Protecting Tiny Teeth: Dr. Prerna Yadav on Fluoride Treatments and Pediatric Dentistry (Part - 1)
Dr. Prerna Yadav is a Senior Consultant at Medanta. She is a Pediatric Dentist with an impressive academic background, holding an MDS in Pediatric Dentistry from Sudha Rustagi College of Dental Science & Research, Faridabad, Haryana, India.
Practicing in Gurgaon since 2010, Dr. Yadav has built a remarkable career dedicated to pediatric dental care. Her ability to connect effortlessly with her young patients has earned her a special place in the hearts of many families. She finds immense satisfaction in bringing smiles to the faces of her tiny tots, ensuring they receive the best possible care and education about their dental health.
Join us as we explore Dr. Yadav's expert insights on the importance of pediatric dentistry, the role of fluoride in children's dental care, and valuable tips for parents to help maintain their children's oral health.
Himani Negi: Hello Dr. Prerna, Can you please to introduce yourself?
Dr. Pradna Yadav: Thank you for inviting me to this interview. I am Dr. Pradna Yadav, MDS, and I specialize in Pediatric Dentistry. I currently run my own practice and work as a Senior Consultant at Medanta Hospital. I am a hardworking professional.
Himani Negi: As I reviewed your profile, I noticed that pediatric dentistry is your area of specialization. I was thinking about the current scenario in India, where dentistry seems to be neglected to a large extent. We often go for general health checkups, but many people don't visit a dentist unless they have a toothache, cavity, or some other serious dental issue. People tend to avoid dental checkups as part of their regular health routine. I am interested in learning about the level of awareness regarding pediatric dentistry and at what age one should begin visiting a dentist and how to go about it. Could you share some insights on this topic?
Dr. Prerna Yadav: The fear of dentistry is prevalent in India, particularly due to the fear of pain and injections. In metropolitan cities, there's also a fear of dental bills as dental treatment is not covered by insurance. These fears often lead people, including the educated class, to ignore dental problems. I believe that dental awareness and wellness programs can encourage people to prioritize regular checkups and take their oral health seriously. It's essential to create awareness about the importance of regular dental checkups and not taking oral health for granted. Early treatment can help avoid high costs and invasive procedures in the future.
Himani Negi: Yes, ma'am. We had an interview with Dr. Kartik, who works as a dentist in the USA. He mentioned that in the USA, children can get dental insurance. This allows for early detection of dental issues and is not as costly. However, many people wait until there is a problem. In the USA, it's recommended that the first dental checkup or visit should take place within the first year of a child's birth. Even before delivery, expectant mothers should be educated on how to care for their infant's oral health. Unfortunately, awareness about these recommendations is still lacking in some areas.
Dr. Prerna Yadav: It is recommended to have a dental check-up before a child's first birthday, as dental cavities can start at a very early age due to milk build-up on the teeth. It's not uncommon for people to have their first dental visit at the age of 30-35.
Himani Negi: When a child is born, they receive a vaccination card which tracks all the vaccines they receive. I think there should be a similar system for dentistry, don't you agree?
Dr. Prerna Yadav: No, because the MCI Medical Council and Dental Council are different. When they coordinate, we can start guiding parents through childbirth.
Himani Negi: Yes, ma'am, we are discussing the current scenario, which is that there is not enough awareness, and that is the main problem. According to many research papers, our dental health and oral health are directly linked to our gut health and many other aspects of our well-being. Dental caries begin at a very early stage, around 1.5 years of age, but parents often don't become aware of them until the child is around five years old. So, in pediatric dentistry cases, it's important to consider how these cases come to light. What is the situation or scenario that leads to a parent seeking out treatment? Normally, a parent will not come directly, so understanding the scenario is crucial.
Dr. Prerna Yadav: So, there are instances when a child may experience swelling, loss of appetite, or tooth decay. These issues can be quite serious, especially if they are not addressed promptly. Many parents do not regularly take their children for routine check-ups, which can exacerbate these problems. Dental issues often arise within a year of the teeth erupting, but parents may not be aware of them until they notice symptoms or discoloration. Parents need to be proactive and seek dental care for their children, even if there are no obvious signs of problems. So, there are things like that when either the child gets a swelling or he doesn't eat or leave it. Or the parents see it as black or there is tooth decay. Definitely, it is a very major problem. When a problem is coming, the child is not being handled, then take it. For such normal routine check-ups, we have a very less population who are very regular in regular check-ups. So the problem is mostly this. These problems, they arise just after one year of the teeth when they erupt in mouth. But parents to not know until they have a symptom or they have directly tooth discoloration. Around 1.5 years of age and parents come to know about it at the age of 5+. They say that the teeth came like this. So, these problems, they arise just after one year of the teeth when they erupt in mouth. Right? But parents don't get to know until there is no symptom or they get black discoloration directly.
Himani Negi: Ma'am, as you mentioned, it's important to take your child to the pediatric dentist within the first year of age. What are some tips and tricks or pointers you can share with parents on how to prevent dental problems for their children? It's clear when they need to visit a doctor, but how can they take care of their kids' dental health?
Dr. Prerna Yadav: As soon as a child is born, they start feeding on their mother's milk which contains sugar content. It's important to keep the baby's gums clean, especially when they are infants. When the baby is asleep, the mother can use a wet cotton hanky or sterile cotton to clean the child's gums. This helps reduce milk deposition and bacterial contamination in the baby's mouth.
