Author:Xu Xiang
Department of Dentistry, Beijing Dongcheng District Maternal and Child Health Hospital
To maintain oral health, remember this principle: “prevention first, treatment equally important.” This means we should pay attention to oral health before problems arise and promptly identify and treat potential issues.
This article will clearly and simply explain how to care for children’s oral health at different age stages (0-4 years, 4-6 years, and 6-12 years).
0-4 Years: Infants and Toddlers
Developmental Characteristics of Oral Health at This Age Children aged 0-4 are in the primary teeth growth phase. Due to the lower mineralization of primary teeth, deeper grooves in primary molars, and the challenges of maintaining oral hygiene at a young age, primary teeth are highly susceptible to caries (tooth decay). Therefore, parents should pay particular attention to caries prevention before their child turns four.
What Can Professional Oral Care Do?
When the first primary tooth erupts, a visit for the initial oral examination is essential. This includes assessing tooth eruption, surface cleanliness, and the health of the oral mucosa. Caries risk assessments can also be conducted to visually indicate current caries risks.
After the oral examination, the dentist will discuss the child’s feeding habits (such as breastfeeding frequency at night) with the parents and provide personalized oral care recommendations. Parents should take this advice seriously and regularly schedule oral check-ups to prevent potential problems.
Additionally, two preventive measures can be employed: 1) applying fluoride varnish on teeth, which forms a protective layer on the surface that effectively prevents caries; 2) sealing the grooves of primary molars with appropriate materials to prevent bacteria from lingering in the grooves, thus reducing caries risk.
What Should Family Oral Care Involve?
Parents’ main task is to cultivate good feeding and oral hygiene habits in their children.
Avoid Sleeping with Milk: Many infants have a habit of nighttime feeding, often falling asleep with a milk bottle. Prolonged exposure to milk can lead to demineralization and softening of the teeth, making them susceptible to bacterial attack and developing caries.
To protect teeth from the effects of night milk, parents should encourage their child to swallow any remaining milk after each feeding and rinse with a small sip of water to help clean the oral cavity, preventing bottle caries.
Brush Teeth Three Times Daily: When the first primary tooth erupts around 4-6 months, a habit of brushing three times daily should be established. Parents can use a toothbrush dipped in water to clean both the inner and outer surfaces of the teeth.
During brushing, the child can lie down with their head resting on the parent’s lap, allowing full visibility of the teeth. If the child is uncooperative, a “knee-to-knee”brushing position can be adopted: two parents sit facing each other, knees touching, with the child lying between their laps; one parent can hold the child’s hands while the other stabilizes the head for brushing. This position ensures safety and enhances brushing effectiveness.
4-6 Years: Preschool Children
Developmental Characteristics of Oral Health at This Age
Children aged 4-6 are in the preparatory stage for the transition from primary to permanent teeth. Typically, the first permanent molar (six-year molar) erupts around age six. To provide space for the permanent teeth, changes in the gaps between primary teeth can occur, increasing the risk of food impaction and interproximal caries.
Focus on Cleaning Interdental Spaces and Preventing Gum Bleeding
Many parents are confused as to why their child’s teeth, which appear clean, still develop caries. This is because the teeth may only “look” clean while bacteria remain in the unseen interdental spaces. Some parents, fearing gum bleeding, avoid using dental floss and oral irrigators. These are misconceptions about oral care.
At this stage, parents should teach children how to correctly use dental floss and oral irrigators. Healthy gums have a certain resilience, and proper use of these tools usually does not cause bleeding. If gums bleed with light contact, it often indicates insufficient cleaning, with plaque causing gum inflammation—the primary reason for bleeding.
Therefore, we must be more meticulous in cleaning areas prone to bleeding. Only inflamed gums will bleed easily; healthy gums are not so easily affected. When gum bleeding occurs, there’s no need to overly worry; as gum inflammation subsides, bleeding symptoms will also decrease.
Correct Daily Oral Hygiene Practices
For children aged 4-6, this is a crucial stage for developing good oral hygiene habits. Parents need to patiently teach correct oral hygiene methods, including brushing techniques and the use of dental floss and oral irrigators.
