Brushing Teeth, a Wonderful Habit To Give Your Children

Brushing your babies' teeth can be quite a stressful ritual. Babies are restless and don't understand why their mothers would want to force open their mouths and insert an object like a brush, that is not just uncomfortable, but oftentimes painful.

As much as parent's may delay this or procrastinate in the hopes of getting children to be more accepting of brushing teeth when they are older, it actually works in the reverse. The older the child gets, the more difficult it is for him/her to make brushing a regular part of their routine. Truth is, the results cannot be observed immediately, and most often children find brushing unnecessary and a chore even when they are older.

Caring for your babies' teeth should begin as soon as they start to appear. Parents are also the best people to lead the way when it comes to teaching kids this important skill.

Teeth are the most vulnerable part of the mouth, do a whole lot of work....masticating, gnashing, biting, chewing, and also have to weather acids from foods that are constantly fed into the mouth. Looking after them must begin when they start to erupt. It's alright if teeth can't be brushed from the start. What matters, is introducing this habit as a part of their daily routine. Start by showing them that brushing is what you do each day, everyday and its the best example you could give.

 In addition to the above,

• Use just a little dab of paste on the finger for babies, and little more than a pea-sized amount for toddlers
• Start with light brushing, and then a little thoroughly, brushing all along the tooth sides and surfaces, twice a day, after waking up and before bedtime.
• Don't turn teeth brushing into a war, pushing and shoving, yelling and fighting which usually happens. Some children take a long while to get used to it. Make this a game, brush yours first and ask them to follow suit, or sing a little rhyme when you do.
• Place your baby in a way that both of you are comfortable. Sit them on your knee and head on your chest and clasp their chin. For older children, stand behind them and tilt their heads upwards.
• Use small circular movements when brushing teeth. This covers all the tooth surfaces, and your child can spit out the paste when they're done. Flouride free toothpastes are better to use when smaller, since kids tend to swallow them otherwise. 

• For babies, it is also important to lightly massage their gums, especially when teething. This can be done after brushing their teeth.
• Teeth brushing is a practiced art which parents need to guide their child on, till they reach an age where they can do it on their own. It has been seen that by age 5-7 years, children are able to do a great job of brushing their teeth.
• The most important aspect of introducing brushing and helping the child take care of their teeth, is the involvement of a pediatric dentist in the entire process. A dentist is not just required to fix things after the teeth are gone bad/caried, but must be a part of the process from the beginning. A regular teeth checkup will ensure that any irregularities, caries, congenital and developmental disorders of the teeth and mouth are looked into at the earliest and treated. This must ideally begin around the age of one year.

This video, explains the act of brushing teeth, and can be shown to your child to make them understand better.

Teeth brushing is as important as eating food, and teeth disorders are linked to various other health and body disorders which can strike later in life. A healthy and regular brushing schedule when started young, will lay the foundation for strong teeth that will last your children for the rest of their life.

Why choose a Paediatric Dentist?

It's time to take your child to visit the dentist. 

Do they really need to see a different dentist than you? 

How do you choose the best dentist for your child?

What is a Paediatric Dentist?

Paediatric dentists, sometimes called pedodontists, are the paediatricians of dentistry. They specialise in dental care for children, from babies up teenagers. Paediatric dentists have done two or more years of training specifically in children's dentistry after completing their dental degree.

How are they different from other dentists?

Paediatric dentists treat only children and so their practices are designed to be a welcoming and child friendly. They have a lot of experience in working with children who are anxious and can spend extra time to reassure them  and explain things in a way kids can understand. During their training, paediatric dentists study developmental psychology to understand how children think differently from adults. They also receive training in working with individuals with special needs.

Paediatric dentists are experts in monitoring dental development as children grow and mature. Therefore they are more easily able to spot potential problems which may require early orthodontic treatment. 

Due to their training and experience pedodontists are proficient in the latest techniques and procedures for children's dentistry.

Paediatric dentists tend to emphasis prevention of dental diseases. They recognise the importance of giving children a good start by helping them to develop healthy habits such as tooth brushing and a good diet early in life. They can also offer treatments that can help to prevent dental decay such as fissure sealants. 

Why choose a Paediatric Dentist?

A child's early dental experiences have a lasting impact. Positive experiences will lead to a child becoming comfortable in visiting the dentist and motivated to look after their teeth. Dentists tend to have an area of dentistry which they enjoy and specialise in. Why not choose a dentist who has the motivation, training and experience to give your child the best care?

The Small Bites Experience

Small Bites is the first exclusive dental centre for children in Bangalore. The Small Bites team offers the full range of dental care in a fun and child-friendly environment. Our little clients soon feel at home with the inviting waiting area and fun décor. 

