Child’s first dental visit - “Get It Done In Year One”

When should you take your child to the dentist for the first time?

The answer is "First visit by first birthday." Surprising?

The child’s first dental visit and oral examination should take place by at least 1 year of age even if there are no dental problems at this age. This “well baby check” enables the dentist and the parents to discuss ways to nurture excellent oral health before any serious problems have had an opportunity to develop. Subsequently, regular check ups should be carried out every 6 months or as suggested by the dentist.

Why so early?

How does the dentist check my little baby? Will my baby allow for check up?

The baby’s check up is done in parent’s presence by taking parent’s help to hold the baby. This not only helps to control the baby’s movements but also gives emotional support to the baby. It is very common and normal for the babies to cry and even be resistant at the first appointment.

Though here is little or no effective communication between the dentist and the child, the child realizes that nothing “bad” happened; and the procedure was permitted by parents themselves. Thus crying and resistance improves over a period as the child grows up and these regular dental check ups contribute in making your child absolutely free of “fear of the dentist”!

What all information you will receive in the initial dental visits of your child?

So gift your baby a healthy smile on his/her first birthday by starting regular dental visits! It is never too early! Neither is it too late to start if your child is already more than 1 year old!

Believe in speciality?

Now you have an option of taking your child to a “Pediatric Dentist” who is specially trained for dental care of children…just as you have a “Pediatrician” who is a specialist in medical care of children!

Know more about Pediatric Dentistry in the next post!

TEETHING

What is teething?

Your baby is teething when his or her first set of milk teeth break through the gums.

When does teething typically start?

Teething usually begins around 6 months of age. The lower front teeth usually come in first. Upper front teeth usually come in 1 to 2 months after the lower front teeth. Parents start to worry if the first teeth are not seen around 6 to 8 months; but it is normal for teething to start at any time between 3 months and 12 months of age.

 

What are the symptoms?

Some babies are fussier than usual when they are teething. This may be because of soreness and swelling in the gums before a tooth comes through.

Teething symptoms may begin about 3 to 5 days before a tooth breaks the skin. But symptoms can be present off and on for 1 to 2 months. They disappear as soon as the tooth breaks the gums. Many babies don't seem to be affected by teething. The most common symptoms of teething include:

• Swelling, tenderness, or discomfort in the gums at the site of the erupting tooth.
• Increased saliva, which can cause drooling. Drooling may cause a rash on the chin, face, or chest.
• Biting on fingers or toys to try to relieve the gum discomfort.
• Refusing to eat and drink because of mouth soreness.
• Irritability and difficulty sleeping.

Mild symptoms that get better usually are nothing to worry about. Call your dentist if your baby's symptoms are severe or don't get better.

Diarrhea and fever during teething???

The common perception is that teething babies and children experience a slight rise in temperature and even diarrhea. However, teething process itself is not related to diarrhea. Because the babies keep on biting fingers or any objects that may be unhygienic, it is the gastrointestinal infection that actually leads to fever and loose motions. The child’s physician or pediatrician needs to be contacted for persistent complaints.

How can you help your baby be more comfortable while teething?

Give your baby cold teething rings to chew on to relieve teething discomfort

Here are some tips to help your baby feel better while teething:

Teething rings

• Use a clean finger (or cold teething ring) to gently rub your baby's gum for about 2 minutes at a time. Many babies find this soothing, although they may protest at first. 
• Provide safe objects for your baby to chew on, such as cold teething rings. 
• Do not use over-the-counter (medicines bought without doctor’s prescription) pain reliever either syrups or gels as they are not safe. Their excessive swallowing by the baby may cause overdose and toxicity. If you want to try these products, talk to your doctor about which types are safe and how often to use them. 

 

Eruption and shedding time table of milk teeth

The four front teeth—two upper and two lower—usually erupt first, beginning as early as six months after birth. Most children have a full set of 20 primary teeth by the time they are 3 years old. The child’s jaws continue to grow, making room for the permanent (adult) teeth that will begin to erupt at about age 6 years. Primary teeth begin to shed between ages 6 and 7 years. This process continues until about age 12 years.

 

“Gaps” between milk teeth is a normal feature and it allows accommodation of large size of permanent teeth that will erupt later. 

