Home Magazine Issues Dec 2012- Jan 2013 Taking care of your teeth

Taking care of your teeth By Dr Tom Mutyabule

Taking care of your teeth – Health review

Healthy teeth and a beautiful smile is every one’s wish. While this is possible some information may be useful to make sure it happens.

About teeth before birth

Baby teeth start developing in the child’s jaws between 6 to 8 weeks of pregnancy while permanent teeth start to develop at week 20.
If the teeth do not start to develop at this time of pregnancy then they will be missing. The mums health, diet and medications taken can affect the development or appearance of the teeth when they eventually appear in the mouth. Nutritious foods rich in calcium are essential especially for the baby’s bones and teeth. However, some medicines like tetracycline should not be taken during pregnancy because they cause staining of the unborn child’s teeth.


Taking care of your teeth - stained teethDiagram showing stained teeth

Note: the upper teeth are brownish due to tetracycline administered to the mum during pregnancy, breastfeeding and the early childhood. However this can be treated in many cases by laser bleaching the teeth.

Dental care in early childhood
The first baby teeth appear in the mouth on average at 6 months of age (the front lower incisor) and the last baby teeth (molars) appear at the age of 2 and a half years. There are usually 10 baby teeth in the upper jaw and 10 in the lower jaw.
Although we lose the baby teeth it is very important to keep them healthy because early loss of the baby teeth can lead to drifting of the remaining teeth and can lead to crooked teeth. The baby teeth therefore serve as the road map for the permanent teeth and should never be removed unnecessarily. The dentist can usually repair damage to the baby teeth and it is worth the trouble to do so since early loss of baby teeth often leads to space problems.

TIPS  for Taking care of your teeth 

It’s advisable to get the child to see the dentist by the first birthday even when there is no pain in your child’s teeth. This can help prevent the dentist being associated with pain and it also enables the child to bond or relate with the dentist before there is ever any need for treatment. It is also a good time for the child to learn about home care for the teeth when there is no fear of dental treatment (Prevention is always better than cure). The moment the teeth appear in the child’s mouth it is essential that routine cleaning is done using cotton and tooth paste. At around 1 year of age it is important that the toothbrush is introduced to the child. When the child is old enough to handle a toothbrush, daily brushing should be encouraged after every meal and after eating sweet foods and snacks.

Bed time snacks should be discouraged and feeding young children with sugary drinks in the feeding bottle at night to encourage them to sleep can lead to a lot of cavities in the baby teeth called feeding bottle syndrome. This is a situation in which the teeth of the child are all decayed (rampant decay/ cavities). Parents should try and substitute the sugary drinks with plain water in the feeding bottle. Avoid dipping the pacifiers in syrups or sweet drinks.
As the child grows in addition to checking the general development of the child, it is helpful to monitor the development of both the jaws and the teeth. The dentist can advise on the corrective measures if any. One habit children like is thumb or finger sucking. This can cause the teeth to drift and cause a condition called open bite. In this case the front teeth do not meet when the child bites.

open
normal

Teeth showing Open bite
Teeth showing a Normal bite

Please stop your child from thumb sucking as soon as you can. Encourage them to stop using the pacifier after 2 ½ years of age, because it can also cause ‘open bite’. Kids with open bite require corrective measures such as orthodontic treatment commonly referred to as ‘braces’ and or maxillofacial surgery to correct the defect.

Dental care during the teenage years
On average permanent teeth begin to appear in the mouth at the age of 6 years. The first ones are usually the first permanent molar teeth and the lower central incisors. The molars are far behind in the mouth and usually they get carious. Studies have shown that in adults the most carious teeth or the teeth lost due are the first permanent molars;
Since they come into the mouth at the tender age of 6 years looking after them can be challenging. The child has to learn to thoroughly brush the back molars. On average by the age of 12 all the baby teeth are lost and the permanent teeth if present have grown or are growing into the mouth with the second molar teeth erupting then

Tips
Brushing and flossing are key to good health and every child should start to learn how to floss their teeth well by the time they are teenagers. Care of the teeth should involve regular brushing and flossing after breakfast, lunch and dinner. A spare toothbrush in the school bag to brush after lunch at school is a good idea.
While it is important to eat nutritious foods (proteins, carbohydrates and fats) it is essential to note that there are some foods which are detrimental to the health of the teeth. Sweets have been known for a long time to be detrimental to dental health. Sweet foods should be consumed in minimal quantities and brushing the teeth soon after eating them is helpful in controlling cavities. Encourage the child to drink less of the fizzy drinks: the colas (Pepsi, Fanta etc.) and if the child must drink them, then using a straw is a good idea to avoid the soda coming into contact with the teeth. This will ensure that the liquid will go straight down the throat.
There are always a lot of bacteria in the mouth and the tongue is a good harbor of the same. Brushing the tongue is very important. There are aids called tongue cleaners that can assist in reducing the bacteria quantity in the mouth.
When we eat food some of it remains behind and it combines with the bacteria to form a film adhering to the teeth called Plaque which is dangerous to the health of the gums, teeth and bones. The bacterial invasion in the mouth can lead to health problems. It is therefore very important to clean the teeth several times during the day to stop plaque formation. Plaque, if it stays long, hardens and becomes calculus which is very difficult to remove and must be cleaned off by the dentist.

When cavities form in the teeth it is very important that they are filled so that holes do not get bigger. The cavities in the teeth may get blocked with food and this may act as a “temporary filling” and give a false sense of security since the pain may disappear at times. If cavities are there in the teeth they usually just get worse with time. The dentist can put a coating on the back teeth called a fissure sealant which protects the teeth against cavities. Compare it to the nail polish for ladies (Tooth polish). This is mainly for the back teeth which have fissures on the biting surface. As the teeth grow it is important to continue to monitor not only the health of the teeth but also their alignment.

Dental care during the adult stages.
Taking care of your teeth in adult hood is comparable to taking care of a car.!!!
Permanent teeth need care in order to remain healthy for a long time.

Studies have shown that mouth health is a reflection of ones general health as an adult. Loosing teeth can result in risk of heart attack!! Normally a full set of permanent teeth is 32 and people with less than 21 teeth have a 69% increase in the risk of heart attacks. Poor dental health not only gives one a bad breath but also leads to inflammation in the mouth.
Regular brushing and flossing after breakfast and dinner is highly recommended. My advice to the working adult who does not go home for lunch is to invest in another toothbrush, toothpaste and dental floss. Using these at the office after lunch promotes good health and keeps bad breath away. Remember you only floss the teeth you want to keep!!!
Nowadays electric toothbrushes have improved the quality of cleaning. Regular cleaning at the dentist decreases the risk of heart disease in the adults by about 25%.

Trauma
When injury occurs to the teeth/ gum, it is very important to seek dental care as soon as possible. In case teeth are broken or lost please get any fragments or teeth that can be recovered from the trauma site. In many cases the dentist can replant the teeth into the jaws.
Transport the fragments or teeth that may have come out in the cheek or glass of cold milk.