We take time to understand and reassure children, especially those who are anxious or have special needs. Pain management is a priority, so that children can feel comfortable and relaxed.

Children can even watch cartoons to help distract them and put them at ease during their dental treatment.

At Small Bites, we are always keeping up to date, using the latest materials and techniques to provide high quality care. We follow strict standards in sterilization and cleanliness. We are the first dental clinic in Bangalore to offer stem cell banking from baby teeth and nitrous oxide sedation.

At Small Bites (click for link to website) we firmly believe that, working together with children and their parents, we can give children healthy smiles to last a life time. 

Fillings for baby teeth

Maybe you have just found out that your child has one or more cavities in their baby teeth?

It is normal for parents to have concerns and questions. 

In this blog, we hope to give some answers and reassurance about fillings for baby teeth.


Children can develop tooth decay soon after their baby teeth come through. Prolonged bottle feeding with sweetened drinks, or frequently falling asleep with a bottle of milk or whilst nursing are the most common causes of decay in babies. Cavities usually do not cause pain in the early stages and young children may be reluctant to open wide to let their parents see or brush their teeth. So, it can come as a surprise to find out that your child has a cavity at a young age. 

Why should we fill baby teeth, won't they fall out later anyway?




Baby teeth are important for normal eating and speech development. A healthy smile is also beneficial for a child's self-esteem once they reach school age. 





Once a cavity has formed it usually progresses resulting in pain and infection. If an abscess on a baby tooth is not properly treated the infection can spread to and affect the developing adult tooth underneath.



Baby teeth also maintain the spaces for permanent teeth to erupt into. Although front baby teeth can start to fall out from around 6 years old, the back teeth need to last until around 12 years old. If baby teeth are lost too early other teeth may tilt or drift into the vacant space, forcing the adult teeth to come through crooked. 

If my child has a cavity what are the treatment options?

Fillings

If the decay is in the enamel or dentine layer only (not close to the nerve of the tooth) the decay can be removed and a filling placed in the cavity. 

Basic procedure:

• Smaller cavities in baby teeth can often be cleaned without using local anaesthetic. If the cavity is deep or the tooth is particularly sensitive, a small injection may be required to numb the tooth. For more information, see this blog post: Questions about local anaesthetic
• The decay is removed and the cavity is washed. There will be some mild vibrations and noise at this stage. A suction tip is used to remove water from the mouth, or your child may spit out when required. 
• The clean cavity is dried by blowing air onto it and then the filling is placed.

At Small Bites, we keep up to date with the latest filling materials and techniques. The two most commonly used filling materials for children’s teeth are:

Glass Ionomer Cement  

• Bonds directly to the tooth surface and so helps prevents leakage around the edge of the filling.
• Releases fluoride which can help prevent further decay.
• It is relatively quick and easy to place and is therefore popular for use with young children where cooperation for treatment is sometimes difficult.
• It  is quite brittle and prone to wear and so it is usually used in areas which are not under a lot of pressure from chewing.
• Reinforced Glass Ionomers have recently been developed which can be used in higher stress areas, such as the biting surfaces of the teeth.
• Glass Ionomer is white in colour but, unlike composite, it does not come in various shades to match the teeth more accurately. It also available in other bright colours for use in back teeth, if children prefer this.

Composite filling

• Composite fillings come in many shades which match and blend in well with the tooth. Therefore, it may be advised for front teeth where appearance is important.
• Composite is stronger and more wear resistant then glass ionomer.

• A blue etching gel, used to prepare the cavity surface, is painted onto the cavity surface and washed off after about 30 seconds. 
• A bonding agent painted onto the cavity surfaces. This adheres the filling material to the tooth.
• Next, the filling is placed in the cavity.
• A blue light is often used to give faster setting of the filling.
• The filling procedure takes a bit longer than for glass ionomer.

Your dentist will check the filling, and polish it, if required. Please follow instructions for looking after your teeth following treatment. It is usually advisable to wait half an hour before eating and drinking and to avoid hard, sticky and chewy foods on the same day. 

Pulpectomy

If the decay has started to affect the area containing the nerve of the tooth (the pulp), a pulpectomy is often required. For more information, see this link: Pulpectomy - Root canal treatment for baby teeth

Crowns

Teeth which are too broken down to adequately hold a filling or which have undergone pulpectomy usually require a crown to strengthen the tooth. This will be covered in a future post.

At Small Bites, the exclusive dental care centre for children in Bangalore, we have plenty of experience with young children and work to put them (and their parents!) at ease. If you have any questions or concerns, please contact us.



