Oral Health

By Jane Doucet on February 28, 2011
Everything you wanted to know about your child’s dental health, but were afraid to ask

Although the mouth is part of our body, we tend to treat it as a separate entity, often ignoring bleeding, swollen or tender gums and tooth pain until we can no longer stand it. Never mind that for most parents, taking their children to the dentist isn’t a fun outing.  To coincide with National Oral Health Month in April, ParentsCanada asked Dr. Sarah Hulland, a pediatric dentist in Calgary and spokesperson for the Canadian Dental Association, to answer the following questions about kids and their teeth.

Why does my daughter resist brushing her teeth, even lie about it? Why do kids hate it so much?
A/ Children like to be in control of things.
Tooth brushing is one area that parents often allow their kids to have too much control, too early. If they then try to retake control, the kids will often rebel. “Children hate things they don’t understand, so explain to them in an age-appropriate manner why we need to care for our teeth, the same way you’d explain why we wash our hands after using the bathroom and cover our mouth when we cough and sneeze,” says Dr. Hulland. “You might have to repeat the information until you press the point home, but it’ll be worth it.”

When can my child start brushing his teeth by himself?
A/ You should help your child brush his teeth until he’s at least eight years old and help him floss until he’s at least 10. Many children will tell their parents they can do it themselves, but most won’t take the proper time or use the right technique on their own. “If your child resists your help, offer to let her do the morning brushing alone while you help with the evening one,” says Dr. Hulland. “A compromise is a good solution.”

My son has good oral hygiene and still gets cavities. Why?
A/ There are about 150 variables involved in maintaining proper oral health. There are genetic considerations, such as the quality and quantity of mineralization of the teeth. Then there’s the consistency and quantity of the saliva we produce (some people have stickier saliva, with less buffering capacity).
There are also “environmental” issues, such as how often we eat (the more meals and snacks we consume, the more likely we are to have cavities); how long it takes us to eat (slower chewers have “fermentable carbohydrates” such as sugars and starches in their mouths for longer periods of time, increasing cavity risk), the types of foods being eaten (junk food versus fruits and veggies and sugary juices and pop versus water). Believe it or not, there are also psychological issues: stressed people tend to produce more acidic saliva and are more likely to eat more fermentable carbohydrates such as candy.

My daughter has white stains on her teeth. What are they?
A/ Many things can cause spots on teeth. One common reason is associated with a history of trauma to the primary teeth, which results in a freckle-like spot on the permanent teeth. Some spots are actually “demineralization lesions” associated with poor hygiene habits, which can develop into cavities. Ask your child’s dentist to examine the spots. That exam, along with a review of overall oral health history, will help provide an accurate explanation of why the spots are there and what, if anything, can be done.

A trip to the dentist really scares my son. What can I do to ease his fears?
A/ Try to determine why your son is scared. If he’s frightened simply because of the unknown, there are many books that walk children through a dental visit, such as The Berenstain Bears Visit the Dentist. If he’s scared because of what he has heard from other family members or schoolmates, discuss this in an open and positive manner. “For example, if he heard that the dentist had to ‘yank’ out another child’s tooth, you can use that situation to talk about why your son needs to maintain good brushing and flossing habits to prevent cavities from developing,” says Dr. Hulland. “Reinforce the concept that the dentist is helping keep your son’s mouth healthy, to put a positive spin on things. If your child has anxiety issues, you can ask the dentist to help you find ways to make the visit less stressful on both your son and yourself.”

I’m on a limited budget with no benefits. How often does my daughter really need to see the dentist?
A/ The number of yearly visits should be tailored to your daughter’s risk for cavities and other oral health problems. Some people need to have their teeth cleaned every three months; others just once a year. “Many people determine the frequency of dental exams and cleaning by how often their health insurance pays for these procedures,” says Dr. Hulland. “But your daughter’s dentist and hygienist should make those decisions after reviewing her oral history.”

How often do children need to have dental X-rays?
A/ Radiographs should be done on a prescription basis. For example, a child with a high-cavity history may need to have them taken every six months to help determine if new cavities are developing. Some children require them less often, perhaps every 12 to 18 months. “Not all radiographs are taken just to see cavities,” says Dr. Hulland. “They’re also used to evaluate tooth maturation, the position of developing teeth, crowding and missing teeth and other potential problems.”

What are dental sealants? I survived without them.
A/ For many children, sealants are a wonderful preventive service that will help them reduce the risk of cavities on the biting surfaces of their teeth. A sealant is a plastic material applied to the chewing surface of the molars to prevent food from getting trapped or acid from forming cavities. Sealants don’t reduce the risk of cavities between the teeth, though, so flossing is still important. “Not all teeth benefit from sealants if the groove anatomy on the biting surface of the teeth is very shallow,” says Dr. Hulland.

Are braces really necessary?
A/ “It depends on the nature of the crookedness of the teeth and the irregularity of the bite,” says Dr. Hulland. “People with excessive or insufficient growth of their jawbones often need braces to allow for proper biting and chewing.” Talk to your child’s dentist or an orthodontist to help clarify whether braces will improve function or simply improve the look of the teeth.

Are teeth whiteners safe for children?
A/ “Whiteners haven’t been clinically tested for children younger than 12, so I wouldn’t recommend them,” says Dr. Hulland. That’s because when teeth are still young, the nerve system inside the tooth is wider, making the tooth more sensitive to temperature and chemicals such as whitening agents.

How do I find out if my dentist is legit?
A/ You can call your provincial dental organization (PDO). The PDO will be able to tell you whether your dentist is a licensed member of their organization, and only those members who meet their accreditation criteria will be listed there. Word of mouth is another valuable tool, so ask friends or neighbours who like their dentist for referrals.
Visit the Canadian Dental Association’s website at cda-adc.ca, click on Visiting the Dentist and scroll down to How to f’ind a Dentist to find your provincial office.

Published in March 2011.

Jane Doucet is a Halifax-based writer and frequent contributor to ParentsCanada.

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