Care for the growth of seedlings丨"Small mouth" has "big article"

Pamper the growth of seedlings

Original title: The prevalence of caries in children is on the rise, and experts remind - (introduction)

"Small mouth" has "big article" (topic)

People's Daily overseas edition reporter Wang Meihua

As the saying goes: "Bad teeth, disease runs all over the body." "Oral health is closely related to overall health. Oral health in childhood is not only related to the growth and development of children, but also has a profound impact on their health throughout their lives. What are the common oral health problems in children and adolescents? How to protect teeth scientifically and effectively? Liu Min, director and chief physician of the Science Popularization Department of the Beijing Stomatological Association, was recently interviewed by this reporter to interpret the "big article" in the "small mouth".

Protecting your child's oral health starts with trying to get pregnant

"My children brush their teeth carefully since they were young, and they rarely eat sugar, why are their teeth still so bad?" "When should we start protecting your child's oral health?" Many parents often ask such questions.

"Many people say that oral health care starts during pregnancy, because the baby's baby teeth begin to develop during the mother's pregnancy. In fact, we recommend that women do oral self-care before pregnancy, because the oral health of pregnant mothers is closely related to their own health and the health of the fetus. Liu Min introduced that studies have found that pregnant women with periodontal disease have an increased risk of premature birth and low birth weight newborns; If the pregnant mother has multiple untreated caries teeth in the mouth, toothache and inconvenient treatment may occur during pregnancy, and after the birth of the baby, caries-causing bacteria may be transmitted to the baby through close contact between mother and child, increasing the risk of caries in the baby, "Guardians who are in close contact with infants and young children, including the child's father, grandmother, grandmother, etc., may transmit caries-causing bacteria in the mouth to infants and young children, and it is recommended that oral examination and treatment be carried out; Couples of childbearing age should carry out a comprehensive oral examination when preparing for pregnancy, so as to achieve pregnancy without dental disease and lay a good foundation for the oral health of the child. ”

In 2019, the National Health Commission issued the "Healthy Oral Action Plan (2019-2025)", which clearly stated that oral health services for the first 1,000 days of life should be carried out, and oral health knowledge should be the focus of premarital physical examination, maternal health management and pregnant women's school curriculum.

The first 1,000 days of life refers to the period from the fetal period of a woman's pregnancy (270 days) to the birth of a child at the age of two (730 days), which is also defined by the World Health Organization as the "window of opportunity" for a person's growth and development. Liu Min said that it is very meaningful to pay attention to the first 1,000 days of life, and the baby teeth of infants and young children are basically during this period from development to eruption.

"There are two sets of dentition in a person's life: the primary dentition and the permanent dentition. The primary dentition consists of 20 baby teeth arranged in an arrangement, 10 on the upper and lower jaws. Liu Min introduced that the newborn had no teeth at birth, and the first baby teeth began to erupt at about 6 months of birth, and by the age of 2 and a half, 20 baby teeth were basically erupted. By the age of 6, the child begins to develop permanent teeth to replace baby teeth, a total of 28-32 permanent teeth, all of which are replaced around the age of 12.

Children need to be brushed by their parents until they are 7 years old

When should a child start cleaning his mouth?

"When your baby doesn't have teeth, you can start cleaning your mouth, and brush your teeth from the latest after teething." Liu Min introduced that before and after teething, the gums will have swelling, itching and other discomfort, the baby may have crying, drooling, etc., parents can use clean gauze dipped in some cool white open to wipe the gums to relieve the baby's discomfort, let the baby gradually adapt to clean the mouth, for the habit of brushing teeth after teething to lay a good foundation.

"From the point of view of preventing tooth decay, after the baby's two baby teeth are exposed, you can start brushing your teeth." Liu Min suggested that parents should transition to brushing their babies with normal toothbrushes as soon as possible, and toothbrushes with ordinary bristles have the best cleaning effect and are the most convenient to use. Before the age of 3, the baby does not rinse his mouth and uses a toothpaste the size of a rice grain every time he brushes his teeth; As teeth erupt and the gaps become smaller, it is recommended to floss to clean adjacent surfaces of plaque and dirt. After the age of 3, the baby will rinse his mouth, and it is recommended to use toothpaste the size of a soybean grain to brush his teeth. Children under the age of 7 cannot brush their teeth independently, parents should insist on helping children clean their mouths twice a day in the morning and evening, and it is especially important to clean their mouths once before going to bed. Oral cleaning involves brushing and flossing, taking care to be thorough and not missing anything. At the same time, it is recommended to brush your teeth with fluoride toothpaste. After the age of 7, children can generally provide basic oral health care (brushing and flossing) on their own, and parents should regularly check that their teeth are clean according to the child's condition. In addition, parents should also take their children for professional oral examinations regularly, and it is recommended to have examinations every six months.

Controlling the frequency of sugar consumption is more critical than controlling the amount of sugar eaten

According to the results of the fourth national oral health epidemiological survey, the caries rate of primary teeth in 5-year-old children in China was 70.9%, and the caries incidence rate of permanent teeth in 12-year-old children was 34.5%, and the prevalence of caries in children showed an increasing trend. It is worth noting that untreated cavities do not heal on their own, and without intervention, the end result of their development is tooth loss.

