The First Visit

Nowadays children have little to worry about when  visiting to the dentist. We like to see children when they are very young and it is helpful to bring them along when mum or dad have their own check-ups. It  works well to take a few minutes of that appointment and let a young child have a ride in the chair often sitting on their parent's lap. Just letting them play in the corner and watch mum or dad having a clean allows them to get used to the surgery, the nurses and dentists and that mum or dad survive!!

Some children, even as young as 18 months,  will jump up on the chair and open their mouth for a quick look with no problem at all. Others may take three or four visits. This is why we prefer, if possible, to tag them onto their parents appointment. This way no one feels under pressure to "perform". The first visit should be fun and rewarding (literally!). Once we do get to have a look and clean their teeth then they are nearly always good patients in the future.

Children need regular check-ups to not only check on any cavities but also jaw development (See our web page on Orthodontics).

Early Treatment

Early cavities can be treated very easily, often without the need for injections, and restored with tooth coloured materials. It is important to try and keep the baby teeth until they are due to fall out, as they help the path of eruption of the adult teeth and maintain jaw size and spaces. Early loss may cause the other teeth to move into the gaps and block out the un-erupted permanent teeth.

Prevention

Fizzy sugary drinks can be a dental disaster. Many popular drinks are also quite acidic (popular sports drinks) and this causes not only decay but gross erosion. Dummies used long term can cause a distortion in the shape of the jaws but if  dipped in sugary mixes these also cause gross decay.

Tooth brushing is a gradually learned skill and most children are unable to do it properly without adult supervision. For very young children toothbrush shaped teething rings get them used to having something in their mouth. Gradually they can hold their own baby toothbrush and even if they just bite it it still helps to get them into the habit of cleaning their teeth after breakfast and before going to bed.

Most children under 10 are unable to use floss properly and generally they do not need to. (See our webpage on Gum Disease).

Accidents

See Emergencies

It is rare to get through childhood without some tooth damage. Knocks on baby teeth can cause the tooth to darken, which is literally a bruise within the tooth. Most baby teeth have wide open ended roots and it is not unusual for these teeth to regain their colour 6-8 months later. However, we should check out the damage. In older children, when the front teeth are adult teeth, a knock may cause the tooth to die leading to the need for a root treatment. Again an x-ray will show up any damage needing treatment. Broken teeth can be restored in a number of ways. ( see our web pages on Crowns and Veneers ).

If a tooth is knocked out it should be found and brought straight to the surgery. If this is not possible then it should be washed and either replaced into the socket or kept in water or milk.

Mouthguards are essential wear in any contact sports including basketball. Well fitted mouthguards have saved many a patient from severe tooth damage or loss. Unless the mouthguard fits properly then they will not be worn.

Pregnancy and Teeth

Pregnancy is a special time to take extra care of your teeth and gums. During pregnancy your hormonal balance is altered and your gums become more susceptible to disease.

There is no truth in the old wife's tale that says a tooth is lost for every pregnancy. Good oral hygiene procedures will ensure that you have healthy teeth and gums during pregnancy.

Oral Health Guidelines

Plaque is largely made up of bacteria. By using antibacterial products you can help control plaque formation.

• Visit your dentist before you become pregnant and during pregnancy to make sure your teeth and gums stay strong and healthy.
• Brush twice a day and floss thoroughly every day.
• Use a soft toothbrush and a proven antibacterial fluoride toothpaste.
• Change your toothbrush regularly.
• Eat a nutritious diet from a wide variety of foods.
• Increase your calcium intake.
• Avoid frequent snacks that contain sugar.

If you are pregnant or suspect that you are, it is important to tell your dentist when you visit. Practitioners are careful in prescribing medicines to pregnant women and only advise those which are really needed. Certain medicines such as the tetracycline antibiotics can affect your baby's developing teeth.

If possible dental x-rays should be avoided during pregnancy, however, if your dentist considers it essential for you to have an x-ray, special care and protection will be taken.

Before you become pregnant

It is important to establish good oral hygiene practices now so that when you become pregnant you will already have established a daily routine.

Dental plaque (bacteria) needs to be cleaned from the teeth and gumline by brushing and flossing every day. Brush twice a day with a soft toothbrush and fluoride toothpaste. Use dental floss daily to clean between your teeth where the toothbrush cannot reach. You can check how well you remove plaque by using special plaque disclosing tablets or solution. These are available from your chemist.

Visit your dentist

It may be more comfortable for you to complete any dental treatment required before pregnancy especially as you may experience nausea and vomiting or become tired as your pregnancy progresses.

Now That You're Pregnant

Morning Sickness

The stomach contents are acidic and may dissolve some of the the tooth enamel. To avoid tooth damage after vomiting or gastric reflux don't brush your teeth if you have just vomited. Instead wipe a smear of fluoride toothpaste over the teeth and rinse with water.

• Gagging can often occur whilst brushing your teeth. If this makes you feel sick, try to concentrate on your breathing as you clean the back teeth. Brushing without toothpaste can also help but return to using fluoride toothpaste as soon as possible.
• Cravings may be experienced for certain foods. Frequent snacks and drinks, especially sweet ones, can lead to dental caries (decay). Choose a wide variety of snacks which are low in sugar, fat and salt and high in fibre. Drinks such as milk and water are recommended.
• Your gums  may be easily irritated by dental plaque. When you become pregnant, the hormones in your body change. These hormones can cause your gums to become inflamed, and bleed. Clean your teeth and gums by brushing and flossing each day to reduce the irritation and keep the gums healthy. During your pregnancy, ask your dentist to check the condition of your gums and advise you further on how to care for them.
• Brushing is important, cleaning your teeth and brushing your gums twice a day will avoid plaque build up. Remember, each tooth has two five surfaces - a front, a back, two sides and a top. The only one sure way to prevent dental disease is to clean every surface.
• Fluoride strengthens the teeth and prevents decay. Fluoride is found in most toothpastes and your dentist may recommend you also have a fluoride mouth rinse or have a professional topical fluoride treatment. For your baby there is no clear evidence that taking fluoride tablets during pregnancy will strengthen the baby's developing teeth or help prevent decay for the baby's teeth. If water supply is not fluoridated then your dentist may advise that the baby have a fluoride supplement.
• Calcium is very important. When you are four months pregnant your baby's teeth and bones begin to calcify. The calcium and phosphorous needed comes from what you eat and, if necessary, from your bones. These minerals do not come from your teeth.

When you are 7-9 months pregnant your baby needs more calcium and phosphorous. These minerals are best obtained by eating more dairy foods.

Milk and milk products are an excellent source of calcium. Choose those that are low in fat and sugar. If you don't drink milk or eat milk products such as cheese and yogurt choose other products that are high in calcium. If you are having difficulty see your doctor or dietitian for advice. They may recommend calcium supplements. The recommended daily intake per day for women is 1,100mg during pregnancy, and 1,200mg while breastfeeding.

Looking Ahead

At first your newborn baby does not have decay causing bacteria in their mouth.

As the teeth come through the gum the bacteria that causes decay is passed to the baby by the main carer, usually the mother through kissing, food tasting or by cleaning the dummy in their own mouth.

It is important that carers thoroughly clean their own teeth and have all their own decayed teeth treated so they will have low levels of bacteria. This will reduce or greatly delay the transfer of these bacteria to the baby.