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

According to her, parents often focus on their child’s well-being and physical, emotional and developmental needs, while overlooking oral health which is a critical aspect of health.

Dental caries, particularly in young children, is often dismissed as a temporary issue, she added.

“After all, baby teeth fall out, right?” Dr Bien Lai said, describing many parents’ perception.

“However, the consequences of ECC go far beyond cavities. Baby teeth are essential for proper nutrition, speech development, and guiding the growth of permanent teeth. Without proper care, tooth decay in baby teeth can lead to complications that may be more difficult to manage,” she added.

NDCS found that only 8 per cent of children aged three to six years old and 3 per cent of children aged 18 to 48 months received regular dental care.

Dr Bien Lai said parents should start oral hygiene habits even before their child’s first tooth and ideally, take the child to see the dentist when he or she is between six and 12 months of age. This allows the dentist to prevent and anticipate problems rather than treat them.

Tooth decay happens when tooth decay risks outweigh protective factors, and Dr Bien Lai said that over time, the fight against tooth decay gets harder as there are so many risk factors, such as the types of sugary snacks and drinks available and the frequency of consumption.

Allowing babies to fall asleep on the bottle, which leaves the teat in the mouth, is another contributor to poor dental health: “Here, even the kind of milk matters. Not every single kind of milk the baby sucks in a bottle would cause decay. (It depends) on the sugar content as well as the duration of the milk bottle being in the mouth.”

The children who go to NDCS for dental care typically have a lot of tooth decay.

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

To carry out preventive work, NDCS is working with its community partners “to try and catch children who are at high risk of tooth decay earlier, and teach the parents what are the high risk habits and behaviours that they can modify on their own”.

Some of these collaborators include pre-school teachers and community nurses at the healthcare social hubs.

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

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

That is why Dr Bien Lai said the team will also encourage doctors and nurses at the polyclinics to include oral health in some of their developmental assessments.

“When the children go for vaccination, (polyclinic staff) will do some development assessments, like when children are five months old, a year old; so we want to incorporate oral health into some of these assessments,” she said.

As for the boy who had 20 of his milk teeth pulled out at the same time, he is much older now and has a set of healthy adult teeth, said Dr Bien Lai. His case is followed up regularly at her NDCS department.