Tooth decay is the most prevalent chronic disease of childhood in Nagaland and despite being overwhelmingly preventable is on the rise among young children rapidly in the last 10 years of my clinical practice.
Dental caries – the disease process leading to cavities – is established in the first few years of a child’s life, with some children being susceptible to decay soon after their teeth first appear. The occurrence of tooth decay before the age of six years – known as Early Childhood Caries (ECC) – is of particular concern both because of its prevalence (affecting 50% of five year olds) and because past caries experience is the best predictor of tooth decay across the lifespan. The younger a child is when they experience their first cavity, the more likely they will experience more cavities in both their baby and permanent teeth.
Effective prevention requires early intervention, risk-adjusted care, and parental engagement and education. Both the American Academy of Pediatric Dentistry and the American Academy of Pediatrics agree that a dental care be established by one year of age, particularly for young children deemed at high-risk for ECC.
By establishing a dental care early in life, children and their families can be provided with oral health counseling and primary prevention services at a time when interventions can make the most difference – before dental caries is established in a child’s mouth. Early dental care may also reduce dental care costs while improving health outcomes and has been associated with reduced costs in tooth repair.
In my clinical practice it is very important to discuss thoroughly with the parents or caregivers about their child's oral health and their goals for their own and their child's oral health and oral healthcare. Consultation involves certain questions.
Examples of these questions are:
What do you want for your child's oral health teeth?
What are your worst fears about your child's teeth?
What are you dental care challenges? How would you like things to have turned out? How could it be better?
What do you want for your child's teeth in the future?
If you could have one with wish for your child's teeth, what would it be?
Parents and caregivers can be considered gatekeepers for the oral healthcare of preschool children, therefore their oral health knowledge, beliefs, attitudes and behaviour may directly, or indirectly, influence early childhood oral health. Although not directly linked to behaviour change, improving the knowledge and awareness of parents and caregivers is a key element of dental prevention in preschool children.
My advice to all the parents and child caregivers
If breastfeeding discontinue.
• Stop bottle feeding (switch to cup).
• Don't give sugary drinks at night.
• Limit sweet drinks to mealtimes and try to give natural fruit juice instead of colas or other sweet drinks.
• Help to brush your child's teeth twice a day (one of which should be at bedtime)
• Help to brush from behind your child.
• Use fluoride toothpaste (pea size amount)
• Limit sweet snack to no more than three times a day at mealtime.
• Use fruits and savoury snacks instead of chocolates and candies.
• Register child with a dental clinic.
• Take your child for a dental check-up and fluoride varnish treatment every six months.
Dr. Temjennungsang Longchari
Dental Touch & Facial Aesthetics
Midland, Dimapur.
