Treating Children

Because of experiences as a child, I want children to have a positive experience of coming to the dentist, because this foundation will determine how easy on them visits to the dentist will be for the rest of their life. I started out my career treating them, spending five years treating mainly children.

Parents often feel concerned and some upset when their children need treatment. These feelings are often conveyed to their children, who are very perceptive even at very young ages. A child may become anxious and chances of cooperation diminish. Treatment can't be completed, or carried out to a standard we wouldn't really want, so repeating or continuing problems occur.

To make treatment more comfortable a change has occurred in the way that first teeth are treated. The best way to treat damaged back teeth is to remove decay from the tooth and cover it with a stainless steel crown, or a fully shaped and contoured filling. These require a fully cooperative child who accepts local anaesthetic. Although this is best for the tooth, it may not be best for the child. To overcome this a simpler approach is adopted by gently removing soft decay from the tooth and filling the space with a type of plastic that sticks well even if there is moisture around. This doesn't require local anaesthetic, because the decay has no nerves in it. To keep the mouth stable and prevent or at least slow decay regular visits (about every six to eight weeks) to have fluoride varnish painted on. This may continue until the adult teeth erupt.

Often problems occur with newly erupted adult teeth where they have not formed properly. At the age of six the first adult molar teeth come through, and they tend to be the most prone. Sometimes the outer coating of enamel is chalky and crumbles allowing bacteria into the tooth and decay starts very soon. These teeth usually form from four or five separate parts which join together under the gum to form the whole tooth. If they don't fuse properly there are spaces for bacteria to enter and decay to occur rapidly, even before the tooth shows through the gum fully. This presents a very difficult problem because a six year old needs treatment, which to be successful, needs to be carried out very carefully. There is a good chance of doing so if the child has visited every few months and is used to us, in which case we are likely to detect the problem at an early stage and treat easily, whilst a child attending for the first time possibly in pain is likely to have a very damaged tooth and treatment may be distressing or impossible requiring referral for a general anaesthetic so the tooth can be removed. The latter child may find it difficult to ever accept dental treatment without undue anxiety.

Tips for parents

Your children will only get tooth decay if the harmful bacteria that cause it can grow in their mouth and have the sugar to feed on.

If parents and siblings have decay, the harmful bacteria are likely to pass to the baby in large numbers and be ready to attack the teeth as soon as they erupt if the baby is fed food or drink containing refined carbohydrates (sugars...remember fruit juices and smoothies are refined carbohydrates, in that they have been freed from the fruit and able to provide bacterial nourishment around teeth).

A baby born into a family with no tooth decay will have only a few harmful bacteria, which must fight to survive. If these children are fed high sugar foods and drinks the harmful bacteria will grow, take over and cause damage, but this could take several years.

So your children's chances of having decay are influenced by the dental health of parents and siblings, so to reduce a new baby's chance of problems visit a dentist for advice and treatment before it's born.

It is important to take your child to the dentist from an early age (6 months, when the first teeth come through) so that problems can be discovered early on.

It is important to be very careful about what you say to a child about visits. Always try to be positive and portray it as being normal everyday thing like shopping for clothes/shoes, having a haircut and so on. Please don't make comments about how you felt as a child, unless it was positive, and avoid saying things such as "It won't hurt".

For a young child, you can make a game of practising opening wide to check teeth, so they know what to do. They will happily look in your mouth and see how many teeth you have.

This will make their visit much more enjoyable and interesting for them.