Process of Dental Caries in Children

All of us are well aware of what teeth decay actually looks like, how it manifests itself, the physical changes and the causes for it. Not many know the process of decay, and how early intervention can stop and even reverse the deterioration of teeth.

Everyone is susceptible to tooth decay. While adults can prevent it or look after their teeth better, children cannot do the same. It is left up to us parents to ensure we know the stages of caries and how we can intervene at the right time, with the right methods and prevent further damage from taking place.

Dental caries in children unfolds over a prolonged period of time. Below is the process by which this happens,

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•       The mouth is a cavity that is exposed to germs all day, everyday. Bacteria grow in the gut and help in the process of digestion, with the process beginning in the oral cavity. Bacteria also enter the oral cavity with food. The breakdown of food causes the formation of plaques, sticky whitish deposits that collect around the gum line, grooved surfaces of teeth and edges of fillings. Plaque allowed to collect for a prolonged period of time, hardens into 'tartar'.
•       Plaque also uses the remnants of food in the mouth to produce 'acids'. Some foods like beverages and meat are already acidic and affect the teeth.
•       Acid attacks the outer layer of teeth, the enamel and dentine, and erodes them gradually over a period of time. Gradually a small hole or cavity begins to appear on the surface of the tooth or the enamel. This stage is usually painful.
•       Once holes are formed in the enamel or outer lining of the teeth, it becomes easier for plaque and bacteria to reach the dentine (layer just below the enamel). Dentine is usually softer and gets eroded faster. 
•       If treatment doesn't begin at this stage, the bacteria reach the tooth pulp, where nerves are exposed to them, resulting in a excessive pain.
•            When bacteria infect the tissue within the pulp and this isn't treated, it leads to the formation of a dental abscess.

It is often seen that tooth decay typically occurs with molars and pre-molars, large back teeth used for grinding, which have irregular surfaces, making it easier for food to stick and cause infection. These are also unreachable and not cleaned regularly.

Tooth decay in children, can manifest in any number of ways;

•      Breakage of teeth
•      Toothache or pain    
•      Infection of nerve or pulp
•      Death of nerve and numbness 
•      Swelling of face
•      Vomiting, headache and other general symptoms

It is important to remember that dental intervention in children, can save them from pain and many other future problems. It can also help save their milk teeth, in turn ensuring that their permanent teeth grow properly and giving them good oral health for life.

A pediatric dentist not just treats caries once they have begun, but also looks for signs and symptoms of impending tooth damage in children. Beginning a child's dental check-up as early as age 1, can go a long way to ensure that our children don't suffer as much as we do.

Choosing the Right Toothbrush for Your Children's Teeth

Toothbrushes are one of the most important tools in dental hygiene, and yet they are often taken for granted. While adults choose toothbrushes based on ease of use and other fancier requirements - dual bristles or unusual shape, with children we often buy what we assume is best for them in terms of their looks.

Toothbrushes have come a long way - from 'chew sticks with frayed edges', still used in rural areas, to those crafted with bone or wood. Nylon bristled plastic toothbrushes, as we see them today, were only introduced in the 1930's.

Why Brush?

Toothbrush plays an important role in a child's oral health. Brushing removes accumulated food, plaque found between teeth and even the yellowish stain on them (a sticky film of bacteria). If plaque is left untouched, it leads to tartar formation or whitish deposits between teeth. When this tartar hardens, brushing becomes difficult, leading to gum tissue swelling or bleed. This is when periodontal or gum disease actually begins.

Which is the best toothbrush to choose for your child's teeth?

The toothbrush market is bursting with them in various sizes, colors and shapes. It is often difficult to choose which is the perfect one. Below are a few pointers about what you can look out for;

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•       Soft Bristled - Children have small teeth, and their gums are sensitive. Soft bristles help remove plaque and food from the gum line, as well as are gentle on gums. It is better to choose toothbrushes that have a rounded end or are polished. 
•       Comfort matters - It doesn't matter what toothbrush you choose for your child's teeth, it must be comfortable. Long toothbrushes can cause injuries and short ones may not reach certain areas of the mouth. The only criteria you should look for, is whether the brush fits their mouth and reaches the back of it as well.

•       Regular or Powered Toothbrushes - Electric powered toothbrushes are very popular abroad, but haven't yet caught the fancy of Indians in a big way. While powered have been thought to clean teeth better, regular ones are just as good, safer and also cost-effective.

