How do I help my children look after their teeth?

Teaching your child, good oral care at a young age is an investment in their health that will stay with them for life. You can start by setting an example, taking good care of your own teeth sends a message that oral health is very important and anything that makes taking care of teeth fun, like brushing along with your child or letting them choose their own toothbrush, encourages good oral care.

To help your children protect their teeth and gums and greatly reduce their risk of getting cavities, teach them to follow these simple steps:

  1. Brush twice a day with fluoride toothpaste to remove plaque-the sticky film on teeth that’s the main cause of tooth decay.
  2. Floss daily to remove plaque from between your teeth and under the gum line, before it can harden into tartar. Once tartar has formed, it can only be removed by a professional cleaning.
  3. Eat a well-balanced diet that limits starchy or sugary foods, which produce plaque acids that cause tooth decay. When you do eat these foods, try to eat them with your meal instead of as a snack-the extra saliva produced during a meal helps rinse food from the mouth.
  4. Use dental products that contain fluoride, including toothpaste.
  5. Take your child to our dentist for regular check-ups.

What Brushing Techniques Can I Show My Child?

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You may want to supervise your children until they get the hang of these simple steps:

  1. Use a pea-sized amount of fluoride toothpaste. Take care that your child does not swallow the toothpaste(this is difficult with very young children-so we recommend using a children’s toothpaste which contains lower levels of fluoride).
  2. Using a soft-bristled toothbrush, brush the inside surface of each tooth first, where plaque may accumulate most. Brush gently back and forth.
  3. Clean the outer surfaces of each tooth. Angle the brush along the outer gum line. Gently brush back and forth.
  4. Brush the chewing surface of each tooth. Gently brush back and forth.
  5. Use the tip of the brush to clean behind each front tooth, both top and bottom.
  6. It’s always fun to brush the tongue!

How important is Diet to my child’s Oral Health?

A balanced diet is necessary for your child to develop strong, decay-resistant teeth. In addition to a full range of vitamins and minerals, a child’s diet should include plenty of calcium, phosphorous and proper levels of fluoride. If fluoride is your child’s greatest protection against tooth decay, then frequent snacking may be the biggest enemy. The sugars and starches found in many foods like biscuits, sweets, soft drinks and even some savoury snacks are food for bacteria in dental plaque and are converted to acids. These acids attack the tooth enamel and can lead to cavities.
Each “plaque attack” can last up to 20 minutes after a meal or snack has been finished. Even a little nibble can create plaque acids. So it’s best to limit snacking between meals.

For more info on diet and dental health please see Link to diet advice hyg section

What should I do if my child chips, breaks or knocks out a tooth?

With any injury to your child’s mouth, you should contact Our dentist immediately. Our dentist will want to examine the affected area and determine appropriate treatment.

If your child is in pain from a broken, cracked or chipped tooth, you should visit our dentist immediately. You may want to give an over-the-counter pain reliever to your child until his/her appointment. If possible, keep any part of the tooth that has broken off and take this with you to our dentist.

If a tooth is completely knocked out of the mouth by an injury, take the tooth to your dentist as soon as possible. Handle the tooth as little as possible-do not wipe or otherwise clean the tooth. Store the tooth in a cup of fresh milk (never ever store it in tap water or wash/wipe it clean) until you get to a dentist. It may be possible for the tooth to be placed back into your child’s mouth, a procedure called re-implantation.

What are dental Fissure Sealants and how do I know if my child needs them?

A dental sealant creates a highly effective barrier against decay. Sealants are thin plastic coatings applied to the chewing surfaces of a child’s permanent back teeth, where most cavities form. Applying a sealant is not painful and can be performed in one dental visit. Your dentist can tell you whether your child might benefit from a dental sealant.

For more info on fissure sealants visit Link to fissure sealants hyg page

At what age should my child start Orthodontic Treatment?

This has to be one of the most commonly asked questions by concerned parents. It can be very confusing as when dropping your child off at the school gates, some children are wearing braces and some are not.
The answer is that current studies indicate that there is NO benefit to starting Orthodontic treatment early on your child—all it seems to do is prolong the duration of treatment for them , and the finish date is still roughly the same age.
So, the current recommendations are that Orthodontic treatment should be started while the second baby molar is still present and before the second adult molar comes through–this is roughly around 11-12 years of age.

