Oral Health Topics

Accidents and mouth injuries

If your child has an accident that causes damage to their teeth or mouth, contact your dentist or after hours services.

You may need to complete an ACC form at the dentist. Although accident care for under 18s is covered by ACC, some dentist may charge a fee, ask your dentist about this.

Baby teeth

Baby (deciduous) teeth are important for eating, speaking and smiling. Baby teeth also hold space in the jaw for adult
(permanent) teeth.

If baby teeth are removed before they fall out naturally, the nearby teeth may drift into the empty space. This means there may not be enough space for the adult tooth that comes in later and could cause crowding of the adult teeth, which can lead to other problems.

Start healthy eating, drinking and cleaning habits early to help set up habits for life- which means strong, healthy adult teeth.

Enrol your child as soon as possible. Your child needs regular dental checks from 2 years old so any problems can be identified early. This also gives you and the dental therapist the opportunity to talk about teething, how to prevent tooth
decay, and other questions you may have.

Our dental therapists and assistants are there to support you and your child to make their dental check ups as easy and comfortable as possible.

If you have any questions or concerns about your child’s teeth before their first appointment, call 0800 TALK TEETH (825 583).

Cleaning teeth

Starting a tooth brushing routine early in life, will increase the likelihood of your child having, strong, healthy adult (permanent) teeth.

Baby teeth should be cleaned as soon as they start to appear- around 4 ½ months.Your child’s teeth need to be cleaned twice a day, in the morning and especially before your child goes to bed.

A clean gauze wipe or clean dry wash cloth with a tiny smear of toothpaste can be used for cleaning when there are only a few teeth in the mouth.

Once your child has more than 3 teeth, a small, soft toothbrush with a smear of toothpaste should be used. Electric toothbrushes are equally as effective for cleaning your child’s teeth.

Children need your help brushing their teeth properly because they don’t have the hand skills until they are around 7 years old. Place toothpaste on your child’s toothbrush until this age also to make sure they don’t use too much.

Brushing timers, songs and sticker charts can help with make tooth brushing a fun and healthy habit for life.

Dental floss

Flossing is important for cleaning between teeth where a toothbrush cannot reach; especially where teeth may be crowded.

To floss your child’s teeth:

• Have your child lie back in your lap, face up, so you can get the best possible view into their mouth.
• Use a lamp for good lighting.
• If the teeth are tight together, use a gentle seesawing movement to guide the floss between the teeth. Don’t snap the floss against the gums as this can hurt.
• Floss teeth in tight contact with each other- this is where a toothbrush has the greatest difficulty reaching.

Flossing requires good hand coordination. Most children can begin flossing for themselves around ten years of age. A dental floss holder may be useful for your child. Begin by teaching your child to floss their front teeth. When this can be done safely, begin teaching your child how to floss their back teeth.

Speak to your dental therapist for further advice on flossing your child’s teeth.

Early Childhood Caries

Early childhood caries (ECC) is a type of childhood tooth decay that begins on the front teeth before the child turns two years old. It is usually noticed near the gum line of the upper front teeth. Early childhood caries affect about 1 in 10 children.

The most common cause of ECC is placing a baby in bed with a bottle of milk or sweetened liquid. The milk or liquid sticks to their teeth overnight, beginning the process of tooth decay.

In very rare cases, babies who are breast fed over a long time throughout the night are also at risk. A sweetened pacifier (dummy) can also cause early childhood tooth decay.

Because these children are so young, treatment can be a major problem, and some children may require general anaesthesia (GA) to put them child to sleep so they can be treated.

Parents need to be alert for signs of early tooth decay and keep the teeth healthy by avoiding sweetening pacifiers (dummies) or letting baby go to sleep with a bottle.

If you feel your baby is showing signs of decay or discoloured teeth or gums, call 0800 TALK TEETH (825 583) to make an appointment as soon as possible, even if your child is under 2 years old. In all cases, please ensure your child is enrolled
for the Bee Healthy Dental Service.

