Presenter: Good morning Dr Tan. Now first of all, let’s talk about common dental problems. What can we expect children to have?

Dr Tan: Good morning. Well, children are prone to most of the common dental diseases that adults are prone to. For example: cavities, gum disease, malocclusion or crooked teeth. But it is noteworthy to mention that children are prone to certain dental problems, which are lifestyle-related. And for brevity, I will deal with two.

The first of these is early childhood caries, which is an aggressive form of dental decay that attacks preschool children, and is related to the prolonged use of a nursing bottle – filling the nursing bottle with milk or sweetened liquids and letting the child go to sleep with the nursing bottle at night. It happens also with demand breastfeeding; that means you let the child sleep at the breast at night.

The second thing is traumatic injuries to teeth. Trauma to the primary dentition occurs in about 30% of preschool children, with no sex predilection and there is a peak period for this: maybe around one and a half to two years, where the child is learning to walk, and they’re not so stable on their feet. In the secondary dentition, the incidence is around 23% for males and half for females, with a peak period of eight to ten years old. This is the time when children are active and involved in contact sports or high-activity sports such as rollerblading. And nine out of ten times, they do not protect their teeth by wearing mouth guards.

Presenter: So, Dr Tan, should we be concerned? Kids’ teeth fall out anyway, and then it’ll get replaced by a permanent set.

Dr Tan: Well, you know, kids do feel pain you know. And what are the normal sequelae (after effects) of dental decay? When it reaches the pulp, they get a bad toothache. And I certainly don’t think you want your child to go through that. So if you do not attend to decay or you do not spot them early, then symptoms will show.

Your body will produce warning signals like pain on eating, and subsequently, if you still ignore it, then pain even at night.

Baby teeth no doubt will fall off, but they do have a function in the mouth. They do not drop off until 6 to 12 years old. There is a period of use, and during this time, children need to eat, talk and function with these teeth. Premature loss of these teeth doesn’t mean that they will get a new tooth coming out straight away. Everything has a biological timing. So, yes, it is extremely important that you look after your child’s teeth even though they are milk teeth.

The other thing is, evidence points out that the state of the milk teeth is an indication of how the permanent teeth will be like. If you leave a lot of rotten milk teeth in the mouth, chances are that when the new teeth come out, they would come out in an environment that is full of bacteria and dirt, and these too will be similarly affected.

Presenter:  Now, how can parents teach their children proper dental care methods? It’ll be so much better if they too knew what they needed to do as kids to take care of their teeth.

Dr Tan: I think the first thing to teach them, as a parent, are good habits. Eating habit is one of these. Number one, never get your child addicted to sweets. Some children develop sweet tooth very easily because they have all the time been given sweet things. I have children who come into my clinic, and they have never ever drunk plain water. Whenever they are thirsty, parents or caregivers give them juices, so much so that when I say “change them to plain water when they’re thirsty” the child automatically rejects it.

The other thing is parents, being role models, should demonstrate healthy eating habits themselves. If they’re snacking on candy all the time, you cannot expect a child to learn from that habit. If you do not brush your teeth, then of course the child picks that up from you.

Call-in Segment 1

Caller 1: I have a two and a half year-old pair of twins. Their teeth have a kind of black stain on them. I don’t know what it is. They have tried brushing, but the stains are still there.

Dr Tan: Well, these are chromogenic stains. Sometimes, they are related to diet. The most common causes of these stains are diets supplemented by iron. So you may want to check if your child does take any supplements which contain iron. If no supplements are given, then sometimes it is due to some bacteria in the mouth, which causes these stains. These stains are only aesthetically problematic, but they do not pose any health risk. So, for most children who develop these stains, I’m afraid you’ll have to bring them regularly to a dentist to remove them.

Caller 1: Any advice also on bringing them to a dentist? Because we do brush their teeth and they do resist it. We are planning to bring them to a dentist but I foresee some battles. They have never been to a dentist before.

Dr Tan: If they have never followed you to a dentist or been in a dental environment before, a good point to start is to tie the child’s visit with your visit, and let them observe how you yourself go through dental treatment. There are lots of books and reading materials on how to introduce your child to dentists. Prime the child before you actually bring him.

Caller 2: My son is eight years old. Like all other children, he has a laziness of brushing teeth. I’ve heard of battery-operated toothbrushes, the round type. Are they really useful compared to conventional toothbrushes?

Dr Tan: Yes, of course. I think they are great aids. I used that for my child. He grew up with such a toothbrush. But, the thing is, you have to do it the first few times because children sometimes just play around and don’t actually brush effectively. So I’d suggest you let the child brush the first time and then you do one final round yourself. I personally find it a great aid in helping me brush my child’s teeth.

Presenter: On that note, Dr Tan, we’d like to thank you for joining us on the Breakfast Club.

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