My child is teething, when should we start brushing their teeth?
Even before teething starts, it is advisable to encourage your child to clean their mouth after food or bottle feeding. There are great products on the market like oral wipes for infants or soft finger cloth toothbrushes. As soon as the first two teeth on the lower jaw come through start using a soft baby brush every morning and evening with just a “smear” of toothpaste containing fluoride while still continuing with the wipes after milk or food.
At what age should I bring my child for the first visit to the dentist?
We would like to see them when they are about one, then again at two years old, and after that twice yearly. That way we can catch signs of proneness to decay or crooked teeth, and develop a prevention strategy in time to make a difference.
When my child’s teeth are loose should we pull them out, leave them or show the dentist?
Ideally the milk teeth will become so loose and bothersome, that your child will want you or us to help remove them. Of course often the tooth falls out or “disappears” while eating (this is not a problem - it will pass naturally).
How often should my child brush their teeth?
As soon as the first tooth appears, teeth should always be thoroughly brushed twice daily. They should be brushed for at least two minutes with an electric toothbrush and at least three minutes by hand. They should also be brushed for up to five minutes every once in a while.
Should we buy our child an electric toothbrush?
To ensure strong healthy teeth and to develop good lifelong dental habits it is important to brush a child’s teeth as soon as they appear in the mouth. Electric toothbrushes, however, are not suitable for babies and children under the age of three. To ensure that they receive the best possible oral care you should brush with a specially designed toothbrush, such as the Oral B Stages 1 toothbrush, which has a rounded head and soft bristles, using a small amount of toothpaste. For babies of three months and over it may also be beneficial to use teeth wipes to prevent baby bottle tooth decay.
For older children, manufacturers including Braun Oral B and Phillips have developed a range of child friendly electric brushes. The Oral B brush is easy for small hands to hold with a ‘squish grip’ handle, and smaller head. The Phillips Sonicare for Kids has two power options for different stages of oral development and two handle grips suitable for the use of either parent or child. Whether using a manual or electric brush, it is recommended that until the age of seven you should help children brush their teeth in order to develop good technique and ensure a thorough clean.
Electric brushes can be beneficial as they help children, who have less manual dexterity than adults, to clean hard-to-reach places such as the backs of the teeth. Many brushes also have built in timers to ensure that they brush for the recommended two minutes and musical tones and pictures which make brushing a fun activity. The novelty of using an electric toothbrush can help encourage children to brush regularly, although children under ten should be supervised when using them. Avoid mashing the tufts against your teeth and instead use light force and slow movements, to allow the electric bristle action to do its job. Electric rechargeable brushes are more effective than battery toothbrushes, as the batteries don’t run down. They have more power and directional movement. Brushes using rotation oscillation movement have been found to be more effective at removing plaque bacteria. Always use a children’s power brush for younger children. As they grow it is acceptable to use an adult brush but on reduced low power, before moving onto full power.
How much toothpaste should we use?
Children’s brushing should be supervised until age seven when they are not at risk of swallowing the toothpaste. Children aged up to three should use a smear of toothpaste and those aged three to six should use a pea-sized amount of toothpaste. You should encourage children to spit, not rinse.
How often should they visit the dentist?
Twice yearly is standard and the minimum. If the parents have problems (gum disease or “bad teeth”) or the children have had a history of decay, three or even four times a year is beneficial.
What should I do if my child falls and breaks or damages a tooth?
The two most important things to remember when a tooth accident happens are firstly, time matters – get to us as soon as possible, and secondly look for and bring all pieces of tooth you can find.
What are the signs my child’s teeth require orthodontic treatment?
Tooth grinding, pressing, headaches in the morning, muscle spasms, receding gums, speech difficulties, not being able to close lips without consciously doing it and cracking noisy jaw opening could all be signs that orthodontic treatment is needed. If you are in any doubt come and see us so we can take a look.
Is it worth paying privately for orthodontics when they can have it for “free” under the NHS?
Ten years ago dentists had access to unlimited funding, and could therefore offer treatment to any child whose parent or guardian requested it. They were also paid a reasonably high fee to allow the use of the most up-to-date materials and to dedicate enough time for treatment, and had absolute choice over the treatment they used. It was also unlikely for there to be significant waiting lists as busy practices could contract another assistant to help out with the workload.
