SingaporeMotherhood | Baby & Toddler

November 2017

“My Child is 5 and He Needs 3 Tooth Extractions!”

Tooth decay is occurring at an alarming rate amongst younger children in Singapore. What can you do to help keep your child’s pearly whites safe from the drill?

“We need to extract three of your child’s teeth.” These are probably some of the most horrific words that parents may hear when they bring their children to visit the dentist. The first thoughts that may come to mind are, how could this happen? What have I done wrong? We make the kids brush their teeth every day. Don’t the kids have dental check-ups at school? Fret not, mum and dad. You are not alone, and neither is your child, says Dr Daryl Wee, a New Zealand-trained dentist at TAG Dental.


How Bad can Childhood Tooth Decay Get?

The worst cases I have seen are when three-year-old children need to have their four upper front teeth extracted. This is in addition to complex filling procedures on other affected teeth – which may be all the remaining teeth the child has!

Sadly, this is not uncommon. Tooth decay is occurring at an alarming rate amongst younger children. A June 2017 Straits Times article reports that 50% of Singapore’s pre-schoolers have tooth decay, while 38.4% of Singapore’s pre-schoolers have severe early childhood decay. This is where there is extensive tooth decay present in multiple teeth.

Often when a parent brings a child in to see me to treat a toothache or “hole in the tooth”, there is a very high likelihood of detecting multiple other teeth that are at various stages of tooth decay. When the decayed teeth are treated early, more complex procedures can be avoided, even avoiding the need for any extractions.

Tooth decay is the most common cause for the early removal of kids teeth. So here are a few tips to keeping teeth clean and healthy to avoid the dreaded early loss of teeth caused by tooth decay.
The goal is to reduce the impact of tooth decay development by intervening as soon as possible to manage further tooth destruction, as well as to reverse the tooth decay process if possible.

What A Child’s Teeth are Made Of

Kids’ teeth, commonly known as milk teeth and primary teeth, are the first set of teeth that we grow up with. They need just as much attention as adult teeth and face the same risks of tooth decay.

The outer enamel layer of kids teeth, at about 1 mm, are half the thickness of adult enamel. Hence the progress of tooth decay is much faster. Children will own these teeth from around 6 months of age until they are 12 years.

During this time their teeth contribute greatly to the development of speech and chewing of foods. Premature extraction of kids teeth will create gaps and spaces between teeth. Furthermore this will increase the risk of affecting the subsequent positions of a child’s future adult teeth.

Understanding Tooth Decay Risk

There are three factors to think about when it comes to tooth decay. Firstly, tooth surfaces that are difficult to keep clean are at the highest risk of tooth decay. In addition to that, a diet which includes of sweetened food and drinks throughout the day is another factor. Furthermore, any active or previous tooth decay is also a risk factor. Here are two things that you can do immediately to help stem tooth decay in your child.

1. Reduce Sugars

The easiest and most immediate way to reduce the risk of tooth decay for your child is to reduce sugars in the his diet. Check the quantity and the frequency of his sugar consumption. What you can do: Reduce the frequency of sugary foods that he consumes throughout the day. That cup of fruit juice, for instance, can be replaced with a cup of water. Limit juice to mealtimes, or rather, just one mealtime. Do not use sweets as treats or as bribes.

2. Take Milk Bottles Out of Beds

Tooth decay caused by night feeding mainly affects the upper front teeth. This is commonly called “milk bottle caries”. Avoid putting your child to bed with a milk bottle. Tooth decay can also occur if you are still breastfeeding your child at night as salivary flow is reduced at night. Hence sugars are held in the mouth for a much longer time. What you can do: Encourage your child to brush his teeth just before bedtime. In addition, teach him to place emphasis on cleaning the back of his upper front teeth. Children whose upper front teeth are placed much closer together or which are crowded together face a greater risk of milk bottle caries.

Tooth Brushing for Kids

As a rule of thumb, always perform the brushing for your kids as early as possible to get them familiar with it. Once your child is interested in holding the toothbrush, you can get them to learn how to brush their teeth. Kids under the age of nine will not have the necessary hand dexterity to brush all their tooth surfaces well so you should follow up with a thorough clean for them.

As they grow older, they can perform more of the brushing while you do the checking and additional cleaning. The responsibility for brushing should be a gradual handover from parent to child. As your child grows and his fine motor skills improve, he will develop the ability to brush his teeth by himself. Get him to brush twice every day.

Make Time to Visit the Dentist

Kids’ dentistry has come a long way from the traditional “drill and fill” approach that we grew up with. These days dentists provide a preventative approach instead. Start bringing your child to the dentist once she turns one. Continue with dental visits every six months to allow for detection and assessment of any tooth decay at an earlier stage.

The dentist can determine your child’s caries risk status, and let you know if intervention strategies are required. Maintain that biannual relationship with the dentist to help your child prevent, arrest, and possibly reverse tooth decay. This is how a great smile begins!

Dr Daryl Wee is a New Zealand-trained dentist at TAG Dental. He has extensive experience with kids’ dentistry, treating children and providing parents with the knowledge on how to maintain good oral health throughout childhood.

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“My Child is 5 and He Needs 3 Tooth Extractions!”