**Brushing Techniques**: The circular brushing method is recommended, cleaning the outer surfaces, inner surfaces, and chewing surfaces while ensuring no tooth is missed, especially the distal surface of the last tooth. When cleaning the inner surfaces of the upper and lower front teeth, the toothbrush can be held vertically, brushing from the root towards the biting surface.
**Using Dental Floss and Oral Irrigators**: After brushing, use dental floss to clean between teeth. Introduce the floss into the interdental space in a sawing motion, avoiding direct pressure that could damage the gum papilla. Once in the space, press against one side of the tooth and pull up and down to remove food debris; then switch to the other side and repeat. After cleaning, use an oral irrigator to flush out any small particles, ensuring the water stream is perpendicular to the surface for effective cleaning.
Regular Oral Check-Ups
While cultivating good oral hygiene habits, regular dental check-ups remain essential. This stage is a high-risk period for interproximal caries, which can quickly lead to pulpitis and pain. Regular examinations can help detect early caries and provide filling treatments to inhibit progression; for those without caries, fluoride applications can be performed. For children aged 5-6, dentists will pay special attention to the eruption of the six-year molars and inform parents about care methods.
6-12 Years: School-Age Children
Focusing on the Care of Six-Year Molars
The six-year molar, or “first permanent molar,” usually erupts around age six, though some children may see these teeth emerge earlier. During the initial eruption phase, when the gingival flap partially covers the chewing surface, parents should pay special attention to cleaning this tooth. When brushing, ensure that the bristles reach into the grooves of the tooth and apply adequate pressure to clean thoroughly. As the gingival flap recedes, the chewing surface becomes fully exposed, making the deeper grooves more susceptible to caries.
Effective Prevention of Pit and Fissure Caries
The most effective prevention method for pit and fissure caries is sealing these grooves. To minimize the risk of caries, it is recommended to seal the grooves of the six-year molars in two stages: first sealing the occlusal grooves when the chewing surface is fully exposed, then sealing the buccal grooves once they are also visible.
Focusing on the Care of Maxillary Lateral Incisors and Bicuspids
By ages 8-9, both maxillary lateral incisors should have erupted. To effectively reduce their risk of caries, it is advisable to perform pit and fissure sealing. The morphology of maxillary lateral incisors can vary significantly, with a higher prevalence of abnormal lingual grooves and pits. These malformed teeth tend to have deeper grooves compared to normal ones, placing them closer to the pulp; if caries occurs, it is more likely to lead to pulpitis and pain.
Therefore, if deep abnormal grooves are identified during a dental check-up, special attention should be given to these teeth to ensure thorough cleaning and prevent food residue retention. Sealing these deeper grooves is also advisable.
Sealing is not limited to molars; deep grooves in maxillary lateral incisors and bicuspids should also be sealed to provide early intervention against caries risk.
Focus on the Care of Second Permanent Molars
For children aged 11-12, parents should prioritize the eruption and health of the “second permanent molars.” Newly erupted teeth have a lower degree of mineralization, making them more susceptible to caries. Additionally, their position at the back of the mouth can cause nausea during brushing, making cleaning more challenging. Given the role of these teeth in future chewing function, they require significant attention.
At this age, children often exhibit strong independence and may resist excessive parental intervention; meanwhile, their self-discipline is still developing, necessitating appropriate supervision. If inadequate cleaning is noticed, parents should communicate patiently to understand the reasons behind it. If nausea is causing cleaning difficulties, consider using a smaller toothbrush and reducing the amount of toothpaste. If it’s due to laziness or forgetfulness, emphasizing the importance of cleaning this tooth is essential. Once the gingival flap recedes completely and the chewing surface is fully exposed, pit and fissure sealing should also be performed for additional protection against caries.
Conclusion
Effective children’s oral care requires collaborative efforts from both dentists and parents. Instilling good oral hygiene habits in children early on is critical for achieving lifelong dental health. As the saying goes, “May all people in the world be free from illness; what harm is there in letting medicine gather dust?” We hope every child can be free from oral diseases and grow up healthily and robustly.
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