"Parents, don't let your children brush their teeth on their own"

Interview with Dr. Chantal Kengo, Specialist Pediatric Dentist

One of the main causes of tooth decay in children is poor oral hygiene, more specifically inefficient brushing of teeth. What happens when we let our children do the brushing on their own? Find out from Dr.  Chantal today.

You see a lot of children and parents every day. What do most parents say when it comes to brushing their children's teeth?

During consultation, parents would often say "My child knows how to do it", "My child does not want me to brush his/her teeth" or "I want my child to be independent." Most parents allow their children to brush their teeth by themselves. What happens then? The child does a very poor job of cleaning his teeth, and ultimately, the end result is cavities.

What do you recommend parents when it comes to their children's oral hygiene?

Every child is different but in general parents should brush their child's teeth until they are about 5 to 8 years old. Remember that it is very important that parents continue to supervise their children's brushing until the age 10 to 12. This is to make sure that they're doing it thoroughly. Brushing should be done for two minutes minimum twice a day.

What if the child insists on brushing on his own?

Brushing is a skill. Like many skills, it take years to learn it and be good at it. Young children usually do not have the manual dexterity to brush or floss properly. If your child wants to do it by himself, let him! It's a great way for him to practice but ALWAYS make sure that you brush his teeth before or after he's done it for himself. For older children aged 10 to 12 years, make sure that you supervise them. Be there when your child brushes his teeth and make sure that your child is doing it well. Reinforce whenever necessary.

Do you still see many cases of tooth decay in children?

I see a lot of cases. In fact, although tooth decay is preventable, the World Health Organization reports that around 60 – 90% of children around the world have tooth decay.

What other advice can you give parents?

Aside from proper oral hygiene and regular checkups, one other main thing that parents should focus on is their children's diet. I suggest a diet with very minimal intake of sugar to help protect your child from cavities. If you must give your child some sweets, give a small serving along with a main meal, or have a “Sweet Day”, one day in the week where your child can enjoy some sweets. Parents should also be wary about juices. Juices, even those labelled fresh or sugar-free, are loaded with sugar and acids. Limit juices and encourage your child to drink more water instead.

Is a Root Canal Treated Tooth Susceptible to Decay?

By Dr. Kavita Tarale, Specialist Endodontist

The only difference between a normal tooth and a root canal treated tooth is the absence of nerve supply and blood supply to the root canal treated tooth. And hence, there is no sensation to hot and cold food.

However, teeth that have had root canal treatment are at a risk of formation of tooth decay and gum disease, just like any other tooth. And if allowed to advance, either of these conditions can ultimately lead to tooth loss.

I have noticed that some of my patients think that since when a crown is done, very little or no original tooth structure is visible above the gum line, there is no chance of tooth decay on that tooth. A crown is connected to a natural tooth underneath it and because of this, decay can form around the edges of a crown.

Dr. Kavita Tarale, BDS, MDSSpecialist Endodontist

With proper care, root canal treated teeth can last life time. Root canal treated teeth tend to dry out, become brittle and can break. With a filling and crown, the tooth can be protected against breakage but not against decay. Proper brushing and flossing along with regular dental checkups can help prevent decay as well as any gum problems.

Dental decay or caries is an infectious disease caused by specific bacteria. But just having the bacteria present in your mouth does not mean you will develop decay. Other factors must be present. What are those other factors?

The most important other factor is sugar. When you ingest a meal with lots of simple sugars (this includes candy and sugary sweets, but also food with large amounts of sucrose), the bacteria consume those sugars. Upon consumption of those sugars, they release acid. That acid goes on to attack the mineralized part of teeth and weaken them. Over time, the hard enamel shell of the tooth is dissolved which leads to cavitation.

This decay process can occur on any surface of the tooth regardless of whether the tooth is vital (tooth with nerves and blood supply) or non vital (tooth that no longer has access to nutrients and blood flow). Hence, good oral hygiene practice at home along with a regular dental checkup is mandatory to maintain a healthy oral cavity.

Can Braces Make My Teeth Loose and Fall Out?

By: Dr. Argiro Kechagia BDS, MFDS (rcsed), MSc     

The answer is NO.

Within the first 1-2 days after the braces are fitted, teeth will begin to shift and feel quite loose. This is the normal pattern of tooth movement and is the method teeth use to move through braces. Patients may feel as if their teeth are getting loose and may see opening where no spaces existed before. This is perfectly normal, although sometimes can cause concern to the patient if not addressed and explained by the orthodontist prior to the treatment.

