Tooth decay is one of the most common diseases in children. In Malaysia, up to 73% of pre-school children experience dental caries and some even have bottle or nursing caries. However, tooth decay is largely preventable with good oral habits, low cariogenic diet and awareness of good oral habits in the very people who care for them.
The Malay have a saying; ‘Melentur buluh biar dari rebungnya’ which means to inculcate good habits we would need to start from young. Children need guidance and parents, be it the mother, father or their guardian play an integral role in shaping, guiding and supporting these good habits.
Oral care for infants and toddlers (0-5 years old)
Parents should understand that it is their role to help clean their children’s teeth and set aside time to do so. Children at this age do not have the manual dexterity or the understanding required to brush their teeth and require the help of the parents to do so. This also allows the child to familiarize himself with having his teeth cleaned as part of a daily routine.
Figure 1: Finger toothbrush
Figure 2: Baby toothbrush
The majority of babies are born without teeth, however cleaning is recommended to remove milk remnants from the tongue and gums. This is done with the use of a clean gauze or cloth wrapped around the forefinger. Mothers’ can also use finger toothbrushes which are widely sold in baby shops and departmental stores (Figure 1). There is no need for any toothpaste yet at this stage. It would be easier to clean babies’ teeth if their head is cradled in mother’s arms in front of you. As more teeth appear, a baby toothbrush would be needed (Figure 2). When children are older they would still require tooth brushing under supervision. Generally a children’s toothpaste can be introduced between 2-3 years of age. Mothers’ should assume the responsibility of placing a smear of toothpaste onto the bristles as over ingestion of fluoride toothpaste may cause fluorosis in permanent teeth.
Mothers’ should also schedule a visit to the dentist when their first tooth erupts between the ages of 6 months to one year. This allows the child to familiarize themselves with having their teeth checked on a regular basis.
Good feeding practices are also important to ward off dental decay. Mothers’ should avoid rewarding or bribing children with sugar so that children do not get a taste for sweet foods. If a bottle of milk or beverage is necessary before bedtime, caregivers should ensure that children are not put to bed with a bottle. If children are using pacifiers, the pacifiers must never be dipped in sugar.
Oral care for pre-school children (5-7 years old)
Children at this age often experience the loss of a primary front tooth or the eruption of a first molar. If these children have acquired a taste for sweet foods and are consuming them on a regular basis, it places these permanent teeth at risk of dental decay. Hence, mothers’ should reduce the availability of sugary snacks at home by not purchasing these types of foods, and instead replace them with “tooth friendly” foods like nuts, rice crackers and fruit.
Many mothers at this stage assume that their children are able to brush their teeth independently. However, mothers should still help as food debris removal may not be as effective. As tooth brushing is done twice a day, once in the morning and once at night, caregivers may help with nightly tooth brushing and allow independent tooth brushing in the morning. This allows the mothers to monitor their children’s efficacy in tooth brushing and also set the tone for independent brushing as the child becomes older.
Oral care products at this stage would still be childrens’ toothbrushes (Figure 3), however the type of toothpaste used may differ according to the child’s dentist’s recommendation.
In conclusion, although dental decay is common; it is overall a preventable disease in children. Children at their young age are not equipped with the manual dexterity, knowledge and awareness required to take care of their teeth by themselves and require the guiding hand of his/her mother to achieve good oral health.
|Last Reviewed||:||23 August 2019|
|Writer||:||Dr. Leslie S. Geoffrey|
|Accreditor||:||Dr. Savithri a/p Vengadasalam|
|Reviewer||:||Dr. Sharol Lail bin Sujak|