Dr Mary Cheong Poh Hua
Ministry of Health
The toothbrush of the child should be changed if the bristles begin to splay.
Parents, especially mothers, have a major role in the oral health of their children, in particular the young and very young children.
This is because very young children are totally dependent on adults, in most cases, their parents, for virtually everything; from feeding, bathing, toilet, sleeping to safety, nurturing and educating.
They are the most effective people to help instil habits in the child that contribute to good dental health.
However, the converse is also true, where parents are also responsible for developing habits in their children that contributes to poor oral health.
WHY IS THIS SO?
Dental disease/caries - multifactorial and preventable
We need to understand the cause and progression of dental disease and the factors that influence or modify the disease.
It is well known that dental disease, in particular, dental caries is a multifactorial disease that is influenced by lifestyle and is entirely preventable. The cause of dental disease is primarily bacteria (in particular Streptococcus Mutans) that are present in the mouth called plaque. The bacteria metabolise the sugars present in the mouth and produces acids as waste products.
These acids dissolve the minerals of the tooth structure and soften the enamel and later the dentine, causing cavities in the tooth.
However, other factors that influence this process are time; the frequency, type and amount of sugar that the tooth and bacteria is exposed to; the resistance of the tooth structure to acidity; the removal of bacteria from the teeth and mouth/the presence or absence of cariogenic bacteria in the mouth; the presence of intervention procedures such as fissure sealants, topical fluoride rinses or gel.
Studies have shown that preventive approach rather than curative approach plays a significant role in improving oral health status. It has been found that the presence of dental services alone was relatively unimportant in improving the oral health status of children. Other dental preventive and social factors play a significant role in improving the oral health status. Studies have indicated a relationship between the parental socio-economic characteristics and the oral health of their children. In addition, the primary socialisation process between the parents and their children in all aspects of life such as dietary practices, dental health awareness and perception will also influence the oral health status of their children.
Importance of early intervention and education for the child
It is very important to introduce good dental health care early in the child's life as this would most likely lead to good oral health in adult and would eliminate the negative psychological and emotional impact that dental pain and it's related treatment has on the younger age group and it's long term effect and implications to dental health in their adult life. There is also the greater chance of maintenance of good oral health later in life if primary health care (prevention of dental disease and promotion of dental health) is started at a young age.
Parental influence has the greatest impact on determining the dental caries of their young children, as they are largely dependent on their parents. A child is not a free agent. The ability of a child to act is limited by parental willingness and ability to assist the child. A child may be taught the importance of eating low-sugar foods. However, if his mother continues to serve high-sugar foods, the child will not be able to adopt healthier habits. Therefore, parental attitudes towards oral health are important factors in a child's oral health.
Since children are dependent on the adults for their general well being, including their oral health, it is therefore, important to recognise the role and responsibility of parents in providing early intervention and education for their children during their formative years.
The responsibility of pregnant mothers
Studies have shown that gum (periodontal) disease and poor oral hygiene are related to: -
Low birth weight, Premature birth and Heart disease
It is therefore important for pregnant mothers to be responsible to their babies by taking very good care of their oral health during pregnancy.
Recommended guidelines
Tooth brushing
Parents should brush their children's teeth from the moment the first tooth erupts till the child begins to develop the manual dexterity to brush independently with supervision at age two-seven years old.
Children's fluoridated toothpaste should be used for brushing the child's teeth only when the child can spit or rinse, usually from the age of two years onwards. Parental supervision must be emphasised. This is for plaque removal effectiveness and also to ensure that the child does not swallow any fluoridated toothpaste.
The size of the fluoridated toothpaste to be used should not be more than the size of a pea.
The toothbrush of the child should be of a small head, ie about the length of a 20 cents coin in diameter and the bristles should be soft. The toothbrush of the child should be changed if the bristles begin to splay
Infant feeding
Breast-feeding is preferred to bottle-feeding.
If bottle-feeding: -
Bottle-feeding are encouraged to be stopped by the age of one to three years old and should be replaced by a cup.
Bottle-feeding time should NOT be prolonged.
The bottle should NOT be in the child's mouth for extended periods of time. Bottle-feeding should NOT be a pacifier for the child. Appropriate attention and nurturing should be given and should NOT be replaced by bottle-feeding.
Bottle-feeding before sleep/nap should NOT be encouraged. Bottle feeds should NOT have any sugar or sweetened beverages added.
SNACKS
Sugary snacking should be discouraged and should be limited to less than three times a day.
Sweets/candies should not be used as rewards for good behaviour or good performance as this may encourage it to be a habit, which will jeopardise the oral health of the child.
When forced to give sugary snacks, it should only be during meal times and not in-between meals.
Parents should know the sugar contents of foods given to the child. Parents are encouraged to read and understand food package labels. Children are only allowed not more than 25 grammes (five teaspoons) of sugar per day and adults 50 grammes (10 teaspoons) of sugar per day. NOTE: One can/tin of sweet beverage contains about five to 10 teaspoons of sugar.
Child education
Parents should not instil fear in their children regarding dental health or dental treatment.
Parents should not threaten their children with "toothache" or dental pain and it's related dental treatment (injection, extraction) for bad behaviour or disobedience.
Dental Health should be taught in a positive manner that will build awareness in their children regarding their oral health care without undue fear that is unbeneficial to the child. This will cause the child to have a negative attitude towards dental health and indirectly jeopardise their dental health. The child may develop an irrational fear towards dental clinics and dental treatment later on in life when there is a need for it.
Source: Weekend 1 November 2008
No comments:
Post a Comment