1. DIET

Discerning diet for a healthy dentition!

The better the child is nourished, the lower the caries risk. Often the nutritive value of a diet is badly understood and can lead to the loss of the substance of the teeth. Through our diet analysis we try to help your child maintain a good oral health.

Suggestions of a good diet:

• Daily at least: One warm meal
• 1 glass of milk
• 2 pieces of fruit
• 3 portions of vegetables
• 1 slice of whole-wheat bread
• 0.5 litre of water per 10 kg body weight

Valuable tips:

• Sweets as little as possible
• Better to have a big portion of sweets once than to nibble sweets the whole day long
• Fruit juices or sweet drinks should be taken only during the main meals
• At least 3 portions of vegetables
• Whole-wheat bread is better than white bread
• Strong spices and herbs stimulate the production of saliva
• Chewing gum after food prevents the building of acid, thereby preventing caries
• Beware! Even condiments (e.g. ketchup) could contain sugar

2. BRUSHING

Brushing not only removes food-remnants but dangerous dental plaque as well.

Brushing Advice:

Dental plaque comprises bacteria and metabolic waste-products. The bacteria multiply rapidly and as a sticky mass adhere to the teeth and aggressively produce acid. This acid attacks the enamel of the teeth and caries are produced.

If the dental plaque is regularly removed, the teeth will remain healthy!

3. Fluoride

Fluoride is an essential trace-element in our system which hardens the dental enamel.

Fluoride makes the teeth resistant against acid attack!

The amount of fluoride that we acquire from our daily diet is mostly insufficient.

An additional fluoride application makes the teeth resistant to acid attack and bacteria. We advise the parents what form of fluoride would best suit their child.

The following methods can be administered for additional fluoride supply.

Local application:

• Fluoride-containing tooth paste
• Fluoride varnish or fluoride gel
• Systemic application:
• Nourishment (drinking water with fluoride)
• Fluoride tablet

4. Dental Flossing

Many children have teeth that have grown tightly crowded in their mouth and this increases the risk of interproximal caries.

Why do we use dental floss?

These proximal spaces are too narrow for the tooth brush to do its duty and also for the dentist to check for caries with the naked eye. That is why regular fluoride application and flossing aids the prevention of interproximal caries. Parents and children will be taught how to manipulate dental floss for a proper use, and our preventive- team is always present for guidance.

5. Dental Decay

Dental decay happens when the enamel and dentin of a tooth become softened by acid attack, producing a cavity.

What causes dental decay?

Dental decay is caused by plaque acids that gradually dissolve away the enamel and dentine of the tooth to produce a cavity. Dental decay is the same as tooth decay and is also known as ‘dental caries’. Decay damages your teeth and may lead to the tooth needing to be filled, crowned or even extracted.

What is plaque?

Plaque is a thin, sticky film that keeps forming on your teeth. It contains many types of bacteria.

Why do my teeth decay?

Decay happens when sugars in food and drinks react with the bacteria in plaque, forming acids. Every time you eat or drink anything containing sugars, the bacteria reacts with it to form acid. These acids attack the teeth and start to dissolve the enamel. The attacks can last for an hour after eating or drinking, before the natural salts in your saliva cause the enamel to ‘remineralise’ and harden again. It’s not just sugars that are harmful, other types of carbohydrate foods and drinks react with plaque and form acid. Snacking on sugary or acidic foods and drinks can increase the risk of decay as the teeth come under constant attack and do not have time to recover. It is therefore important not to keep snacking on sugary foods or sipping on sugary drinks throughout the day.

What are the signs of dental decay?

In the early stages of dental decay there are no symptoms, we may be able to spot an early cavity when we examine or x-ray your child’s teeth.

What happens if I don’t get it treated early?

Toothache is a sign that your child should see the dentist immediately, as it is a warning that something is wrong. If you don’t do anything, this will usually make matters worse, and your child may lose a tooth that could otherwise have been saved.

