Today is week 7 of the school year 2018.

Caitlin was ok for the 1st week and then she has been crying consistently every morning when we drop her off at school. She started to refuse to go to ballet classes and refuse swimming, which we later really had to withdraw because she's so traumatised, she has been crying EVERYDAY whenever "swimming" was mentioned. I am very reluctant to take her off ballet because she has been rather happy in class until she begins Kindergarten. Maybe her anxiety was related to the starting of school, and a very new change in routine? I think we should hang on for awhile. Although she cries a lot when we drop her off, her teachers said she's alright once lesson begins and my mom said she looks happy when she fetch her from the school gate. I thought starting school late would prevent such crying episodes. I guess things do not go so easily for our headstrong girl.

Kieran has been enjoying weekly swimming. Progress seems to be slow but steady. I am hoping he will be able to swim very well soon. He has been scoring rather well for school spellings. Today he has a Math test. Not sure how he will do for that. Yesterday, I went through the revisions with him and he got all the questions correct. Last night he showed me a shaky front lower tooth. Yippee! Finally he is going to have adult teeth. Many of my group of "Rabbit babies" are experiencing the change and he's the last among them to have shaky baby teeth. My baby is growing up!

The children are sleeping on their own beds, and in their own room now. We got a low bunk bed for them from Palette Box. In the middle of the night, I will sometimes hear a soft "mummy" and will pull a tiny little girl up and settle her in my bed, between hubby and me. Kieran loves his bed and he has never woken up to look for us in the middle of the night. I hope, in a few months' time, we will get peace and quiet in the night.

Caitlin has bad tooth enamel that encourages decay

The dentist told me that Caitlin's tooth enamel were badly formed, that is why she gets cavities easily. Badly formed enamel already has lots of pits that trap food. Sigh.

What we can do now is to brush her teeth twice a day with fluoride toothpaste and at night, we let the toothpaste with fluoride remain on her teeth, and dap a bit of fluoride toothpaste on the cavities. And also, we have to wean her off the night feeds (she can't have fluoride on her teeth and then drink milk right?) which I have already done when I found out that she has so many cavities. Fluoride therapy, the dentist said, would delay the progression of decay until she is old enough to go through the procedure for filling. The brown spots will not go away but will not get deeper, and some beginning decay may remineralise.

Badly formed enamel... that never happened to Kieran. He has nice teeth although two of his molars had decay which were filled. Being experienced with dealing with tooth decay with my older child, I was very diligent with brushing and cleaning of teeth for Caitlin, my second born, so why does the decay still happen? Why was her enamel so weak and badly formed? I'm agonising over these questions. So I did some research.

Breastfeeding mothers does not need to rush to wean their babies off night feeds to prevent decay. In fact research has shown that breast milk can protect baby's teeth from decay. Unfortunately, research has also shown that night nursing exacerbates decay if baby already has cavities. A lot of factors goes into baby tooth decay. It could be genetics, medications mother took while pregnant and affected the formation of baby teeth, mother's health while pregnant with baby, presence of bacteria that caused the decay (the sugar bugs) and of course parents' diligence in brushing and taking care of babies' teeth. I've read that antibiotics caused weak tooth enamel. I'm avoiding antibiotics for my kids unless absolutely necessary. I had a very serious episode of stomach flu that required hospitalisation and strong medication while I was 8 weeks pregnant with Caitlin and I thought that might be the reason for her badly formed enamel. Every time I brush her teeth, or see her smile, and see those cavities, I say sorry to her. I'll take extra good care of her teeth now. I hope she won't have to go through too extreme restorative dentistry work that requires GA, and I certainly pray this won't affect her permanent adult teeth.

Read more about weak tooth enamel here.

Mothering

The thing about being a mother is that we are always worrying about our children. I have been telling myself to relax but I really can't. If my child shows a slight indiction that he may be developing a fever, I will panic, and if my child gets a tooth cavity, I will see it as an indication that I am a bad mother, that I haven't been taking good care of the children. Care for the children is never enough. There's always more to be done, more to do, more to perfect, and so on.

