Many parents think that primary (milk) teeth are unimportant as they usually fall out well before puberty and are replaced by permanent teeth.

But early dental care is important, said DrHelena Lee of Specialist Dental Group (Henry Lee Dental Surgery) at Mount Elizabeth Medical Centre.

'Although primary teeth are replaced, it takes many years,' she said. 'Meanwhile, aside from the pain of treatment, these teeth are necessary for chewing, speech, self-confidence and space maintenance.'

Space maintenance is where primary teeth act as a guide for permanent teeth to grow into a space. Without them, permanent teeth may grow out crooked or may even 'drift' away from their rightful place, reducing the space available for the next tooth.

So what should parents do?

» Start young: The child's first dental visit should be at 12-18 months. This is less a check-up and more getting the child accustomed to the idea of seeing a dentist.

'It's better to start young,' said Dr Lee, 'so that by the time the pain starts and some dental work has to be done, they'll be used to it.'

Just as for adults, subsequent visits should be every six months.

Dr Lee said brushing should begin as soon as the first teeth emerge in infancy: 'You can dip a small cloth in hot water and gently brush the gums, or you can just use a clean finger.'

At the age of three or four, a child may be taught to brush his own teeth with a soft-bristled toothbrush, and to floss. But check that your child is brushing thoroughly and not just focusing on his front teeth.

'This is especially important when the first molars start to emerge at the back,' she said. This usually happens around the age of six.

» Prevent decay: Tooth decay is one of the most common problems facing babies and children today and can be extremely painful to treat. One way to reduce the risk of decay is to get children to brush thoroughly and frequently, at least twice a day. They should develop healthy eating habits too.

'Some children take an extremely long time to eat,' said Dr Lee, 'but the longer food is in contact with the teeth, the greater the risk of decay. Bacteria in the mouth that causes tooth decay feeds on the food.'

Don't let your baby fall asleep with a bottle in his mouth as the milk or juice may pool and surround the teeth.

Older children should cut down on snacking by eating more substantial meals and they should be made to rinse or brush after eating, said Dr Lee..

'Sticky' foods such as chocolate and gummies should be avoided as particles left behind may lodge between teeth and are hard to remove.

» Dealing with accidents: These usually affect the front teeth, causing them to chip, dislodge or even fall out.

If a tooth falls out, don't wash it or attempt to re-insert it. Instead, smear it with your child's spit or put it in a container of milk and take your child to a dentist immediately.

'Some parents scrub the tooth clean,' said Dr Lee, 'but this washes away whatever cells may be left on the tooth and makes it harder for the tooth to reconnect with the bone. Even if the tooth has fallen into dirt, the dentist will clean it before re-inserting it and prescribe antibiotics.'

If a tooth is only dislodged, however, the procedure is different.

'We will leave the tooth in the mouth to heal naturally, and maybe put the child on a diet of soft food for a few days,' said Dr Lee.

Treatment for chipped teeth depends on whether the root is exposed.

If the chip does not expose the root of the tooth, then it may be left alone. But if the root is exposed, a root canal may have to be carried out if the pulp beneath gets infected or inflamed.

'You may be scared of dentists, but try not to communicate your fear to your child,' added Dr Lee.

This article was first published in Mind Your Body, The Straits Times on Apr 23, 2008.