“Prevention is better than cure”, an adage more useful as it is clichéd. From the last two posts we have looked into the importance of a child’s teeth, cause of Dental Caries and its consequences which might be onerous upon you emotionally as well as economically. So, how can we decrease this burden?

The key to prevention of Early Childhood Caries or any other form of caries lies in dealing prudently with the causes underscored in the last post. The principle of prevention has to do with limiting exposure to sugar, reducing the amount of germs or bacteria that child has, protecting the teeth with fluoride, and visiting the dentist.

1)      Diet and Time

• Sugar-containing drinks like milk, juices, etc should be limited to mealtimes or snack time. In between meals sugar in any form (drinks, chocolates, biscuits etc.) should be stopped.
• The child should not be put to bed with a bottle containing anything other than water.  
• Provide healthy food instead of food with high sugar content. 
• Pacifiers should never be dipped in sweet agents like honey, sugar syrup, etc.
• Infants should be encouraged to drink from a cup by their first birthday. Children should be weaned off the bottle/breast at about 12 to 14 months.
• If your child has to take any medicine for more than a few weeks, you can ask for sugar-free medications. If they are taking medicine with sugar in it, clean the teeth after they take their medicine.

2)      Reduction of Bacteria

• The mother or other caregivers should make sure that they do not have untreated decay in their own mouth in order to prevent it from spreading to their children. So, they should get the decay treated and maintain oral hygiene.
• Caregivers should be careful not to pass bacteria in their saliva on to their child by saliva-sharing activities like sharing food, drinks, utensils, or toothbrushes.  They should also not pre-chew food.
• During infancy and before the eruption of the first teeth, the gumpads or the toothless gums should be wiped clean with clean cloth or gauze after every meal.
• Toothbrushing should begin with the eruption of the first tooth.

Brushing Technique– When brushing the sides of teeth, tilt the brush so that the bristles come in at an angle, pointed partially toward the gums.  This will allow the bristles to clean the tooth all the way down to the gums.  Use gentle pressure and a circular motion, since the area where the tooth meets the gum is rounded. Once the back teeth start to come, you may need to pull the lips and cheeks back to reach all of the areas of the teeth. Be sure to clean the chewing surfaces of back teeth also.  The fissures (grooves) on these surfaces are best cleaned with a scrubbing motion.

3)      Protect the teeth

• One of the most important elements for our teeth is Fluoride. Fluoride helps in protecting the teeth from the bacterial acids and can even repair the tooth enamel in case of early stage of caries.The best way for your child to get fluoride is from fluoridated water but it is not available in all regions, and especially not in developing nations where even water is scarce.  If your house does not have fluoridated drinking water, the dentist may prescribe regular fluoride applications for your child or they may recommend that you start brushing your child’s teeth with fluoride toothpaste.All fluoride products should be kept where the child cannot reach them. As too much fluoride ingested at one time can damage developing teeth. Also, fluoride ingested in very large quantities can cause sickness and even death.
• If your child has defects in the enamel of the teeth, the dentist may decide to repair them with tooth-colored filling material to prevent them from becoming decayed.

4)      The Dental Visit

• Your child should visit the dentist within 6 months of the appearance of the first primary tooth, or by 12 months of age, whichever comes first.
• Try to schedule the first visit early in the day when the child is alert and rested.

  On the day of the visit say, “Today we get to go to the dentist!  The dentist will use a special little mirror and a light to ‘count’ your teeth and to make sure that they are all nice and healthy.”

• It is important that you be calm, patient, and reassuring. You may need to sit in the dental chair and hold the child during the examination.
• The dentist will examine the child’s teeth, jaws, bite, gums, and oral tissues for any problems with development or disease.  The dentist will ask questions about your child’s diet, sucking habits and hygiene.
• A dentist or hygienist can show you how you brush your child’s teeth properly and discuss whether or not your child needs to use fluoride.  The dentist may also talk to you about your child’s sucking habits.  Sucking on fingers or a pacifier should be discontinued by the age of 2, or the child’s bite will become disrupted.

So, there you have it. This simple knowledge if followed properly might save you a lot of time, money and of course emotional stress. In case of any queries please comment below this blog.

[Editor’s Note: Dr. Poojan Shrestha is a dentist at Patan hospital.]