Protecting our children from abuse - Part 1

In this blog, we are going to cover a non-dental issue, because it is one that is important for us all to be aware of.


It is an issue which people do not like to discuss or even think about, but child abuse is alarmingly common in India and around the world.  As adults, we have a responsibility to protect not just our own, but all children from abuse. 



What is child abuse?
Child abuse is the term used when an adult, or another child, harms a young person under the age of 18. There are many types of abuse -  physical, emotional, sexual, neglect and specific offences such as child trafficking.

In this article we will concentrate on child sexual abuse (CSA), but many of the principles can also be used to protect children from other forms of abuse. 

How common is child sexual abuse in India?
Children from all social classes and backgrounds are susceptible to abuse. It is impossible to know the true incidence of CSA as the vast majority of those abused do not tell anyone. Social stigma in Indian society often prevents people from coming out in the open and talking about abuse. 

A goverment study published in 2007 (http://wcd.nic.in/childabuse.pdf), found that 53% of the children surveyed reported having faced sexual abuse, 21% serious sexual abuse. In the majority of cases the abuser was someone known to the child, or in a position of trust and responsibilty. Most of those abused had not reported it to anyone. With statistics like these, it is not an issue that we can afford to ignore.

How can I keep my child safe?
Parenting is challenging, and the issues are different for babies and small children than for older children who are starting to become independent. Childhood should be a carefree time and we don't want to worry our children, but we need to give them some guidelines on keeping safe. 

We tend to be concerned about our children when they are out and about but, as the majority of abusers are known to the child, we also need to consider keeping our children safe at home, school, when visiting relatives and friends or participating in other activities or using the internet. In a future article, we will look at safety issues for various situations. 

Good Communication

Good communication with your child is the key, both to listen to their concerns and so that they will listen to you when you give advice and rules on keeping safe. 

As the quote says, this needs to start when your child is young. Listening to your child, at a time when you are not rushed or distracted is important. Put down your phone, and make eye contact with your child. 

Find the best times to talk and listen, maybe at bath-time or bedtime, going to and from school, while in the car or walking together. If your child wants to talk when you are busy, assure them that you will make time as soon as possible. Ask your child about their feelings and emotional well-being. The art of listening builds trust. Your child may also have other adults, such as grandparents, who they trust and can talk to.



As difficult as it may seem, it is better to give your child some guidelines on keeping safe, rather than waiting until until you have a concern. This should be done in a way that is appropriate for your child's age and understanding. A good tip is not to treat it like a lecture, it's much better to find easy ways to have comfortable chats, little and often. Adding simple conversations into your day or routine about staying safe will help prevent your child from feeling like it's a big deal, unusual or weird.

The UK charity NSPCC has developed The Underwear, or P.A.N.T.S rule as a simple way of talking to your child without using scary words or mentioning sex. You can click on the above link for details, but in summary:-

Privates parts are private
Always remember your body belongs to you
No means no
Talk about secrets that upset you
Speak up, someone can help



In India, Enfold Proactive Health Trust, based in Bangalore, are involved in education and training to protect children from sexual abuse.

In the next blog, we will discuss signs that may raise concern and what to do if you suspect abuse or a child tells you they have been abused. 

Are Baby Teeth Important?

Are baby teeth Important? What if your child gets cavities in their baby teeth? Is it really necessary to get them treated if they are not having any toothache? Surely the baby teeth will fall out after a while anyway?

Though you lose them early in life, your primary teeth, also called baby teeth or milk teeth, are essential in the development and placement of your permanent teeth. They also help in speech development. The permanent teeth develop close to the roots of the primary teeth. 

Untreated infection in baby teeth can affect the normal development of the permanent tooth. Primary teeth also maintain the spaces where permanent teeth will erupt. If baby teeth are lost too early other teeth may tilt into or take up the vacant space, forcing permanent teeth to come in crooked. 

Although baby teeth start to fall out around 6 years old, some will remain until 12 years or even later. By taking your child for regular check-ups any problems with the baby teeth can be seen early and treated or prevented from progressing. This way more complex treatment, which may be more expensive and require more cooperation from the child, can be avoided. If your child is taught to look after their baby teeth, they are much less likely to have problems once their permanent teeth come through. 

Which foods cause tooth decay?

Your child's diet is one of the most important factors in developing dental decay and small changes can make a big difference. 

In the previous blog post we looked at how foods containing sugar combine with bacteria in plaque to produce acid. If the teeth are subjected to frequent or long periods of acid attack, decay becomes likely to occur.

Most people are aware that children who eat too many sweets and candies are likely to get cavities. However, any foods that are are high in refined carbohydrates (starch), such as crackers and chips, can cause decay if the foods remain stuck to the teeth for long periods of time, as the starch breaks down into sugar. In fact, one good way to determine if a snack is good for a child is to check their teeth 20 minutes after consumption. If the teeth are still filled with food, the risk for dental decay will be higher. These foods should be eaten only rarely and teeth should be brushed afterwards.

There are a lot of "hidden sugars" in processed food. If you read the ingredients, they may be labelled as sucrose, glucose, lactose, or fructose - these are all types of sugar. In addition to containing high levels of sugar, many children's breakfast cereals also stick onto the teeth. Even diet soda drinks and concentrated fruit juices can cause decay as they are acidic.

It is not realistic to ban your child from eating sweets. altogether. Instead, limit consumption of sweets and candy to maximum of once a day, preferably at the end of a meal. Those treats that dissolve and clear from the mouth quickly eg. a milk chocolate bar, are better than hard candies, lollipops or sticky caramels. Sweets should be eaten in one go, rather than continually snacking on them.

Children do get hungry and need to snack. Choose healthy snacks such as fresh fruit and vegetables, nuts, cheese. For drinks in between meals go for water or milk without added sugar.

What causes dental cavities?

When you consume any food or drink containing carbohydrate, or sugar, the bacteria in the plaque on your teeth metabolise it, producing an acid attack which lasts for at least 20 minutes. The acid dissolves the outer surface layer of the teeth (enamel).

The acid attack will be much longer if the food remains stuck onto the teeth, or if snacking continues over a period of time, eg. eating a bag of sweets one by one, or continuously licking a lollipop. Also, If babies or toddlers fall asleep with a bottle, or whilst nursing, the milk will remain on their teeth for a longer period of time.

If food and drinks containing sugar are limited to mealtimes, with sugar free snacks and drinks in between, the teeth can recover from these short periods of acid attacks. In the early stages of decay (before a cavity is formed), the enamel can repair itself by taking in minerals from saliva. Fluoride also helps to strengthen the enamel in this process.

However, with frequent snacks and drinks containing sugar, cavities become much more likely to occur.

Once the enamel layer crumbles, a cavity is formed, bacteria enter and the decay process spreads rapidly.

To prevent dental decay, the aim should be to reduce the amount of time that any food containing sugar is present in the mouth. Drinking water or rinsing after eating can help. Try to make snacks and drinks, between meals, sugar free as far as possible. 

 

Regular, thorough brushing to remove plaque build-up from the teeth will also help but, as it is not possible to prevent plaque from building up again after brushing, diet is of extreme importance in preventing cavities.