We are keen to visit local nurseries and schools to educate our toddlers on the importance of looking after their teeth. Recent visits have included:

• Maytime Montessori in Ilford

• Greenways Kindergarden in Chigwell

• Marylands School in Stratford

• Stepping Stones nursery in Stratford

Children's Oral Health

Good oral hygiene helps to prevent dental problems - mainly plaque and calculus which are the main causes of gum disease and caries (tooth decay).

• Dental plaque is a soft whitish deposit that forms on the surface of teeth. It forms when bacteria (germs) combine with food and saliva. Plaque contains many types of bacteria. You can remove plaque by good oral hygiene.

• Calculus, sometimes called tartar, is hardened calcified plaque. It sticks firmly to teeth. Generally, it can only be removed by a dentist or dental hygienist with special instruments.

• Cavities (tooth decay) is when holes form in parts of the enamel of a tooth. A main cause of cavities is due to a build up of plaque. The bacteria in the plaque react with sugars and starches in food to form acids. The acids are kept next to the teeth by the sticky plaque and 'dissolve' the tooth enamel. If you have tooth decay you may need fillings, crowns or inlays.

• Gum disease (periodontal disease) means infection or inflammation of the tissues that surround the teeth. Most cases of gum disease are plaque-related. Plaque contains many different types of bacteria and a build up of some types of bacteria are associated with developing gum disease. Depending on the severity, gum disease is generally divided into two types - gingivitis and periodontitis.

• Gingivitis means inflammation of the gums. There are various types. However, most cases of gingivitis are caused by plaque.

• Periodontitis occurs if gingivitis becomes worse and progresses to involve the tissue that joins the teeth to the gums (the periodontal membrane).

• Gum disease is the most common cause of tooth loss in adults. It is also a main cause of bad breath (halitosis). However, gum disease is often treatable.

It is important to get into a regular habit of good oral hygiene. The most important are to brush and floss your teeth every day.

Brush your teeth at least twice a day using a soft-tufted brush. The head of the brush should be small enough to get into all the areas of the mouth. Spend at least two minutes brushing, covering all areas (inside, outside, and biting areas of each tooth). Pay particular attention to where the teeth meet the gums. Get a new toothbrush every 3-4 months. Many people find that an electric toothbrush does a better job and so they have become popular.

It is usually advised that you should use a toothpaste that contains fluoride. (The fluoride helps to prevent tooth decay.)

Floss your teeth at least once a day after brushing, and preferably twice a day. (Some people who have not flossed before are surprised as to how much extra debris can be removed by flossing in addition to brushing.) If you are not sure how to floss, then ask your dentist or dental hygienist. Briefly: the 'usual' floss looks a bit like cotton thread. Cut off about 40cm. Wind the ends round your middle fingers of each hand. Then grab the floss between the thumbs and first finger to obtain a tight 3-4 cm section which you can pull between teeth. Gently scrape the floss against the sides of each tooth from the gum outwards. This will clean the narrow spaces between the teeth which toothbrushes cannot get to. Use a fresh piece of floss each time.

Some people prefer floss 'tape' which may slide between the teeth more easily than normal floss. Also, some people use disposable plastic 'forks' with a small length of floss between the two prongs. The plastic fork may be easier to hold and manipulate. However, they are more expensive than a roll of floss.

The gums may bleed a little when you first begin to floss. This should settle within a few days. If it persists then see a dentist as regular bleeding after brushing or flossing teeth may indicate early gum disease.

The measures above are usually sufficient. However:

• Many people also use an antiseptic mouthwash each day to help prevent gum disease. In particular, for those who are unable to use a toothbrush, regular rinsing with an antiseptic mouthwash will help to clean the teeth.

• Many people also clean their tongue after cleaning their teeth. You can do this with a toothbrush. You can also buy a special plastic tongue scraper from pharmacies.

• If you smoke, you should aim to stop smoking. Smoking is a major risk factor for developing gum disease.

• Eat a well balanced healthy diet. In particular, you should limit the amount of sugary foods and drinks that you have. Sugars and sugary foods in the mouth are the main foods that bacteria thrive on to make acid which can contribute to tooth decay.

• If children need medicines, wherever possible use sugar free medicines.

• Some people chew sugar free gum after each meal. Chewing gum increases the flow of saliva. Saliva helps to 'flush' the mouth to help clear any debris remaining from the meal.

