It’s been a while since my last update.I have been rather busy with the clinic and balancing my time to spend with my family.I have to remind myself that in spite of the long hours spent at the clinic,my family still come first .

Speaking of families,I want to share a little about this lovely family who came last month with their youngest daughter Cheyenne,who is four.

Cheyenne had never been to a dentist and she was a little apprehensive.This little girl had decay on almost every single tooth in her mouth.Not quite uncommon in children who have a regular diet of sweets and candies.

Anyway,Cheyenne had many fillings to be done.Her parents had explained to her as much as a 4-year-old could understand that she would need some dental treatment.And this is the right thing to do.Many children are terrified because they do not know and they do not understand why they are placed on a foreign-looking chair and asked to open their mouth,not to mention having unfriendly-looking instruments poking at their teeth!Parents play a vital role in preparing their children before coming to the dentist.Explain to them about having their teeth examined.Be truthful and do not attempt to tell half lies.The worst thing to do is to deceive your child that you are bringing him or her somewhere else,and the next moment he or she is shoved into the dental surgery.No wonder they re-act and resist!Of course,the ultimate damage that can be done is to threaten and frighten your child with horror stories about the dentist.I have seen the lasting impact of such inflicted fear,all the way into adulthood.

Coming back to Cheyenne,after a thorough examination on her teeth,we embarked on a treatment plan which would span over the next few weeks.As apprehensive as she was,I managed to coax her to start with one filling on her first visit.Subsequently,I have completed her planned restorations,which totaled 8, in 5 separate visits.

The reason why I am writing about about Cheyenne is because she has a wonderful family who gives her incredible support.On her first visit,her parents ,together with her older brother and sister,were all present with her in my dental surgery.I thought that was a very endearing thing for the whole family to come along and give her the moral support.And on subsequent visits both her siblings were always accompanying her,and they are only 10 and 8 respectively.

After practising dentistry for so many years and having encountered a whole variety of different personalities,I am convinced that the “fear of dentists” is a universal condition,and it transcends all ages,gender,ethnicity and nationality.And,I also discovered that having someone close,perhaps a family member or a good friend,to go along for a dental appointment,will help take away some of the fear and apprehension,provided the support-giver is encouraging and not equally as fearful.

Therefore,I truly commend the Woon family for their relentless support and encouragement towards Cheyenne.With many reminders not to take candies regularly and to brush her teeth well(actually I reminded her parents that they play an important role in managing the candies,and they have to help brush Cheyenne’s teeth as she does not have the dexterity to brush her own teeth well yet),she will have a better dental condition from now on,and she will hardly have any problems coming to the dentist in the future.Well,I am looking forward to seeing her in 6 months’ time,and I wouldn’t be surprised to see her entire entourage!

Lets talk a little bit about children.Those of us with small children often fear injury on our little precious ones.And it is immensely stressful when they fall and hurt themselves,especially when the injury is on their faces(including their mouth and teeth).

 I saw an 11 year-old child recently,who had a fall and broke her 2 front permanent teeth.I felt for her mother as she told me about how freaked out she was when she saw her daughter’s condition.The little girl was in pain,but was very brave about it. Anyway,she had her teeth restored and now we are waiting to see whether the pulp of the teeth recovers.I will be seeing her next week to review her condition.

That’s her restored teeth,note the swelling on her lower lip.The tooth on the left was severed up to almost a third of its original,something like this:

 and the one on the right had a diagonal fracture.I would have taken a “before” picture,but the child was quite distressed when she came in,so I did the “after” instead and she was a picture of happiness after that!

Here are some tips,to be more informed whenever you encounter a child with tooth injury.

Types of Tooth Injuries:

• Loosened tooth - may bleed a little from the gums

• Displaced tooth (usually pushed inward)

• Chipped or fractured tooth

• Avulsed (knocked out) tooth — a dental emergency for permanent teeth

When to Call Your Doctor for Tooth Injury

Call Your Doctor or Dentist NOW if:

• You think your child has a serious injury

• Permanent tooth knocked out (Reason: needs reimplantation ASAP; 2 hours is the deadline for tooth survival). First Aid Advice: Transport the tooth in some milk or saliva (milk is best). If over 30 minutes away, try to replace the tooth in the socket before coming in

 • Permanent tooth is almost falling out

• Bleeding won’t stop after 10 minutes of direct pressure

• Tooth is greatly pushed out of its normal position

• Tooth that’s pushed out of its normal position interferes with normal bite

 • Severe pain

Call Your Doctor or Dentist Within 24 Hours if:

• Baby tooth knocked out by injury. (Reason: can’t be reimplanted but dentist will check for damage to permanent tooth)

• Tooth is slightly pushed out of its normal position

• Can see a chip or fracture line in the tooth

• Tooth sensitive to cold fluids

• Tooth feels very loose when you try to move it

Home Care (Read “Call Your Doctor…” first):

Local Cold

For pain, apply a piece of ice to the injured gum area for 20 minutes.

Pain Medicine

If it still hurts, give acetaminophen (e.g. Panadol) .

 Soft Diet

For any loose teeth, offer a soft diet for 3 days. By then, it should be tightened up.