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Dental health tips for kids – Interview with Dr. Tricia Percival

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The Mummyhood Journals started as a way for me to share my experiences as a young mother and to connect with other mothers over these stories. As the blog continues to develop, it is my intent to start including posts that are genuinely beneficial to other mothers.

Looking through my social media feeds I have noticed a lot of questions from young mothers regarding health advice for their children, so, I thought that it would be a useful idea to include interviews with actual doctors/medical practitioners, who could answer some of these questions better and more accurately than I ever could.

On that note, The Mummyhood Journals is pleased to introduce the first post of its “Healthy Kids” series.

In this post, I interviewed Dr. Tricia Percival, a paediatric dentist (and my son’s wonderful dentist) on some of the questions and concerns that some of us new mothers may have about our children’s oral care.

Thank you, Dr. Percival, for agreeing to the interview.

TMJ: At what age should we carry our toddlers for their first dental visit?

DP: It is recommended that your child should see a paediatric dentist/ dentist when the first tooth appears, or no later than his/her first birthday. The purpose of the age 1 dental visit is to learn about your child’s oral health and how to best care for your child’s unique needs before any problems occur. Many dental problems can be prevented or more easily treated in the early stages. By establishing a good working relationship with a paediatric dentist/ dentist, parents will ensure that their child receives proper dental care beginning at an early age. Setting a precedent for dental appointments at an early age also helps children to become accustomed to a proper oral care routine.

TMJ: What should we expect at this first visit?

DP: At the visit, you should expect the dentist/ paediatric dentist to:

  • Review your child’s history
  • Respond to your questions and concerns
  • Talk with you about your child’s overall oral health, including:
    • Development
    • Teething
    • Bite (how your child’s teeth will come together)
    • Soft tissues such as gums and cheeks
    • Oral habits such as finger sucking
    • Factors that affect the risk of cavities, such as diet, hygiene practices, fluoride use and whether others in the family have had cavities
    • How to prevent trauma to your child’s mouth
  • Perform a thorough assessment of your child’s mouth
  • Show how to clean your child’s teeth and give you a chance to practice
  • Give specific advice about home care, including hygiene, diet and use of toothpaste and other fluorides
  • Tell you what to expect as your child grows and develops in the coming months
  • Suggest a schedule for follow-up care

TMJ: Are there any questions that parents should be sure to ask the dentist at this visit?

DP: The best way to prepare for this visit is to consider what you want to know, what you want to look for and what you should expect. Be prepared to ask about any concerns you may have.

TMJ: Are there any red flags that parents should look out for when selecting a dentist for their child?

DP: In recent years, most dental schools have prepared new graduates to provide care to young children, however many dentists are less familiar and less comfortable with infants and toddlers. Here are two ways to find a dentist who cares for young children:

  • Look for an office that suggests your child be seen when the first tooth appears or by the child’s first birthday. Call the dentist’s office and ask, “At what age does your office recommend that children be seen for their first dental visit?”
  • Look for a paediatric dentist who specializes in the care of young children. To find a paediatric dentist, try one of the following:
    • Ask your family dentist for a name.
    • Contact the Dental Council of Trinidad and Tobago for their paediatric dentist listing

TMJ: Should parents start brushing their children’s teeth as soon as they grow out and what toothpaste/toothbrush is the best?

DP: Cleaning and brushing teeth removes plaque (the build-up on teeth) that causes tooth decay.

  • Starting at birth, clean your child’s gums with a soft infant toothbrush or cloth and water.
  • Parents should use a tiny smear (similar to the size of a rice grain) of fluoride toothpaste to brush baby teeth twice daily as soon as they erupt and a soft, age-appropriate sized toothbrush.
  • Once children are 3 to 6 years old, then the amount should be increased to a pea-size dollop and perform or assist your child’s toothbrushing.
  • Children should spit out toothpaste after brushing but do very little or no rinsing. They should not swallow excess toothpaste after brushing.
  • Remember that young children do not have the ability to brush their teeth effectively and will need an adult to help them brush their teeth.

TMJ: Do we need to brush our toddlers’ teeth twice a day, every day, as older kids and adults do?

DP: Yes, it is important to brush your toddlers’ teeth twice a day, every day as older kids and adults. Clean all surfaces of the teeth and gums twice a day (after breakfast and last before bed).

TMJ: At what age should we introduce flossing and mouthwash? What mouthwash would you recommend for children?

DP: As soon as two teeth touch each other, floss between them once a day. You can use regular floss to do this. Again, parents will often need to perform this for their kids. Although many kids have spaces between their teeth, many of these spaces can close especially between the ages of 3 to 4 years old.

Mouthwash is not a must-use for every child. It is not typically recommended for kids under the age of six but it is often a way to get an added dose of cavity protection in children over the age of six years.

 There are reasons for this: The first is that some types of mouthwash for children contain fluoride and although fluoride is great at preventing tooth decay too much too early can also cause a problem for the developing teeth. Secondly, children below the age of six years may not be able to swish well without swallowing a little.

Kids having fresh breath is often a common parental concern. Diluting popular adult mouthwashes to assist, can, however, be harmful. Many of these mouthwashes contain high levels of alcohol and are quite harsh for the child’s mouth.  A chat with the dentist/ paediatric dentist can determine if and when mouthwashes are recommended for the child according to their dental needs and risks.

TMJ: Are dental X-rays safe for children?

DP: Dental X-rays are imaging techniques that may be used to highlight any abnormalities in dental tissues. They help to check for holes or decay in the teeth and make sure that the teeth are developing in the correct position, including teeth that have not yet emerged through the gums

There is very little risk in dental X-rays. Paediatric dentists/ dentists are especially careful to limit the amount of radiation to which children are exposed. Adequate radiation protection including high-speed film and digital x-rays are some of the techniques used to ensure safety and minimize the amount of radiation.

TMJ: What should we expect when our children start to lose their baby teeth? Is it normal for the tooth to be painful?

DP: Usually when a child is about 6 years old, his/her teeth will begin to become ‘shaky’, ‘wobbly’ or loose. Keep the teeth and gums as clean as possible as many kids are afraid to brush these shaky teeth. Let your child wiggle the tooth until it falls out on its own. This will minimize the pain and bleeding associated with a lost tooth. Be aware that ” shaky baby teeth” can occur from age 6 years all the way to the age of 12 years as adult teeth erupt.

TMJ: How often should my child visit the dentist?

DP: A schedule for follow up visits will be determined by your child’s oral health professional. Visits can often occur twice a year but can increase to as many as 4 times a year for children who are assessed to be at high risk for dental disease.

 

About Dr Percival:

Dr Tricia Percival is a lecturer in paediatric dentistry at the University of the West Indies (UWI) School of Dentistry and has been a practising paediatric dentist for the past 15 years. She received her undergraduate training at the UWI Dental School and completed her postgraduate degree at the Eastman Dental Institute, University College London. Among other areas of interest, Dr Percival also has a focus on treating children with special needs.

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