Enamel hypoplasia and hypomineralisation

Enamel hypoplasia and hypomineralisation are defects in the tooth enamel (the outer layer of the tooth) that can cause teeth to be discoloured or have thin or missing enamel or irregular pits and grooves. These teeth are at greater risk of tooth decay so it is important to brush teeth twice a day with adult strength or 6 years plus fluoride toothpaste and choose snacks with no added sugar.

Your dental therapist will advise you if they have any concerns about your child’s teeth. More information about hypoplasia.

Fillings

Teeth need to be filled when a tooth decay causes a cavity (hole) in the tooth.Fillings may be white (resin filled) or silver (amalgam).

A filling helps stop decay in that tooth getting any bigger. If a cavity is left untreated, an abscess, infection and swelling can result.

If your child requires a filling, your dental therapist will be able to provide you further information on the different types of fillings available.

Finger/thumb sucking

Thumb/ finger sucking is common habit for young children. If your child sucks their thumb or fingers, they may give up the habit on their own. Otherwise, encourage your child to stop around 3 years age. Constant thumb or finger sucking may cause upper teeth to protrude, or speech problems.

Fissure sealants

A sealant is a protective plastic material placed on a tooth to help prevent tooth decay. These are usually applied to molars with deep grooves to prevent food particles from getting caught. For more information, click here.

Fluoride

Fluoride toothpaste is one of the most effective, safe and proven ways to prevent tooth decay.

Spit, don’t rinse after brushing so the fluoride from toothpaste can keep working to protect and strengthen teeth.

Fluoride varnish is used by dental therapists to strengthen tooth enamel and help prevent tooth decay. It is applied to the surfaces teeth which may be at risk for early tooth decay, and to teeth which show early signs of decay. For more information, click here.

Water fluoridation For more information, go to Fluoride Facts.

Fluorosis

Too much fluoride while teeth are developing (up to age eight) can cause fluorosis. However, fluoride is not the only cause of white or brown spots on teeth. These spots are part of the enamel and cannot be removed.

It is very important to keep fluoride products (including toothpaste) out of reach of children to prevent accidental
overdose.

Missing teeth

Missing teeth are more common in adult (permanent) teeth than in the baby (deciduous) teeth. Some people only have one or two teeth missing. Missing teeth may be genetic, or related to another medical condition.

Mouth guards

Children can have accidents that damage their mouth or teeth. Mouth guards help reduce injuries to the mouth and teeth.They are used in many sports such as rugby, football, hockey, and skateboarding. Mouth guards can be purchased at various sporting stores, or custom made by a dentist.

Custom fitted mouth guards are made from a mould of your child’s mouth. This makes it easier for the child to talk while wearing the mouth guard and it offers better protection.

Mouth guards can also be made for children wearing braces.

Mouth piercings

Mouth piercings can cause damage to teeth or the soft tissues of the mouth (gums, lips, tongue, cheeks).

If considering a mouth piercing (or tattoo), ensure that these are done in sterile conditions to avoid risk of infection. It is important to clean jewellery regularly to also prevent infection.

Mouth wash

Mouth washes should not be used instead of regular tooth brushing and are not recommended for children under six years old. Your dental therapist can advise you on whether your child could benefit from a mouthwash and the right mouth wash to use.

Antibacterial mouth washes (such as those containing chlorhexidine) help prevent the build-up of dental plaque (a thin substance that sticks to teeth. This should only used under supervision as prescribed by your dentist or orthodontist.

Orthodontic care and braces

You will be informed by your child’s dental therapist or dentist if your child requires orthodontic treatment (e.g. braces). Orthodontic treatment, including the extraction of teeth solely for orthodontic purposes, is not covered under the free dental scheme, you will need to pay for this treatment. If you are considering orthodontic treatment for you child, the Dental Council have developed an information sheet and video to help you understand your options. If you have any questions, call 0800 TALK TEETH (825 583). For a list of orthodontist in the Wellington Region click here.