Why is the prevalence of caries on the rise in children? "The increase in oral caries is often related to the economy, and many countries have this experience - the economy is better, the degree of food refined by the people has increased, the intake of fine, soft and sugary foods has increased, and the incidence of caries has gradually increased." Liu Min emphasized that parents are the first responsible person for their children's oral health, especially when their children are 1-2 years old, they should pay attention to scientific feeding.

"If the baby falls asleep with a bottle after 1 year of age (including breast milk and formula), the occurrence of dental caries is almost inevitable; Night milk (including breast milk and formula) after the baby's 1 year of age is also almost equivalent to dental caries. Liu Min said that caries is the result of caries-causing bacteria in the mouth breaking down sugar to produce acid and corroding teeth, and the baby's caries is the same: the sugar in milk is fermented by cariogenic bacteria to produce acid, and baby teeth are immersed in this acidic environment for a long time, and the tooth tissue is easily damaged to form caries. Sleeping with milk and eating breast milk frequently at night are the main causes of caries in baby teeth, and babies after 1 year old are not recommended to drink night milk; After the age of 1, in addition to drinking milk, will gradually try less salt, less sugar, less stimulation, light taste of complementary food, the baby will not gargle, after drinking milk or eating complementary food, you can give the baby a few sips of warm boiled water, can achieve the purpose of simple cleaning of the mouth. In addition, warm boiled water should also be the baby's daily drinking water, do not add vegetable juice, vitamins, calcium tablets, etc., if you need to supplement the above nutrients, should be drunk in a short time, should not be used as daily drinking water.

Since sugar is the main cause of dental caries, in order to prevent dental caries, should the child's intake of sugar be strictly controlled?

"It's not scientific to emphasize sugar control." Liu Min stressed that controlling the frequency of eating sugar is more critical than controlling the amount of sugar, and when you want to give your baby pastries or snacks, you can eat them with meals in moderation, but try to avoid snacks between meals. If you want to give your baby sugary drinks such as freshly squeezed juice and honey water, you can use a cup or bowl and spoon instead. Remember to brush or rinse your mouth after eating to reduce the amount of time sugar stays on the surface of your teeth.

Self-care is fundamental to preventing dental caries

Some people think that "baby teeth don't need to be treated if they are broken, and they will have to be replaced sooner or later anyway", is this view correct?

"Of course not. Broken baby teeth affect your child's chewing and pronunciation, and the inflammation and pain it causes are real. If the baby teeth are badly damaged, the development of permanent teeth will also be affected. Liu Min said that baby teeth are the compass for the development of permanent teeth, and there is a developing permanent tooth embryo under each baby tooth, and if the baby tooth is broken, if not treated in time, it may affect the health of the following permanent tooth embryo and future permanent teeth; If the baby tooth is removed prematurely due to severe decay, it may lead to jagged teeth that do not erupt enough in the future.

"The earliest eruption of the permanent dentition is the first permanent molar, which is at the back of the deciduous dentition, which is a large tooth, one on the upper and lower left and right, a total of 4. Because it often erupts when children are about 6 years old, it is also called 'six-year-old teeth'. Liu Min said that the first permanent molars are particularly important, and easy to decay, and are also mistaken by many parents as baby teeth, must be protected, the first permanent molars have an exclusive protective measure - pit and fissure sealing.

"When we open our mouths, we can see that the occlusal surface (the side that chews food) of the big teeth behind is uneven, and the concave part is called a pit and fissure. Some children's pits, food and bacteria are impetished in, it is difficult for parents to clean in place with a toothbrush, tooth decay can easily start from these gaps, medically called this caries pit and fissure caries. Liu Min said that pit and fissure sealing is an internationally mature appropriate technology for preventing caries of the first permanent molars, and it is also the main intervention of China's children's oral public health project. It refers to the coating of the material to the pits and fissures of the teeth to form a protective barrier and fill the gaps in the teeth, so that on the one hand, food debris is not easy to settle on the surface of the teeth, on the other hand, oral cleaning becomes easier.

Of course, not all children need a pit and fissure seal. Experts said that children have a high risk of caries, deep pits and fissures, and are not easy to clean, so they need to be closed to the pit and fissure. If the pit and fissure are shallow and the child has a low risk of caries, closure is not required. If the first permanent molars have decayed and need to be filled, they cannot be closed. In addition to pit and fissure sealing, fluoride teeth for school-age children is also a common practice to prevent tooth decay.

"Pit and fissure sealing and fluoride coating are just one of the ways to prevent caries." Liu Min stressed that doing a good job in self-care is the root of preventing dental caries - eat less snacks, eat healthy food, rinse your mouth fully after eating, effectively brush your teeth with fluoride toothpaste every morning and evening, use dental floss, and regularly go to the hospital for oral examinations to protect oral health.

Source: People's Daily Overseas Edition