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Better brushing needed for the health of Waikato children's teeth - DHB

Fuseworks Media
Fuseworks Media

Looking after your pearly whites is more important than ever, particularly from a young age. Children’s dental care is free from birth to year 8, but the war with tooth decay is still a constant battle for everyone.

"And dentistry is no longer the lone wolf in the healthcare system," said recent guest speaker at Waikato DHB’s annual Big Day In conference Professor of Paediatric Dentistry Nicola Innes PhD BDS (Hons) from Scotland’s University of Dundee School of Dentistry department.

"The profession has woken up to the fact that the sugar agenda and large worldwide health organisations have embraced dentistry as part of non-communicable diseases and are moving towards shared problems that lead to diseases like diabetes, cancer, cardiac conditions and obesity," she states.

"As health professionals [in treating children’s oral health] we have this pivotal role in imparting information to children and their families because we see them regularly for check-ups and we have their trust.

"But it’s equally important people take care of their teeth properly at home through simple and correct tooth brushing and nutrition," says Innes who had recent worldwide media attention on tips for correct tooth brushing, with highlights from the best way to brush, that mouthwash is not a necessity to ensuring you have the right amount of fluoride in your routine to fight decay.

Innes along with Dundee colleague Mark Robertson, a senior clinical researcher presented at the Big Day In and master class sessions on techniques and research on minimal intervention and minimally invasive dentistry for children, encouraging new ways of managing dental decay rather than the old fashioned ways of drill and fill.

Putting a stainless steel crown over a child’s decayed primary tooth (baby tooth) in a technique that is painless and requires no anaesthetic injection or drilling and can be done in about 5 minutes was taught.

"It just makes so much sense," says Nicola. "The bugs in dental plaque on your teeth love sugar and oxygen then suddenly you put something over the top, so the bugs can’t get the sugar, they can’t get the oxygen and they just die so it stops tooth decay in its tracks," says Innes.

"Children also think they’re really cool, calling them transformer teeth or princess teeth" says Rob Aitken Waikato DHB’s principal dental officer.

Going to the clinic and seeing a therapist can be very easy to cope with for many children now who have serious tooth decay.

Aitken says: "When Nicola presented on stainless steel crowns in 2011 we had a lightbulb moment, and were [Waikato DHB] arguably the first to pick up this treatment and run with it in New Zealand."

A recent visit from Minister David Clarke saw a four-year-old boy present (watch in the promotion video) on one of Waikato’s mobile dental units. "He had a number of people watching him have a stainless steel crown applied and was pulling the thumbs up during the procedure. He was treated in minutes," says Aitken. "This isn’t an isolated event, it happens every day."

But Aitken and his team say in terms of general dentistry for children and public health dentistry, we need to be more focused on prevention, rather than treatment.

"We need to start at the beginning; we need our patients to buy into better, daily oral hygiene practise. Regular daily tooth brushing, caring for their mouth, along with diet.

"As a profession we are not winning by simply filling things and patching up holes," states Aitken.

Although Waikids Community Oral Health service is focused on children, there are a number of challenges facing everyone both professionally and for the public says Aitken, "Services and carers aren’t yet ready for some things to come, for example, adults that are going into rest homes with their own teeth.

"Historically, they went in with dentures, if you have dentures in a rest home your oral health care is not such a big problem, but if you go in with your own teeth, it’s a whole new world."

"Some of these patients have complex crown and bridge work, or implant work and so caring for their mouths and trying to fix what is wrong is going to be a huge challenge facing New Zealand dentistry.

"Instead of doing flash veneers, more fillings and drillings, we need more conferences about taking it back to basics and how we prevent tooth decay in the first place.

"It all starts with our children, so that when they reach adult stage, good tooth brushing is built into them - it’s a long game and requires a different mind-set from parents, children, and oral healthcare specialists as a whole," he finalises.

In Scotland, they ran a successful supervised tooth brushing programme called CHILDSMILE delivered to nurseries and junior schools. Prior to this programme Scottish kids used to have far worst teeth than kiwi kids, but today far less Scottish kids have dental decay, and those that do, have less fillings due to this programme.

Innes said: "By implementing the £1.8millon CHILDSMILE programme, they’ve dropped the cost of child dental care by £5million per year."

A small study undertaken in Northland showed oral health improved within one year of introducing a brush-in programme. Aitken says: "This, along with encouraging drinking water and milk at school, is an opportunity for schools and early childhood centres to significantly improve the lifetime health of children. The Community Oral Health Service is interested in helping schools and early childhood centres willing to implement a programme."

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