• Children should be taught good oral hygiene as young as possible.

• Have regular dental checks at intervals recommended by your dentist (this is normally at least once a year). A dentist can detect a build up of plaque and remove calculus. Early or mild gingivitis can be detected and treated to prevent the more severe periodontitis. A dentist can also advise about special 'coating' of children's teeth to help prevent tooth decay.

Dental decay (cavities) is the most common chronic disease of childhood, affecting 50 percent of children by middle Childhood and nearly 70 percent by late adolescence.

Chronic gingivitis is also common among children. The mildest form of periodontal disease, gingivitis is often caused by inadequate oral hygiene which leads to plaque build-up. Fortunately, most oral diseases can be prevented. The best way to ensure that your child does not get cavities or periodontal disease is to instil proper oral habits early. Good oral hygiene routines should be established as early as infancy and continued throughout life. Dental hygienists are valuable resources in promoting, establishing, and maintaining oral health in infants, children, and adolescents.

The First Years

Oral health care is a job that begins even before a child gets his or her first tooth. You can help your child get a head start on having a healthy mouth and smile by wiping your infant’s gums with a damp washcloth or gauze pad after each feeding to remove plaque and food residue. Also, parents should clean the infant’s baby teeth as soon as they come in with a soft cloth or baby toothbrush and a pea-sized amount of fluoridated toothpaste. You should also avoid putting your child to bed with a bottle, unless it’s filled only with water. Baby bottle tooth decay occurs when children fall asleep with a bottle of milk, formula, juice, or other sweet liquid in their mouths. It can also develop when children fall asleep while breastfeeding. The sugars from these liquids are left lingering on the child’s teeth. Using these sugars as food, the bacteria in the mouth produce acids that attack the teeth, causing decay. A child’s first oral health visit should come around his or her first birthday (or six months after the first tooth erupts). Your oral health professional will check for cavities in the primary teeth and watch for developmental problems. Eruption patterns can vary; often teeth will erupt early or may be delayed.

Toddler Teeth

At age two or three you can begin to teach your child proper brushing and flossing techniques. But remember, you will need to monitor brushing and flossing until age seven or eight, when the child has the dexterity to do it alone. Often there are natural spaces between the primary teeth to hold the place for the permanent teeth. If spaces are present, you do not need to begin flossing until the teeth touch. (This may occur in the molar areas first and you should floss your child’s teeth until he or she is six or seven years old or until he/she can tie his/her own shoelaces). Then you should monitor their techniques and consistency.

Older Children and Oral Health

When a child’s permanent molars come in (usually around ages 6 and 12) parents should consider having sealants applied. Sealants are thin protective plastic coatings placed on the chewing surfaces of back teeth. Research has shown that using sealants can reduce pit and fissure surfaces in back teeth by more than 60 percent.

If your child has braces, be sure to check out special orthodontic toothbrushes, floss threaders, and other interdental appliances to help keep spaces between teeth and arch wires clean. Orthodontic appliances (retainers) also require daily care. You should soak the appliance in a denture-cleansing bath but make sure to rinse thoroughly before reinserting it into the mouth. Gum health is essential throughout the time your child wears orthodontic appliances. Your child may need to be seen by the dental hygienist on a more frequent interval to monitor the health of the gums.

One of the best ways to protect your child’s smile is by practicing prevention. Mouth guards should be worn for all contact sports, sports that involve a ball and any extreme sports like skateboarding or rollerblading. In the event that there is injury to the mouth, call your dentist immediately. If a permanent tooth is involved in the accident and comes out of the mouth, push it back into the area or place it in milk and go to the dentist. If it is a primary tooth, it is important that you not reimplant the tooth.

Smile Savers

Some good oral health practices should begin from day one and continue throughout the teenage years.

You should change your child’s toothbrush three to four times a year, and after every illness to avoid bacteria and germs. You also should limit the amount of sugar children can eat by encouraging them to eat fruits and vegetables for snacks instead of candies and cookies. Also, limit snacking between meals, and make sure they brush afterward. Check to see if the water supply that serves your home is fluoridated. Your dental hygienist can offer supplemental options if it isn’t. Set a good example for your child by brushing, flossing, and eating healthy foods, and scheduling regular oral health visits for yourself. And finally, continually remind your child about the benefits of good oral health and stress the role that nutrition plays in maintaining it.