Baby Teeth Do Matter

July/August 2010, Singapore Health

A child’s gap-tooth smile may look cute, but a mouth full of decaying milk teeth is no laughing matter. About 40 percent of pre-school children in Singapore show severe tooth decay, caused by a bacterial infection known as early childhood caries. This puts them at high risk of developing caries even when their milk teeth have been replaced with adult teeth. The most likely source of infection is the infant’s mother or caregiver.

Early childhood caries can be spread to the child through saliva from the mother or caregiver who has untreated dental disease. This can happen with sharing of food or cutlery. To address this oral health problem, paediatric dentists at the Paediatric Dentistry Unit of National Dental Singapore (NDC) set up a clinic dedicated to children and their parents. The Infant Oral Health Clinic at NDC is the first in Singapore to offer a comprehensive programme which identifies caries risk, monitors oral development, and educates parents and caregivers on caring for their infants’ teeth.

Dr Tan Wee Kiat, Senior Consultant and Head, Paediatric Deintistry Unit, NDC, said that there is a misconception that baby or milk teeth can be left to decay as they will eventually fall out. Of those pre-schoolers who have high levels of decay, 90 percent of the decay is untreated, which implies that parents are not taking their children to dentists for regular check-ups. This may, in part, be due to the fact that pre-schoolers do not have access to a school-based dental programme, unlike older children in primary schools.

In 2003, a national oral health survey of 6,000 school children aged six to 18 years, found that only 52 percent of six-year-olds had no decay in their milk teeth, while 20 percent had more than four decayed milk teeth. On average, a six-year-old had 1.75 decayed, extracted or filled milk teeth, a 0.27 increase compared to nine years ago.

Children with severe tooth decay require extensive treatment, which may involve extraction of the decayed teeth. Prematurely extracted milk teeth have no replacement until the permanent teeth emerge, which usually happens between the ages of six and 12.

Each year, NDC treats 500 pre-schoolers for early childhood caries. Treatments range from total extraction of all milk Ateeth to full-mouth restorations. Such treatments are a costly affair. Procedures under general anaesthesia can cost between $1,000 and $2,000 and require the child to spend about one hour or more in an operating theatre.

For each operation, in addition to the dental specialist, anaesthetic and nursing services need to be mobilized. “The parents and child undergo unnecessary stress for a condition that can easily be prevented,” said Dr Tan.

American Academy of Pediatric Dentistry now recommends that a child’s first visit to the dentist should be at age one or shortly after the first tooth appears. Said Dr Tan: “It is easier to acclimatize the child to dental treatment when we can start with non-invasive procedures."

Read article clipping here