Pacifiers

Pacifiers (dummies) may help comfort your baby.

For safety reasons and tooth development, use a pacifier with an oval shaped teat and a large flange that sits on the outside of the mouth. Do not put any sweetener on the pacifier and follow the manufacturers instructions for keeping it clean. It is recommended to discontinue use around two years old.

Pulpotomy

A pulpotomy is a procedure that is done when decay is deep. Part of the pulp (nerve) of the tooth is removed because it is inflamed. This allows healthy tissue to survive and means a tooth can be kept until it falls out naturally. Your therapist will be able to explain more about this procedure and how likely it is to be successful. For more information, click here.

Stainless Steel Crown

Stainless Steel Crown is a silver cap that the therapists fits on the pack baby teeth to protect them. The tooth may be weak (hypomineralised) or damaged by tooth decay. For more information, click here.

Our service uses two techniques to place a stainless steel crown. For information on the Hall Technique, please click here.

Teething

Teething is a normal part of every child’s development. Common signs your child is teething include:

• Crying at night
• Red cheeks
• Drooling
• Irritability and restlessness

Teething does not cause fever. If your baby has a high temperature, contact your doctor as soon as possible.

Pan relief medication is not necessary for teething. However, teething rings, gels, powders, may help relieve your child’s discomfort while teething.

It is important to use a sugar and alcohol free product. Speak with your dental therapist, doctor or pharmacist to discuss suitable options.

Tooth decay

Tooth decay occurs when bacteria in our mouths feed on sugars and produce acid. The acid breaks down and damages the
outer parts of the tooth. If this damage goes deeper into the tooth, the tooth can get infected and your child may experience pain.

Tooth eruption

For most children, the first tooth usually comes in around 4 ½ months age. When baby (deciduous) teeth fall out, there may appear to be a white piece of tooth remaining in the gum. This is the new adult (permanent) tooth starting to come through the gum and usually erupts around six years age.

If your child has a wiggly tooth and is in pain, call 0800 TALK TEETH (825 583).

Tooth grinding (Bruxism)

Some children grind their teeth at night. This habit is called bruxism and is not unusual in the early years.

The reasons for bruxism are not clear. The grinding habit can be minor or a child can wear teeth severely. If the habit continues in later years and there is damage to the adult (permanent) teeth, some form of treatment may be needed.

Some suggestions for treatment include minor tooth adjustments, the use of mouth splints or relaxation techniques

Toothpaste

For best protection, brush teeth for two minutes, twice a day (in the morning, and before bed) with full strength fluoride toothpaste containing at least 1000 parts per million fluoride.

For children under five years old, use a half-pea sized amount of fluoride toothpaste, or less if they only have a few teeth.

For children over five years old and adults, use a pea-sized drop of fluoride toothpaste.

Two rows of teeth

The appearance of two rows of teeth is due to the adult teeth coming in behind the baby teeth before the baby teeth have fallen out. The appearance of two rows of teeth is not uncommon, occurring in about 30% of children.

Sometimes the baby tooth or teeth may need to be removed, but in many cases the baby teeth fall out a few weeks after the adult teeth appear. An X-ray may be needed to see how much of the roots of the baby teeth remain and assess the need for extractions.

Call 0800 TALK TEETH ((825 583) if you have any concerns.

Wisdom teeth

Wisdom teeth are the third and last molars to come into the mouth. Wisdom teeth erupt at different times, usually between 16 and 24 years. Wisdom teeth may need to be removed if there is not enough space for them to come through, if they are impacting on other teeth, or causing pain and discomfort. Your child’s dentist will advise you if wisdom tooth removal is
required.

X-rays

X-rays show areas of your child’s teeth which may have decay that cannot be seen by just looking.If your child is at primary school, they may have an x-ray at their dental check up when the mobile van visits their school.

You can indicate if you do or, do not want your child to receive x-rays without your permission on your child’s dental enrolment form.

Information sheet: Materials we use