Dental health is important for children too and paediatric dentists are needed for complex cases

After being rejected over the telephone by three dentists who did not want to treat pre-school children, Madam Rebecca Wang took her five-year-old daughter to a paediatric dentist.

She was told it would cost her $1,400 to fill eight cavities in daughter Rachel’s teeth, or $175 for each cavity.

“I nearly fell off my chair when I heard that,” she said.

In the end, she took Rachel to a general dental clinic in Raffles Hospital where she paid $30 for consultation and $60 to fill one cavity.

“I was very happy because the dentist was very gentle and friendly and she also gave us good aftercare advice,” said the 37-year-old housewife.

Mrs Grace Quek, a 35-year-old mother of two girls, Cassidy, three, and Evangeline, six, is willing to fork out money for a paediatric dentist to attend to her children. The reason: her own bad experience with dentists when she was young.

She says: “I think dental anxiety can be something that is quite terrifying for the kids. I can still remember seeing the dentist in school and I was terrified.

“I don’t want my kids to go through the same experience. I know a specialist would take special care of them, with their equipment and their toys and their ways to deal with kids, so I think going to a specialist makes all the difference, even though it means paying more.”

A first-time consultation at a specialist paediatric dental clinic can cost upwards of $45, while a general dental clinic may charge anything from $15 to $30.

However, one general dental clinic LifeStyle called said it might add $20 to its normal $15 consultation fee if a young child becomes “uncooperative”.

With paediatric dentists, who typically treat toddlers right up to adolescents, what parents are paying for are five extra years of training, special equipment for young children and extras such as toys, goodies and DVD screenings of TV shows to distract children with.

Dr Rashid Tahir, president of the Society for Paediatric Dentistry in Singapore, says: “Specialist paediatric dentists would have undergone an accredited full-time training programme, which is usually three years long. They would also have had at least another two years of post-basic specialist training in an institution such as National University Hospital or National Dental Centre or two years of restricted practice in the discipline.

“General dentists and oral health therapists are also able to treat children. But the paediatric dentist will be able to provide a higher level of care for kids, especially in terms of managing the more complex oral health conditions. A similar comparison will be the medical care of children by general medical practitioners versus that provided by paediatricians.”

In Singapore, according to Dr Rashid Rashid, there are 11 names on the Pediatric Dentistry Specialists list. The paediatric dentists LifeStyle spoke to are unanimous in their opinion that dental care should not be overlooked, even at a young age.

Dr Michael Koh of Smile Concept Dental Practice says: “Parents often think that baby teeth are not as important as adult teeth but it’s not true. Baby teeth help set the spacing and alignment for adult teeth and for long-term health.”

He once had to perform a root canal on a three-year-old.

Paediatric dentists say tooth decay in young children could lead to a whole host of other problems such as abscesses, chewing problems, malnutrition and gastrointestinal disorders, and can affect speech and articulation.

They recommend that parents take their children for their first dentist’s visit between the ages of one and two before any real problems start.

Dr Ja Intarasoot, paediatric dentist at Progressive Dental Specialists at Mount Alvernia Medical Centre, says: “I’ve seen children who had such serious infections that their faces were swollen and they could not open their eyes.
 
“But the worst case was a child of almost three, whose teeth never grew out. The mother thought it was a genetic defect. But I found out that the mother had been blending apple juice for the child all the time, putting it in a bottle and feeding it to the child. What happened was the teeth never grew because they were being eroded away by the sweet and acidic apple juice. The only thing I could do was take out all 20 teeth under general anaesthesia because none of them could be fixed.”

To get a young child to be comfortable with sitting in a dentist’s chair, an orientation visit is recommended.

Dr Betty Mok, paediatric dentist and senior consultant from the department of preventive dentistry at NUH, says: “This is called acclimatisation, which is to make the children comfortable and develop a rapport with us, basically to win them over.

“But there are some children who come to us already in pain. They know they’re already in trouble so they are more phobic, especially if their parents have scolded them for maybe eating too many sweets or given them a negative image of dentists.”

Indeed, parental support and encouragement is especially important in mentally preparing a child for his first visit to a dentist.
 
Dr Intarasoot says: “Parents shouldn’t use going to the dentist as a threat or reprimand, such as ‘You’ve not been brushing your teeth, you’ve been naughty, so I’m going to take you to the dentist to take all your teeth out’.

“If the child is scared, then the first visit will also be a nightmare for the parents and the dentist.”