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Lesson 101: Oral hygiene for children

Lesson 101: Oral hygiene for children

Siti Rose Khairina Tay is not scared of dentists nor intimidated by dental instruments like mouth mirrors and periodontal probes.

She is only three years old and has visited the dentist four times, probably more times than most children twice her age.

Unlike most Malaysian parents, Siti Rose’s mother Dr Siti Salmiah Awang started teaching her children about oral hygiene almost as soon as they had teeth.

When Siti Rose was just a year old, her mother taught her how to brush her teeth and started taking her for her bi-annual dental check ups.

“Oral care in children is vital from the moment their teeth start to erupt at about six months. It prevents early caries development and avoids other abnormal conditions concerning teeth development,” says Dr Siti Salmiah, 45.

At home, the PJ-based family physician gets her five daughters – aged three to 12 – to brush their teeth twice a day.

Toothbrushes are replaced every six months (or sooner) to ensure the bristles are in good condition. She is slowly training her girls to get into the habit of flossing.

Siti Rose and her sisters undergo dental check-ups every six months. Their mother says dental visits help the girls familiarise themselves with dentists and dental clinics.

The secret to wonderful pearly whites? Ensure children brush their teeth at least twice a day. – Photo: The Star/Art Chen

“I encourage my girls to build a closer rapport with these medical professionals. At the clinic, the nurses teach them about the do’s and don’ts about oral care too. They have become so at ease with dentists and don’t mind going for regular check-ups,” says Dr Siti Salmiah.

Oral care is one of the important foundations for healthy permanent teeth. Therefore, it is essential to establish a proper oral hygiene routine early in life to help ensure the development of strong and healthy teeth.

Thanks to modern technology, patients can watch their favourite movie while the dentist works his magic. – Photos: The Star/Samuel Ong

Mother-of-one Prof Ammu Kutty G.K.Radhakrishnan thinks children should be taught that dentists are “superheroes” who help protect their pearly whites.

Six years ago, her daughter Akshainie developed a cavity in her tooth. Like most children, she was nervous about the dental visit, fearing her tooth would be extracted.

“Thankfully, Akshainie’s dentist was trained to treat children. She was allowed to play on the dental chair as well as handle some of the safer instruments like hand-held mirror. After calming her down, the dentist started the check-up and the procedure went on with ease,” says Prof Ammu, 55, who takes Akshainie for dental check-ups on a yearly basis.

The associate dean at a private medical university in KL added it was initially difficult to train Akshainie to get into the routine of brushing her teeth regularly. But that changed after finding the suitable toothpaste and tooth brush.

“The toothpaste needs to have a pleasant taste that would encourage children to brush their teeth.

“It is equally vital that the ingredients in children’s toothpaste are safe and effective,” says Prof Ammu, who encourages her 10-year-old daughter to watch videos on oral hygiene on YouTube.

Brushing your teeth regularly gets rid of plaque and other nasties, Prof Dr Ammu Kutty G.K.Radhakrishnan tells her daughter, Akshainie.

Akshanie’s dentist, IMU Oral Health Centre clinician in-charge Dr Hussein Al-Wakeel, says parents play an important role in instilling good oral care in their children.

“Parents, as consistent role models, are key to making their children understand the importance of oral hygiene.

“Tooth brushing should be presented as a habit and an integral part of the daily hygiene routine. Children are very sensitive to social stimuli such as praise and affection, and learn best by imitating their parents,” explains Dr Hussein, adding the foundation for healthy permanent teeth in children and teenagers is laid during the first years of life.

To avoid tooth decay, children should eat healthily, make smart food choices and practise good toothbrushing habits, Dr Hussein advises.

“Save treats like candy and cookies after mealtime, since this is when the amount of saliva produced is greater and helps protect children’s teeth.

“Flossing can help remove the candy particles. To make flossing fun, use flossers with your child’s favourite character,” says Dr Hussein, who encourages children to drink more water to help prevent tooth decay.

Prevention is better than cure

In the early 1970s, the Ministry of Health launched its School Dental Service (SDS) to ensure optimal oral health among students.

This service is provided in school dental clinics and dental clinics, and complemented by mobile dental clinics.

The programme has managed to reach almost 98.2% of primary and 84.0% of secondary schoolchildren in 2009, according to the ministry’s Oral Health Program’s official portal.

While oral health awareness among school children has improved, the National Oral Health Survey of Adults showed that oral health of preschool children is of concern with an increase of caries (tooth decay).

The report states children who have caries in their milk teeth were found to be three times more likely to develop caries in their permanent teeth.

Dr Ng advises parents to ensure their children go for regular routine dental check-up and preventive care. Photo: The Star/Ronnie Chin

To address this problem, Malaysian Dental Association president Dr Ng Woan Tyng advises parents and children to place more emphasis on the need for routine dental check-ups and preventive care.

“Regular dental check-ups can help lessen the need for invasive procedures like injections and extractions. Routine visits are a method to acclimatise children to the dental environment and to instil a positive mindset on seeing a dentist.”

Dr Ng says dentists practise many behaviour management methods to overcome an anxious child.

Some patients are given audio visual eyeglasses during treatment. This helps keep patients still and distracted while dentists are performing their work.

“Behaviour management techniques can be broadly divided into two groups – pharmacological (using medicines for sedation or general anaesthesia) and non-pharmacological (such as ‘tell-show-do’, role modelling or positive reinforcement).