For more complex cases, where the upper teeth appear more prominent than the lower teeth (buck teeth), treatment is indicated before the pre-teen growth spurt (usually 11.5 yrs for a girl, and 12.5 yrs for a boy).
If your child does not appear to have canine (eye/fang) teeth erupting or palpable, then it has been shown that some benefit may be derived from your dentist electively extracting the baby canines around 10 years of age.

Once treatment starts, your child should have regular dental check-ups, and visits to the hygienist, as their orthodontist will primarily focus on the position of the teeth, and assume that the child is having regular dental examinations with their general dental practitioners.

Which toothpaste is best for children?

The current advice is that adult toothpastes should be used for children over 2 years of age, and NO toothpaste before then. This is down to the fluoride content in the toothpastes-proprietary childrens toothpastes do not contain high enough levels of Fluoride. From a taste perspective, this presents a challenge as most children complain of a burning sensation from the general adult toothpastes (the mint and eucalyptus flavours tend to burn their sensitive and tender gums and mucosa).

Top 10 Tips for school children:

  1. For consistent cleaning, it is best to try to brush their teeth and gums at the same time every day. The first brushing should take place either before or after breakfast and older children may also rinse their mouths with an alcohol free mouthwash. The second daily brushing should be last thing before bed, with no more snacks or drinks other than water after this.
  2. Only use the recommended amount of toothpaste and ensure all teeth and gums are cleaned thoroughly. Toothpaste should not be swallowed. Older children may use different sized inter-dental brushes to clean plaque from inaccessible areas.
  3. We recommend that parents brush their young children’s teeth or help them brush their teeth until they are about six. They need to monitor their brushing until they are about ten. Toothbrushes should be changed every three months.
  4. Ensure children eat a healthy diet and reduce their intake of high sugar content foods. What goes into your child’s packed lunch can be very important as they will not have a chance to clean their teeth until they get home from school. Keep snacks between meals to low-sugar or sugar-free foods such as cheese, fruit and nuts.
  5. What your child drinks can have just as much effect on their teeth as what they eat. Milk and water are suitable drinks to quench their thirst. Beware of high energy sports drinks as they have a very high sugar content.
  6. Children should have visited our dentist before they are 3. If they haven’t been, it’s easy to arrange an appointment.
  7. Ensure their visit is a positive one. Children will often take their cue from parents when visiting our dentist. If older brothers and sisters are going to the dentist, bring their younger siblings along so they can see what’s going on, get to know the surroundings and maybe even get a go in the chair.
  8. Children’s teeth are generally checked up to 3 times by the public health dentist during primary school. Try to ensure you make it to these appointments.
  9. Children at high risk of decay may benefit from fissure sealants on back molar teeth as they come through, normally at about 6 and then again at 12 years of age
  10. If contact sports such as football, rugby, hockey or hurling are being played at the school ensure that your child has a mouthguard.

What is Fluoride and how do I know if my child is getting the correct amount?

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Fluoride is one of the best ways to help prevent against tooth decay. A naturally occurring mineral, fluoride combines with the tooth’s enamel to strengthen it. For most children the proper use of fluoride toothpaste will be sufficient to help prevent decay. For children at high risk of dental decay and without access to fluoridated water, milk, or salt, your child’s dentist may suggest using fluoride drops or mouthrinse in addition to a fluoride toothpaste.

For more info on fluoride see put link to fluoride section on new hyg info

oral cavityWhat is this?

Mouth cancer is a highly lethal disease and is one of the most debilitating and disfiguring of all malignancies. It is estimated that two to three Irish people die from the disease every week, which is more than skin melanoma, Hodgkin’s Lymphoma or cervical cancer, and the incidence of the disease is increasing particularly among younger people, particularly in respect of cancer of the tongue.
Oral cancer starts in the cells that line the inside of the mouth, and can form on the lips, inside the cheeks, on the gums, the tongue, the bony palate, or the surfaces underneath the tongue. Lip and oral cancer can occur on any surface lining the lips and oral cavity.

What causes Mouth Cancer?

Research show that smoking and drinking alcohol are the main risk factors and the risk is even greater if a person smokes and drinks. Those who both smoke and drink, have a 15 times greater risk of developing oral cancer than others. A diet deficient in fruit and vegetables also predisposes towards the development of oral cancers and it has been estimated that this may be responsible for 10-15% of cases in Europe. For lip cancers only, over exposure to UV light is implicated.
There is evidence that exposure to second-hand smoke may increase oral cancer, with a 63% risk increase shown for never smokers exposed to SHS at home or at work. Among those exposed at home and at work for more than 15 years, there was an 84% risk increase.

