Junior Zone: 6-12 Years

When children’s teeth are loose should we pull them out, leave them or show the dentist?
Ideally the primary teeth will become so loose and bothersome, that the child wants his parent or dentist to help remove it. If it hangs on too long, it may hinder the child in eating or brushing properly which has a detrimental effect on the whole mouth. In earlier days it was usually the grandfather who used a piece of string and had the natural authority to help the child through this! Of course often the tooth falls out or “disappears” while eating (not a problem, it will pass naturally). When the tooth buds are crowded in a small jaw, sometimes they break through into the mouth by slipping past the primary tooth instead of resorbing it. These teeth stand in double row behind the primary teeth and should be assessed by a dentist as to whether or not they need to be removed. Sometimes a child doesn’t have the adult tooth (inherently missing adult teeth). When teeth are suspiciously late in erupting, an X-ray will clear up the question and help the dentist to provide advice on consequences.

Are there any provisions we should make before adult teeth start appearing i.e. diet, brushing?
It is important to know that during teething, the mouth is more prone to plaque accumulation (because the child may not be brushing as well due to discomfort and also because the niches and pockets at the gum line are increased due to erupting teeth). Decay in between the teeth is statistically much more likely to occur ( age 7) due to the adult teeth shoving the other teeth together and also being bigger themselves, causing the contact areas between teeth to be larger. This is often the age at which children will be instructed to begin (or increase) their flossing, if they had not been told already. Also parents and children should know that new teeth are not completely mature in the sense that the enamel is still a bit soft just after coming through. The natural saliva in the mouth plays an important role in the final hardening of these new immature teeth as the mineral content of saliva varies widely. Some additional fluoride at this point is very advantageous.

How often should they brush their teeth?
Twice daily, properly, mandatory, no questions asked, no exceptions made! Brushing longer is always better than shorter. Two minutes with any type of toothbrush is the minimum.

What age should they start flossing?
There is not a specific age; it is dependent upon the natural anatomy of the teeth and the proximity of the teeth to one another.

How often should they visit the dentist?
Twice yearly is standard and the minimum. If the parents have problems (gum disease, “bad teeth”) or the children have had a history of decay, 3 or even 4 times a year is beneficial because the increased frequency of cleanings is advantageous to the oral microbiology.

Will sucking fingers effect the development of the teeth, i.e. straightness?
Yes indeed, it is a bad habit and will make buck teeth! Sucking on pacifiers as well!

What are the general typical treatments you offer a child of this age?
Ideally children should be in a prevention scheme to ensure that their home tooth brushing is adequate and if need be, supported by a hygienist. When indicated, X-rays are necessary to access the hidden in-between areas so vulnerable at this age. Orthodontia is sometimes initiated when crooked teeth or misaligned jaws develop because of inherited tendencies. When decay is present, early detection is essential so that modern materials like white composite fillings can be used to restore the tooth. Even severely damaged teeth (through accidents or decay) can be restored and saved.

Are there any concerns to look out for when adult teeth are coming through i.e. gum colour, straightness?
The colour of the enamel often gives important information about the hardness of the tooth. The chewing surface of the tooth is either flat (lucky child!) or deeply fissured (biscuits leave brown spots in all the chewing surfaces); a sealant will protect the tooth from decay. Most children have teeth that are a bit crooked at the beginning. It will improve with growth and development but few children have naturally straight teeth.

What should I do if my child falls and breaks or damages a tooth; do you offer emergency dental care?
The two most important things to remember when a tooth accident happens are: TIME matters…get to the dentist ASAP, don’t accept waiting…..we would take you on immediately because it is so very important. Secondly – look for and bring all pieces of tooth you can find.