Dental care for school-age children

• Teeth development 
• Cleaning your child’s teeth 
• Other teeth concerns 
• Dental sealants 
• Injuries to teeth 
• Mouth guards 
• Visiting the dentist 

Teeth development

Baby teeth can arrive in any order, although the central bottom teeth are often first. Most children have a full set of 20 baby teeth by the time they’re three.

Adult teeth start developing inside babies’ jawbones after birth. After a baby tooth falls out, an adult permanent tooth takes its place.

Children usually start losing their baby teeth from around six years of age. From 6-12 years, children have a mixture of adult and baby teeth. The baby teeth at the back are replaced around 10-12 years of age. By this age, most children have all their adult teeth except for the third molars (wisdom teeth). The adult teeth don’t get replaced, so you just have to look after them.

If your child’s baby teeth came late, the adult teeth will probably be late too. If you’re concerned about your child’s teeth development, see your dentist.

When adult teeth are coming through:

• Your child might find chewing is more difficult when teeth are loose or missing.
• Your child still needs to eat healthy foods.
• Keep up your child’s teeth-brushing routine, taking extra care around the loose teeth or sensitive areas.
• Allow loose teeth to fall out on their own. If you try to pull out a tooth before it’s ready to fall out, it can snap. This can cause pain and infection.
• Sometimes an adult tooth will come through before the baby tooth has fallen out. If the baby tooth hasn’t fallen out within 2-3 months, see your dentist.

Cleaning your child’s teeth

By the time your child reaches school, she might be starting to clean her own teeth. If so, it’s a good idea for you to either start or finish the cleaning process. Your child will still need your supervision and help until she’s at least eight years old.

The best way to clean your child’s teeth

1. Use a child’s toothbrush that has soft bristles of different heights to clean the teeth and gums properly.
2. Stand or sit behind your child so he’s secure. Doing it in front of a mirror is good too, because it lets you see his mouth.
3. Cup your child’s chin in your hands with his head resting against your body.
4. Angle the bristles of the toothbrush towards the gum. Move the brush in gentle circles to clean the outer and inner sides of the teeth and gums. Lift your child’s lips to brush the front and back of the teeth and at the gum line.
5. Brush back and forth on the chewing surfaces of the teeth.
6. Gently brush your child’s tongue.

Have a chat with your dentist about the need to floss your child’s teeth.

Toothpaste and fluoride
Fluoride is a mineral that helps build strong teeth and bones and prevent tooth decay. If children take in too much fluoride, it can cause ‘fluorosis’, or a build-up of white marks on the teeth. Although this affects the appearance of the teeth, it doesn’t usually affect health.

Most tap water in Australia has added fluoride. Fluoride is considered safe and beneficial for strong teeth. In fact, fluoride works best when it’s taken in very small amounts throughout the day via sources such as fluoridated tap water, foods and drinks containing fluoride and fluoride toothpaste.

You can use regular adult fluoride toothpaste once your child turns six. You need to use only a pea-sized amount of toothpaste smeared onto the toothbrush. Encourage your child to spit the toothpaste out as you clean. She doesn’t need to rinse with water, though. The small amount of fluoridated toothpaste still in her mouth will help build strong, healthy teeth.

Some children who are at high risk of developing dental caries might be prescribed a fluoride mouth rinse by their dentist.

Keeping the toothbrush clean
After cleaning your child’s teeth and gums, rinse the toothbrush with tap water.

Store the toothbrush upright in an open container to allow it to air-dry.

If other family members’ toothbrushes are stored in the same place, make sure the brushes don’t touch. This reduces the risk that decay-causing germs will travel between brushes and into your child’s mouth. And when it comes to toothbrushes, there’s no sharing! One for each family member is best.

Toothbrushes should be replaced every 3-4 months, or when the bristles get worn or frayed.

Other teeth concerns

Thumb-sucking
Most children grow out of the habit of sucking thumbs and fingers from 2-4 years of age.

You can usually reverse the effects of thumb-sucking up to 5-6 years, because children still have their baby teeth. If children are still sucking after this age, dental problems can come up.

Vigorous finger-sucking (that’s when you hear a popping sound when a child takes thumb or fingers out of his mouth) and prolonged sucking can affect the growth of a child’s jaws and the alignment of teeth. If you’re concerned about your child’s sucking habits, talk to your dentist.