Don't forget to read our other posts for advice on preventing dental decay:

It's Never to Early to Start Preventing Tooth Decay
What Causes Dental Cavities?
Top Toothbrushing Tips

Stem Cell Banking from Teeth

Many people are familiar with stem-cell banking from the umbilical cord at birth. Did you know that it is also possible to bank stem-cells bank from baby teeth and young, healthy adult teeth? This recent technology has great potential to enable treatment of diseases and aid healing and repair using an individual’s own stem cells in future years.

What are Stem Cells?

Stem Cells are the “master cells” of the body which have the potential to differentiate into various types of cell, depending on the part of the body. They are also able to self-regenerate or multiply.

There are two main types of human stem cells:

Embryonic Stem Cells are obtained from early embryos. They have the potential to become any type of cell in body. The embryos are usually donated as extra embryos following IVF treatment. However, their use is controversial as collection of the stem cells results in the destruction of the embryo.

Adult Stem Cells are found in various parts of the body. They have the potential to become various types of cells. Bone marrow, umbilical cord blood and dental pulp tissue are good sources of adult stem cells.

      What are the advantages of Dental Pulp Stem Cells?

    Stem cells from teeth are mesenchymal stem cells which have the potential to become many different types of cells in the body.

Dental stem cells are easily collected by extracting the tooth and are found in high concentrations within the tooth pulp.

There are no ethical issues, since the stem cells are harvested from teeth that would fall out naturally or are to be extracted for other reasons.

I have already banked stem cells from my child’s cord blood. Why should I also consider banking dental stem cells?

Banking dental stem cells is complimentary to cord blood banking. The stem cells obtained from the umbilical cord are hematopoietic stem cells which are able to differentiate into all types of blood cells to treat blood diseases. The stem cells from the dental pulp have a much wider range of potential therapeutic uses.

In what treatments are stem cells already being used?

The use of haematopoietic stem cells to treat diseases and conditions of the blood system, such as leukaemia and anaemia, is well established. This demonstrates how powerful stem cell therapies can be. Scientists all over the world are currently researching ways to harness other types of stem cells and use them to learn more about, to diagnose, and to treat various diseases and conditions.

What diseases can potentially be treated using stem cell therapy?

Research has shown that adult stem cells can be taken from one area of the body, transplanted into another area and reprogrammed to grow into a completely different type of tissue. 

Stem cell science is continually moving forward. 

Many potential treatments are currently being tested in animal models and some have already been brought to clinical trials:

•  Type 1 (insulin dependent) diabetes
•  Treatment of spinal cord injuries
•   Neurological diseases e.g. Parkinson’s disease
• Heart disease
• Regeneration of bone, cartilage and other tissues
• Treatment of Autoimmune diseases

Which teeth can be used for stem cell banking?

Baby (milk) teeth

These should be extracted and sent for stem cell banking soon before they are due to fall out.

Healthy adult teeth

When extraction is planned to make space before orthodontic treatment.

Wisdom teeth

These are often extracted due to lack of space.


Teeth with decay are not suitable for stem cell banking.

Teeth from children and young adults usually give a better quality and quantity of stem cells than older teeth.

At Small Bites -  the exclusive dental care centre for children in Indiranagar, Bangalore - we have partnered with Stemade to offer stem-cell banking from baby teeth and young, healthy adult teeth. 

If you have any further questions please contact the practice. (Click Small Bites link above).

Further information is also available on Stemade’s website (click for link).

At what age should children see an orthodontist?

I am concerned about the way my child's teeth are coming through but they still have some baby teeth. Is it too early to see an orthodontist?

Many people have the opinion that it is not worth visiting an orthodontist before all the baby teeth have fallen out. This is because, the traditional fixed (train-track type) braces can only be used for adult teeth. 

However, there are situations where it is better to see an orthodontist earlier. 

The adult teeth start coming through from around 6 years old and if there are any concerns an orthodontic assessment can be done between the age of 7-9 years.

For some orthodontic problems treatment can be started before all the adult teeth have come through.

Which orthodontic problems may be suitable for early diagnosis and treatment?

• Baby teeth removed early - other teeth may tilt into or take up the vacant space, causing the permanent teeth to come through crooked. Using a space maintainer can prevent more complicated and costly treatment later on.

• Protruding front teeth - which can be prone to accidental injury.

• Open bites - teeth not meeting when biting together.

Upper incisor tooth in "cross-bite" behind lower incisor

• Cross bites - upper teeth coming through behind the lower teeth.

• Difficulty in biting or chewing.

• Growth discrepancies of the jaws and/or teeth out of proportion.

• Some cases of crowding - not enough space for all the adult teeth.

• Missing teeth - sometimes teeth are absent from birth (they just do not grow). An x-ray would be needed to confirm the tooth or teeth are missing. A decision can be made to either close the space or maintain the space for dental implants later.

• Adult teeth under the gum that do not come through within the normal age range - the cause can be investigated and treated. 

