Dr Praveen Chopra, MDS
Chief Dental Surgeon
Even the riches of richest countries could not control the dental problems with the highly sophisticated treatment models. Just reliance over the expensive treatment model has not succeeded in controlling dental health disturbances. The answer lies in augmenting treatment facilities along with utmost importance to prevention–prevention and prevention. Otherwise, a person gets a tooth restored to function at one point of time and lands up with the problem in several others a few months/ a year later.
We need to put a lot of stress on the prevention of illness including dental diseases. Not only that, there needs to be a strategy aimed at primary prevention of oral cancers, so common in our part of world.
These pics that you find embedded in this post are the dental photographs of a four and a half years old child. These days such pics are quite common. Unfortunately, lack of awareness, junk food, lack of oral hygiene etc are all aggravating this problem.
This child of four years is having his all teeth rotten, badly carious, most of them already broken down with the carious process. This is not definitely a case of stitch in time saves nine! Here already enormous damage has occurred to a growing child’s dentition. All 20 teeth are in really bad shape. But medical personnel are trained to do whatever best they can do in a given situation.
This is boy’s first visit to a dentist- that too becasue one of his badly decayed tooth starting hurting. It alarmed his dad to bring him to us.
The condition that he is suffering is known as ‘Rampant Caries” in which a lot number of teeth get decayed at a time. It is a situation peculiar to children. kids who are used to keep that milk bottle nipple or pacifier in the mouth during night are at great risk to develop rampant caries.
His father was telling that though this child had left bottle feeding long back, but now during night he grabs the bottle of this younger sibling who is two and a half year old and keeps using it througout night.
So, that explains Rampant Caries in this little boy.Further, they could not come earlier to the dentist since his dad was told by ‘somebody’ that these are milk teeth only, they will shed off anyway. You see that is also a big myth well rooted in the community.
Anyhow, such cases have to be treated as soon as possible. The rule in such case is to treat as many teeth as possible. Since it is a very rapidly progressing disease, it destroys the teeth in a very short time. This boy is also very cooperative and that’s why i could do two very important fillings in his two molar teeth in a single sitting- last little more than half an hour. Such teeth are to be handled very gently, little bit of bury further destroys whatever is left there in the mouth!
So many broken root pieces are there in his mouth. Ideal situation is that such broken root stumps are removed and then the patient goes in for space-maintainer appliances. However, in my dental practice of 40 years, I hardly came across of 0.1% of pediatric patients who could manage to get such an appliance. There are many reasons for that, wont be able to discuss them here.
But the best policy in these cases is to treat as many teeth as possible and as early as possible. For the broken roots depending upon the health of surrounding gums, these are best left undisturbed. Extracting these root stumps opens of plethora box of problems mainly leading to crooked teeth, malaligned teeth and teeth remaining buried deep inside the jaw bone! Mother Nature has been so great that even these seemingly useless root stumps are in a way are reserving the space of the succedaneous teeth (permanent teeth which will take their place subsequently). It so happens that with the normal eruption pattern, the developing permanent tooth will put pressure on these fragile, broken roots which will lead to their (broken roots) shedding off.
During all these years till the age of 12, we have to keep a watch on their teeth- both broken as well as those which are developing in the jaw. It is facilitated by various types of X-rays, depending upon their availability. Whenever, we find any permanent tooth not following its time table or its normal path, we decide to remove milk tooth, if it is causing obstruction.
Lets look at the important messages for kids dental health-
Dental Check up at 6-monthly interval and first dental check of a kid has to be at the age of 1 year.
Bottle feeding is to be discouraged as far as possible (Consult paediatrician for details) and never any pacifier (nipple) be left in the mouth of the child during night- it is the breeding ground for Rampant caries.
Any cavity in a milk tooth requires dental intervention. Dont be influenced by what layman or neighbour says- they dont know dentistry! Kutch to log kahenge, logon ka kaam hai kehna…!! But one needs to rely on a qualified dentist.
Night time brushing is equally important, if not more! Teach your child to use tongue cleaner as early as you can! Tongue cleaning has been an integral part of our ancestors since thousand of years.
And be in touch with your dentist to know the best oral hygiene practices for you and your family, little ones too! Of course, a stich in times saves nine- true, but for that one stitch one has to to go the tailor master only- there lies importance of periodic, regular 6- monthly dental check-up.
Just to highlight the importance of regular periodic dental check-ups, just have a look at these two pictures- you see when child is asked to clench his teeth, he is able to clench but in the front region this huge gap is there. It indicates to us that there is some parafunctional habit which is leading to this abnormality, which if left unattended ( i mean that habit as well as the damage already caused) can play havoc even with adult dentition. His father confirms that he is a thumb sucker – and occasionally puts any finger in his mouth habitually. Even the second picture confirms that he is having this habit of tongue-thrusting. We need to use habit-breaking appliances too for this child.
Take care of your Natural pearls! Nature has engineered these jewels to last lifetime! The other day, on whatsapp a 92-year old grandma was enjoying a sugarcane…with full josh, just watching her embarrased me that I am more than 30 years younger to her but can’t relish that ‘ganna” (sugarcane) the way she is doing. God bless her!
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