Top items in my worry list are now Caitlin's front teeth cavity and Kieran's phonics. I'm trying to see if I can help her teeth remineralise by giving her the appropriate vitamins and starting her on fluoride and xylitol brushing since she now can spit out after gargling. Caitlin is a stubborn and fiery little one. Getting her to accept me brushing her teeth is like fighting a battle with her. I have found a way to get her to cooperate a little bit more, which is to let her watch an iPhone app of a cute panda brushing his teeth and then gargling. I can set the brushing timer to as long as I like. She finds it interesting and often laughs at the silly panda, so I place the phone with the app running in front of the wash basin and coax her into brushing. If she struggles, then well, I have to keep brushing despite her cries. It's sad to see her struggling twice or thrice (sometimes I brush her teeth in the afternoons if we are not outside) everyday during toothbrushing but that is better then seeing more cavities on her teeth. She has about 5 small but noticeable ones on the front teeth. The back molars look alright and all of her lower set of teeth are nice. I don't know how the decay only happens on the front ones.

Kieran is now learning very fast and to help him absorb the good stuff, I'm reading a lot to him, teaching him to recognise simple Chinese words, and to learn to write simple letters and strokes. He's progressing at a snail speed but at least there's progress and he won't go to Kindergarten next year not knowing anything. I'm also teaching him phonics myself using this teaching tool: The ordinary parent's guide to teaching reading. There's an audio companion which I borrowed from the library. While teaching, I also learn valuable lessons on phonics. I'm convinced that phonics help young children read better, and he has to read, otherwise he can't even understand math problems at Primary One. If he don't finish learning phonics by K1, he will confuse it with Han Yu Pin Yin that he will learn in K2.

So being a mother, we have no time to relax. My favourite way to "relax" is sipping hot, bitter-sweet black tea in a cooling air conditioned room, away from the suffocating heat in the rest of the house, and temporarily away from that forever "Mama! Mama!". Sweet black tea works wonder for my soul. 苦中作樂，因為人生就是甜中帶苦，苦中帶甜。

Caring for children's teeth

I'm just sharing some tips by the paediatric dentist on caring for the preschooler's teeth:

• Bring the child to see the dentist when she is young (some recommend when the first teeth sprout) to get her used to seeing one, so that when she needs cleaning or treatment done later on, she's not so afraid. I started bringing Kieran for dental visits when he was two years old. I was a bit late. Many started at one year old or younger.
• Brush the child's teeth three times a day. By this time, the child will have all his baby teeth. And he would have learnt how to spit out water after gargling. So you can brush with a fluoride toothpaste. 
• Use an adult strength fluoride toothpaste. The dentist recommended one with 1400ppm (the strength of fluoride in the toothpaste). We bought one with tutti fruitti flavour at 1350ppm, which is close enough. The fluoride will help to re-calcify the enamel if food/acid/juices decalcify it. This prevents decay. Kieran will not use an adult's toothpaste because of the mint.
• Floss the teeth which are close and tight together as trapped food will cause decay. Kieran's teeth have tiny spaces in between them which the dentist say is great because these are spaces for adult teeth to come in. That is good news for us because it means we only need to floss between those teeth that are tight together which is between the molars and between the two front teeth, total of 5 times.
• Floss at least once at night. I floss whenever his teeth trap food which is after every meals. But then I'm a SAH(Paranoid)M so it's my prerogative. Haha!
• Reduce teeth contact with food/milk/juices. Kieran usually had a bottle of milk to sip throughout the morning. I changed it to lesser amount of milk so that he can finish the milk quickly and brush his teeth. He also took very long to finish his meals so now I time him and coax him to finish his meals within an hour. He has some vitamin gummy bears a few times a week. I let him eat them before lunch, then the sweet stuff will be chomped away while he eat his lunch, and then brushed away after lunch. I also reduced his intake of sugary drinks when we go out. I used to buy him yakult or strawberry milk or fruit juices to drink while he's on the stroller. Now he drinks plain water and he only have these sweet stuff occasionally after meals and then brush after drinking it.

The paediatric dentist said his mouth and gum shape is very good and is genetically determined for a nice set of adult teeth. I hope this means no need for braces. He must have gotten the good genes from his daddy. Hubby has a beautiful set of teeth that look like you know the silhouette logo you see on 黑人牙膏 packaging? Haha!

