I had the opportunity to interview Dr Lim Swee Teck, a Pediatric Dental Specialist from T32 Junior recently and learned quite a bit about taking care of babies and kid’s teeth, eliminating kid’s fear for the dentist and what to do during dental emergencies.
Dr Lim is also affectionately known as Dr Friendly by his patients. He had 3 years postgraduate studies in the States specializing in Pediatric or Children’s Dentistry and is the first male Pediatric Dentist in Singapore. He is also the author of the Healthy Smile Series, a series of very effective children books that educate and motivates children to take care of their teeth and oral health.
Qn: What is the difference between a pediatric dentist and a family dentist?
Pediatric dentistry has a wider scope compared to a family dentist. We are called upon to manage situations that a family dentist is unable to handle. Family dentists play an important role for routine care such as checkup, polishing and removal of baby teeth. There are many family dentists who are great with children too.
Qn: What are the main things parents should look out for when it comes to taking care of their kid’s teeth?
Parents need to pay more attention to good oral health care practices for their children at home to prevent problems like gum infection and tooth decay. This should start when the child is 6 months old. At one year old, babies are susceptible to Early Childhood Caries caused by the milk bottle feeds. It can also happen when they are breast fed. This is because milk being a carbohydrate when retained around the teeth and gums, are broken down by the bacteria in the mouth and converted into acid. This acid then softens or decalcifies the tooth structure, causing them to break down and become cavities.
I have seen cases where children as young as 3 years old needed to be treated under General Anaesthesia as most or all of their teeth are decayed and infected.
Some parents allow their children to habitually go to sleep with the milk bottle in the mouth and letting it act as a pacifier. Such a habit increases the chances of milk retention to cause severe milk bottle decay or Early Childhood Caries. In situations where the child needs the bottle, what parents can do is to substitute the milk bottle after the feed with another bottle that has water. This helps to rinse away the retained milk as the child suckles.
When the baby is 6 months old, parents should start using a soft wet towel wrapped around the finger to wipe the gums and baby teeth after each feed. Starting early teaches and trains the infant to accept cleaning after a feed better. There are also handy products like Spiffies ToothWipes for cleaning and preventing cavities.
Qn: Many young kids are afraid to visit the dentist. How do we help them get over the fear?
When a person has had pain and bad experiences during childhood, such memories are strongly entrenched. Therefore, do not take a child to a dentist only when he/she has a toothache or a large cavity on the tooth.
For those children who are fearful, we allow them to observe their parents, sibling or another child having dental care. This helps to familiarize them with the environment and the things found in a dental office. This allays anxiety and apprehension. Parents can also prepare the child mentally through books that tells the child that the dental office is a fun place and visiting the dentist is fun and not something to be anxious about.
One way that I manage children’s fears is by creating and showing them that visiting the dentist is a fun experience. Children do get intimidated by the many strange tools and equipment in a dentist’s office. I make them feel special and excited with the experience through the use of exciting terms like “magic chair” to describe the dental chair. Tools also get nick names like “baby mirror”, “baby spoon” and “baby fork” so that kids become more familiar and receptive to them. These terms and keywords have been tested over years of practice and they work like a charm.
As such we create an environment that is fun, magical, exciting, friendly, and inviting to the kids so that they feel at ease, good and motivated about the visit.
Qn: Is it advisable to remove our child’s loose baby teeth ourselves?
An important note is to never yank out a kid’s loose baby tooth with a thread or dental floss. This can be a very painful and traumatic experience for the child. The baby tooth, however loose, is still attached to the gum which is highly innervated. If a child has had such an experience, the child will develop a phobia with the dental floss and will refuse to allow his teeth to be flossed in the future. It is far better to bring the kid to the dentist, who will numb the gums and tooth thoroughly before taking it out – making it a pleasant and painless experience.
Qn: At what age can parents stop helping their kids with brushing and flossing for their teeth and let the kids do it themselves?
Allow the children to brush first followed by the parents checking, helping and teaching them to brush correctly. Parents should continue helping their child to brush till they are 9 years old. By this age the child’s manual dexterity would have developed to allow them to brush thoroughly and properly. Even then parents should continue to spot check.
Parents should also help the kids to floss until they are 13 to 14 years of age.
Qn: What is you advice about letting kids eat candies and sweets?
It is really quite difficult to tell a child not to eat sweets and candies as almost everyone is giving kids sweets as an expression of their love. Trying to stop children from eating the sweet treats is quite difficult and unrealistic especially when everyone around them is indulging in this habit. So rather than trying to stop them totally, we educate the child and make them responsible through ensuring that they know what to do after indulging in the sweet treats. They need either to brush or gargle or rinse immediately after each snack of sweets, cookies, candies and sugary drinks. This is a more realistic approach as we are teaching them responsibility.
Qn: Is Dental Trauma where children break their tooth common? What should we do with any broken tooth in case of trauma?
Dental trauma is becoming common as children indulge in extreme sports. Fortunately, we do not see many cases of children breaking their teeth here as parents are generally more mindful about safety. For any injury to the teeth, the child must be checked and cared for by a dentist.
In the event that a front tooth is completely knocked out, you need to do the following:
a. Pick up the tooth
b. Do not wash it
c. Immerse the tooth in the owner’s saliva so as to keep the tooth lining alive
d. Take the child immediately to the hospital or dental clinic
e. The tooth will be implanted and splinted
Q: I wish I knew about books like Timmy Visits the Dentist (Volume 1 from the Healthy Smiles Series) when preparing my child for his first visit. What motivated you to write the books?
I firmly believe that good and proper oral health care for children should not be just on treatment but on prevention. Through creating the Healthy Smile Series, I hope to educate parents and children and help them to understand the importance and the how and why of taking care of their teeth and oral health. Through such knowledge they will be able to acquire a good habit for life. This will create a happy group of people with a healthy habit and attitude and with no fears of the dentist. Maintaining a healthy mouth can also lower one’s risk to systemic diseases.
After a pleasant interview, Dr Friendly showed me around the kid’s reception and entertainment areas and the kid’s treatment rooms. The boys and girls treatment rooms have decors in sweet and soothing colors and decorated tastefully with cute stickers of cartoon characters on the walls. On the ceiling in each room is a television for the kids to watch their favorite cartoon movie as they are undergoing care.
The children feel so at ease and at home.
I love the girl’s room. So pretty.
With a TV and toys dangling from the ceiling, would any kid not want to visit the dentist?
There are appropriate coloring materials and stickers for the kids to subtlely remind them to take care of their teeth.
Dr Lim Swee Teck practices at T32 Dental Centre, T32 Junior
Camden Medical Centre
Tel: (65) 6733 1388