Kids’ Tooth-torial

by Carla Mia Carandang, M.D, DPPS

Oral and dental health is of great importance to a child’s overall health, well-being and quality of life. Poor oral health can lead to untreated dental diseases causing eating, sleeping and learning problems in children and adolescents. This will have a negative impact on a child’s social interactions, school achievement, general health and quality of life.

Interesting facts regarding your child’s teeth

Dental development, specifically calcification of the primary teeth, starts early during fetal period and is completed by the 3rd year of age. See the table and accompanying image provided for further information on the timing of eruption of primary teeth in children. Delayed eruption is considered when there are no teeth eruption by 13 months of age.

What are the most common dental problems?

Dental Caries (tooth decay or cavities) and Periodontal Diseases (gum diseases) are the two most common oral health diseases affecting the Filipinos. There is 87.4 % of Filipinos suffering from dental caries while 48.3 % has gum disease (based on the 2011 National Monitoring and Evaluation Dental Survey).

Here are some risk factors that can increase the chance of your child to have cavities:

• Some family members (older brothers, sisters, or parents) also have cavities.

• Eating and drinking a lot of sugary foods and drinks, like soda, candies and juices especially between meals.• Children with special health care needs.• Children wearing braces, orthodontics or oral appliances.

How to care for your child’s teeth?

The Philippine Pediatric Dental Society, Inc. (PPDSI) developed guidelines to help fight the early onset of dental caries in children. Together with the Philippine Pediatric Society, Inc. (PPS) and guided by the American Academy of Pediatric Dentistry (AAPD), they advocate for the appropriate use of fluoride as part of the comprehensive oral health care for infants, children, adolescents, and persons with special needs. When used appropriately, fluoride is both safe and effective in preventing and controlling dental caries. Various topical fluoride applications are recommended in the form of toothpastes, mouth rinses and varnishes, especially because of the lack of water fluoridation in the Philippines. As a preventive measure, it is recommended that the first dental visit should be done at the time of eruption of the first tooth and not later than 12 months of age.

Here are some key points to guide you:

• For infants, use either a washcloth or soft brush in cleansing teeth to reduce bacterial colonization.

• Avoid prolonged bottle feeding or bottle feeding your child while asleep as this can increase the risk of early dental caries.

• Children 6 months to < 2 years old should use a smear size (2.5mm) of toothpaste containing no less than 1000 ppm fluoride, twice daily.

• Children 2-6 years old should use a pea size (5mm) of toothpaste containing no less than 1000 ppm fluoride, twice daily.

• Children 6 years old and above should use 10-20mm (or full length of the bristle) of toothpaste containing 1350-1500 ppm of fluoride, twice daily.

• Spitting out excess toothpaste and no water rinsing is preferable because thorough rinsing reduces the fluoride in the mouth to sub-optimal conditions.

MOST IMPORTANTLY, if your child has a high risk to develop cavities, always remember to keep in touch with your dentist, pediatrician, or family doctor to make sure you are taking extra steps to protect your child’s teeth.

REFERENCES: Pediatric Healthcare Handbook of the Philippine Pediatric Society, 2018Kliegman RM, S. B. (2016). Nelson Textbook of Pediatrics 20th Edition. Elsevier, Inc.