Good dental care must start early

By Donya Betancourt

SANUR, Bali (JP): A beautiful smile is meant to last a lifetime. Many health professionals believe teeth should last 100 years if properly cared for and that there should never be a need to extract normal healthy teeth because of decay from neglect in proper care and hygiene.

It is not difficult to have healthy teeth one's entire life, but mostly it is a lucky few who have good teeth until old age. The problem primarily lies in the fact that children face too many unhealthy food choices that promote tooth decay. As parents trying to educate our children about proper food choices and tooth care, we are forced to compete with television and the bombardment of commercials promoting every imaginable candy available for breakfast, lunch and dinner, in addition to every tooth-decaying snack on the market.

Yet as parents we have a responsibility to take care of our children's teeth and teach them how to do it properly. The science of dental health has changed radically over the last 20 years and the attitudes that most of our parents taught us about dental health care are no longer accurate. Today we can prevent tooth decay; it is no longer just a fact of life to experience rotten teeth. Prevention is the key.

The average age of getting the first tooth is about 6 months old, but it can vary from 3 months to 18 months. Start the prevention process when the baby is a newborn by using a clean cloth dipped in clean water and gently rub the gums, tongue and inner cheek twice daily, preferably morning and evening. This will prevent oral thrush and the first teeth will emerge in a clean environment.

The greatest benefit in starting with a newborn is that it gets baby used to the cleaning process; when the infant has teeth he or she will easily open his or her mouth for you to clean. After a few teeth have emerged, it is important that the parent clean the child's teeth regularly, in the morning and before bedtime, using the "scrub technique". The procedure for doing this is that you must stand behind your child using a small soft toothbrush and brush from side to side. When brushing the back teeth, gently pull away the cheek to make the opening larger to prevent trauma from the toothbrush, then brush the tongue and the roof of the mouth if the child allows it.

Try to make it fun, like by playing with the brush and blowing bubble. What we are trying to do is teach our children to embrace a good feeling toward cleaning their teeth.

Dental floss is used to get rid of food particles and bacteria stuck between teeth and prevent proximal caries (decay of the side). Parents should continue to help children with brushing and oral hygiene until they reach about 5 years.

What about nursing-bottle caries? Typically, milk is the main nutrition source for newborns until about 6 months old but after that age you can start solid foods and your baby will need less milk. When your child is 1 year old he or she will need milk only three times a day and should stop night feeding. In order to prevent tooth decay from bottle feeding, you should give your baby milk when it is meal time, not when going to bed, because the more teeth which have contact with milk, the higher the risk of tooth decay.

Never add sugar or honey to milk and give your baby water every time after he or she drinks milk. Also start using a cup rather than a bottle when your baby is more than 1 year old. Eating habits are also important, and it is not advised to give the child sweets or candies after meals or milk before meals. It not only creates an undesirable habit, but also has the child eating all day but with no appetite at meal times.

Is it true that fluoride is good for teeth? Fluoride does prevent tooth decay because when the enamel of a tooth is formed with fluoride, it resists acid much better and discourages the activity of bacteria. Many municipalities in the United States and Europe add fluoride to city water.

There are two ways to get the fluoride treatment: taking it orally and applying it directly on the surface of the teeth by your dentist by toothpaste, or mouth rinses. It is important to remember that too much fluoride can cause white and brown specks on teeth so it is important to give the correct amount. If there is little or no fluoride in the community water system, children can take it in prescribed vitamins or tablets; for syrup it is 0.25 mg (milligram) per one ml (milliliter) and 0.5 mg per one ml.

For tablets there are two doses, one of 0.25 mg per tablet and another of one mg per tablet. The dose depends on the age of your child and how much fluoride is in your water. Consult with your child's doctor before starting fluoride treatment. A good time for your child to make the first visit to the dentist is at the age of 1. I think the possibility for our children to have a life-long companion of good healthy teeth is exciting and a cause worth the extra time and effort. My recommendation is to focus on diet and hygiene, give your child fruit to satisfy the craving for sweets and condition your child to enjoy and practice proper dental hygiene. And keep smiling.

-- The writer is a pediatrician based in Sanur, Bali. If you have questions, please contact her at drdonya@hotmail.com, or you can reach her at features@thejakartapost.com.