We all know the essentials of keeping teeth clean and healthy: brushing, flossing, and regular visits to the dentist. But as children grow and develop, their needs change too. To find out more about the different stages of childhood dental health, we talked to Prosthodontist at Beijing United Family Hospital and Clinics (UFH), Dr Chung-Ming Tse.
Dr. Tse is from Canada, and has worked at UFH since 2001. Before coming to Beijing he studied in the US, practiced in Canada, taught in Hong Kong, and worked as a flying dentist in Australia and New Zealand, serving less privileged people in remote areas.
Tears and Teething
Children’s primary teeth begin forming at the fetal stage, six to eight weeks after conception. The age at which teething begins varies from child to child, but they usually come in the same order and in pairs (lower front teeth first, molars last). It takes about two years for all 20 to emerge. Some babies are born with teeth! Some famous examples include Napoleon Bonaparte and Julius Caesar.
Dr. Tse’s Tips
• Start brushing babies’ teeth as soon as the first primary tooth erupts, usually between the age of six to nine months
• Get their first dental checkup when they get their first tooth, or at the latest by one year of age, in accordance with American Association of Pediatric Dentistry recommendations.
• Wean kids off of a pacifier by age 3-4. “It’s OK to use one for security or comfort reasons,” says Dr. Tse, “but the child must be weaned off it to prevent deformation of the dental arch.”
• Watch out for early childhood caries, or baby bottle caries. (Caries is the technical term for tooth decay; “baby bottle” because drinks containing sugar, even naturally occurring sugar, are associated with this disease. Soda, formula, cows’ milk, and fruit juice can all
contribute to problems.)
• Ease teething pains with teething toys, cold gauze to rub on their gums if your child feels uncomfortable, or over-the-counter
topical medication such as Orajel if discomfort is severe.
Primary teeth are generally called “baby teeth” in North America. In British English they’re “milk teeth”, and it’s the same phrase in Chinese:
乳齿 (ru chi). The technical term for them is “deciduous”, like trees that lose their leaves in winter.
Dr. Tse’s Tips
• Be sure to brush their teeth with toothpaste containing fluoride, because unlike in some western countries, Beijing water is not fluoridated.
• Dental floss should be used, especially when teeth are in close contact to prevent caries forming between teeth.
• Limit the frequency of meals to three meals a day with two snacks, and control their diet to reduce the consumption of candies.
• Parents can encourage children to brush on their own first, then brush again for them, making sure their teeth are really clean. This practice should continue until the child is about six. Younger children do not have the manual dexterity to clean their teeth properly on their own.
The Tooth Fairy Cometh
Across the English-speaking world, when children lose their baby teeth, they put them under the pillow, so the Tooth Fairy can exchange them for money. In Spanish-speaking countries the same job is carried out by Perez Mouse. In China, children traditionally throw lower teeth onto the roof and bury upper teeth in the ground.
Dr. Tse’s Tips
• Both traditional and electric toothbrushes are fine. Which you select depends on the time taken and technique of brushing. It’s recommended that kids brush their teeth for at least two minutes, twice a day, or better after each meal.
• Watch for retained teeth (milk teeth that don’t fall out on their own). Watch too for permanent teeth that are not coming through when they should.
• Mouth guards are essential for active children who play contact sports.
Many children need extra help to get their teeth to grow straight. This is usually tackled in the early teenage years, although Dr. Tse says some problems need to be addressed even earlier still. Not every culture admires a perfect smile though. In Japan, prominent canines (yaeba) are so sought after that some women have cosmetic treatment to give them the ideal impish look!
Dr. Tse’s Tips
• Early orthodontic treatment, also known as interceptive orthodontic treatment, should be considered for children at the age of four or five to stop harmful oral habits, or to correct a simple cross-bite of front teeth. At seven to nine years it can help to guide jaw growth, to reduce the risk of trauma to protruded front teeth, to correct harmful oral habits, to improve appearance, to guide permanent teeth to a more favorable position, and to improve the way lips meet.
• Comprehensive orthodontic treatment should be considered from ages 11-13 years to align the permanent teeth and improve the way the lips meet.
• Signs that orthodontic treatment is needed include:
– Early or late loss of baby teeth
– Difficult in chewing or biting
– Grinding or clenching of teeth
– Mouth breathing
– Thumb or finger sucking
– Crowding, misplaced, or blocked-out teeth
– Protruding teeth
– Teeth that meet in an abnormal way such as an open bite, cross-bite, or severe over-bite or under-bite
– Biting the cheek or biting into the roof of the mouth
– Speech difficulty
– Inability to close lips comfortably
– Facial imbalance or asymmetry
– Mandible that shifts, makes sounds, is protruded or recessed.
Beijing United Family Hospital Dental Clinic
Tue-Fri: 9am-7pm; Sat-Sun: 9am-5:30pm. 2 Jiangtai Lu. (4008-919191 (24hr Service Center)) http://beijing.ufh.com.cn/department_city/dental-clinic将台路2号
This article originally appeared on page 22-24 of the April 2016 Issue of beijingkids. Click here for your free online copy. To find out how you can obtain a hard copy, contact email@example.com.
Photos: Makelessnoise, Jenn Durfey, Jinx!, and Monica Y Garza (Flickr), and courtesy of UFH