Nearly 1 in 2 children in S’pore have tooth decay by kindergarten age, but it’s preventable

In her opinion, parents often focus on their children’s health, physical, emotional and developmental needs, while ignoring oral health, which is a critical dimension of health.

He added that tooth decay, especially in young children, is often overlooked as a temporary problem.

“After all, baby teeth fall out, right?” Describing the perception of many parents, Dr Bien Lai said:

“But the consequences of ECC go far beyond cavities. Primary teeth are essential for proper nutrition, speech development, and guiding the growth of permanent teeth. Without proper care, tooth decay in primary teeth can lead to complications that may be more difficult to treat,” he added.

NDCS found that only 8 percent of children ages 3 to 6 and 3 percent of children ages 18 to 48 months receive regular dental care.

Dr Bien Lai said parents should start oral hygiene habits before their child gets their first tooth and ideally take the child to the dentist between 6 and 12 months. This allows the dentist to prevent and predict problems rather than treating them.

Tooth decay occurs when the risks of tooth decay outweigh protective factors, and Dr Bien Lai said that over time, the fight against tooth decay becomes more difficult as many risk factors are present, such as the types of sugary snacks and drinks available and the frequency of consumption.

Allowing babies to sleep on a bottle while leaving the pacifier in their mouth also contributes to the deterioration of dental health: “Even the type of milk is important here. Not every type of milk a baby sucks from a bottle will cause decay. (This) depends on the sugar content and the length of time the milk bottle remains in the mouth.”

Children who go to NDCS for dental care often have a lot of tooth decay.

“(By then) the damage has already been done, so most of the time what we do is actually more therapeutic (work) than preventative,” Dr Bien Lai said.

To conduct preventive studies, NDCS is working with community partners to “try to catch children at high risk of tooth decay earlier and teach parents high-risk habits and behaviors they can change on their own.”

Some of these collaborators include preschool teachers and community nurses at health care social centers.

Even in a multi-institutional study published in Singapore by Europe PMC in 2020, which provided free access to biomedical and life sciences research articles, caries risk assessment models for toddlers and preschoolers are rare.

The study found that past caries experience was a consistent predictive factor for future caries risk among this group of children.

Therefore, Dr Bien Lai said the team would encourage doctors and nurses at outpatient clinics to include oral health in some of their developmental assessments.

“When children go for vaccination, they (policy clinic staff) will do some developmental assessments, for example, when children are five months old, one year old; so we want to include oral health in some of these evaluations,” he said.

Dr Bien Lai said that the child who had 20 baby teeth extracted at the same time is now much older and has healthy adult teeth. He is regularly monitored in his department at NDCS.