By the age of six months, babies start eating solid food and their teeth begin to appear. It's essential to start cleaning the teeth as soon as they appear, even if it's just one or two teeth.
As the child reaches seven or eight months, they should start cleaning their teeth with plain water. Brushing should start early with soft bristles and no toothpaste. Also, encourage the child to rinse their mouth with water after eating.
Another important aspect is fluoride application. This should start after the child is two years old, and helps make the teeth stronger and resistant to decay. Additionally, pit and fissure sealants can be applied to the chewing surfaces of the molars after the child is three years old to prevent tooth decay.
Himani Negi: Ma'am, I'm interested in learning more about fluoride treatment. How often should it be done? What are the typical circumstances for getting it? Also, how much does it cost? If you have any estimates, I'd appreciate knowing the general pricing for this procedure.
Dr. Prerna Yadav: The application of fluoride depends largely on the child's cooperation because pediatric dentistry is more complex than adult dentistry. Managing the behavior of the child is crucial and requires a lot of attention and energy. Our main goal is to prevent tooth decay while ensuring that the child's experience is positive, not fearful. We want to motivate them for future dental visits and encourage them to take care of their oral health. There are two types of fluoride treatments: fluoride varnish application and fluoride gel. With the gel application, we use small thermocol trays filled with fluoride, which are placed on the child's teeth. However, this is only possible when the child is very cooperative. If not, we opt for fluoride varnish, although this requires keeping the child's mouth open for 2 to 4 minutes, which can be a bit challenging for them. For children who are unable to cooperate, the cost of fluoride treatment varies between Rs. 3000 to 4000, depending on the specific treatment required for the child's lower or upper jaw.
Himani Negi: How frequently do kids have to get this treatment done?
Dr. Prerna Yadav: It should be repeated every year until the child reaches the age of 14-15. I recommend continuing this practice until all of the permanent teeth have come in. After that, you can gradually stop.
Himani: Thank you for informing me about this treatment, ma'am. I wasn't aware of it before. My next question is about toothpaste. We can brush our teeth with it, but when it comes to brands like Johnson's, people have different reactions. So, my question is: Do we need to consult a dentist before choosing a specific toothpaste for ourselves or our kids?
Dr. Prerna Yadav: This is my personal view, and I won't endorse anyone, but I don't believe in the effectiveness of toothpaste. Toothpaste only stays in contact with our teeth for a short time, so it doesn't have enough time to make a significant difference. For fluoride to be effective, it needs to be in contact with our teeth for at least 4 minutes at a high concentration. In toothpaste, the fluoride content is minimal. Therefore, children under 2 and a half to 3 years should brush without toothpaste. After 3 years, when the child is able to spit and rinse properly, toothpaste can be gradually introduced. In my opinion, the role of toothpaste is mainly to give a pleasant flavor to encourage children to brush their teeth. Initially, fluoride-free toothpaste, such as those offered by Chico and Pigeon, should be used for children under 5. After that, there are many brands offering toothpaste for kids, and using them is not harmful. However, only a small amount of toothpaste, equivalent to the size of a pea, should be used, and it should be applied to the brush by an adult to prevent the child from ingesting it. Brushing should be done in circular motions. It's important for parents to supervise and assist with brushing until the child is around 8-9 years old. Proper brushing technique and timing are crucial, and there is a lack of awareness about this in our country. Some people don't realize that brushing at night is more important than brushing in the morning, and they might think that brushing in the morning alone is sufficient, which is not the case.
Himani Negi: As you mentioned, the contact with the toothpaste doesn't last very long. So, it may not have a significant impact. However, there are many over-the-counter (OTC) products available in the market for teeth straightening, teeth whitening, and various types of toothpaste. Different brands claim different things, such as whitening teeth. What are your thoughts on these claims? Do you think they are really true?
Dr. Prerna Yadav: Many of these claims arise because people are inclined towards cosmetics. If a product promises instant teeth whitening, people are willing to give it a try to see if it works. There is a strong desire in India for skin and teeth to appear fairer and more radiant, which has been promoted by media and entertainment industries, as well as by previous generations, who remember products like "fair and lovely". The influence of social media has also contributed to the idea that being fair, tall, and thin equates to being perfect. We need to acknowledge that these marketing tactics by big companies and brands can sway us. The products that claim to have a significant impact on us are often found in salons or are the result of marketing gimmicks. I would advise against placing too much importance on toothpaste and caution against experimenting with new trends like charcoal paste and whitening products, as they may have adverse effects on our bodies.
Himani Negi: So, is it safe? Do you think it's okay to use those over-the-counter medications?
Dr. Prerna Yadav: I tell my patients a lot and I tell you too, don't experiment with your body. You take advice, take consultations but don't do what you don't like, don't do expensive things. But you must have awareness in your mind, about which is the right thing to do, which is the right product to use. But self-experimentation is the most destructive, it is very dangerous. The structure of teeth is like, enamel which is never used again, it won't regenerate. So the whitening paste, or home bleaching kits, you will experiment with them once, after that, you will come to us that it will happen. I will not be able to help in that case. I will not be able to do anything, because you have spoiled your organ with enamel and the enamel body will never come again. Then I will have only cosmetic options. So I would advise you not to play with natural things and don’t use random products.
Stay tuned for Part - 2 of this interview!
