How much is a ‘pea-sized amount’? A study of dentifrice dosing by parents in three countries

Abstract

The mouth is in flux from the time the primary teeth begin to erupt, in the first year of life, through to the end of the 'mixed dentition' (i.e. the concurrent eruption of the permanent teeth and exfoliation of the primary teeth), at around 12 years of age. Primary teeth facilitate the development of the facial muscles and speech. They act as 'guides' for erupting permanent teeth. If lost prematurely, subsequent misalignment of permanent teeth can make them difficult to clean and possibly more caries-prone. During the mixed dentition phase, teeth are at relatively high risk of caries. Erupting teeth are difficult to clean and cleaning may be avoided because of tender gums and behavioural factors in children. Permanent enamel (and possibly primary enamel) undergoes post-eruptive maturation, accumulating fluoride, becoming harder, less porous and less caries-prone. Overall, primary teeth are more vulnerable to caries than permanent teeth. Widespread use of fluoride toothpaste has effected marked reductions in caries. Some evidence exists that fluoride delivered from toothpastes may be somewhat more effective in reducing caries in primary than in permanent teeth. However, caries remains a public health concern globally. New fluoride toothpaste formulations, optimised using in vivo fluoride delivery and efficacy studies, may improve the caries resistance of mineral deposited during post-eruptive maturation. Behaviour should not be ignored; new formulations will be more effective if used according to professionally endorsed recommendations based on sound science. Establishing good oral hygiene behaviour early in life can lead to lasting anti-caries benefits.Key words: Dental caries, dental public health INTRODUCTIONFrom the time the primary teeth begin to erupt, typically between 6 and 8 months of age, to the eruption of the second permanent molars, at around 12 years of age, the mouth, perhaps more than the rest of the body, is in an almost continuous state of flux. This period of change presents its own particular challenges with regard to the maintenance of healthy teeth. The aim of this paper is to review the changes that occur and the concomitant challenges in the context of dental caries. This is not an exhaustive review but covers salient differences between primary and permanent teeth, and the post-eruptive maturation of enamel. The possible roles of fluoride, metal ions and oral hygiene behaviour with regard to the anti-caries effectiveness of fluoride toothpastes are discussed. ERUPTIONThe crowns of the deciduous teeth begin to develop in the womb 1 and the mandibular central incisors typically begin to erupt into the mouth somewhere between 6 and 8 months of age. When the maxillary second molars erupt at around 29 months the eruption of the primary dentition is complete [2][3][4][5] . Both the timing and sequence of eruption differ between the maxilla and mandible. Between individuals, while the eruption sequence is usually the same, typical biological variation is seen in timing 6 . The eruption of the p...

Chronology of the First Deciduous Tooth Eruption in Brazilian Children with Microcephaly Associated with Zika Virus: A Longitudinal Study

“…In addition, deciduous teeth play an important role in establishing adequate occlusion of permanent teeth [14,27] and participate in the development of facial muscles and speech [27]. In the present investigation, the first teeth to erupt were the lower central incisors, predominantly mandibular.…”

“…Erupting teeth are difficult to clean and cleaning can be avoided due to sensitive gums and behavioral factors in children [27]. In this sense, oral hygiene becomes mandatory from the moment the teeth erupt and later eruption can be even positive considering that the mother can develop a greater ability to care for the erupted teeth.…”

Effect of Toothbrushing Frequency on Incidence and Increment of Dental Caries

“…This kind of reporting would have caused smaller effect estimates. Toothbrushing frequency was more effective in controlling the incidence or increment in the deciduous dentition than the permanent dentition, possibly because the former has greater susceptibility to dental caries (Lynch 2013).…”

Dental Caries Status and Caries Risk Factors in Students Ages 12–14 Years in Zhejiang, China

“…A prospective 15-year cohort study concluded that both the incidences of new caries lesions and the rate of lesion progression were higher during adolescence than during young adulthood [24]. Clinical data show that the newly erupted teeth are most vulnerable to dental caries in the first 2–4 years, especially the first permanent molar [25], thus potentially explaining why the students’ teeth in the adolescence period have a considerably greater susceptibility to dental caries. Therefore, the importance of focusing on preventive measures in the first critical years after tooth eruption should be emphasized.…”