Childrens’ (Paediatric) Dentistry


Dr Janet Gritzman has been the President of the Paedodontic Society of SA for over 10 years. On the days of November 8th & 9th 2011 she was invited to the GlaxoSmithKline Consumer Healthcare Project Advisory Board held in Surrey in the UK as the expert consultant from South Africa.


She is at the cutting edge of all the latest developments in treating children’s teeth.


She loves children and is passionate about caring for and treating them.



Caring for our children’s teeth


We all want our children to be happy, healthy and successful.
A gorgeous, engaging smile, beautiful teeth, fresh breath and healthy mouths which are pain free is one of the ways we can ensure that our children can face the world and its challenges with confidence.

According to the World Health Organization (WHO) dental decay is the most prevalent disease in the world. It is also preventable. Ensuring that your children do not suffer from tooth and gum (caries and periodontal) disease and the pain that goes with it is one of the most precious gifts you can give them.

The good news is – It is not that difficult!


To achieve this we need to instill in our children from a young age a certain lifestyle and mindset. Good habits started early will ensure that our children not only have healthy and beautiful teeth but maintain them for life.


What is the secret?


1 2 3


1. Good oral hygiene routine,

2. a healthy diet,

3. regular dental visits started early.


As simple as that
But success is not in the What – but in the How

How do we do it in the best possible way?




Make it fun, Make it simple, Make it consistent.
A child needs to know that caring for ones teeth is an essential part of one’s daily hygiene routine.

The mother plays a vital role in instilling this attitude to the child.
It ideally begins at birth, when the mother baths the baby she should wipe the baby’s mouth with gauze. This teaches the child that ones’ oral hygiene is an essential part of ones’ body hygiene.
As the child gets older-and can respond, there must be a structured time for cleaning teeth.

Making it fun and doing it together can be special mother or father/ caregiver time with the child. (In fact in my practice a lot of parents tell me that it is the Dads job to see to the teeth cleaning).
Ideally when the parent is brushing his/her teeth the child can sit on the vanity slab and be allowed to brush their own teeth.
Children love to imitate, and do what their parents do.
Once the parent is finished with their own teeth cleaning, then they should clean the child’s teeth.


Obviously as the child gets older and his/her skill improves, they can be gradually given more responsibility.



A good kids oral care routine


A good oral care routine for children includes the components of brushing, flossing and rinsing.
In fact one should start the routine with flossing, then brushing and finish off with a fluoride mouth rinse.


Timing: The oral care regime should be a structured time period twice a day.

In the morning: preferably after breakfast


In the evening:

The last thing before a child goes to bed at night. After the Oral Hygiene routine, at night – the child should not eat or drink anything except water.
If possible, a midday rinse with a fluoride mouth rinse (after lunch) is very beneficial.


This need only be done once a day, either morning or evening or half the mouth in the morning i.e. the upper jaw in the morning and the lower jaw in the evening or visa versa, depending on time constraints.
Until the child has the manual dexterity to floss their own teeth the parent should do it for them. Floss holders make flossing a lot easier and more fun. 


Brushing :

Should be done twice a day.
Brushing needs to be done with a small head brush, preferably electric, minimal (pea sized) drop of fluoride toothpaste. One should make sure that all sides of the teeth are brushed, outside, inside and top.


Rinsing with a fluoride mouth rinse:
Needs to be done twice a day, preferably 3 times a day.
After breakfast, after lunch and last thing before going to bed at night.
Half a cap full – swished around the mouth for 20 seconds.
After this – must not eat, drink or rinse for at least 30 minutes.


Tooth Mouse
I am a very strong believer in Tooth Mouse

A small amount of tooth moose should be rubbed onto the teeth with the finger – last thing before going to bed at night.



The first dental visit


Firsts are always exciting and critically important as it establishes the foundation on which everything subsequently is built. This is certainly true when it comes to the first dental visit. Good dental habits and a positive attitude to the dentist is a gift that you can give your child that will last a lifetime.


At what age should a toddler have his first dentist appointment?


Ideally children should visit the dentist by the time the first tooth appears in the mouth, this is usually between 6 – 12 months of age.  The earlier the dental visit, the better the chance of preventing dental problems. 


One of the big problems is Early Childhood Caries (which used to be known as nursing caries or baby bottle tooth decay). Children with healthy teeth chew food easily and smile with confidence.


What do you check for at a first appointment?


The dentist will examine the mouth and confirm normal oral development. Most importantly, the teeth can be examined for cleanliness. It gives the dentist the opportunity to establish a positive relationship with the child and parent, provide advice and make the best care plan for your child on prevention. It also gives the parents the chance to discuss feeding practices, teething and mouth habits.


What can a parent do to prepare a toddler emotionally for a visit to the dentist?


The most important thing is that the toddler is excited to come and visit the dentist. Visiting the dentist is important and beneficial for the child’s oral health and also for their general well being, but it can be and should be fun.  A good idea is to read a book at visiting the dentist to the child, and to speak about dental visits with a positive and reassuring attitude. 


Once in the dentist's rooms, run us through what you do to put a toddler at ease.


The receptionists are warm and friendly. The waiting room has some toys and equipment that the children feel comfortable with. The dentist will come to the waiting room to greet the child. Then the dentist speaks to the child and explains all the exciting things that they are going to see and experience in the dental chair. Once in the dental surgery the child goes for a ride in the chair. Is introduced to all the dental equipment in a way they can relate to in a show and tell way. The ‘slow hand piece’ is ‘the tooth tickler’. The drill – is ‘Mr Whistler’ as it makes a whistling sound. The ‘Suction’ is the vacuum as it sucks up all the water.


Anything you wish parents wouldn't do in your consulting rooms?


It is vitally important that children have a positive attitude towards dentists and dentistry. When a parent comes into the dental surgery and says they hate coming to the dentist or they would never be so brave it defeats the purpose of everything we have being working to achieve.


After a first visit, at what age should the toddler next see the dentist?


Children should see the dentist regularly every 6 months. This gives the child and the dentist a chance to build up a rapport with each other and the regular appointment will ensure that problems are picked up early.


Is there an age restriction on when a child can get fillings for the first time?


Dental decay is an infection of the tooth, it is caused by a bacteria. If left in the mouth then the decay will get bigger and spread from tooth to tooth. It is important that the fillings are done as soon as possible.


What are the main issues you face when working on toddlers? (behavioural, emotional)


Fear is the number one problem. Once the child is confident and pleased to come to the dentist then it is far easier to do dental procedures on the child. Children also have a shorter concentration span, dental visits have to be planed so that a child can cope.


What's the difference between a paediatric dentist and a regular dentist?


Paediatric dentists (or what we call in this country child friendly dentists ) are dentists that focus on the oral health of young people. They enjoy working with children, they are prepared to take the extra time to make the visit to the dentist pleasant and to establish trust and confidence that will last a lifetime.  They focus on prevention, early detection, and the treatment of dental diseases and keep up to date on the latest advances in dentistry for children.


Is it necessary for a toddler to see a paediatric dentist?


Yes, our main concern is what is best for your child.