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April 18, 2007

Tooth erosion and decay

Blogged under Dental Education,Oral health care by DrJean on Wednesday 18 April 2007 at 10:04 pm

I recently saw a young man in my clinic who had not visited a dentist for a substantial period of time.He was persuaded to come to see a dentist because he had bleeding gums and “black stains” on his teeth.

When I did the initial examination,I asked him a couple of questions and discovered that he is a smoker,he is not very diligent in his tooth-brushing(and obviously does not floss) and he drinks a lot of Coca Cola.That,by the way is one of the potent combinations for dental disaster.

I spent a rather long session cleaning his teeth and teaching him how to brush and floss correctly and advising him against his high-sugar and high-acid diet.

This picture was taken 2 weeks later after his swollen and bleeding gums had healed considerably and he had been brushing his teeth much more carefully.The black patches are due to erosion  and decay.He also had extensive decay in between all his front teeth.

The erosion is due to his long-term relationship with Coca Cola.Dental erosion is a process whereby the tooth stucture (enamel  and sometimes,dentin)is destroyed by the long-term exposure and action of acid on it.This is an external cause ie from his diet.The decay is also a contribution from Mr Coke plus the fact that he was not careful with his tooth brushing.Decay is a process where the tooth structure is destroyed  by acid-producing bacteria,Streps Mutans.

The process of dental erosion is irreversible and requires treatment to arrest the situation, and also a drastic change in dietary and oral hygiene habits.Decay is a progressive disease which needs to be dealt with as soon as possible before it progresses to reach the pulp of the teeth.

There was much to be done for this young man.He had taken a tremendous  step to improve his oral hygiene and to visit the dentist more regularly.He also promised to cut down on,if not stop all his fizzy and sweet beverages.One of his front teeth is already non vital,due to the decay reaching and destroying the pulp of the tooth.And he would require a root canal treatment for that tooth.

As a first line of treatment,now that he is able to manage his oral hygiene reasonably well,I did some direct composite veneers to his 4 front teeth,after removing all the decay present.

He was rather pleased that he can now smile confidently after such a long time.

Just to mention a bit more on dental erosion,young people especially teenagers and young working adults are most susceptible because of the high consumption of fizzy or soft drinks.The diet version may be lower in sugar content,but the acidic effect is actually much worse.Pure fruit juices which are acidic like citrus juices,are just as bad in its errosive abilities.

There need to be a more acute awareness about this problem.I see an increase in dental erosion and decay amongst the growing affluent society.When I walk along the aisle of the supermarket where drinks are being sold,I see rows and rows of soft drinks,juices of all sorts,not to mention a whole load of sweetened drinks like cultured milk,soya milk and the list goes on.

Apart from your dentist advising you or your child about this problem,parents and care-givers play a crucial role.Watch what your children are drinking and take them for regular dental check up,so that if there is an inherent problem,the situation can be quickly diagnosed and delat with accordingly. 


April 5, 2007

Kids’ colouring competition Q1/07

Blogged under Children by DrJean on Thursday 5 April 2007 at 6:19 pm

The 1st quarter of 2007 has passed.How time flies!

The level of enthusiasm among the children who come to iSmile to do colouring is phenomenal.Especially after we gave away prizes at the end of last quarter.

We decided to give away more prizes this time.Yay!!

Below are the winners in no particular order.Congratulations!!


 Ling Xuan Xi,7                                             Elicia Yap,9


Timothy Hiew,6                                           Pang Hsin Yi,8

Lee Yong Le,7

April 1, 2007

Brushing your children’s teeth

Blogged under Children,Dental Education by DrJean on Sunday 1 April 2007 at 9:08 am

When do we start brushing our children’s teeth? The moment their teeth erupt.It’s never too early to start.The sooner you get your child familiar with the habit of brushing,the less problems you will have in getting your child to cooperate.

What if our child refuses to let us brush their teeth? This can be very stressful and frustrating to parents.Allow your child to play with the toothbrush but always supervise.You do not want any untoward accidents.Then tell your child that you will finish up the brushing for him or her.Again,this may take some time before your child actually cooperates and allows you to help.So,do be patient.

Children below the age of 7 generally do not have the manual dexterity to brush their teeth well.Therefore,it is important for parents to be aware that the child needs to be assisted when they brush their teeth.

You will need to select a suitable toothbrush for your child.The brush should be small enough to fit comfortably into your child’s mouth and its bristles should be soft.There are so many varieties in the market,so we are really spoilt for choice.

A children’s toothpaste can be used once the child is able to gargle and spit properly.Again,there are several brands of children’s toothpaste available,and if a fluoride toothpaste is used,it should contain not more than 500ppm of fluoride.Use only a pea-sized amount.As much as we are concerned with fluoride ingestion,it does provide good protection to our children’s teeth.

The best position to brush your child’s teeth would be to stand behind or beside your child with your other arm gently holding the jaws.

How long should we brush?The recommended duration to brush is actually 3 minutes,which is a LONG time.It can be extremely challenging if your child is the normal active,can’t-keep-still type.So,I would suggest you sing a little song,one of those children songs which should take you about a minute or slightly more.You could have one of your child’s favourite songs sung during toothbrushing time.

Start by brushing the back teeth,focusing on the biting surfaces where it is usually most prone to decay.Brush the outer surfaces followed by the surfaces in the palate area.Then move to the front and finish up by brushing the front teeth both outside and inside.Use short circular motions to give a scrubbing effect.

Get your child to rinse thoroughly by gargling some water and spitting it out.Inevitably,they may swallow some toothpaste in the process,but it is alright as long as they are using children’s toothpaste with very low fluoride content.

You can try to floss your child’s teeth from young.Again stand behind your child,or let your child lie on your lap while you floss the teeth which are touching one another.

Finally,compliment your child on being so good and cooperative.Tell them how clean and shiny their teeth look.Constant encouragement and praise will raise their self esteem and they will be more interested and aware of their oral health as they grow up.

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