Is there anything I can do to protect my child’s teeth against decay?

The best way to prevent dental decay is by brushing the teeth thoroughly twice a day with fluoride toothpaste, making sure that you brush your child’s teeth the inner, outer and biting surfaces. Using dental floss helps remove plaque and food from between your teeth and gum line. These are areas a toothbrush can’t reach.

Also visit the dentist regularly, as often as recommended, and try not to give your child sugary and acidic food and drinks. Avoid giving snacks between meals as this limits the times the teeth are under attack from acids. You can give sugar free gum, preferably with Xylitol, for ten minutes helping the mouth to produce more saliva, which helps neutralise any acids which have been formed.

6. Oral Ulcers

Small to middlesized ulcers found on the inner side of lips, the floor of the mouth, the inner side of the cheeks and on the tongue.

Aphthous ulcer (canker sore) Advice...

Has your child ever had herpes or mouth ulcers?

If the answer is yes, then you know how painful they can be, even though they are harmless. These harmless blisters can make eating, drinking and sleeping, a nightmare.

What are these small ulcers?

Aphthous ulcers (canker sores) are small to middlesized ulcers found on the inner side of lips, the floor of the mouth, the inner side of the cheeks and on the tongue. They take one to two weeks to disappear. There are not any definitive medical explanations as to why these uclers appear but genetic factors are involved. Stress or micro-trauma in the mouth (for example, due to a tooth brush injury or sharp crisp edges) may trigger ucler formation. Allergies to certain foods and/or hormonal changes are known etiological factors. Some indications are found for imbalances in the gastro-intestinal nervous system, explaining the stress factor or their occurrence after illness.

There are no known means of preventing these ulcers but there are a few sure things that you can do to prevent the ulcers from getting worse. Children typically get them when they are overtired because of a change in sleep patterns (such as on holidays). Also after birthday parties with many sweets or again on holidays when unusual foods are eaten.

The best way to deal with them is “to live healthily” and according to the clock, which means sleeping well and enough. Eat typically bland diet foods like potatoes and cooked vegetables; not too oily or too spicy. Get enough rest and avoid extremes. Realize they do take a while to go away and they are painful. Your dentist can prescribe a pain-easing ointment if necessary.

If your child gets oral ulcers rather often:

• Make sure she/he is sleeping enough/regularly
• Consider undue stressors in his/her life
• Have meals always at the same time of day
• Decrease your child’s consumption of acidic fruits like cherries, peaches, pineapple, tomatoes, citrus-fruit juice or other sour items

Herpes ulcers

These are just as unpleasant as the aphthous ulcers. They appear around the mouth on the lips and as a rule are made up of many tiny blisters coalescing as one pustule. The pustule may swell and then burst open, releasing a fluid substance, before it heals up with crust formation.

Different from Aphthous ulcer, the cause of Herpes blisters is known as the Herpes simplex Type 1 virus. The first infection usually sets in at pre-school age and is accompanied by a reddish, swollen mucous membrane, bleeding gingiva, fever, swollen lymph nodes and lethargy. After the first contact with this virus called Herpetic Gingivo-stomatitis, the virus sits passive in the basal cell ganglion of your child. When the virus has found a home in a nerve cell, it can always become active in the future and cause ulcers again. Factors known to trigger an attack are diseases, fever, and strong sunshine, and even a trauma can cause your child to suffer the same ordeal again.

A few suggestions to make the pain your child is suffering a little bit more bearable:

• Make your child drink a lot of fluids to prevent dehydration
• Giving your child a straw with which to drink the fluids may help decrease the unpleasantness
• Apply or rinse with medication for the pain
• Use a lip balm when the lips of your child are dry, cracked or chapped
• If it increases to be too unbearable for the child to brush his or her teeth make him or her rinse his or her mouth with water after meals
• If the ulcers do not disappear within 10 days, make an appointment with us to investigate

7. Herpes in children

Herpes gingivostomatitis is a mouth infection that occurs in children aged 6 months to 5 years. It is caused by a virus called Herpes.

