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Children's Dental Hygiene

When will my child's teeth come through?

Babies start to develop their first teeth (also known as milk teeth or deciduous teeth) in the womb.  The teeth begin to emerge through the gums (a process known as teething) at around six months of age; by the time they are two or three years old most children will have their first set of 20 teeth. The bottom middle teeth usually appear first, followed by the upper middle teeth, then the teeth along the sides of the mouth and the back.

Permanent teeth develop in the jaw; as they develop they press on the roots of the milk teeth, which fall out allowing the adult teeth to come through. This starts at around age six, and most children will have their adult teeth by age thirteen – except the wisdom teeth which develop in the late teens and early twenties.

Adults can have up to 32 permanent teeth; bear in mind that all children are different and develop at different rates.

When should my child first visit the dentist?

As a parent herself, Yasmin recommends that you start taking your child along with you when you go for your own dental checkups; this will get them used to the sights, sounds and smells of a dental practice as well as the idea that regular dentist visits are part of the normal routine.

If you take your baby to see Yasmin when the first teeth start to appear, she will be able to make sure that their teeth are developing correctly, and give advice on caring for your baby's teeth, dealing with teething problems and relevant dietary advice.

Yasmin will also be able to advise you about how often your child should attend dental appointments for a check-up. This will usually be at least once a year. The focus at Confident Smiles is upon preventing tooth decay and gum disease.

How can I prevent decay in my child's teeth?

The basics of good oral and dental hygiene apply to children just as they do to adults.

Cleaning your child's teeth should be part of their daily hygiene routine. For the first year, brushing teeth is not necessary. However, the gums and mouth still need to be kept clean – this should be done by wiping them after meals with a soft damp cloth. For infants below the age of two, you can use a special infant toothbrush that fits over your finger to clean their teeth or a soft toothbrush designed especially for young children. For older children choose a toothbrush with soft bristles, a small head and a flexible neck to absorb excessive brushing pressure, and use a small amount of fluoride toothpaste. Children brushing their own teeth should be supervised until at least the age of seven, and you should make sure they spit out the toothpaste and do not swallow it.

Dr. Yasmin George may also recommend hygienist appointments as your child gets older so they learn about brushing their teeth and are given Preventative advice.

Try to make sure your child eats a diet that promotes oral and dental health right from the start. Your baby after the age of one should not take a bottle of milk to bed; milk contains sugars, so drinking milk right before sleeping means that these sugars have all night to attack the newly emerged teeth. Some processed baby foods contain a lot of sugar; sometimes this is shown as fructose, glucose, lactose or sucrose. Check the list of ingredients: the higher up the list sugar is, the more there is in the product. When your baby starts eating solid food, encourage them to eat savoury foods such as vegetables and pasta, rather than sweet or sugary foods. A baby is not born with a sweet tooth and will only develop a taste for sugary foods if they are given them regularly. Squashes, flavoured milk and juice drinks should not be given to young children because they can cause tooth decay; fizzy drinks should also not be given to babies or toddlers because they can damage the teeth.

As your child gets older, ensure he or she eats a balanced diet, and discourage snacking on sugary or acidic foods or drinks: if you want to give your child a snack, try to stick to cheese, vegetables and fresh fruit. Limit dried fruit as it is high in sugar and can stick to the teeth.

Discuss with your dentist the use of dental fissure sealants. Fissure sealants are often applied as soon as the permanent teeth start to come through. This is usually between 6 and 8 years of age. The rest are usually sealed as soon as they appear which can be any time between 11 and 14 years of age.

Sealants are only applied to the back teeth - the molars and premolars. These are the teeth that have pits and fissures on their biting surfaces. Your dentist will tell you which of your child's teeth should be sealed after they have examined them, and checked whether the fissures are deep enough for sealing to help. Some teeth naturally form with deep grooves which will need to be sealed, others with shallow ones which will not.

When might my child need orthodontic treatment?

The word orthodontics means "to straighten teeth" and it is a type of dental treatment that aims to improve the appearance, position and function of teeth that are crooked or badly positioned.

Teeth may be become badly positioned due to many factors, including:

  • incorrect development of the upper or lower jaw, leading to an incorrect "bite" – ie the teeth do not meet together properly when the jaws are closed
  • accidental loss of one or more teeth, so neighbouring teeth move into the vacant space
  • adult teeth erupting in a small or narrow jaw leading to crowding and even impaction (where eruption is blocked by an existing tooth)
  • continual breathing through the mouth forces the tongue to thrust forward when swallowing, and over time this will push the front teeth out of position. The abnormal tongue function can also affect growth of the jaws.
  • constant thumb-sucking or use of a dummy will cause the front teeth to protrude, sometimes so severely that they cannot be closed together, tongue function can also be affected which in turn can affect growth of the jaws.

You want the best for your child: straight teeth, properly sized jaws, a good profile and a broad, beautiful, beaming smile. It is important that your dentist monitors that teeth, gums, jaws and bite develop properly, and the earlier your child is checked, the more likely these situations are to be identified. Your dentist (if he or she is trained in orthodontics) or a specialist orthodontist will be able to detect potential problems from as early as age six or seven, and early treatment may prevent more serious problems from developing, or make future treatment less complicated and less lengthy. In many cases the best results are often obtained between the ages of seven and thirteen while the child is still growing; indeed some results may not be achievable once facial growth has finished.

If you are unhappy or concerned about your child's dental development then it is worth getting advice from more than one practitioner particularly if you are being advised that at age 7 or older, no treatment is possible.

In cases where an inappropriate habit is causing the problem, unless the habit is addressed, moving the teeth back into the correct positions will be a waste of time as the habit will immediately force them out of position again. As a first step your dentist can recommend specialists to address breathing problems, retrain tongue movements, and supply thumb- and finger-guards to prevent thumb sucking, and orthodontist-recommended dummies.

Once the inappropriate habit is removed, teeth can be moved gently over time into the correct positions by means of orthodontic braces and other appliances if necessary. After the active phase of tooth movement a retainer of some sort will be needed to hold the teeth in their correct positions and ensure long-term stability.

Advances in modern orthodontics have made the treatment much less likely to involve extracting teeth. In the past it was thought necessary to remove teeth to "make room" for the remaining teeth to fit side by side when newly aligned in what had been a crowded jaw. Orthodontists and dentists now understand how to widen the palate and broaden the jaw, making room for all the teeth and creating broad, natural and attractive smiles. These techniques, often referred to as Functional Jaw Orthopaedics are of course most effective when the jaw and palate are still growing.

Won't my child feel self-conscious wearing braces?

Recent advances can now save children and particularly teenagers the embarrassment of having to cope with metal braces on their teeth. Tooth-coloured brackets and wires can be used; or for less severe cases, clear plastic aligners such as Invisalign are available and are virtually invisible.

Brackets can also be fixed on the inside surface of the teeth rather than the outside, visible surface.