as are “flossettes”. Both products are available at the Supermarket, are reasonably priced, and allow a closer clean (especially around orthodontic work) than ordinary floss.
As mentioned earlier, we adults should continue positive oral health habits and regular check ups for our own sake, but also to role model the importance of caring for teeth throughout life to our children. Let’s keep those chompers cheerful and those smiles beautiful.
Thanks to Esther Walker, 2nd year student at Otago University School of Dentistry for agreeing to be interviewed for this article.