Teeth-grinding
Teeth-grinding in school-age children is pretty common and doesn’t usually need treatment.

Some children clench their jaws quite firmly, and others grind their teeth so hard that it makes a noise. Some children grind their teeth during sleep. Often, they don’t wake up when they do it – but other people do!

Most of the time, teeth-grinding doesn’t last and doesn’t cause damage to your child’s teeth. But if it does keep going, you might want to talk to a dentist. It could lead to your child experiencing headaches, tooth or jaw pain, or wearing down her teeth. Devices to protect teeth from grinding at night can help. You can get them from dentists.

Dental sealants

Your dentist might recommend dental sealants for your school-age child.

Dental sealants are thin, plastic coatings that dentists bond to the chewing surfaces of teeth (where most cavities in children are found). These sealants stop plaque build-up in the grooves of teeth and help prevent tooth decay. The process of applying the sealant is simple and quick, with no pain and very little discomfort for your child.

Sealants don’t stay on your child’s teeth forever. Your dentist will check them regularly. They might sometimes need fixing or reapplying.

If you’re interested in dental sealants for your child, speak to your dentist.

Injuries to teeth

Injuries to your child’s face and teeth can occur when he’s running, climbing, riding scooters and bikes and all the rest. It’s a good idea to see a doctor or dentist if your child damages his teeth or face.

If your child knocks out a baby tooth, don’t try and put it back in, as this can cause problems later on when the adult tooth starts to come through. Losing a baby tooth before it’s ready to come out usually isn’t a serious dental problem, but it’s important that you take your child to the dentist immediately for a check-up. Seeing the dentist and knowing that an adult tooth will eventually fill the space, and that pain or tenderness in the area will soon go, might help to reassure you and your child.

Losing an adult tooth is a bit more serious, but there are a few things you and your child can do that might keep him from losing his tooth permanently after an accident:

• Find the tooth.
• Hold the tooth by the top (‘crown’), not the roots.
• If the tooth is dirty, rinse it in milk or saline (salt and water) solution for a few seconds.
• Don’t let the tooth dry out.
• Put the tooth back in its socket immediately.
• Hold the tooth in place with aluminium foil. If you don’t have any aluminium foil handy, your child can bite down gently on a handkerchief.
• See your dentist immediately.

If for some reason you can’t replace the tooth in its socket (for example, your child is unconscious), put the tooth in milk, saline solution or wrap it in plastic cling film and see your dentist immediately.

If your child chips or fractures a tooth, keep the piece of tooth and store it in milk. See your dentist immediately.

Mouth guards

Mouth guards can help protect children’s teeth from knocks and falls. If your child plays sport, it’s good to try to get her used to wearing a mouth guard from an early age.

There are three types of mouth guards:

• ready-made
• ‘boil and bite’, which you mould around your child’s teeth and jawbone
• customised, which are made by a dental professional. These provide the best protection because they’re specifically fitted to your child’s teeth and jaws.

Mouth guards should:

• be thick enough (4 mm) to provide protection against impact
• fit snugly and be comfortable
• be odourless and tasteless
• allow normal breathing and swallowing
• allow normal speech.

To help your child’s mouth guard stay clean and in good shape, you can make sure your child:

• rinses it before each use, and brushes with a non-abrasive toothpaste afterwards
• cleans it every now and then in soapy water, making sure to rinse it thoroughly
• carries it in a container that has vents
• doesn’t leave it in the sun or in hot water.

Take the mouth guard along to your child’s dental visits to make sure it still fits correctly. The mouth guard might need to be replaced when changes happen in your child’s mouth, such as adult teeth coming through.

Visiting the dentist

Everyone has different dental needs and risks. These different needs will affect how often your child needs to visit the dentist. This is something you can discuss with your dentist.

Your child might not always see a dentist – many other oral health professionals are fully qualified to work on your child’s teeth, depending on your child’s needs. They include dental therapists, dental hygienists and oral health therapists.

Public dental care
Dental care for children is often free in the public dental system, up to a certain age. Contact your local public dental provider for details.

Private dental care
There are private dental clinics all over Australia. You’ll have to pay for your appointments, but people with private health insurance might receive a rebate after attending.

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