How dangerous is this Mouth Cancer?

The death rate associated with this cancer is particularly high not because it is hard to discover or diagnose, but due to the cancer being routinely discovered late in its development. Often it is only discovered when the cancer has metastasized (spread) to another location, most likely the lymph nodes of the neck.

Who is most at risk of Oral Cancer?

While historically the majority of people are over the age of 40 at the time of discovery, it is now occurring more frequently in those under this age. Exact causes for those affected at a younger age are now becoming clearer in peer reviewed research, revealing a viral aetiology (cause). There are also links to young men and women who use conventional “smokeless” chewing or spit tobacco. Promoted by some as a safer alternative to smoking, it has in actuality not proven to be any safer to those who use it when referring to oral cancers.

Campaigns to promote the safety of smokeless are being initiated, but it is clear that while it may reduce lung cancers, it has a negative effect on the rates of oral cancers, pancreatic cancer, periodontal disease, and the chronic infections that it produces may even link it to heart disease as well. The gains against lung cancers may occur, but there will be new losses in other areas. The jury is out on other new smokeless tobacco dissolvable products, and until their use has acceptable research behind it we recommend avoiding it.

What can your dentist do?

Oral cancer is an ideal cancer to identify early by screening. It is frequently preceded by an identifiable pre-malignant lesion and the progression from dysplasia occurs over a period of 2.5-8 years. However, current analysis of Oral Cancer patients shows that the majority of oral cancers present at an advanced stage (III and IV), when the chances of successful treatment are low.

This may partly be due to the stereotypical oral cancer patient (an elderly male, who abuses tobacco and alcohol) not presenting to his dentist or other health care professional. Our Dentists at Portobello Dental Clinic do an Oral cancer screening at each examination (check-up) visit.

Gender and Oral Cancer:

Interestingly, in this regard there are gender differences between women and men relating to smoking and oral cancer. The relative risk is much higher in women at all levels of smoking. Additionally, it has also been suggested that women may be more susceptible to cancers that are provoked by alcohol.

What are the symptoms of head and neck cancers?

The symptoms of head and neck cancers depend on where the tumour is found. Some common symptoms include:
 A sore or ulcer that does not heal
 Difficulty or pain on chewing and swallowing
 Sore throat, difficulty speaking or a hoarse voice
 Changes in your breathing at rest
 Unexplained loose tooth
 A swelling or lump
 Pain in the face or jaw
 Earache or ringing in the ear or hearing problems
 Numbness
 Blocked or bleeding nose
 White or red patches in the lining of the mouth or on the tongue that do not go away

Uncertain, unproven or controversial risk factors:

a-Mouthwash
Some studies have suggested that mouthwash with a high alcohol content might be linked to a higher risk of oral and oropharyngeal cancers. But recent research has questioned these results. Studying this possible link is complicated by the fact that smokers and frequent drinkers (who already have an increased risk of these cancers) are more likely to use mouthwash than people who neither smoke nor drink.
b-Irritation from dentures
It has been suggested that long-term irritation of the lining of the mouth caused by poorly fitting dentures is a risk factor for oral cancer. But many studies have found no increased risk in denture wearers overall. Since poorly fitting dentures can tend to trap agents that have been proven to cause oral cancer, such as alcohol and tobacco particles, denture wearers should have them checked by a dentist regularly to ensure a good fit. All denture wearers should remove their dentures at night and clean and rinse them thoroughly every day.

c-Irritation from a broken tooth

Any long term irritation of the lining of the mouth—e.g. cheek repeatedly being cut by a broken tooth, can potentially predispose you to Oral Cancer.
d-Human Papilloma Virus infection
Human Papilloma Viruses (HPVs) are a group of more than 100 related viruses. Most HPV types cause warts on various parts of the body, but a few HPV types seem to be involved in Oral Cancer. The current estimate is that HPV may be a factor in about one-fourth of oral and oropharyngeal cancers. People with oral and oropharyngeal cancer linked with HPV infection are less likely to be smokers and drinkers, but oral cancers that contain HPV DNA seem to have a better outlook than those without HPV. Most people with HPV infections of the mouth and throat have no symptoms and only a very small percentage develop oral or oropharyngeal cancer.

Treatments for Oral Cancer:

Small oral cancers respond equally well to either surgery (which is generally very aggressive and disfiguring) or radiation therapy; advanced cancers are treated with both and sometimes with chemotherapy to relieve symptoms. For recurrent cancer, radiation therapy is the primary treatment.