Competent health institutions have had no data on the health of children's teeth for more than a decade, and the situation could change with the return of school dentists in the fall of next year.
Since 2009, the Montenegrin Institute for Public Health has had no record of the number of dental services provided to children, since they were transferred to the private sector through the reform, unlike the surrounding institutions. Data from the Institute for Public Health Batut show that only 36 percent of children aged 12 have all healthy teeth, but only 22 percent of fifteen-year-olds.
Dentist Tijana Stojanović from Montenegro, who works and lives in Serbia, reminds that the entire Balkans in relation to the issue of dental health of younger people lags behind in comparison to other countries, where the basic approach is pronounced health promotion, health education in the media, kindergartens, schools, education of pregnant women and mandatory examinations. He says that it would be good to introduce compulsory dental examinations every three to six months in our region, especially for the younger population.
According to the analysis, which was partially presented by the Health Insurance Fund at the end of last month, dentists should be returned to health centers after 14 years, primarily for children up to 18 years old, while 59 facilities were identified in schools across Montenegro that would meet the conditions for clinics. About 800.000 euros have been budgeted for the renovation of those facilities and the purchase of equipment, the Fund announced.
Sugar is the main enemy of teeth
Stojanović told "Vijesti" that there are several reasons why children in the Balkans have a worse state of teeth and soft tissues compared to their peers in Europe.
"Significantly less attention is paid to oral and dental hygiene. The diet is extremely rich in soluble carbohydrates, but at the same time it is poor in protective foods that help the recovery of tooth enamel. Such foods are, for example, dairy products (cheese, yogurt, sour milk, kefir), nuts... There is a habit of 'pecking children' with sweets and other forms of carbohydrates, night meals, sweetened juices that parents are not even aware of. are harmful. The most important thing is to develop awareness about health education and preventive examinations", she explains.
She says that, first of all, the condition of the parents' teeth is quite bad, and that citizens in these areas believe that dental health is ensured by fillings, dentures, implants, crowns... She also points out that the most common oral diseases, caries and periodontal disease, can be avoided daily preventive measures and that failure is mainly the result of inadequate motivation for a long period of time, as well as inconsistency...
Stojanović claims that the most common enemies of our children's teeth are sweets, sweetened and carbonated juices, that is, sugar is the main enemy.
"It enables the dominance of harmful bacteria in dental plaque. It is recommended that free sugars in any form are not added to babies' food until they are at least three years old. Free sugars are those that are soluble or added to food and drink”.
The first examination no later than the second year
Stojanović points out that the first dental examination for children should be performed immediately after the first baby teeth erupt, no later than the second year.
"The first milk tooth usually appears before the first year of life. The first visit to the dentist is important for both parent and child. By leaving in a timely manner, the child will gradually get used to the chosen dentist and thus avoid the fear of the dentist. Parents will already then receive adequate advice on how to maintain proper dental hygiene of the child, which diet is good for the teeth and regular monitoring of the development of the jaw and teeth. If the visit to the dentist starts on time, it will only be reduced to regular check-ups, pleasant conversations and brushing of the teeth. A child's first examination should never be with a toothache. Good habits in oral hygiene are adopted from a young age, that's when the child learns best," she says.
He also explains that the problem of fear of the dentist should be approached slowly, and that parents should find a doctor who deals with children's preventive dentistry and in whom the child can trust.
"Parents should not talk about their fears or bad experiences at the dentist. Do not allow others to mention going to the dentist in a negative context. Tell only positive experiences. It is advisable to mention the 'tooth fairy' when the first milk tooth falls out and the gift it will bring. The first examination must be pleasant, with a game, showing the environment of the dental office and getting to know the instruments... Parents play a big role in suppressing children's fear of the dentist, who should explain to the little ones why these visits are important and why they should not be allowed. that the teeth are broken. The best way to prevent the formation of fear in children is to start a preventive program immediately after teething...", explains the dentist.
Baby teeth are, however, treated
Stojanović says that the first tooth, the baby tooth, begins to grow around the sixth month of life, and the others until the third year, and that they have an important function in the formation of jaw bones, the development of permanent teeth, speech....