Age specific brush use;

1. Babies and Toddlers - Using a damp cloth or gauze, rubbed gently in circular motions is sufficient to clean baby's teeth. Toothbrushes are available for babies, which are small and convenient. Beginning their use early, makes the child get used to the ritual and removes accumulation of milk and food.

By 2 years of age, toddlers are eager to brush themselves, and longer toothbrushes with small heads and soft grips can keep them busy with their teeth.

2. Five to Eight - At this age, the child shows his readiness to brush independently. The toothbrushes although similar to adult ones, are still small with large handles. Manual and powered are often available for pre-adolescent children.

Buying the right toothbrush for your child's teeth, isn't where it all begins and ends. For clean and healthy teeth, brushing must be done twice a day, after breakfast and before bed at night. Flossing must be done whenever possible, to remove food accumulated between teeth. When toothbrush bristles fray or after a period of three months - whichever earlier - new toothbrushes have to replace the old ones. Brushes for kids are to be replaced more frequently than that of adults.

It is always important to involve your child when buying toothbrush for themselves, so that they grow to love the entire process of cleaning their teeth lifelong.

9 Ways of Handling Your Child's Thumb Sucking Habit

As adults, all of us have our ways of relaxing. While we may indulge in reading or a sport, our children have their own ways of unwinding. Of the many things we observe in our babies as they learn and grow, Thumb Sucking is one of the commonest habit that is also the way for them to cope and relax.

Thumb sucking signifies so many things; that the baby is feeling hungry, that he or she is teething, and often it also shows insecurity. This is a normal and healthy part of an infant’s growth.

Infants often suck on thumbs, fingers, pacifiers, toys and even food during play and sleep. Sucking on an object gives them a sense of security and comfort. This habit usually lasts till the age of 4, often even up till 6 years.

If thumb sucking continues beyond 6 years, especially at the time permanent teeth are beginning to be formed, then it is a cause for concern, since the habit often leads to a whole host of dental problems.

Often after 5 years, children develop language skills that help them cope. Therefore the habit when continued beyond this age, may indicate children’s inability to cope or convey what they feel.

Depending on the intensity of the thumb sucking, frequency and duration, teeth can gradually get pushed out of their original position, can become misaligned, making them protrude and resulting in an ‘overbite’, a condition in which teeth don’t clamp down properly.

In addition, the misaligned teeth don’t close the mouth fully, causing malformed jaws as the years go by.

Thumb Sucking therefore has to be observed and stopped before it becomes a habit that causes harm and irreversible dental damage. If your child is approaching preschool and still shows signs of not overcoming the habit, then parents will have to intervene to know why it I so.

Below are 9 ways that you can help your child wean themselves off this habit;

•      DO try to gradually limit the time and place where your child sucks their thumb, either to the bedroom or house itself. Try to prevent them doing it outside in public. Explain that the activity must be restricted only to bedtime.
   
•      DON’T make it a tussle of wills. Thumb sucking is an involuntary habit, so ordering the child to ‘Stop’ won’t get you anywhere. He or she may hide and do it or turn hostile which doesn’t solve the problem. Try to praise them whenever you see them not doing it, rather than criticizing when he is. This is positive reinforcement. 

•      DO take time every now and then to talk to them about the habit. Help them understand why the habit isn’t good, and tell them you will be there whenever they want to stop. 

•      DON’T prevent them from thumb sucking after a stressful time or when they are injured. The child usually does it to seek comfort, and preventing them from doing it will traumatize them further. 

•      DO practice self-awareness with your child. If they are sucking their thumb, make them aware of what they are doing. Try to make them find other ways to soothe themselves, like hugging a stuffed animal or a toy.

•      DON’T replace the thumb sucking habit with handing them chocolates or lollipops. It is cruel to remove one habit and replace it with something worse.  
   
•       DO practice role play to make your child understand that he/she is growing up and there are some habits he cannot carry with him as he grows. Showing them how other grown-ups like their uncles and aunts, or the neighborhood policeman behave, can help them process whether they want to continue with the habit. 

•      DON’T try shoving a glove or mitten into their hands, whenever you catch them sucking their thumbs. When this is done as babies, it might not matter much, but when older, this will frustrate them and cause them to suck on their fingers more. 

•      DO remember, that although thumb sucking is worrying, the child will eventually grow out of it when he is ready. You may have tried everything you can, and yet do understand that your kid will grow out of it.