Now, I'd also like to share some tips from another dentist on getting the preschooler to fill his teeth:

• Prepare him for the treatment. Talk to him about it, show him videos about filling teeth. Tell him that it will be quick and painless (which is true, contrary to what we believe! No, Kieran does not need local anaesthesia at all for his filling. But then again that's because his cavity was shallow. If your child needs a root canal, it will be a different story.)
• Get the calmer parent, and the parent whom the child is less attached to to accompany him into the dentist's room. In my case, it is the daddy. Kieran fussed to see mummy and the dentist and daddy said he could very soon if he will be cooperative. Daddy won't give in to his cries and whims, unlike me! So this is a very good decision, to let Daddy go in for treatment with him.
• When you bring the child for his first visit, let him get used to seeing the dentist and build a rapport with her, and let her do some less scary treatments like cleaning and polishing and checking the teeth. This also allows the child to not be afraid of lying down on the dentist's chair.
• The dentist's clinic has a computer on top that lets him watch cartoons on youtube while she fills his teeth so that's a very good distraction.
• Give a small toy as reward to the child for being brave after he has done his treatment. Kieran has been saying that he wants a doctor's toy set so we got it for him and passed it secretly to the dentist, and the dentist said she will give it to him after he gets his tooth cavity cleaned and filled. He was allowed to hug the toy while she filled his teeth.

I am so happy to see the black spot on his tooth replaced with nice white composite filling. Kieran hated brushing his teeth like all preschoolers but it's our job as parents to make sure he gets his teeth clean no matter how much he hates it. Clean teeth means no toothache, no heart pain, no anxiety and no need to worry about coaxing the child to do dental treatment, and of course, less money spent.

I noticed some greyish spots on his teeth but I guess decalcification has already taken place on some molar crevices, so I'm extra vigilant. Even if it's the festive period now and sugary temptations are everywhere, there can be no slacking off the brushing and flossing for mummy and daddy.

Kieran's cavity is filled!

Kieran's dental appointment went fantastically well! I was so happy that I finally can eat and sleep without worrying!

At the dentist's advice, daddy went into the dentist's room with Kieran instead of me. Both daddy and the dentist were pretty strict with Kieran. I heard him cry for mummy and my heart broke but my nerves were racking and it really was better for me to stay outside. My anxiety could scare Kieran. Amazingly, in 5 minutes, I heard the dentist praising Kieran because the cavity has been filled! I was so happy outside the dentist's room that I almost cried tears of joy. This means no more GA! No more dental surgery that puts my dear son at risk!

There is another cavity at the side of his molar, in between both molars but the dentist say it's too small for her to place the excavator in to dig in and she will review him next month to see if the cavity has grown big enough for her to dig. If it is still small by then, he only has to do it when he's older. Meanwhile, we floss and brush well for him.

That left hubby and I wondering why the paediatric dentist we brought Kieran to earlier on said he must do the fillings by GA when one cavity could be filled so easily? Another puzzling thing is the paediatric dentist said she will fill both larger cavities at the molars as well as other 5 smaller cavities (which the dentist who filled his teeth said are not cavities), and also put sealants on all his molar crevices, and this process will take 1.5 hour and of course charge us doctor's fee for 1.5 hour which comes up to a thousand plus! But one cavity could be filled in 5 minutes for a child who is awake and requires coaxing. If the child is not even struggling, I bet she could do it in 2 minutes. So why the 1.5hour huh?

Anyway, we have decided that he does not need the GA. But we have stupidly paid the doctor's fee at the clinic to secure a date for the GA, so we need to get the refund back from the paediatric dentist's clinic. I called earlier and the clerk said if we decided not to go ahead, we can get a refund. I don't know whether they will honour their words? I certainly hope so because it is expensive!

The lesson learnt? Always always always get a second opinion. Never rush into making decisions.

And a more important lesson: always brush and floss your child's teeth very DILIGENTLY three times a day, morning, afternoon and night, especially at night before bedtime. That could save you and your child lots of pain!

For tips on caring for your preschooler's teeth, see my blog post here.

Booking Dental Appointments

Kieran has a cavity on this molar for quite some time. And we have to get it fixed asap.

Recently, to our horror, I found out that Caitlin also has one cavity on her front teeth.

I did some research and we have two choices, School Dental Clinic at Health Promotion Board and Dr Ong Yean Sze's Kids Dental World at Mount Elizabeth Novena Hospital. I don't think SDC treats Caitlin since they treat preschoolers. And since Kieran has a cavity, I think its better to go for a paediatric dentist who is well known for her skills with young children. I'm so frightened that I really hope hubby can come with me to the dentist's visit with me and Kieran. We booked the appointment date two weeks later. They actually have an available slot tomorrow at 3pm but I was afraid that Kieran can be very cranky since its afternoon after his lunch. Caitlin's appointment is in Feb, before Chinese New Year. I hope that they will be very cooperative during the visit and I hope his cavity can be filled without much trouble, without the need for GA or anything.

Simply calling the dental clinic makes me all nervous. I hope I didn't take that cup of tea this morning. It makes me more anxious and jumpy.