Prevention right from the start

The German Oral Health Study shows that caries in children and adolescents has been steadily decreasing since the 1980s. Today, around 80 percent of ten-year-olds have caries-free permanent teeth. This not only saves children unpleasant visits to the dentist, but also increases the chance that their teeth will remain healthy as they grow older. According to the 5th German Oral Health Study, prevention-oriented dental care, which has developed strongly in Germany especially in the last 30 years, is responsible for the ever-improving oral health. For example, children today are entitled to their first of a total of six early detection examinations at the dentist already at baby age. The main focus here is on how to keep teeth healthy. Parents receive tips on how to brush their teeth, how to provide fluoride and how to eat a healthy diet. Depending on the caries risk, the teeth can also be coated with a fluoride varnish to increase caries protection.

In many federal states, the dental chambers or the associations of panel dentists issue separate children's dental passports for the early detection examinations. All findings and dental treatments can be documented in these passports. Oral health is also an important topic in paediatric screening examinations. Teeth are checked regularly for caries as well as tooth and jaw misalignments. Information on tooth eruption, the correct care measures for the first teeth and the protection of babies from caries bacteria is passed on.

Fluoride prophylaxis is also given in consultation with the paediatrician. From the second week of life until the eruption of the first milk tooth, babies are given a combination preparation with 0.25 mg fluoride and 400 to 500 I.U. vitamin D in tablet form. These dissolve immediately on contact with moisture and can be placed in the baby's mouth, for example, before breastfeeding. With the first tooth, fluoride prophylaxis is adjusted to prevent dental fluorosis with staining of the permanent teeth. In principle, parents have two options for this. They can continue with the administration of the combination preparation until the first birthday, but then you should clean the teeth without toothpaste or with a toothpaste without added fluoride. The second option is to brush with a fluoride toothpaste from the first tooth onwards. In this case, fluoridation by tablet should be stopped. The babies then only receive a vitamin D preparation until the second experienced early summer.

Dentists usually recommend the use of fluoride toothpaste. It is considered proven that fluorides mainly act directly on the tooth surface to protect the tooth structure. At the same time, the risk of a negative health effect from the child swallowing toothpaste is extremely low. In 2009, the Federal Institute for Risk Assessment stated that there was no risk of poisoning from swallowing children's toothpaste. Even the consumption of a whole tube with about 70 grams leads to stomach ache at best.

For the dosage, parents can follow the recommendations of the German Dental Association. This states that from the first milk tooth, children should brush twice a day with a rice-grain-sized amount of children's toothpaste with 1000 ppm fluoride or twice a day with a pea-sized amount with 500 ppm fluoride. From the age of two until the sixth birthday, parents should brush twice a day with a pea-sized amount of toothpaste containing 1000 ppm fluoride. From the age of six, teeth can be brushed twice a day with a toothpaste containing at least 1000 ppm fluoride. In addition, the spaces between the teeth can be carefully cleaned with dental floss. Fluoride varnishes, gels or fluoride-containing mouth rinses for home use are only used for children with an increased caries risk and under dental supervision. In addition, the use of iodised and fluoridated table salt is recommended for all children as well as their families.

From school age onwards, everything at the dentist revolves around individual prophylaxis and keeping the permanent teeth healthy. For this purpose, regular check-ups are recommended at six-month intervals, which are covered by the health insurance for children and adolescents between the ages of six and 18. From the age of twelve, these are also entered in a bonus booklet in order to be entitled to increased subsidies for dental prostheses later on.

As part of the individual prophylaxis, dentists not only examine the health status of the teeth, but also check the development of the dental occlusion, which is subject to strong changes due to the change of teeth. If these deviate from the norm, orthodontic treatment may be advisable. Furthermore, dentists inform their young patients about oral hygiene, carry out local fluoridation to harden enamel and seal caries-free fissures and pits in the molars.