“Sometimes, when all methods fail, the last resort will be to subject the child to general anaesthesia for a comprehensive dental treatment.”

Ipoh-based Dr Ng encourages parents to make dental visits part and parcel of a child’s formative years. “Children need to understand the need to an start early in oral hygiene care. This basic care is the same as any other routine self-daily care. Oral care from young sets the mindset of these children that routine dental care is important.”

As a rule of thumb, everyone should brush their teeth twice a day, with brushing before bedtime a must.

“During sleep, salivation is minimal and food debris or plaque will be retained on the tooth surface for a long period of time.

“This can lead to an increased chance of demineralisation of the tooth surface that could eventually lead to cavities.

“In general, cavities are a result of an acidic condition caused by oral bacteria acting on substrates in the mouth.”

She adds early oral health care helps prevent dental related problems including toothache, dental related infection, and malocclusion, misalignment between teeth and dental arches.

“Consequences of untreated dental disease can lead to disturbed sleep, difficulty in eating, and absence from school.

“Severe untreated dental disease may put the child at risk of being teased because of poor dental appearance and repeated prescription of antibiotics,” says Dr Ng, who recommends that children visit dentists as early as a year old.

She explained dental visits allow dentists to monitor the dental development of the child and identify dental related problems in the early stages.

“Often, children are brought in to see a dentist when there is a problem. Hence, children have the impression that the dentist may do something ‘painful’ to them,” says Dr Ng who adds children need to see the dentist at least once a year.

These dentists-turned-entrepreneurs invented a clever way to choose the lowest price you want to pay for dental treatment — here’s how it works

These dentists-turned-entrepreneurs invented a clever way to choose the lowest price you want to pay for dental treatment — here’s how it works


Going to the dentist is often an opaque process in which you’re seldom, if ever, given the price you’re going to pay for your treatment before setting foot inside the door.

While most of us have learned to accept the terms of today’s medical industry, two Brooklyn-based dentists are attempting to upend the traditional route to dental treatment.

Richard and Derek Giddon, a father-and-son team who have nearly 40 years of combined dentistry experience, have created a new tool to discover affordable dental care that allows consumers to pick the price they’re able to afford.

“When you go to the dentist and have x-rays and an exam, they tell you what you’ll need, and then, what it costs,” said Derek Giddon in an interview with Business Insider.

“I can’t think of any other industry in 2018 in which the consumer is so completely powerless. If you can’t afford the fees that the doctor gives you, what options do you have?”

The Giddons’ solution to this problem is Smylen.com, a website that matches dentists with patients seeking treatment. The website is modeled after an early version of the affordable hotel-searching tool Priceline, which originally let people search the site for hotel rooms based on location and cost.

Like the early version of Priceline, Smylen lets you search for the dental treatment you use based on cost and location in a reverse bidding process. This reverse bidding process is an important aspect of the site, said Giddon, because it provides dentists that partner with Smylen a degree of anonymity.

“The dentists aren’t hanging a sign outside their window that says ‘$99 Crowns,’” said Giddon. “These fees exist within the system, and the only person who knows they’re getting the cheaper deal is the person who gets it.”

Giddon said he hopes Smylen will provide options for people who are uninsured to receive dental treatment. A recent study by the American Dental Association found that less than one-third of young adults make yearly trips to the dentist because they think it’s too expensive.

“There’s nothing that exists right now to give people this type of service,” said Giddon. “It’s a major problem in this country. Everyone is always talking about affordable care, but if you don’t have coverage, affordable care is often inadequate in terms of covering what you need.”

Giddon anticipates Smylen’s service will provide options for services that aren’t typically covered by insurance as well, including cosmetic procedures like tooth whitening, dental implants, and Invisalign.

While Smylen is designed to provide Americans with affordable dental treatment, Giddon said he believes the medical community will benefit from the company’s offerings as well.

“It’s a new way of bringing dentists business,” said Giddon. “If they know that there are times or days of the week when their office is empty, they can set the fee and services they want to offer during those times.”

In an effort to offer only premium services, the dentists who partner with Smylen are rigorously vetted, said Giddon. The company uses the same vetting process used by insurance companies when partnering with a new medical office.

“We feel strongly that our focus is that we have the right dentists,” said Giddon. “These dentist have stellar reputations. You shouldn’t be nervous when you’re sitting in their chair.”

Smylen’s services, which launched on Monday, are so far only available within New York’s five boroughs, but Giddon hopes to bring its service to the rest of the US as well.

Here’s how it works:

First, you pick the dental treatment you need.


If you’re unsure of which service is right for you, you can use Smylen’s self-diagnosis tool to get a general idea of the treatment you might need.


Then, pick the fee you want to pay for the service you picked and place your bid.


Smylen connects dentists and patients through relevant area codes. Currently, Smylen provides its services only within New York City, but Giddon says he plans to expand Smylen’s offerings to different parts of the US later this year.


After you enter your credit card information, you’ll be matched with a dentist. If the price you picked is an acceptable bid for a dentist, your card will be charged the moment you match. In this instance, my bid for a $99 whitening service matched with a Brooklyn-based dentist.


Because Smylen’s price point tool is based on bids, you may have to enter several different amounts before you match. Once you do, you’ll be prompted to pick a time that works.


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