           

TOOTHBRUSHING TECHNIQUES FOR DIFFERENT AGE GROUPS OF CHILDREN

The basic premise of any good habit is that it should be cultivated at an early age. In the same way oral hygiene for children should begin immediately after birth and should be a part of overall hygiene. In the initial years, it is of course the parent’s are responsibility. Even though more and more participation on the children’s part can be expected as they start growing, it is necessary that the parents are involved to some level for each age group. Positioning of parents and child should also vary according to the child’s age. 

INFANTS (0 TO 1 YEAR OLD)

• Needless to mention, it is totally the parent’s  job.
• Start cleaning baby’s gums and tongue with soft wet piece of clean cloth even before eruption of teeth. 
• Start tooth brushing as soon as the first tooth is visible using soft, infant-sized toothbrush / finger brush.

Toothpaste: not necessary (as baby may not like it and is not able to rinse)

Position: cradling the child with one hand and massaging the teeth with the other hand

"smear" of  toothpaste

TODDLERS (1 TO 3 YEARS OLD)

• Most toddlers enjoy imitating their parents; will readily practice brushing teeth on their own and may even be resistant to allow anyone else to do the brushing.
• Although children should be encouraged to begin this rudimentary brushing, adequate cleaning is not accomplished by them. Hence parents still play the main role in thoroughly brushing all the areas of mouth.   

Toothpaste: minimal; only a “smear” (thin layer) on the brush    

"Knee to Knee" position for toddlers

Position: important as many children are resistant for brushing by parents

“Knee to Knee” Position:

• Two adults sit facing each other with knees touching
• Rest the child on the laps
• One adult holds the child’s legs and arms; the other performs brushing

PRESCHOOLERS (3 TO 6 YEARS OLD)

·         Though there is significant improvement in the child’s ability to manipulate the toothbrush, parent’s still have to continue brushing their child’s teeth. (Even if they feel that the child can now brush on his/her own).

Toothpaste: still very less; only a pea sized amount

Position:

• Position yourself behind the child
• Tilt the child’s head up
• Cradle the child’s head in your arm to provide support
• Use your free hand to pull back the lip or cheek

(Do not stand in front of child as it does not provide support to child’s head)

SCHOOL-AGED CHILDREN (6 TO 12 YEARS OLD)

• Children can assume more responsibility of oral hygiene (just like homework and household chores)
• Parents involvement still needed; but they can switch to “active supervision” than performing brushing for child
• Actively inspect for cleanliness in all areas of mouth; help the child brushing in certain “difficult-to-reach areas” of mouth like back teeth

ADOLESCENTS (12 TO 19 YEARS OLD)

• Difficult stage!
• They have developed the skills for adequate oral hygiene
• But, their compliance problem, poor dietary habits and pubertal hormonal changes increase risk of dental cavities in this age group

How to deal with the problem???

• Stress their increased responsibility as young adults without appearing authoritarian
• Be ready to adapt to their child’s changing personality and continue to reinforce the need for good oral hygiene
• Increasing their awareness about dental problems as well as appealing to their “appearance” can help in motivating these children

How many times? When?

• At least two times every day
• Brushing at night before bedtime is most important as the process of cavities formation is very fast during sleep hours
• Brush after eating than before it; e.g. after breakfast than immediately after awakening

(This would not only help to remove the food particles from tooth surfaces, but also allow the fluoride in the toothpaste to exert its protective action on the teeth more efficiently)

Is brushing still a battle?

Here are some ways to make brushing more of fun and less of a battle!

Begin early: If started soon after birth, it becomes a habit or a part of routine for the babies and they enjoy it!

You are your child’s role model: So if you brush with them, they will definitely follow you!

Make it a challenge: If you put it as a challenge or task to be achieved and promise reward at the end of achieving it, children will readily take it up as the sense of accomplishment means a lot to them!

So, make a weekly chart for brushing and give a reward to the child on Sunday only if the chart is filled fully!  

Last and the most important - Do not use “taking to the dentist” as a threat if your child does not brush! This will put a negative impact on the child’s mind about dentistry and will make dental treatment difficult if required any time!

Children’s psychology is changing continuously at every age. So just understanding the child’s mind and changing yourself according to child’s age would help achieve the task!