Looking after baby teeth

Dental pathways Give me the baby teeth and I will show you the wo/man.

There is a 500-year-old saying which goes “Give me the child until he is seven and I will show you the man.” The idea is that the early life experiences of a child can shape the sort of person they will grow up to be.

Now, as new research from Otago University suggests, it appears that this old idea can be applied in dentistry today.

Tooth decay affects nearly everyone at some point in their lives, but it affects some people more than others. This can be for a variety of reasons: too much plaque (bacteria) on the teeth, eating or drinking sugary or acidic foods too often, deep grooves in the teeth that can’t be cleaned easily, insufficient fluoride exposure, or a combination of these issues.

Tooth decay can be prevented, but all too often children and adults who are at risk do not receive enough long-term preventive care. Eventually, tooth decay occurs and it gets worse over time. So how early is it possible to know who is at greatest risk of the worst tooth decay through life? This is where the Dunedin Multidisciplinary Health and Development Study can help. This study has followed the same 1037 Dunedin-born people over four decades, and is the first long-term study in the world that has collected dental information along with information on general health and development.

Through the Dunedin study, new research suggests that for every cavity in a baby tooth, the likelihood of tooth decay in the adult teeth increases dramatically. The research shows that unless something is really done about it, tooth decay will keep progressing over time. Children with lots of tooth decay become adults with lots of tooth decay, who need many fillings or dental extractions in their permanent teeth.

Looking after your teeth needs to be a lifelong habit that starts in childhood, because what happens to children’s teeth will affect them for their whole lives. Early loss of the baby teeth can cause the adult teeth to come through crooked, so it is important to repair the teeth with fillings if possible, instead of extracting them. Fillings also help to reduce pain and keep the teeth functioning, but fillings don’t reduce or remove the risk of future decay.

Children get a second chance. Everyone gets a second set of teeth – the adult teeth – most of which come through between the ages of six and 12, when some of the baby teeth are still present. Even in children who had a lot of decay in their baby teeth, the new adult teeth are free of decay to start, but they are not free from risk. The new adult teeth need protection.

So if your child has already had tooth decay at a young age, how can their future rate of tooth decay be minimised? Every child should be seen by a dentist or dental therapist regularly, beginning early in life. High-risk children need to be seen more often. As part of seeing a dentist or dental therapist, the grooves in the back teeth should be “fissure sealed”, and this should be done as soon as possible after the first adult teeth come into the mouth at about age six.

Fluoride plays an important role as well. Although many regions in New Zealand have fluoride in the water, this alone isn’t enough to prevent decay among children and adults who have high risk of decay. Dentists and therapists can apply concentrated fluoride to actually reverse some tooth enamel damage. It is also important to minimise the frequency of sugar consumption, whether it be from sweet drinks, foods, or lollies. Dental flossing should be introduced from a young age, and tooth brushing should be done at least twice a day for two minutes at a time, with a soft toothbrush and a suitable fluoride toothpaste. There are also special toothpastes for high-risk children and adults available from your dentist.

Baby teeth are precious and they need to be cared for very well. If your child has had a lot of tooth decay in their baby teeth then their adult teeth will need extra special care. It is never too early to start thinking about a child’s future.

By Dr Jonathan Broadbent, senior lecturer at University of Otago. Jonathan is the current NZ Outstanding Young Dentist (2011-2012).

For more information about caring for your family’s oral health, visit www.healthysmiles.org.nz.