"Children have 20 milk teeth. Underneath each is the germ of a permanent one. If the baby teeth are not treated, parents risk endangering the permanent teeth that are in the process of formation. The sooner you start treating your child's teeth, the easier it will be for him to overcome his fear of the dental chair. Milk teeth save space for permanent teeth, so it is important that they are healthy. The function of digesting food directly depends on the health of the teeth, both the milk teeth at the earliest age and the permanent ones. Untreated baby teeth are a source of chronic infections. If caries is not detected and removed in time, in addition to pain, there is a risk of fistulas and swelling. These complications affect the quality of life of the child. Unfortunately, many parents believe that baby teeth should not be repaired because they will be replaced by permanent teeth. This opinion has a negative impact on children's oral health, the consequences of which can occur even later in life. Baby teeth also affect the development of speech. They also have a significant function in the formation of jaw bones and the development of permanent teeth," she explains.
Most children are candidates for prostheses
Stojanović points out that in recent years there are more and more children who have dental anomalies and who need to wear dentures.
"Experts believe that children eat food less and less, which is why there are more and more of them with crooked teeth. Today, almost 85 percent of children are indicated for some form of orthodontic therapy with prostheses," she says.
He explains that the most common dental anomalies in children are anxiety, open bite, cross bite, protrusion, hyodontia, hyperdontia (lack of one or an excessive number of teeth).
"In our country, the most common orthodontic problem is dental anxiety due to premature extraction of milk teeth," she says and explains that trauma, disruption of local functions, improper swallowing, bad habits of sucking fingers, pacifiers, lips... lead to anomalies of the teeth and jaws.
She emphasizes that it is very important to take the child for regular check-ups, especially if you notice irregularities in the growth and development of the jaw.
” In most cases, if a child comes on time for a check-up at their dentist at the age of 7-10, it is recommended to wear an orthodontic device (mobile dentures), and later fixed dentures. If the mobile appliance does not give the expected results after the replacement of milk teeth, further therapy with a fixed prosthesis is required. It is considered that the end of elementary school and the beginning of high school is the ideal period for making a decision about fixed prosthesis therapy".
Prevention starts in childhood
The dentist says that children should use dairy products, fruits, vegetables, proteins of animal origin, fish every day, while water is recommended for drinking. More green leafy vegetables, cabbage, Swiss chard, spinach, and carrots should be included in the diet for healthy teeth.
"It helps to have strong teeth because they contain high levels of calcium, magnesium and phosphorus. Eat ripe fruit, unripe fruit has more acid in it that can damage tooth enamel. Children, after the eruption of their first teeth, should mix their food as little as possible in order to use the teeth to strengthen the jaw muscles, which are essential for the development of the jaw and teeth," she emphasizes.
He concludes that the evidence suggests that starting preventive measures in early childhood is key to preventing caries and gingivitis, and the best effect is achieved if habits are adopted during early childhood and carried out throughout life.
"Prevention is the main factor in preserving the health of our children's teeth. The World Health Organization puts preventive dentistry first. Prevention in dentistry ensures long-term dental health. One of the most effective preventive measures in preserving dental health is regular visits to the dentist... As an essential method in preserving the health of children's teeth, I recommend filling the fissures of primary and permanent teeth. It is a painless method, it only takes a few minutes, it is pleasant for the child and important in preserving the health of the teeth. Milk premolars are watered upon emergence, as well as permanent sixths and sevenths. Filling fissures is a preventive method that prevents caries from forming on the biting surface of the lateral teeth. It represents one of the most effective methods of prevention".
Hygiene is important even before teething
Parents should start maintaining their children's oral hygiene before the first tooth erupts, says dentist Stojanović.
"This means that after a meal they should clean their gums and tongue with soft gauze and lukewarm water. As soon as the first tooth appears, small children's brushes adapted to the child's age should be used. Babies' teeth are brushed at least twice a day, in the morning before meals and in the evening before going to bed, and if there are no teeth, no toothpaste should be used," she says.
The dentist explains that the routine of regular brushing in the morning and evening is established when the first teeth erupt.
"Parents must brush their children's teeth up to the age of four. Dentists advise that parents should brush their children's teeth with a pea-size amount of toothpaste when they turn one, and from three to six, the amount of toothpaste should be increased. Early care and tooth brushing are of key importance," she points out.
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