ERUPTION OF TEETH

Typically the first or milk teeth start coming through at six months, initially the central incisor teeth and then in sequence backwards with all 20 present at age 2. The lower teeth usually appear before the corresponding uppers, but as with all features of growth, the eruption of teeth is subject to considerable individual variation. The second or adult teeth erupt from age 6 and replace each milk tooth in sequence.
As the child grows, external forces can affect the development of the teeth and jaws: sucking thumbs, fingers or dummies can lead to distorted alignment of the front teeth, requiring orthodontic treatment for correction. (International Journal of Paediatric Dentistry  9  (3), 169-173)
 

CLEANING & DECAY PREVENTION

It is common knowledge that sugar makes teeth decay: the sugar is metabolised by the bacteria in dental plaque releasing acid as a by-product which attacks the teeth and gums. There are three key ways to prevent this: reduce the intake of sugar,  clean the plaque off the teeth and make the teeth more resistant.

Control of sugar in the diet is the most important factor in prevention of tooth decay. (Paediatric Dentistry UK National Clinical Guidelines 1999) Although some sugar is part of a balanced diet, sugar is added to numerous foods from breakfast cereals to tomato ketchup, often in significant quantities, particularly in food products aimed at children. The simple advice is ‘read the label’.
It was discovered some 50 years ago that the frequency of sugar consumption rather than total consumed determines the amount of decay. (Vipeholm Dental Caries Study 1954) Each time sugar is eaten, the  consequent damaging acidic attack on the teeth lasts 45 minutes (Stephan 1934); thus eating a packet of sweets slowly throughout the day causes more harm than gobbling the lot in one go.

Teeth cleaning should start as soon as the teeth erupt using a small-headed soft ‘First’ toothbrush with just a smear of special infant toothpaste, changing to a child size brush and paste later. The British Dental Health Foundation suggest that you may find it easier to stand or sit behind your child, cradling their chin in your hand so you can reach their top and bottom teeth more easily and use small circular movements and try to concentrate on one section at a time, not forgetting to brush gently behind the teeth and onto the gums. Make tooth brushing a routine - preferably in the morning, and last thing before your child goes to bed. They recommend supervising brushing up to age 7.

Fluoride is a naturally occurring substance which hardens tooth enamel, making it more resistant to acid attack. It is present in drinking water in varying amounts according to local geology and levels may be altered by water companies to an optimum level. Using Oxfordshire (UK) as an example, in Oxford city, drinking water contains a natural, unsupplemented low level of fluoride (0.14 parts per million), although higher levels of fluoride can be found in water in the Witney and Stokenchurch areas. (Thames Water Utilities water quality report). As most people now use a fluoride toothpaste, other fluoride supplements are not usually recommended. (Paediatric Dentistry UK National Clinical Guidelines 1999)
 

VISITING THE DENTIST

There is no fixed age for children to start visiting the dentist, but the teeth can be examined as soon as the child is likely to co-operate, typically aged about 3. However, before  this, it is recommended that children come to the practice  to familiarise themselves with the surroundings and to watch their parents, brothers or sisters having their teeth checked (British Dental Health Foundation). Less children now require fillings – in Oxfordshire 64% of 5 year olds have no dental decay. (Oxfordshire Health Authority Dental Care Services (October 2000) - Primary Care Group Profiles).

In Oxfordshire (UK) most local dentists are independent but many still offer some N.H.S. treatment – contact the Health Authority helpline on 0118-9183359.  Dental care for children remains free under the health service.
 

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