Children and teeth: bread is better than bananas

Did you know that milk teeth decay more quickly, that changing teeth too early can lead to a lisp and that parental dental hygiene is important right through to teenage years? Answers to questions parents have about their children's teeth.

Thoroughly care for milk teeth? What's the point? They'll fall out just like that.

This attitude is still widespread among parents today. And very wrong. Because the first teeth in life are valuable: they form the foundation for a healthy and solid set of teeth for life.

«That's why brushing teethonce a day is mandatory from the first tooth,» says Priska Fischer from the Department of Conservative Dentistry and Periodontology at the University Medical Centre Freiburg im Breisgau. At the latest when the first molars appear in the second year of life, teeth should be brushed in the morning and evening: with a brush with a small head and soft bristles. Its handle should be thicker than that of adult brushes, making it easier for children to handle.

What is the right dose of fluoride?

A low-fluoride toothpaste is recommended for the youngest children. Toothpaste for adults usually contains between 1000 and 1500 ppm (parts per million) of caries-preventing fluoride. This corresponds to 1 to 1.5 milligrams per gram of toothpaste. As children up to school age are more likely to swallow a lot of toothpaste instead of spitting it out, children's toothpaste may contain a maximum of 500 ppm fluoride, i.e. 0.5 milligrams per gram of toothpaste.

As soon as the first permanent teeth appear, stronger fluoridation is necessary.

Priska Fischer

The intermediate stage are so-called junior toothpastes, which are fluoridated like a toothpaste, but have a gentler taste and may even have fruit flavours. These toothpastes are usually recommended from the age of six or seven. «However, it sometimes makes sense to start earlier,» says Priska Fischer. «The decisive factor should be when the first permanent teeth come in. For some children, this is already the case at the age of four or five. Then more fluoridation is important.»

We need a well-functioning set of milk teeth in order to eat. In order to be able to take a bite of bread or a carrot, the teeth must be correctly aligned. The first teeth also have a so-called placeholder function. The first permanent molars use the rearmost milk molars as a kind of scaffolding that they use to hold themselves up. If this orientation is missing, the permanent molars often push too far forwards through the jaw - it is not uncommon for the orthodontist to have to ensure the correct tooth position later on.

If the incisors in the upper jaw fall out too early, this has negative consequences for speech development

Milk teeth are also essential for the process of learning to speak: if the incisors in the upper jaw fall out too early, this has negative consequences for speech development. The tongue suddenly has more space at the front than it needs, causing S and Z sounds to sound strange and the child begins to lisp. In the worst case, the constant tongue movements lead to an open bite after the change of teeth.

A cleaning system for life

This is why modern dentistry does everything it can to preserve even severely damaged milk teeth for as long as possible. There are crowns for milk teeth and dentures for children, and root canal treatments are also carried out on the first teeth. However, this should only be done in exceptional cases. Prophylaxis therefore means: care, care, care.

Milk teeth should be cared for just as well as permanent teeth. This is because they are less mineralised than permanent teeth and therefore decay more quickly. The germ Streptococcus mutans and the lactobacilli - the two biggest causes of tooth decay - do not care whether it is a milk tooth or a permanent tooth. Once caries occurs in children's teeth, it can have serious consequences, as the nerve cavity of the tooth is larger in relation to the hard substance than in a permanent tooth. This means that caries can reach the nerve more quickly. «Once the nerve is inflamed, the bacteria can also attack the protected permanent tooth underneath,» explains Priska Fischer.

Parents can use colouring tablets to raise awareness of dental care.

Fischer advises that parents should continue brushing until primary school age. Only at this age can you see whether the children have succeeded in developing their own brushing system. This is important because such patterns usually last a lifetime. From kindergarten age - when the little ones must be able to spit - parents can use colouring tablets from the pharmacy to raise awareness of tooth cleanliness: Red discolouration indicates where plaque has remained and needs to be brushed more thoroughly. Whilst a mouthwash is a rather negligible part of dental care for children, dental floss is an important tool. It should be used consistently from the moment you can no longer see any space between two teeth. «This should be done by the parents, as dental floss is still difficult for children to handle,» says Priska Fischer.

However, the lack of fine motor skills should not be a reason for parents to be tempted to buy an electric toothbrush for their children - at least not at the beginning. After all, every child should first master the basic brushing technique with a manual toothbrush so that they can fall back on it when the electric toothbrush is not available. "I always compare it to tennis and table tennis," says Priska Fischer, «one is played from the wrist, the other from the arm - it's the same with the manual toothbrush and the electric one.»

