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Poor Oral Care In Children: A Hidden Epidemic

Bleeding gums and rotten teeth affects almost three quarters of preschool children in Malaysia, and this can have severe consequences on a child’s wellbeing and development.

Dr Yogeswari Sivapragasam, senior lecturer and consultant in paediatric dentistry, School of Dentistry at International Medical University. Picture courtesy of IMU.

KUALA LUMPUR, March 13 – Many people think of good oral health as having white teeth and a nice smile, but there is so much more to it than that.

Practising good oral health care from infancy into adulthood as part of overall health is simple and easy. Unfortunately, many fail to see that poor oral health has far-reaching consequences, 

What’s more, childhood cavities are not harmless – studies show that children who have cavities at a young age are three times more likely to have them as adults.

The Malaysian National Oral Health Survey of Preschool Children (NOHPS) reports that 71.3% of 5-year-olds already have cavities!

What can parents do to prevent this from happening? Dr Yogeswari Sivapragasam, senior lecturer and consultant in paediatric dentistry, School of Dentistry at International Medical University (IMU), offers some valuable advice.

Start Them Young (From Birth)

It is easy to overlook oral care in babies – after all, they won’t have teeth till months later! However, babies should still have their gums cleaned at least twice a day.

This helps to set the foundation for a lifetime of daily oral cleaning routines. 

Besides that, parents should also get advice from health care practitioners, such as a nurse advisor at community clinics or paediatricians, on how to care for their child’s oral health from birth, which includes what to do when their teeth first appear. 

Say ‘No’ To Salt And Added Sugar (Until Later)

As children – and their teeth – grow, exposure to new foods is natural, as their diet expands in accordance with their changing nutritional needs.

However, it is important to introduce new foods gradually and mindfully.

Dr Yogeswari advises parents to delay the introduction of added salt and sugar into their child’s diet, so that they do not develop a liking for these flavours early in life.

A lifelong preference for sweet foods can lead to higher risk of dental problems as well as chronic health conditions such as obesity and diabetes, she explained.

Make Dental Visits Fun And Regular

It is quite common for adults to have an aversion to visiting the dentist, and this may have developed from their own negative experiences.

However, it is important that parents put aside their personal fears and help to create a positive experience for their child.

Children should receive their first dental check-up when they are one year old (remember this: “first birthday, first dental check-up”). Thereafter, a check-up is advisable every six months.

As it is unlikely that they will have any dental problems at this young age, this will help young children have a positive experience rather than associate dental visits with pain and fear.

Regular visits will help to normalise the experience of visiting a dentist, and will go a long way towards preventive care.

The idea behind early dental visits is that potential problems are detected early and prevented from progressing further, according to Dr Yogeswari. 

Be Alert To Behavioural Changes 

It can happen that children sometimes refuse certain foods or refuse to brush their teeth. While this may be easily explained as the child being fussy or picky, there could be another reason behind it. 

A child with cavities or gum disease may experience chronic discomfort or pain, causing them to avoid foods that require chewing.

This may inadvertently lead them to avoid whole foods such as apples and chicken, and choose softer foods instead, many of which are processed and contain higher levels of salt, sugar, and fat.

Over time, this may lead to nutritional deficiencies or chronic conditions that can affect a child’s health into adulthood. 

Long-term pain can also cause irritability, or affect their ability to concentrate during lessons in preschool.

In addition, poor oral health can also affect a child’s self-esteem if they are teased due to the appearance of their stained or rotten teeth. This may cause them to avoid social activities or become withdrawn.

As such, Dr Yogeswari advises parents to be alert and check for possible dental problems if their child suddenly appears to be unwilling to chew or becomes irritable without any apparent cause.  

Different Ages, Different Oral Health Needs

Parents can help to support their child’s oral health through different stages of development by being observant of any visible signs such as bleeding gums, ulcers, or discolouration of the teeth.

Dr Yogeswari also cautions against the common misconception that milk teeth are not important as they will drop out anyway after a number of years, and stresses that establishing a lifetime of healthy oral health habits begins in childhood. 

Here’s her advice for oral care at different ages.

  • After birth, before the baby’s teeth develop.

Use a clean, damp cloth wrapped around a finger, gently wipe the gums in the morning and at night.

  • After the first teeth appear.

Use a baby-friendly toothbrush with a toothpaste that contains fluoride to gently brush the teeth and gums at least twice a day, as part of a routine. 

  • Pre-school age.

At this age, children are able to hold a toothbrush but will need their parents to manually guide them on how to do so thoroughly.

  • School-going age.

By this time, children should be able to brush their teeth independently, with supervision from parents. 

“We cannot isolate oral care from the rest of the body. Oral health and general health – they are interlinked. Overall health literacy, a healthy diet and good personal hygiene including good oral care habits all contribute towards overall health and wellbeing.

“It is therefore essential to establish good oral care habits from infancy, with daily hygiene and preventive care as part of everyday life.

“This will make oral care a natural part of life, allowing parents to gradually entrust children to continue these healthy habits into adulthood and for the rest of their lives,” said Dr Yogeswari.

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