What is it?

Herpes gingivostomatitis is a mouth infection that occurs in children aged 6 months to 5 years. It is caused by a virus called Herpes, which is the same virus that causes cold sores on the face or lips. Infected saliva from an adult or another child is the mode of infection. The incubation period is 3-6 days, with an abrupt onset of the symptoms.

Signs and Symptoms:

Your child may have sore open blisters and swelling of the gum, lips, tongue or hard palate, may have high fever and feel tired. It may be hard for your child to eat and swallow because of the pain. Your child may also have bad breath and a sore throat. The blisters usually heal in 1 to 2 weeks. Viral shedding from the saliva may continue for 3 weeks or more.

Care:

Your child may not feel like eating solid foods until his/her mouth feels better. Feed your child soft foods. Good choices are strained baby foods, soft fruits, mashed potatoes, yogurt and pudding. Your child should not eat salty, spicy and hard foods.

After each meal, rinse your child’s mouth with warm water. If possible let your child rinse or gargle his mouth and throat with warm salt water. Wash your hands and your child’s hands often. Wash any toys that your child puts in their mouth before and after your child plays with them.

Make sure your child drinks a lot of fluids to prevent dehydration. Give your child cool liquids to drink. This may help soothe the mouth and numb the pain.

Good choices are milk, milkshakes and clear liquids. Do not give citrus or carbonated drinks such as orange and grapefruit juice, or lemonade. These liquids will cause your child’s mouth to hurt more.

Your child may want to use a straw if they have blisters on the lips or the end of the tongue. Use a lip balm when the lips of your child are dry, cracked or chapped. You may give your child ibuprofen or tylenol for the pain.

8. Tooth Grinding

Bruxism is the medical expression for teeth grinding. The pressure between the upper and lower jaw while sleeping or under stress.

Noises in the night:

Sound asleep you all of a sudden hear a rattling noise that wakes you up. You listen carefully and after examination you, surprised, find out it is coming from your child’s bedroom. Expecting the worst you run in to your child’s room and stop in your tracks. Your childs teeth are grinding aggressively but she or he is still sound asleep.

Bruxism is the medical expression for teeth grinding. The pressure between the upper and lower jaw while sleeping or under stress. Originating from the Greek word “brychein” (meaning as much as grinding teeth) Bruxismus displays a common child behaviour aspect. Bruxism is not triggered by one specific factor. Some children grind their teeth on account of having their upper and lower jaw not closing properly. Other children grind their teeth as a pain converter with tooth problems and earaches- However generally children grind their teeth due to stress. If your child ever becomes nervous in front of a class test or nervous due to family affairs the risk of Bruximus for a child increases exponentially.

If you discover that your child has a teeth-grinding problem visit a paediatric dentist. The paediatric dentists then examine whether the enamel from the occlusal surface on his or her teeth is ground off or if your child has any orthopaedic problems. The dentist then also judges if the loss of tooth substance or sensitivity came down as a psychological influence on the child. Then the dentist is able to decide on the right treatment plan. For example, if a permanent tooth has been harmed. A mouth guard could be constructed, especially in children older than 9 years old. The mouth guard is able to protect the teeth from further damage and help prevent facial or temporo-mandibular joint pain. The mouth guard would be custom-made for the individual and the child would have to use it during sleep.

You could also help your child to put an end to this habit by doing the following:

• Speak to your child and find out if there is anything you can do to help with the problem your child is facing
• Let your child have a warm bath or shower before going to bed
• Play calm and pleasant music when your child goes to bed
• Read a story from his or her favourite book
• Find something interesting for your child to do as part or the daily routine before going to bed
• Most children stop this habit as they become teenagers. When you go out of the way to help your child, the child will most definitely grow out of this habit. Do not worry too much; these noises in the night will not go on forever!