Child's Play

Tell me the tooth

Prolonged use of pacifiers by children may affect the alignment of their permanent teeth and their occlusion (the way they bite), said Dr Rashid Tahir, a paediatric dentist.
Prolonged use of pacifiers by children may affect the alignment of their permanent teeth and their occlusion (the way they bite), said Dr Rashid Tahir, a paediatric dentist.PHOTO: YOUNG PARENTS
Prolonged use of pacifiers by children may affect the alignment of their permanent teeth and their occlusion (the way they bite), said Dr Rashid Tahir, a paediatric dentist.
Prolonged use of pacifiers by children may affect the alignment of their permanent teeth and their occlusion (the way they bite), said Dr Rashid Tahir, a paediatric dentist.PHOTO: YOUNG PARENTS

Crooked teeth, unhealthy feeding or pacifier habits. Sasha Gonzales gets expert advice for dealing with common dental scenarios.

Q. My child is seven, but still uses the pacifier to soothe herself to sleep. How do I wean her off it?

A. Many kids have a habit of using a pacifier when they are tired and stressed, or for comfort at bedtime.

Such prolonged habits may affect the alignment of a child's permanent teeth and her occlusion (the way she bites), said Dr Rashid Tahir, a paediatric dentist at The Kids Dentist at Camden Medical Centre.

"Ideally, the pacifier habit should have stopped by the time your child is three years old," he said.

"The latest age for a kid to stop using the pacifier should be before her permanent front teeth - her incisors - erupt, and that happens when she is about six or seven years old."

One way to get your child to give up the habit is to set a deadline - for example, her birthday.

Dr Wee Yong Kiat, a dental surgeon at NTUC Health's Unity Denticare, has these other suggestions:

  • Snip off the pacifier tip to make the sensation of sucking less desirable. Gradually snip off more of it, until there is no longer anything for her to put into her mouth.
  • Give her something else that provides comfort and security, such as a blanket or a pillow.
  • Gradually reduce her usage or remove it once she is asleep.

Q. Some of my kid's milk teeth are black, but my friend says to let this be as his permanent teeth will grow eventually. Is she right?

A. Black- and green-stained teeth are more commonly found on primary (milk) teeth, said Dr Wee. This is due to sulphur-oxidising bacteria in the mouth.

A simple cleaning by your kid's dentist should eradicate such superficial stains. However, very dark, discoloured teeth may indicate severe decay. Take your child to the dentist early to prevent further damage to his teeth.

"The functions of milk teeth are not just chewing, speech and aesthetics; they also lay the foundation spaces for the growth of underlying permanent teeth," Dr Wee added.

Q. My four-year-old still likes drinking milk from a feeding bottle. Is this bad?

A. Many kids do this as a bedtime ritual, to help them fall asleep, Dr Tahir noted. But this habit has been associated with tooth decay in young children.

"The feeding bottle is only appropriate for use by babies who depend on formula milk as their main source of nutrients, before they are fed solids," he said.

"Once your little one is 14 or 15 months and has started eating solids, there should be less reliance on feeding bottles.

"Instead, your child should be encouraged to drink milk from a cup."

Q. My child's teeth are yellow. Can he use whitening toothpaste or go for laser whitening?

A. Permanent teeth always appear more yellow compared with primary teeth, and this is normal, Dr Tahir said.

The enamel of the permanent teeth is more translucent and shows more of the shade of the underlying darker coloured dentine.

Other common reasons for yellow teeth include stains from food and plaque bacteria found around his teeth. The stains build up due to poor brushing or oral hygiene.

The best way to prevent this is to teach him good tooth-brushing habits and techniques. You should help him brush his teeth until he is about seven years old.

Dr Tahir does not recommend the use of whitening toothpaste, which may contain strong chemicals. He also does not advise laser whitening for children as it involves bleaching agents.

Q. When should I stop helping my kid brush her teeth?

A. Once she is good at spitting water out after brushing, and is able to spend about two minutes cleaning all the surfaces of her teeth well, you can stop helping her, said Dr Poon Kee Hwang, a specialist in orthodontics at My Braces Clinic.

But it is important to do a spot check at least once a week to ensure that she is doing it correctly.

Q. I tried to get my kid to floss, but she doesn't like it. Is flossing necessary and how do I do it for her?

A. Dr Poon advises getting your child to floss her teeth using small, disposable, individual flossing aids. These are easier to use than regular string floss.

There are also products which shoot out micro-droplets or a jet of pressurised water to clean in- between teeth. However, they are probably more suitable for older children.

Q. How do I know if my child needs braces?

A. As every child has his own unique smile and bite problems, there is no "magic" age at which he would be deemed ready to wear braces, said Dr Poon.

The American Association of Orthodontists recommends all children to get screened by an orthodontist at the age of seven, so that any problems regarding the developing face and dentition can be detected early.

The screening will determine if your child needs braces or not.

If your kid's face and dental transition into adult teeth are progressing normally, then, on average, treatment with braces can start when his baby teeth have been replaced with adult teeth - when he is between 11 and 14 years old.


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This article first appeared in Young Parents magazine. Young Parents, published by SPH Magazines, is available in both digital and print formats. Go to www.youngparents.com.sg/subscription to subscribe and for more parenting stories.

A version of this article appeared in the print edition of The Straits Times on October 20, 2015, with the headline 'Tell me the tooth'. Print Edition | Subscribe