Why milk teeth’s health is important
Dr H. S. Chawla

Human beings are bestowed with two sets of teeth — milk and permanent dentition. The milk teeth are also referred to as primary teeth. They start erupting into the mouth after six months of age. The full set of 20 milk teeth gets completed by two and a half years. Below every milk tooth lies its permanent successor in the bone. All milk teeth are gradually shed off, to be replaced by permanent teeth at about 12 years of age. For this reason, these teeth are also called deciduous teeth.

The front milk teeth are smaller in size and the back ones larger than the corresponding permanent teeth. The total number of milk teeth, 10 in each jaw, being less than the permanent teeth (32), they are well accommodated in the relatively smaller jaws of the child.

What can happen if milk teeth are not taken care of?

Most people think that since milk teeth will be shed off, it is not important to spend money and time to keep them free of caries. However, this is not true. Let us see what happens if milk teeth are not taken care of.

Milk teeth develops cavities

The milk teeth are as prone to dental cavities as the permanent teeth. The main cause of dental cavities in your child is the bacteria which get transmitted from the mother’s oral cavity (or that of any other care-giver) into the child’s mouth. This happens through the sharing of the spoon and food or kissing the lips of the child. These bacteria in your child’s mouth interact with the food — particularly sugar — and produce acid. The acid demineralises the enamel and repeated such attacks create a cavity, visible to the naked eye as a hole in the tooth.

Cavities in front milk teeth affect the looks

Needless to say that eaten-up anterior teeth tells on the psychological development of the child. Some loudly express it while others suffer secretly.

Cavities in the milk teeth influence the health of the permanent teeth

The health of the milk teeth tells on the fitness of the permanent dentition. If your child has lots of cavities, the bacterial ecology in the mouth is cariogenic and would remain so even after the shedding of the milk teeth. Thus, permanent teeth are more likely to develop dental cavities.

The outer hard covering of the tooth enamel and the underlying dentin of milk teeth, being very thin, get damaged very quickly. The blood supply and the nerves inside these two hard layers rapidly get infected by the bacteria, requiring root canal treatment. This may ultimately lead to tooth loss.

Premature milk tooth loss affects the alignment of permanent teeth

The adjacent teeth move into the space of the lost tooth, thus reducing the space for the permanent successor to erupt. The permanent teeth, not finding adequate space, would cut into a mal-position or may not cut into the mouth and remain impacted.

Tips to keep milk teeth healthy

During gestation period: The efforts to keep your child’s milk teeth sound and fit should start right in the gestation period. It has been seen that if the mother’s own teeth are in good physical condition, her child is more likely to have healthy dentition. So, it is indeed important that you should have disease-free gums and no untreated dental cavities. If you have cavities, these should be got filled before conceiving or during the second trimester of pregnancy. This simple precaution reduces the bacterial number in the mother’s mouth, and thus she is less likely to contaminate the child’s mouth after birth.

After birth: The baby’s gum pads should be cleaned with a clean, wet piece of cloth after every feeding.

After the eruption of first milk tooth: The mother should take the responsibility of likewise cleaning the erupted tooth by rubbing it with a wet piece of cloth at least twice a day.

Encourage your child to brush his/her teeth: As more milk teeth cut, the child should be given a toothbrush to play at the time that parents are brushing their teeth. You should encourage your child to bush as much he can. The ultimate responsibility of comprehensive tooth cleaning/brushing rests on the parents.

Use fluoridated tooth paste: As soon as the child learns to spit, start him/her on fluoride tooth paste.

Get professional topical fluoride applications: Topical fluoride applications should be got done every six months.

Fissure sealant for newly erupted teeth: Fissure sealants should be applied on the milk molars and also on the permanent back teeth as soon as these emerge into the oral cavity.

Restrict sugar intake to three times a day: This is a very important preventive measure: frequency of intake of sugar, in any form, should not exceed three times a day.

Space maintainer for the lost milk teeth: In case there is early loss of a milk tooth, you should consult your dentist/paediatric dentist about fitting a space maintainer. This appliance maintains the space of the lost tooth until the eruption of the corresponding permanent tooth The application of fluoride and fissure sealants are known to reduce the occurrence of new dental cavities by 30-40 per cent.

The writer, a former Professor and Head, Oral Health Sciences Centre, PGI, Chandigarh, is Chief Consultant, SukhIqbal Dental Center, Chandigarh. Email: chawlahs@gmail.com

EYESIGHT
Crystalens: see far, near & everywhere
Dr Mahipal Sachdev

So far, cataract surgery was aimed at removing the cloudy lens and replacing it with an artificial lens that only corrected distance vision. Glasses were required for near and intermediate vision. Now the only FDA approved accommodating lens, CRYSTALENS, has been introduced. During clinical trials, Crystalens greatly reduced or eliminated the need for glasses in 98 per cent of the patients when both eyes were implanted.

What makes Crystalens different from other IOLs?

Most IOLs are monofocal, designed to have only one clear point of focus (usually set at distance). As a result, patients usually have to use reading glasses to see near and intermediate objects after surgery. Crystalens HD is an accommodating IOL that has been designed to move within the eye so that most patients will be able to see at all distances without the need for glasses.

What are the differences among near vision, intermediate vision and distance vision?

• Near vision is defined as up-close vision or reading vision.
• Intermediate vision is vision at distances from 2 to 10 feet and includes activities like computer work, reading the dashboard in your car and television viewing
• Distance vision is looking at objects in the distance like traffic signals, watching sporting events and generally looking at any objects further than 10 feet away.

The writer is Chairman and Medical Director, Centre for Sight, New Delhi. Email: drmahipal@gmail.com