However this has all changed, and under current arrangements, orthodontic providers have to bid for a fixed amount of funding, which will only allow treatment of a certain number of patients per year. Treatment is no longer ‘available to all’ and children must be assessed to see if they fall into a sufficiently severe category under the IOTN (Index of Treatment Needs) before they can be offered treatment. Those who do not meet these criteria cannot be offered NHS treatment anywhere.
Recently, orthodontic fees have not only all been set at the same level (for minor and severe cases alike) but, in many cases, the total fees have been driven downwards, as many large so-called ‘super practices’ compete for funding. Furthermore, there are no additional fees for more complex braces, such as functional appliances to help favourable jaw growth, or anchorage devices to reduce the need for extractions. Because of this, waiting lists have become commonplace, sometimes with waiting periods of many months just for an assessment under the NHS and, even if your child does then qualify for treatment it can be years before this starts.
While the availability of conveniently located, prompt and efficient high quality NHS orthodontics in any given area may not be a problem, it is no longer something that can be taken for granted. Likewise, it cannot necessarily be assumed that the treatment offered (either NHS or privately) is either of the highest quality or the most suitable for each case.
If all cases are funded to exactly the same level, you have to ask yourselves whether all orthodontists are really going to consider offering a longer, more complex – and hence more expensive – treatment if there is a quicker and easier choice available. We cannot comment on what treatments are or are not available in practices other than our own. We can, however, set out what we do offer and this, hopefully, will allow you to make an informed choice about what is best for your children.
What type of orthodontic service can you expect from us?
Orthodontics is not just about straightening teeth but just as importantly ensuring the maximum harmony between all the dental and facial structures. This means not only aligning teeth, but also focussing on issues such as lip support, facial length and symmetry, smile width and most importantly, the face’s profile.
Most importantly is correctly identifying the causes of the problem. Often when a young child complains of goofy teeth it could be caused by three possible options, or a combination of all three:
- The upper front teeth actually do stick out too far
- The upper jaw is too big, or more accurately, too far forwards
- Most commonly of all, that the lower jaw is too small, or too far back
In cases where the causes are not correctly diagnosed, one of the commonest mistakes made is to treat a child who has correct upper teeth and jaw size, but has a very small lower jaw by extracting teeth in the upper jaw. The damage caused to the profile can be horrendous, leaving the patient with small upper and lower jaws. This profile flattens the face, and accentuates the nose, and is one of the least acceptable but all too common orthodontic outcomes.
Any experienced practitioner should diagnose such cases from the outset, and offer growing youngsters an alternative. Unfortunately, such orthopaedic treatments are often more difficult and more expensive to carry out, and consequently may not always be offered.
In terms of the service we provide, we can offer appointments after school, which virtually no NHS clinic can do. Private appointments are tailored to suit individual needs, and many people agree that they feel less rushed. Also, all treatments are either directly supervised by, or more usually carried out by the prescribing dentist. Many NHS practices rely heavily on the use of orthodontic therapists to carry out the majority of the treatment itself, frequently totally unsupervised by the dentist. Furthermore, private patients are offered a range of treatment options, from such minor things as simply choosing from invisible or brightly coloured braces, to making choices regarding jaw growth options instead of extractions.
You only get once chance to diagnose and treat a growing child orthodontically – the profile and smile your child is given now will be with them for the rest of their life. Let us guide you through the complexities of modern orthodontics to help you make the right choices for your child.
What protection is there when playing sports?
The best protection is from a bespoke mouth guard. Custom fit gum shields are far superior to ‘boil and bite’ or off-the-shelf gum shields as they are unique to each person’s mouth and fit better as it is made from an accurate impression of your mouth. A custom-made mouth guard can be up to 2.5mm thicker, act as a shock-absorber following impact and spreads the load following a blow. The contact area of a custom-made mouth guard is greater, breathing is not hindered, it will not move during activity, and speech is less impaired. The British Dental Health Foundation recommends the use of custom-made mouthguards.
At what age can gum disease start to show?
Signs of gum disease – which include bad breath, red gum lines, bleeding while brushing or flossing teeth – can show as early as nine or ten years of age. If your child starts to show any of these symptoms please make an appointment with us so we can take a look and start any treatment that is needed in good time.