If the children are confident in using a manual toothbrush, an electric one can be a sensible purchase, as it removes more plaque than a manual toothbrush - but only if used correctly. "You can also brush badly with an electric toothbrush," says Priska Fischer. According to the dentist, the ideal combination is to brush by hand in the morning and electrically in the evening.

Tooth-friendly food and drink

In addition to brushing, your diet also contributes to healthy teeth. The rule of thumb is to generally eat as little industrially produced food and convenience products as possible. These usually contain a lot of hidden sugars, which trigger the harmful acid attacks of bacteria on the teeth. This also includes many fruit teas for children as well as iced teas and soft drinks for teenagers. The consistency of carrots and apples , as well as wholemeal bread, ensure easy, natural cleaning of the teeth, while a banana sticks to the teeth for a long time. When it comes to sweets, it's all about the right dosage: "It's better to eat ten jelly babies at once than to eat them uncontrollably throughout the afternoon and keep feeding the bacteria with substrate," says Priska Fischer.

The sugar substitute xylitol can prevent tooth decay.

The dentist recommends the natural sugar substitute xylitol for children who have an increased risk of tooth decay. It tastes sweet and is suitable both as a mouthwash and for baking. As xylitol can have a laxative effect in excessive doses, users should approach larger quantities slowly. "When used as a rinsing solution, xylitol blocks bacterial metabolism and can therefore prevent tooth decay," says Fischer. Sealing can also be useful, as it reduces the chances of bacteria attacking the chewing surface of a molar tooth.

Parents should also continue the strategy of brushing and colouring tablets with older children - even if not on a daily basis. This allows children to learn what is really important when brushing their teeth. Especially when the first permanent molars come in at the age of six or seven, dentists often notice that they quickly develop tooth decay - because this happens at an age when parental tooth brushing control has usually already lost its rigour. However, this is required well into the teenage years: adolescents are a clientele that dentists hardly reach with their appeals.

Detailed dental care information at: www.generation-kariesfrei.ch.

8 key facts about milk teeth:

Milchzähne haben wichtige Aufgaben.
Angelegt werden sie in der sechsten Schwangerschaftswoche, und bei der Geburt liegen sie voll entwickelt im Kiefer des Kindes – man sieht jedoch noch nichts von ihnen.
Ab dem vierten Lebensmonat brechen die Zähne durch, und zum ersten Geburtstag sind meist alle oberen und unteren Schneidezähne sichtbar.
Bis zum 16. Monat folgen die ersten Backenzähne, die Eckzähne zeigen sich bis zum 20. Monat.
Ein dreijähriges Kind hat mit 20 Zähnen ein vollständiges Milchzahngebiss.
Die neuen, bleibenden Zähne entwickeln sich unter dem Milchgebiss.
Zwischen dem 6. und dem 12. Lebensjahr werden die Milchzähne durch die bleibenden Zähne ersetzt – wann genau, das ist von Kind zu Kind verschieden.
In der Regel ist der Zahnwechsel abgeschlossen, bis die Kinder 12 Jahre alt sind.

How to protect your child's milk teeth from decay:

Regelmässige und sorgfältige Zahn- und Mundhygiene: zweimal täglich mit fluoridhaltiger Kinderzahnpasta.
Regelmässige Kontrolluntersuchungen beim Zahnarzt zweimal im Jahr.
Zahnfreundliches Essen und Trinken: Produkte, die wenig Zucker und wenig Säure enthalten. Schlecht für die Zähne sind Nahrungsmittel, die an den Zähnen kleben – zum Beispiel Chips, Honig, Bananen oder Trockenfrüchte.
Zahnfreundliche Süssigkeiten: Ein weisses Zahnmännchen mit Schirm auf rotem Grund – mit diesem Logo sind Süsswaren gekennzeichnet, die während und bis 30 Minuten nach dem Verzehr keinen Säure auslösenden Kariesschub verursachen.
Fluoridierung: Fluoride wirken doppelt. Sie hemmen den Stoffwechsel der Karies auslösenden Bakterien und sie härten den Zahnschmelz und machen ihn so widerstandsfähiger. Achten Sie auf eine fluoridhaltige Zahncreme. Vorbeugend kann zudem fluoridiertes Speisesalz zum Kochen verwendet werden.

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