By three years, most children have twenty primary (baby) teeth. At this stage, you want to see spacing between the teeth. Spacing between the upper and lower front teeth will help the larger adult teeth have the space they need. If the baby front teeth are crowded, more jaw growth will be needed for the adult front teeth. Spaces in between the back teeth lessen the chance for tooth decay to develop.
The bite (occlusion) of your child’s baby teeth is very important. Occlusion refers to how the teeth contact and work together. Problems of the bite can affect a child’s speech, jaw position, appearance and the ability to chew properly.
Genetics determines the size and shape of the teeth and the growth and position of the jaw. Thus, if one or both parents have an overbite or underbite, your child may develop the same profile and occlusion starting with the baby teeth.
What you should see is the following:
Normal overjet: All of the front teeth should overlap a little outside the bottom teeth.
- Normal overbite: The lower front teeth should come up and a little behind the upper front teeth. The space (or contact line) between the upper two middle teeth should be over that of the middle lower teeth.
Brushing should be done first thing in the morning and at bedtime – after the final snack.
Make sure your child uses only a pea-sized amount of fluoride toothpaste. If your child doesn’t like the “tingly taste” of the toothpaste you’re using, keep searching until you find the taste they like. Make brushing a family affair. Young children have not yet developed good coordination so your help with brushing is important. Brush along the gum line and the chewing surfaces using a small circular motion. Most children tend to miss the cheek surfaces of the upper back teeth and the tongue surfaces of the lower back teeth. Teach your child to brush their tongue too.
Studies do not show that flossing is important in preventing tooth decay in young children. Brushing and proper diet are most important. We recommend flossing for a child who continues to get decay in between their teeth even after preventative measures have not worked. If there are spaces in between your child’s teeth, there is no need to floss.
As we age through adolescence and adulthood, flossing becomes increasingly important in preventing gingivitis, periodontal infections and breath problems.
Sealants are a very effective preventive therapy against tooth decay. On the chewing surface of the baby and adult molars are pits and fissures, which are normal imperfections of these teeth. Sealants fill in these areas to protect them from decay.
The depth and width of the pits and fissures varies from person to person. There can be pits and fissures on the cheek surfaces of the lower molars and on the tongue surface of the upper molars. Food and germs often become trapped in these areas. A cavity can easily happen because brushing and fluoride are not effective protection against cavities of the pits and fissures. Only sealants are effective protection against decay of these surfaces because they fill in these areas.
The sealant is a liquid that becomes hard like plastic after it is applied to the tooth. Sealant therapy, which was introduced over twenty years ago, is non-invasive (no drilling) and doesn’t require a local anaesthetic.
We may recommend sealant therapy after examining the baby molars, taking into consideration your child’s dental history and other factors.
By age 3 a toddler will have all the twenty primary teeth. The child eats solid food by then and also starts talking fluently. If at this time the child is not taught basic dental hygiene such as brushing the teeth correctly at least twice a day and definitely after the last meal before going to bed, dental caries or tooth decay is going to occur. For children as young as 3 to 6 yr old tooth decay treatments have to be carried out by specialists who are trained and experienced to do the job.
While prevention is much better than cure and proper dental hygiene is the best way to prevent caries in the 3 to 6 yr old group, tooth decay treatments are also very important.
Apart from tooth decay treatments which can be scary for such young children, other dental treatments for overcrowding, occlusion can also be needed. If tooth decay is discovered in the first stage, tooth decay treatment can be simple and less terrifying for the child and early discovery of tooth decay can be made only by a paediatric dentist during an examination. That is why it is important to take your child for regular dental checkups so that decay can be arrested early in its path.
Diet also plays a very important part in the dental health of children. Too much sugar in a kid’s diet can alter the pH of the oral cavity and encourage tooth decay. It is not sufficient to restrict the amount of sweet food and drinks consumed, it is important to understand that most processed food contains sugars in different forms and are generally not very good for health.
Regular and correct brushing of teeth is the most effective way of preventing dental decay. Children have to be taught to brush the correct way and emphasis should be given to brushing teeth before going to bed as the long sleep hours tend to increase bacterial activity in the mouth and accelerate tooth decay.
Tooth decay treatments for the 3 to 6 yr old group consist of drilling and removing the decayed material. Depending on the stage of decay, the drilled tooth is filled with dental filling. Other options such as crowning or root canal treatment can also be considered depending upon how badly the tooth has been affected. These are advanced treatments that may require anaesthesia so that the child does not feel pain or anxiety during the process.
For a small child of this age group tooth decay treatments can be carried out by specialists alone in an environment that is welcoming to the child so that the child feels relaxed and does not resist examination and treatment.