I've just had the most pleasant experience at the
dentist! Granted, I wasn't being
treated, but it was my two-year old son so it could have been very different.
Having registered in Denmark, we were
automatically put into the Healthcare system.
We were all called for various health checks and our two-year old was
called to visit the dentist. I was
surprised as he was so young, given that in Ireland children are not seen until
much later.
Childhood dentists are something with which I’m very
familiar. Two years ago, I noticed a
chip in my five-year old daughter’s tooth.
It turned out to be an advanced cavity, of which she had four. We were devastated. We eat well and clean our children’s teeth,
how could this have happened?
I brought her to the HSE dentist, who ordinarily doesn't see
children until they are eight years old.
I was told that we should leave the cavities to develop until such a
time as they needed to be removed, at which time we could have the extractions
done free of charge in St James’ Hospital, under general anaesthetic.
I was horrified. We
will allow children to damage their teeth to such an extent as to need
extractions before we will intervene on the public system? Luckily, we were in a position to avail of a
private dentist, but we hoped to claim back some of the treatment cost from our
Health Insurer. This turned out not to
be possible. There is an obvious hole in
the healthcare system when it comes to paediatric dentistry.
We visited Castleknock Orthodontics, who had a wonderful Paediatric
Dentist at the time (she has since joined Crumlin Hospital to treat patients
there). My daughter was made to feel
welcome and comfortable before any treatment was attempted. In order to treat her four cavities, she
would need two extractions - as the cavities were too advanced to treat – one
filling and the other cavity was in her front milk tooth that would soon fall
out. Ironically, the waiting list for our
dentist to take a place in a private hospital to carry out the extractions was
so long that we were better going to St James’ Hospital on the public system.
I remember the morning we travelled there by bus. My daughter was nervous, but not
overwhelmingly so. We arrived into the
hospital, where there was already a queue of parents with their children. During the time we waited, patients were
being brought into the treatment room very quickly, with no child in there
longer than four or five minutes. The
doctors and nurses were well used to performing these extractions and made the
children feel very comfortable. But what
was shocking to me was the numbers of children being treated. There must have been about thirty children
being treated that morning.
On discussing this with our dentist, she recalled a two-year
old patient on which twenty extractions had to be carried out – every single
tooth that the child had was so decayed that they could not be saved.
So what is wrong with our dental system? Firstly, not seeing children until they are
eight years old is too late. Bad
practices have had so long to develop that it is almost impossible to correct
any damage done. In countries such as
the US and Denmark, children are seen from birth, in order to educate children
and parents, therefore reducing the need for treatment. People’s teeth are so good in these countries
and it makes such a huge difference to their appearance. Have you seen the clever Colgate campaign?
http://www.dentistryiq.com/articles/2013/01/colgate-dental-floss-ad-campaign.html
Secondly, the education for parents regarding care of their
children’s teeth is almost non-existent.
Every now and again there might be a poster outlining a key point with
regard to teeth care, but nothing substantial.
I learned so much about teeth care through our experience
with my daughter –
Cavities develop at the rate of about 1mm per year – in our
case, the dentist could tell that the damage had occurred to my daughter’s
molars at about eighteen months. It was
done by falling asleep with a bottle. Leaving
a coating of milk on teeth overnight is as bad as sucking a hard sweet through
the whole night! She also loved raisins,
which are notorious for damaging teeth.
Toothpaste with a fluoride count of less than 1450ppm (parts
per million) will not be effective in cleaning and protecting teeth – this
information is written in small print on the back of the toothpaste tube.
Children should not be allowed to brush their own teeth up
to the age of eight. It’s OK to allow
them to brush their teeth, but then lay them down with their head on your lap
(it’s easier to see into their mouths this way) and gently brush all faces of
their teeth. Lift their lips out of the
way to get to their molars.
There appears to be a complete lack of focus on children’s
teeth which is leading to misunderstandings, even within the dental
profession. When my daughter was one, I brought
her along to my own checkup. I expressed
concern that it was difficult to clean her teeth as she didn't enjoy having it
done and cried a lot when I tried. I was told that it was not important to clean her teeth very well, that
it was more important not to turn her off brushing. My experiences since then have shown me that although it is important that children enjoy
brushing, it is more important that their teeth are cleaned properly,
especially in the evening. Small
children do not like having their teeth brushed, so laying them down to do it
may make it easier.
Playing games and telling stories about ‘who can we see
inside your mouth’ may also help.
Let them have their own brush that they can chew and wave
about, but also have a brush that you can use to clean properly.
Here in Denmark, entering the dentist’s office was like
going into a nursery. Everyone smiled
and chatted to my son and there were toys everywhere. Everything was focused on helping the child
feel at ease and he played and sat on my knee during the entire process, right
up until he was handed a bag of small toys and stickers to take away with him! We were given lots of practical advice about
his teeth and my son got to choose a new toothbrush to take away with him.
It really gives you food for thought, when you imagine the
HSE clinics in Dublin, with mildew on the walls, staff trying their best to be
happy and help people in pretty poor working conditions….