Keeping Teeth Caries-Free

How do I make sure that my 6-year-old son’s erupting permanent molar is caries-free?

First permanent molar erupts between the ages of 5-7. They erupt behind the farthest back baby teeth. If not cleaned properly, these teeth can get caries early in life and may require dental fillings or replacements in future. If you take care right from the erupting stage, these teeth will last life-long. Generally, small children do not have dexterity to brush well. Only when they can tie their own shoes do they acquire the manual dexterity necessary to effectively clean their own teeth. Once your son begins brushing his own teeth, you still need to monitor to make sure he is brushing correctly. He should brush teeth two times daily for 2 minutes each time. Things that you need to consider to prevent decay of his teeth:

• Choose healthy snacks like cheese, fruits and raw vegetables
• Limit snacking in between meals
• Limit carbonated drinks and sweetened juices
• Make a habit of rinsing his mouth after eating and drinking
• Visit your dentist and ask for dental sealants

Dental sealants are plastic coatings that are usually placed on the chewing surface of the permanent back teeth, the molars and the premolars, to help protect them from decay. Usually, teeth have deep fissures and grooves, which can harbor food and plaque. Sometimes, these fissures are narrower than the diameters of the toothbrush bristle. Plaque accumulates in these areas, and the acid from plaque bacteria attacks the enamel and cavities can develop. Dental sealants provide extra protection for the grooved and pitted areas by providing a smooth surface covering over the fissured area. Since sealant application is easy, less time consuming, and does not require drilling, children are quite comfortable during the procedure. These sealants last for several years. As soon as his teeth erupt completely out of the gums, sealants can be applied.

Do I need to use any other aid to clean my teeth apart from toothbrush?

Yes, you have to. Tooth brushing alone does not reach the inter-proximal areas of teeth, resulting in 40% of the teeth surfaces untouched. A fundamental principle of prevention is that the effect is greatest where the risk of disease is greatest. Often, caries and gum diseases begin in these areas, and thus are considered areas with high risk. Good inter-dental oral hygiene requires a device that can penetrate sheltered areas between adjacent teeth. Use of dental floss, inter-dental brush and toothpick are the different ways of removing plaque from inter-dental areas.

Depending upon the type of space between your teeth, you can choose the inter-dental aid. If you do not have gum disease, dental floss is effective. When you floss, remember to wind it around the sides of the teeth in a C shape, and not just move it straight up and down. Toothpicks can also be used to remove plaque in between teeth. Triangular toothpicks are better as round toothpicks are thick and blunt to reach. The triangular wood sticks seem to have the correct shape to fit the inter-dental space. Unfortunately, these are not easily available in our market.

Inter-dental brushes can be used and are available in different diameters. These brushes should be the first choice if you have open inter-dental spaces. Choose the diameter that snugly fits into your inter-dental areas. You can wiggle the brush through to the inside until almost all the bristles have gone between the teeth and wiggle out again. You do not have to apply toothpaste on these small brushes. These can last upto 7-10 days. However, the sizes of inter-dental brushes available in the market here are big, hence suitable only for people with gum diseases. Your dentist may have suitable sizes of inter-dental brushes for you. These are simpler to use, less time-consuming and more efficacious than flossing.

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