Thumb Sucking is a habit practiced by every child, but it starts to get worrying when it causes dental problems which can last a lifetime. Ensuring the child gets positive reinforcement to let go off the habit, rather than a harsh approach will help them understand and get rid of it sooner. It will also help in preventing some common dental problems that can develop later in life.

If you are seeing some teeth problems in your child due to this habit, please don't delay showing your pediatric dentist at the earliest, or reach out to the Small Bites Dental Clinic at
+918041256715 or +918025272614.

Preparing Your Child For Their First Pediatric Dental Visit

A visit to the dentist must be a very important part of your child’s quarterly health checkup plan. Good oral hygiene promotes healthy teeth. Since gum problems are tied in to many other problems in the body, getting a headstart on this important aspect of health will keep your kids covered at least when it comes to their dental health.

From a child’s perspective, a trip to the dentist can be very daunting. Lying on a chair in an unfamiliar room filled with huge machines, and a doctor poking instruments into their mouth can scare even the most strong-hearted. Also, with milk teeth growing and falling off, and permanent teeth making an appearance, there might be many trips to the dentist in store for them.

As parents, it is the onus on you to make a trip to the clinic as comfortable and relaxed as possible. This will only make our work as dentists easier and quicker.

Here is what you can do to ease your child’s anxieties;

• Start very young – Children are very adaptable, and the earlier they see a dentist, the more comfortable they will be during a dental visit. Whether it is a regular checkup, preventive visit or even emergencies such as tooth impaction or Root Canal Treatment, they will be open to any procedures. We recommend bringing your child in at age 1 year, or when the first tooth erupts.

• Keep it Simple – The first time dental visit is the most important, to make kids feel comfortable. Try not to explain too many details to them. Giving unnecessary details and explaining procedures may cause anxiety, which isn’t a good frame of mind to enter the clinic. Maintain a positive attitude but don’t make it sound all rosy too. Most importantly, avoid saying everything will be fine. If your child ends up getting treatment and going through pain, he/she will distrust your judgement in the future.
• Mind your words – Putting words like ‘pain’, ‘injection’, and ‘hurt’ in their head, may make them associate such feelings with the dentist and their work. Let us at the clinic handle your kids. They will be taught specific words for such feelings that they can associate with. At Small Bites, we always begin by asking kids to show us their smile and count their teeth. Positive phrases like clean, healthy teeth sound good and do not alarm.
• Pretend Dental Visit – To get children a little accustomed to visiting a dentist, play pretend with them at home. All you need is a toothbrush and chair. Start by counting the number of teeth in their mouth, make your child look in the mirror. Ask them to pretend-play by brushing their doll’s teeth. The aim is to get them comfortable with the routine and open to a visit with us.

• Avoid taking them to your own dentist – Many parents take kids to their own dentist assuming that they can familiarize their kids with the place. Experts caution against this however. Often times your anxiety can trickle down to the kids, especially during certain procedures that your child may never really require. Also adult dental clinics are sterile, simple spaces which may scare them, while in pediatric clinics, there are kid-friendly toys, games and TV shows which will keep them relaxed.

Small Bites Dental clinic is a very kid-friendly place, where children can engage themselves with toys, rubber slides and television. The main examination room also has drawing and animated characters, including stuffed toys to keep kids engaged.

• Fuss over – Small children are oftentimes whiny, cranky, wiggly and do not open to new people. As parents, you have to keep calm and soothe your child gently to take their anxieties at bay. As dentists, we and the support staff are used to working with children and can guide you on what’s best for your child.
• Avoid bribery – Promising a special treat after being a good child at the dentist’s is a complete NO, since this only serves to increase their anxiety. Promising them a lollipop or candy, makes children wonder what they are in for, to deserve such a luxurious treat. Since we also emphasize on clean teeth and avoidance of sweets, it sends a wrong message to children. Instead, as parents you can praise your child's behavior and bravery for going through with the visit. 

• Emphasize the necessity – Teaching your child that a dental visit is a necessity not choice, from a very young age, will ensure they take care of their teeth for life. You can explain that the dentist helps keep teeth strong, prevents cavities from forming and is responsible for their beautiful smile. A calm practical and no-nonsense parental attitude will set the right premise for the child to continue with good oral health.

As parents your role in your child's dental health cannot be over-emphasized. Follow all of the above steps and it will be a breeze getting them to us. In case of any assistance or more help, do reach out to the us on pedopremila@gmail.com.  

More details can be found here.