Not just baby teeth

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Brush RIGHT: When particles get stuck, problems occur.
Brush RIGHT: When particles get stuck, problems occur.


Milk teeth are important and preserving them is crucial.

Schools are closed and dental clinics are open. It’s a hot summer in Chennai and paediatric dentists are busy treating dental problems in children.

One sunny morning my friend Shakeer knocked on my dental office door. He looked very worried. His four-year-old daughter Nafia had severe pain in her teeth the previous night and had hardly slept. I examined her teeth and said I had to do some emergency treatment to relieve her.

Before I could explain, he exclaimed “It’s just a baby tooth, doctor” and set off on the following questions.

Does decay occur in milk teeth?

Tooth decay can occur in milk teeth also. The most common reasons are improper feeding habits like prolonged bottle feeding or breast feeding after one year and as and when the child wants and the inability to keep the child’s mouth clean.

How do feeding habits cause tooth decay?

Decay caused by bottle-feeding causes Nursing Bottle Decay. Milk basically contains carbohydrates like lactose (sugar) and when the bottle is given at bedtime to pacify the child there is a continuous exposure of the teeth to sugar. Also when there is retention of milk, candies, chips, wafers and sweets on the tooth surface there is more acid production and destruction of the tooth surface.

How do we recognise tooth decay?

Tooth decay starts with white spots; then the colour changes to yellow brown or black and finally the tooth breaks down.

Do we have to save the milk teeth? They are going to fall anyway…

Milk teeth are extremely important for eating, biting, chewing helping proper digestion; speech; Aesthetics; facial and jaw growth. They serve as guides for the permanent teeth to erupt and hence help in preserving space. Infection from the milk teeth when left untreated can affect the permanent teeth, which are lying beneath it.

How do we save these milk teeth?

Prevention is always better than cure. The child should have his first dental visit at one year of age. A periodic check up should be done every six months. Tooth-brushing pattern should be monitored. If the decay has occurred it can be restored with different materials based on the extent of decay.

What is root canal therapy? Do children need them?

Once the decay reaches the third layer of the tooth, the child has severe pain or the tooth becomes highly infected. To save such teeth, procedures similar to root canal therapy have to be done. An efficient paediatric dentist should be able to do this with much ease and without causing pain to the child.

If certain milk teeth are very bad and can’t be saved…what next?

Preserving the milk tooth is the first option. If it can’t be done, the milk tooth has to be extracted and the space has to be maintained with Space Maintainers These are small appliances which fit into the empty space and guide the eruption of permanent teeth.

If a child has multiple problems, how can it be managed?

When multiple teeth are decayed or when the child is too young to understand the dental procedures or when parents can’t bring the child for multiple visits the child can be treated under general anaesthesia, where all the teeth can be treated in a single visit without pain or creating dental anxiety for the child.

Is general anaesthesia safe for children?

Anaesthesia should be used in children who have passed certain basic investigations. A qualified anaesthetist should evaluate the child. Anaesthesia is used to greatly reduce the tension and the psychological trauma the child has to undergo in multiple dental visits. This is an internationally accepted safe method to treat young and very young babies.

If milk teeth are decayed and have been treated, can we protect the permanent teeth?

Proper tooth brushing and regular dental check up is important. The permanent molars can be sealed with Sealants (plastic coat on the tooth surface) and periodic Fluoride application, which make them more resistant to decay. Children have 20 milk teeth or baby teeth. All of them fall and are replaced by permanent teeth. They are extremely important for your babies and preserving them is a vital task for the parents and the family. They are not just baby teeth anymore and make sure your baby will not have a sleepless night.

The writer is a paediatric dentist based in Chennai.



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