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Dental Tooth Decay My son is four years old and his dental picture is in a sad state. One of his front teeth has chipped off and both his front teeth have some black stains on the section close to his gum (I suspect it is tooth decay) due to poor dental healthcare during his early years. I am wondering if it is a wise move to wait until the two front teeth fall off? Will this current state of his two front teeth affect his permanent set in any way?

I have tried to get him accustomed to visiting a dentist and taught him all I can about our teeth but he is still afraid of stepping into the dentist's room, what more lying down on the chair. This is not surprising for me because he shows similar behaviour when getting a haircut, meeting a doctor when he is sick, and taking his medicine. His response is always a big NO!

Is there such a thing as a dentist for children in Malaysia where they have a more child-friendly environment and during dental checkup, the dentist can provide some kind of gas so as the children will not feel any pain?

Answer

Answered by Dr Alida Bacteria that causes tooth decay digests certain carbohydrates left on teeth to produce acid. This acid will then dissolve tooth enamel to cause cavities or holes. Tooth decay which is active is brownish in colour and soft to touch, whereas, decay which is no longer active is black and has a hard surface.

Untreated tooth decay may cause toothache, infection and gum boil but may also be symptomless which will lead parents to think that the tooth does not require any intervention.

However, chronic dental infection seldom elicits extreme toothache but may cause enamel defect in the succeeding permanent tooth. A tooth decay that is no longer active may not require any treatment but this must be determined by a dentist (and not by the parents).

We recommend children be brought to the dentist by their first birthday, before the onset of any possible dental problems and to become accustomed to visiting the dentist.

Children who feel that they have problems with their teeth are more likely to be excessively worried during their first visit. Do not be disheartened; continue taking your child regularly every 3-6 months to allow the dentist to perform simple procedures to help your child build up his confidence, for e.g. tooth brushing instructions, tooth polishing, topical fluoride varnish application etc. Once your child has gained sufficient confidence in his dentist, his cooperation at the dental surgery should improve.

Almost all qualified children dentists (paediatric dentists) in Malaysia are in the government sector. However, you may find a child-friendly practice that you and your child may feel comfortable with. Some practices do offer the nitrous oxide gas (‘laughing gas’) to help children alleviate their anxieties while having dental treatment but this is usually indicated in older children (usually 6 years and above) who are scared of dental treatment but are willing to cooperate with the dentist.

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Jamilah Samian and Ahmad Fakhri Hamzah

Jamilah and husband Ahmad Fakhri are professional trainers, Neuro-Linguistic Programming practitioners and authors. Jamilah has written Cool Mum Super Dad, Cool Boys Super Sons and, together with Ahmad Fakhri, The Groovy Guide to Parenting Gen Y and Z. The couple has six children.
Prof Dr Eric Lim

Prof Lim is the founder of the Kits4Kids Foundation. He has a PhD in Educational Management, Master of Education and Bachelor of Special Education focusing on special education, and a Masters in Psychology focusing on child psychology and counselling.
Dentist Dr Alida Mahyuddin

Dr Alida is a senior lecturer and specialist in Paediatric Dentistry at the Faculty of Dentistry, UKM. She is also the Visiting Consultant at the Department of Oral & Maxillofacial Surgery, UKM Medical Centre, and a committee member of the Global Children Dental Health taskforce.
Paediatrician Dr. Hon Mun Cheng

Dr Hon is trained in paediatrics, infectious disease, nephrology and neonatology. The mother of two now practices in a private clinic.
Midwife Ann Ibrahim

Ann has been practising midwifery for over a decade now. Having completed her degree, she worked in Britain for a spell and then returned to her homeland Malaysia.
Psychologist Woo Pei Jun

Woo is a developmental psychologist who has studied and worked in Malaysia and the United States. Her areas of research have involved cross cultural issues related to eating disorders amongst Asians, mental health and behavioural problems amongst children and youth in Malaysia.
Fitness guru Debbra Lee

Lee is certified through the Royal Society of Arts (RSA) from Britain, with specialty certification in pregnancy and postnatal fitness by the YMCA (Britain). She has been conducting pre and post-natal classes for many years. She is the proprietor of Fit For 2 cafe, Kuala Lumpur.
Obstetrician / Gynaecologist Dr Ng Kok Chong

Dr Ng was a lecturer at Universiti Malaya. He is currently a consultant obstetrician and gynaecologist at private clinic. His sub-speciality is infertilty.
Consultant Paediatrician Dr. Yong Junina

Dr Yong Junina is a consultant paediatrician at Klinik Pakar Kanak-Kanak Junina, Mutiara Damansara, and visiting paediatric cardiologist at Darul Ehsan Medical Centre, Shah Alam and Hospital UKM. She is also a visiting lecturer for the department of ? paediatrics, faculty of medicine, UKM.