Hands up all those of you who remember shuddering when as a child you heard the dreaded word ‘dentist’? Remember sitting, terrified, in the waiting room as you listened to the high-pitch wail of the drill, knowing that any second your name would be called by the white-coated person who was going to put you through agony?
Well, the good news is that era has passed. Gone are the intimidating dental chairs, now replaced with child-friendly flat-bed suites and high-tech glasses or TV monitors playing Disney films for children to watch while painless treatments are carried out to stop their teeth ever decaying.
There is more good news. Today, kids are far less likely to need a tooth taken out or even filled, if they follow good dental guidelines. And if they do need treatment, it hardly hurts at all (and is much quieter!).
Friday dental expert Dr Joy Antony, who has four practices in Dubai, firmly believes in the adage ‘prevention is better than cure’. ‘It’s important that children be taught good oral habits from an early age,’ he says.
‘A regular dental check-up twice a year and a balanced diet free from as much sugar as possible is the best way to good oral health. With more advanced treatments available for dental diseases, the longevity of teeth has increased, extractions are less common and oral health is easy to follow.’
So just how do we make sure our children achieve – and retain – those gleaming pearly whites?
Dr Anila Virani, Specialist Paediatric dentist at Dr Joy Dental Clinic, Jumeirah, Dubai, recommends starting correct brushing techniques from the moment a baby’s first tooth arrives. You can do this initially with a special baby toothbrush with a smear of fluoridated toothpaste (modern ones that fit over your finger to clean just one tooth are available.) Parents should continue supervising brushing until their child is five years old, ensuring that they brush in the morning and evening with a pea-sized amount of fluoride toothpaste. Kids dental floss is now available with handles making them easier to use.
She recommends the child have a consultation with a paediatric dentist when the first tooth appears (between six and 12 months of age). This creates a sense of familiarity with the dentist.
With an estimated one in seven children worldwide requiring some kind of dental intervention, oral health care for children needs to be taken seriously. A common misconception is that children’s milk teeth do not matter as they are temporary. In fact, it is very important that the primary teeth be taken care of as infections and early loss of primary teeth can affect the eruption and development of the permanent teeth.
Today, a range of ultra-modern gadgets and dental equipment are available to make treatment a pleasurable experience:
Dental Lasers: The dreaded dental drill has been replaced by modern hi-tech dental lasers to treat decay. ‘Unlike the shrill whine of the drill, the lasers produce only a popping sound and there is no vibration so the procedure is much better than before’ says Dr Antony. In many cases even a local anaesthetic may not be needed.
Wand STA (Computer Controlled Local Anaesthetic Device): Every child’s nightmare – the dentist’s needle to numb the jaw – has been replaced. Instead of the needle is a stylus-like device that does the job virtually painlessly. Also, it numbs only the tooth for which treatment is required.
Nitrous Oxide Sedation: If your child is very anxious, you can request for a nitrous oxide sedation administered through a mask, which will calm kids and make them more cooperative. In case a child is extremely anxious and uncooperative, intravenous sedation can be given by a trained anaesthetist.
However, if kids do need some dental work, here’s the modern way of treating the three top dental problems in childhood…
What it is: Most infants and children suck their thumb. However, if this habit continues after the age of four, it causes the upper teeth and jaw to move forward, giving a bucktooth look. Even their lips moves outward to cover those teeth. The condition can cause children to mispronounce certain words. There is an increased risk of damaging the front teeth.
How it can be prevented/corrected: Educate the child or use reminders taped on the fingers. If these fail, a habit-breaking appliance may have to be inserted. Such devices, known as cribs, are wire arches soldered to bands on the teeth. They sit behind the teeth out of sight but form a barrier to the child’s thumb being inserted.
If the habit is not controlled then it can cause a permanent deformation of the bone and may require more extensive treatment using braces later.
Early childhood caries
What it is: Early childhood caries (ECC), also known as bottle rot, is a disease characterised by severe extensive decay in the teeth of infants or young children from consumption of juice, milk (including formula) and carbonated drinks from a bottle before going to sleep. Oral bacteria convert the sugars remaining in the mouth to acids that attack the teeth.
How it can be prevented/corrected: Parents shouldn’t nurse children to sleep or let them drink anything other than water in their bedtime bottle. Train older children to have a balanced diet. Avoid giving them snacks between meals or food with sugar and starches, especially if these are sticky, like toffees and rich milk sweets.
Preventive treatments such as fluoride therapy, applying fluoride directly on to the surface of the tooth via a gel, paste or varnish by the dentist, can also help.
Another option is pit and fissure sealants. They are resins that are bonded on to the back teeth in a painless and quick procedure and stops food getting stuck in the little grooves and pits in the rear molars.
If decay is present, then the tooth would have to be restored by a dentist using a composite resin. Unlike in the past, unsightly amalgam restorations are no longer used. Composite resins mimic the tooth so well that it is difficult to tell it apart. Similar modern colourings are now available for crowns, replacing the distinctive metallic coverings of the past.
In cases where the decay affects the pulp of a child’s tooth, pulp therapy and root canal treatment may be required to save the tooth. This involves removing a portion of the pulp or the entire pulp and filling the root so that the infection is resolved and the tooth can remain in the mouth until the permanent teeth erupts. Early loss of the milk teeth can cause drifting of the neighbouring teeth into that space, thereby preventing eruption of the permanent teeth in the correct position.
If the tooth has to be extracted early, a space maintainer – a band on the neighbouring teeth with a wire soldered to it – is fixed to hold the space for the erupting permanent teeth.
Crookedness, crowding, gaps and overbites
What it is: Crowded or crooked teeth are seen where there is not enough space in the jaw to accommodate all the teeth. Apart from being unaesthetic, crowding makes it harder to maintain good oral hygiene.
How it can be prevented/corrected: Abnormal development of the teeth and jaw can affect the shape of the face and should be correctly diagnosed and treated by a paediatric dentist or orthodontist at the earliest opportunity. According to Dr Joy, there is now a range of modern braces available so your child doesn’t necessarily have to wear the traditional ‘railway tracks.’
Lingual or incognito braces are hidden from view as they are fixed behind the teeth. Clear aligners, such as the popular Invisalign, have revolutionised orthodontics, particularly for the image-conscious teenager. Apart from being almost invisible, there are no diet restrictions and oral health maintenance is much more easier, since it is removable.
When a patient begins Invisalign treatment, they wear each set of custom-made plastic ‘trays’ or aligners in two-week periods. As they progress through the series of aligners, the teeth begin moving little by little towards the projected final position. Each aligner is custom-made for a precise and comfortable fit. After the treatment, retainers are given to maintain teeth in the corrected position.