• Large gap between the upper front teeth (diastema) - investigation and treatment is often more successful if done earlier.

• Asymmetrical smile

• Persistent thumb or finger-sucking habits - see previous blog for more information. 

What are the goals of early orthodontic intervention?

• Make room for permanent teeth to come through and guide them into the correct position.
• In the case of jaws which are out of proportion, functional appliances can guide the growth of the jaws and correct certain bite problems.
• For simpler problems, later orthodontic treatment may be avoided.
• Potentially simplify and shorten later comprehensive orthodontic treatment  for more complex cases.
• Improve personal appearance and self esteem.

If you are unsure, it is best to see your dentist for a check-up first - they will be able to advise you whether your child would benefit from an early assessment with an orthodontist.

How to help a child who is anxious about the dentist - Part 1

Do you dread taking your child to the dentist? 

Are you worried about how your child will behave? 

Do you put off visiting the dentist until your child has toothache?

Maybe you are anxious yourself and don't know how to help you child overcome their fears?

In this two part blog we will look at ways in which you can make visiting the dentist less stressful, and maybe even enjoyable for you and your child.

Children are not born with a fear of going to the dentist. A small child visiting the dentist for the first time will not know what to expect, apart from what they have picked up from their parents and others around them. Therefore, it is important to try to give your child a positive view of dental health. Depending on your child's age, you can discuss or show them the importance of teeth and looking after them in an appropriate way. They can be encouraged to view the dentist as someone who helps them look after their teeth.

If you are anxious yourself, or have had a bad experience in that past, try not to talk about this in front of your child and advise other family members and friends to do the same. 


A recent study showed that parents' attitudes towards dentistry are often passed on to their children. Children are often listening in on our conversations with others, even while we think they are playing or doing something else. They even pick up on anxieties that we do not speak about by our expressions. If you have fear of the dentist you may find this 4 part blog (click for link) helpful for advice on overcoming your own anxiety.

Finding a child friendly dentist

Of course, it is important to find a dentist who is good with children. Not all dentists are good at, or enjoy, working with children. Find a practice where the dentist and their support staff relate well to your child and work to gain their trust so that your child can feel comfortable with them. The environment is also important in putting your child at ease and the decor should be fun. The waiting area should have toys, books or some form of entertainment to make waiting easier. 

Ask around for recommendations from friends and family or look at reviews from other parents. You can ask dental practices about their experience and expertise in treating children. Pediatric Dentists (or Pedodontists) are specialists in children's dentistry and usually have 3 years further training in Pediatric Dentistry after dental school. If you are in Bangalore, Small Bites in Indiranagar provides exclusive dental care for children. Here, we believe that every child deserves a good start in life with the best preventive dental care.

How can I help my child at home before a visit?

• Try to schedule the appointment at the best time for your child. Small children especially do not do so well if they are tired and hungry. 
• If you or your child are anxious, try to choose a time when the dentist is less busy to minimise waiting and so that there will be more time to discuss any issues and concerns. Even if this means that you have to take time off work it may be worth it for a first visit.
• Be positive. If your child is anxious, listen and show them you understand their concerns but express confidence that they will be okay. 
• Do not use words or scare stories that may upset your child. Even if you say "it's not going to hurt" the main word that your child will hear is "hurt", even though this may not have been in their mind before. 
  
• For young children, you could "play dentist" at home. You and your child can take it in turns to "be the dentist" and check each others teeth. Also try using your child's favourite soft toy or a puppet and "check their teeth." You can buy small plastic mouth mirrors for this, or just use your toothbrush. 
• If your child has a sibling, cousin or friend who is good with the dentist it may be helpful to visit the dentist with them first.
• There are many good children's books and videos available which can help children to understand about going to the dentist.
• If your child has had a difficult time at the dentist in the past, ask them about their concerns. Discuss these with your dentist to find ways to help your child before the next appointment.
• If one parent is particularly anxious, it may be better for the other parent, or another close relative, to bring the child for their appointments.

Ideally, a child's first experience at the dentist should not be for treatment. If at all possible, try to take your child just to see the dental practice and meet the dentist, or at most have a quick check-up, before they have any problems. This will help them to feel comfortable with the environment. 

At Small Bites we also have children's activities (advertised on our Facebook page - click for link) held in the clinic. This is a chance for children to get used to the environment and have fun on a separate day from any appointments. 

If your child, already has pain or problems before they have visited the dentist, don't worry. A good dentist will aim to alleviate the pain at a first visit but do further treatment as your child increases in confidence and cooperation.

Regular visits for check-ups will help your child. It is much better if they do not need treatment every time they have an appointment.

In the second part we will discuss ways that you and your dentist can help your child during their visit and some tips for preventing dental problems.