TEETHING AND CARE OF TEETH

Teething Does Not Give Rise To Any Serious Illness
One of my teachers used to say, ‘Teething causes teething and hardly anything else.’ It is true. If your child has high fever or diarrhoea or any symptom worth taking note of, do not ascribe it to teething.

When the actual tooth is erupting, your child may become irritable or may drool a lot. It is also true that children do have more diarrhoea around the period of teething, possibly due to introduction of foods other than breast milk. The food may be contaminated. Because of itching, the child may put things in the mouth that may give him an infection. So we must look for a possible cause for any symptom or an illness that occurs when the child isteething.


Comfort During Teething
All your child probably needs is more body contact. Give him something clean to bite. I do not recommend the gels for local application available in the market. A little discomfort is a part of growing up. Let the child start learning this gradually from an early age. At the same time, let him feel secure in the arms of a caring adult during such painful experiences. Rub his gums if he likes it. Wash your hands and use your fingers for this purpose. 

If he continues to be irritable, give him a dose of paracetamol repeated after 4 hours, if required.


Delay In Eruption Of Teeth
There is a lot of variation in eruption of the teeth. Some babies celebrate their birth with a tooth. Most cut their first tooth around 6 months. Others may do so around one year. However, the gums may start getting ready from 3 to 4 months onwards, giving rise to irritability, a tendency to bite, and drooling of saliva.

So long as the child does not have any associated problems, delayed appearance of teeth is normal.


Dental Caries
Bottle-feeding and sugar are very bad for the teeth. Bottlefeeding is especially bad if the bottle is given to the child in sleep. Some children get more cavities in the upper teeth as the tongue protects the lower ones. Lack of calcium does not give rise to caries of teeth.

Don’t let your child develop a sweet tooth from an early age. To begin with, give no sugar or sweets. Later on, ensure as little intake of sugar as is possible. Chewing gum, eclairs and toffees are worse than sweets because they are likely to remain stuck to the teeth. 

When it comes to medicines, choose a tablet (if he has already learnt to swallow a tablet) over syrup.

Breastfed children have a much lesser incidence of caries. I have seen an occasional breastfed child with caries who was given sugar during the day and who slept at the breast while suckling — giving the normal sugar in the milk a greater chance to act on the teeth.


Dental Hygiene For The Mother
Ideally, a woman should get her teeth checked up even before she conceives. In case of a difficult pregnancy, the mother who is advised prolonged bed rest may neglect her oral health. During pregnancy, doctors like to avoid dental intervention, especially in the first 3 months. During this period, antibiotics and other drugs are generally to be avoided for fear of probable ill effects of these drugs on the growing embryo. For instance, the antibiotic tetracycline given during pregnancy can result in discolouration of the child’s teeth. 


The Importance Of Baby Teeth
Many mothers believe that baby teeth don’t require any attention because they will be shed. Dr. Dinesh K. Daftary, dental surgeon and specialist in oral medicine, points out that this is far from the truth and that baby teeth have a definite role to play. They allow the child to masticate food properly and also allow for the growth of the jaws and muscles. Baby teeth keep ‘space’ for the next permanent tooth, as it erupts, after the natural exfoliation of the baby tooth.

If the baby tooth has to be extracted or falls before its time, the adjoining teeth will start moving into this gap, leaving a smaller space for the permanent tooth to erupt into at a much later date. 

Therefore, it is important to give the child a good oral hygiene habit right from the age of 2 years. Ideally, the mother should develop the habit of wiping her infant’s teeth with a swab of wet cotton after he has been given milk or food, to prevent these from remaining on the tooth surface. After wiping the teeth with a wet cloth or with a wet cotton swab, the toddler may be given a toothbrush or toothpaste to play with. As he grows older, he may start asking for it. Then he may be taught to brush his teeth properly.


Get Your Child Used To The Dentist
Take your toddler with you when you visit the dentist yourself for a non-painful procedure. Let him have a look at the dentist’s clinic, let him sit in the dentist’s chair if he wants to. Some time after his second birthday, take him for a checkup. Then get a yearly check-up done. If he has any caries, let the doctor attend to them.

The doctor may tell your child about the importance of rinsing the mouth after each meal and brushing the teeth at least once a day, especially before going to sleep.

The teeth must be cleaned with a soft brush. The dentist may teach him to clean the teeth from below upwards for the lower teeth and from the gums downwards for the upper teeth. Do not worry if he does not follow this advice. The important thing is to clean each and every tooth properly.

He may need your help for the first couple of months.


Use Of Fluoride
Fluoride does guard the teeth against cavities, but it can also be harmful. It is best to avoid giving oral fluoride preparations to your child. Find out from your dentist if your city’s water supply has enough fluoride in it. If it does, do not use a toothpaste containing fluoride. If not, the dentist may apply a fluoride solution to your child’s teeth or prescribe fluoride toothpaste. In general, the World Health Organisation (WHO) recommends that no fluoride toothpaste be used below 3 years of age. It could be used once a day between 3 and 6 years and twice a day in older children.


Beware Of Misleading Advertisements 
Advertisements that show that your child can eat junk foods containing sugars and yet remain free of cavities, provided he uses a particular toothpaste, are misleading. One is surprised at how such unethical advertisements are allowed on television. Also, no toothpaste can guard the family against tooth troubles if they do not follow the basic principles of dental care.

PREVENTION OF DENTAL DISORDERS: Breastfeeding, avoidance of sugar, regular brushing, and dental check-ups are the key factors in preventing dental disorders in children. To prevent the permanent discoluration of the teeth, the antibiotic tetracycline should not be given to pregnant women and to children below the age of 8 years.

Dr. Daftary offers the recommendations of The British Nutrition Foundation Oral Task Force given in the British Dental Journal as guidelines to mothers of babies and young children:

• Brush teeth twice a day.
• Limit the consumption of sugary foods and drinks to mealtimes.
• Avoid cariogenic snacks and sugared drinks between meals.
• Do not add sugars to bottles of infant formula.
• Do not give drinks containing sugars or other fermentable carbohydrates in bottles or feeders.
• Do not allow babies with teeth to fall asleep when feeding.
• Ensure that, as far as possible, medicines given are sugar-free.

Dr. Daftary strongly advises that the child should not be allowed to develop the habit of drinking cola drinks because these are highly acidic and tend to demineralise the enamel of the teeth. 

Teach your school going child to use a wet finger to clean his teeth after a meal whenever proper brushing facilities are not available. The purpose is to remove food particles sticking to the surface of the teeth. No decay of the teeth with bacteria is likely to take place if there is no medium such as food particles or milk sticking to the surface of the tooth.

7 March, 2016