Common Dental Problems

 

• Dental Caries

  • Unfortunately, dental caries (dental decay, 'holes', 'cavities') is common in children (in Australia, 46% of children under age of 6 has dental caries)

  • It is a continue spectrum - early decay looks chalky in colour, to brown cavities

  • The child may or may not report pain 

  • It results from a combination of factors (not just from one thing e.g. not brushing the teeth)

  • ​Dental caries occur when the balance between risks (e.g. frequent consumption of drinks containing sugar like fruit juice, inability to remove plaque - tooth brushing adequately or routinely) and prevention (e.g lack of exposure to fluoride - for example from tap water or use of fluoride toothpaste) is tipped (more risks than prevention)

  • It occurs over time when bacteria in the mouth uses any form of sugar and produce acid, which cause minerals in to be lost from the teeth, causing 'holes'. It usuall gets worse over time. 

  • To prevent dental caries, one have to reduce the risks and increase the prevention. Depending on the child, it may or may not be possible to eliminate all risk factors from the diet. If that is the case, then more prevention (e.g. brushing more frequently, higher fluoride concentration toothpaste) will be required. On the other hand, if effective brushing is not possible, then reducing the risks (e.g. less frequent sugar intake) will be beneficial. 

  • Dental caries are usually treated by fillings (e.g. tooth-coloured fillings, stainless steel crowns)

  • If the dental caries progress and getting close to the 'nerve' (towards the middle of the tooth), then more comlpex treatment may be required

 

 

 

 

• Dental abscess / swelling

  • ​When the dental caries progress (due to inability to maintain the balance towards prevention), it can progress into the 'nerve' (towards the middle of the tooth). Over time, the bacteria will travel down the tooth and cause infection to the tissues around. This can lead to swelling in the gum (abscess), or if more severe, swelling in the cheek or face

  • Dental abscess / swelling in children usually require the offending tooth to be taken out

 

 

 

 

• Dental erosion

  • Lost of tooth structure due to acids either from the body (for example gastric juice from reflux) or more commonly, from the diet (for example acidic fruits like apples, kiwi fruits, oranges, fruit juice, cordial, soft drinks, energy drinks)

 

 

 

 

 

• Periodontal Disease (Gingivitis, Periodontitis)

  • ​This means the health of the gum and/or the bone around the teeth are not healthy

  • Gingivitis = inflammation of the gum, usually associate with inadequate removal of plaque around the teeth (ie ineffective brushing), the gum react to the presence of the plaque, resulting in the gum being inflammed. The gum usually looks red and swollen and bleeds easily during brushing or flossing

  • Gingivitis has been reported to be more severe in children with special needs as tooth brushing could be quite challenging. We have many suggestions to help with tooth brushing here for you to consider

  • Periodontitis = infection of the bone supporting the teeth resulting from bacteria present around the gum or the teeth - uncommon in children. Children with Down Syndrome are more prone to periodontitis with age.

 

 

 

 

 

• Dental Trauma

  • Dental trauma is common in children, but some studies reporting that it is even more common with children with special needs e.g. falling off wheelchairs

  • Trauma to teeth is never the end of the world so the most important thing is to keep calm

  • Contact your dentist and discuss what had happened and for assessment

  • Complicated trauma to the teeth sometimes require management by a specialist or at a hospital setting

     

    ​