A child's first visit to the dentist should be as early as this age - Irish dentist
Dr Vanessa Creaven talks to Claire O'Mahony about why early dental visits for children are so important
When it comes to children and looking after their teeth, getting them into good habits and starting early with dental visits can set them up for a lifetime of good oral health.
Feeling apprehensive about a trip to the dentist is not unusual, and in Ireland, it's estimated that some 60pc of people feel anxious to some degree about dental procedures. But it's not a fear that parents will necessarily pass onto children, according to Dr Vanessa Creaven.
The dentist who is behind Galway practice Quay Dental says that being dental phobic is not innate, but learned, and that parents, from the outset, should set out to make dental visits positive experiences.
"We'll often find that kids can pick up things from their parents and they'll hear things at home, with parents saying things like they're dreading going to the dentist."
However, if parents are themselves nervous about the dentist, this can actually have a beneficial impact when it comes to their children. "Often, what we'll find is the patients who have the biggest phobia, or the real nerves about the dentist, are the ones who will get their children in really early and they're very proactive about their child's oral health because they don't want their children to have what they had," says Dr Creaven.
The dentist advises that a good time to bring young children to the dentist is when parents are going for a check-up themselves. "I always chat with mums who say they could be a bit nervous and they don't want children to get in the way while they're having a dental appointment. They feel like the children would be a hassle. I always say absolutely not. The more that you open the dental practice to young children and babies, the more that they'll actually be grand with it," she says.
"The younger you get a child into a practice, the easier they find the experience, the easier they find the treatment. They also tend to need less treatment, because we're able to spot things a lot quicker, than say in a child who comes in around five or six and they have a pain. So then their first experience is about pain or sleeplessness nights with a tooth and that's their first impressions of the dentist."
Prevention is always better than treatment and the guidelines in Ireland are that, ideally, babies should have a dental visit when their first tooth comes up, which is normally around seven months.
"Naturally, you're not booking a seven-month-old in for a check-up, but what I always say is if mum or dad are in, we'll have a quick look at the child's teeth, just to make sure everything is okay and that they're going through their normal sequence of eruption or that there's no sign of decay on the teeth," says Dr Creaven. "We'll often have a nurse in the room and they'll hold them and we'll just have a quick look and then we'll go from there."
"Often, if a two- or three-year-old comes in, they'll sit up in a chair and they'll be able to move the chair up and down. I may look in their mouth for five or 10 seconds, it's not that long, but they can then associate the dentist with a fun chair. We'll give them a few stickers when they're leaving or a colouring book, and they'll play with the lights and the little gadgets we have, so they remember the visit as being something that's not that bad."
However, if a child has dental pain, she recommends taking them to a paediatric dental practice, which is specially geared towards children. "A check-up is absolutely fine in a normal practice, but if they need a bit of work, it does make a difference if they go somewhere especially designed for them," she says.
As most parents are aware, the big dental baddy to be aware of is sugar, which causes a lot of decay. "We can't underestimate the level of sugar in our diets and sugar is in nearly everything now," says Dr Creaven. "It's very easy to say to try and limit the amount of processed food in the diet, but sometimes it can be difficult for parents to get their children to eat anything at all, they just want him or her to eat."
There are some foods which parents think are healthy, but in reality, are not so great for teeth. These include fruit juices as well as raisins and dates. The latter two tend to get lodged in the crevices of teeth, which children may not notice, and which then lie for hours on the teeth, causing decay.
"You're never going to completely escape sugar, so I always say food-free time is the ideal," the dentist says. "Have a breakfast, have a lunch, have a dinner and have a snack and try and leave a couple of hours between meals or food time. But it is a struggle to get children to eat anything some times and you have to think of the whole body as well as the teeth. I would say that crackers are good; cheese is low sugar; toast is okay with jam. Chicken is fine, bread is fine, potatoes and veg and all that good stuff are fine, but if you're thinking about fruit juice, raisins, dates or anything sugary, they need to be eaten immediately after the dinner, or they're not to be snacked on."
When it comes to teeth brushing, children don't have to clean their teeth after meals. In fact, according to Dr Creaven, nobody really needs to clean their teeth after meals and there is a common misperception that the more you brush your teeth, the better. "Ideally, you should be brushing your teeth in the morning and in the evening and two minutes each time. Even as adults, if you're brushing your teeth three or four times a day, you're actually putting a lot of trauma on the actual gum tissue around the teeth," she says, explaining that this can cause gum recession.
"For children, just brush in the morning and evening, and in the morning, it can be before breakfast or after breakfast. Until the child is eight or nine years of age, the parents should be brushing their teeth. Under the age of seven, they need mum or dad to give them a hand, because they won't be able to do it themselves.
"I have adult patients who don't know how to brush their teeth, just because it's a skill, so you can't expect a five-year-old to know how to do it and to know that it should be for two minutes each time."
It's also important that children use a child's toothbrush and children's toothpaste which has less fluoride than the adult version. Flouride, which was introduced to Irish water in the 1960s, is important for fighting decay. However, overexposure to it in the first eight years of life can cause fluorosis and can cause teeth to become mildly discoloured. After the age of eight, it's fine to move children onto an adult toothpaste.
In terms of how regularly your child should visit a dentist, Dr Creaven says it depends on the child in question. "I would say if there's a clean bill of health, once a year is fine. If there's something that I'm watching, I'll advise to come back in six months but generally, coming in once a year is probably fine."
Most important is getting children into the habit of realising how important their teeth are and instilling in them the necessity of looking after their teeth. Also, parents should talk to their dentists. "Engage with your local dentist, touch base with them and ask questions about your children's teeth. We want kids to come in and we want to get them into the routine of visiting the dentist," says Dr Creaven.