Research has shown that tooth movement causes at least small changes in the shape and length of the roots in all patients, but these changes are so small that in 98% of the cases are not visible to the naked eye.

Dr. Argiro Kechagia BDS, MFDS (rcsed), MSc

However, in less than 2% of patients, some visible root shortening occurs during routine orthodontic treatment. The exact cause of tooth resorption (shortening) is not yet known, but it is believed that it’s caused by genetic predisposition, along with prolonged orthodontic treatment that is more than 3 years in duration.  This generally will not result in any long-term problems for teeth, since it is generally believed that a tooth can loosen up to half of each root length and never have a problem.

Overall, braces will not make the teeth loose. However, in rare cases of root resorption the orthodontist will monitor the progress and advise the patient accordingly.

Patients wearing braces should always communicate their thoughts to their orthodontist to get their concerns addressed right away.

Ramadan and Oral Health: What You Need to Know

By Dr. Omar Aldaoudi

Ramadan, the ninth month of the Islamic lunar calendar, is the month of fasting for Muslims.

Fasting is one of the five pillars of Islam, and all throughout the Holy month of Ramadan, Muslims fast every day from early dawn to sunset. All physically, mentally healthy and mature Muslims around the world abstain from eating, drinking, smoking and all other physical needs.

When it comes to oral hygiene and dental treatments, what should dental providers and fasting patients know about Ramadan?

Our specialist prosthodontist Dr. Omar Aldaoudi gives us insight on oral health and dental procedures during the Holy Month. In terms of dentistry, which acts are permissible and which ones would nullify the fast? Find out below.

What do people gain from fasting?

Fasting allows learning self-restraint from indulgence in everyday pleasures, developing self-control and self-discipline, purifying the mind and the body, and empathizing with the poor and hungry.

Health-wise, fasting involves powerful therapeutic processes that can help people recover from mild to severe health conditions. Fasting can lower blood sugar, cholesterol and (systolic) blood pressure. In fact, Ramadan fasting would be an ideal recommendation for treatment of mild to moderate, stable, non-insulin diabetes, obesity and essential hypertension.

What are your advice on oral hygiene for people who are fasting? Can they still brush, floss and use mouthwash as usual?

Toothpastes are allowed during the holy month of Ramadan, although some scholars of Islam consider the use of toothpaste to be highly undesirable because deliberate or accidental swallowing of them will nullify the fast.

You can always brush and floss thoroughly before sleeping at night and I recommend brushing after Suhoor (pre-dawn meal). Brushing twice daily is sufficient for oral disease prevention.

Mouthwashes are commonly prescribed by dentists as an adjunct to oral hygiene. Some patients may be reluctant to use mouth wash for fear of unintentionally swallowing some. If this is the case, you can use it outside fasting hours as advised by your dentist.

Will dental treatments/procedures and administration of an aesthetic (injections) nullify the fast?

Some patients think that actions that take place during dental procedures will nullify their fast but local anesthetics (injections) are permissible forms of treatments for those who are observing Ramadan. However, when patients are reluctant, it is best to re-schedule or delay treatments especially if there is no acute pain/discomfort.

Are there dental procedures that should be postponed by fasting patients if the treatment dates fall on Ramadan?

Dental treatments and preventative procedure (including restorations, scaling and extractions) do not invalidate the fast, but some patients are unwilling to have procedures done due to difference in their views.

Patients who require immediate or advanced treatment, like those who suffer from deteriorating chronic illness or those who face dental emergencies, could break the fast. If it is possible, the dentist can delay or re-schedule treatments for their patients.

What’s your advice on patients who are taking medications and who want to fast?

Oral medications are not permissible and invalidate the fast. If you fall ill and avoiding medication could result to harm and is life-threatening, it’s allowable to break the fast.

When a dental problem occur during the holy month of Ramadan and medications are needed, you can discuss with your dentist. He or she may be able to adapt your medications and/or the dosage.

What are your health tips for people who are fasting?

Don't skip Suhoor. Don't overeat during Iftar (dinner). Avoid eating fried foods, salty foods and high-sugar foods. Drink as much water as possible.

Keep your meals healthy. Whenever possible, opt for steaming, grilling or baking. If you use oil for cooking, settle for healthy options like canola oil.

Drink plenty of water (drink of choice), juices, milk and soups. Cut down on coffee, tea, soda and all other caffeinated drinks – they have diuretic effects and thus dehydrate the body.