Pharmacists play an important role in the promotion of oral health for children by not only encouraging parents and children themselves to look after their teeth but also by promptly referring patients to the dentist should they complain of toothache or orofacial pain.
Dr Geraldine Moses, Adjunct Associate Professor at the School of Pharmacy, University of Queensland, who also has an advisory role with the Australian Dental Association, emphasises the importance of increasing oral health literacy to understand the importance of good oral health.
“We have a lot of work to do, ensuring that people of all ages know even the basic things such as to clean their teeth, to do this regularly and how to clean their teeth properly, even little kids.
“Pharmacies are a great place for oral health education because we are available for advice, and the ability to take people to the oral health section in the pharmacy and help them purchase the tools they need,” she said.
Teething
One concern parents may bring to their pharmacist can be infant teething. Dr Moses emphasises that teething is a normal process. Teething can “hurt a bit, but it’s not very painful.”
However, in providing advice, “We need to move away from the instant recommendation of teething gels”, she said.
Dr Moses said, “the ingredients in them [teething gels] are fairly old-fashioned.” Teething gels “either contain salicylates which are distant relatives of aspirin.” She said teething gels have “very little analgesic effect” and “probably only work for a few seconds.”
“The other ingredient that can be in teething gels is local anaesthetics, and these are, frankly, dangerous.” Dr Moses emphasises that the danger presents when the teething gel is “applied too copiously and by overenthusiastic parents.”
“We need to understand that applying this to the infants’ gums could numb the whole mouth and the throat, which can impair the baby’s ability to swallow properly and protect their airway.”
“If you want to give an infant something to relieve their teething pain, give them paracetamol or ibuprofen, to swallow, since administered systemically, it works much better.”
“It’s safer and will last longer because we know each dose of paracetamol lasts for about four to six hours. A dose of ibuprofen will last for six to eight hours.”
Caries and infection
Dr Moses said that caries (holes in the teeth) and infection are common causes of toothache in children, both of which are largely due to poor oral hygiene practices.
Dental caries, commonly known as tooth decay, refers to the development of cavities in the teeth. Dental decay is experienced by two in five children aged five to 10.2
Dr Moses said the development of caries is usually due to “poor oral hygiene” and “parents not taking enough of an active role in ensuring that their children know to clean their teeth and how to clean their teeth.”
“There can be all sorts of infections around the mouth, and they do occur in children that can be very severe [and] very, very painful,” she said. “for example, abscesses can grow either on the gum or go down the root.”
Dr Moses said if anyone is concerned about swelling in a baby’s face, they should go “straight to the dentist” and “if it [the swelling] looks like it’s spreading, they should go to the hospital.”
“A very bad abscess in the mouth area could very quickly become a widespread infection with septicemia, which can be fatal. As infection from an oral abscess can spread very quickly, a swollen face should be viewed as a medical emergency.”
“For all of these things, you’ve got to get an accurate diagnosis. Remember, it’s outside of our [pharmacists’] scope of practice. So, refer these patients to a dentist if you’re not sure what the diagnosis is.”
“in the meantime, however, You can help the child with their pain by administering systemic medications like paracetamol or ibuprofen or both, simultaneously.”
Pharmacy’s role
Dr Moses said if pharmacists are concerned about a child’s teeth, it is “important it is to get to a dentist quickly and to resist the temptation to send them to a doctor.”
Adding, “pharmacists can educate people to recognise that little kids should see a dentist, from about the age of two.”
“The biggest thing I want people to know and pass on to other people is to stop being scared of dentists,” she said.
“We need to educate parents e that if they are anxious about going to the dentist, that’s what they’ll teach their children, and that’s not helpful. Dentists are lovely people and a dental check-up is generally pain-free.”
The ADA found that “58 per cent of parents didn’t know if they were eligible for free dental care for their kids through the Government’s Child Dental Benefits Schedule.”3
Spreading awareness about free dental care for children is a key way pharmacists can help to promote oral health and prevent toothache and pain. Dr Moses encourages pharmacists to “refer people to their dentist ” and “remember there are public dental clinics, which can cost nothing.”
References:
- Australian Dental Association. ‘Oral Health Tracker’. 2018. <ada.org.au/Dental-Professionals/Australia-s-Oral-Health-Tracker/Australia-s-Oral-Health-Tracker-Children-and-Young/ADA_AHPC_oralhealthtracker2018_childrenandyoungpeo.aspx> [accessed: 1.12.2022].
- Australian Institute of Health and Welfare. ‘Australia’s Children’. 2020. < aihw.gov.au/getmedia/6af928d6-692e-4449-b915-cf2ca946982f/aihw-cws-69-print-report.pdf.aspx?inline=true> [accessed: 1.12.2022].
- Australian Dental Association. ‘Dental Health Week: Oral Health Habits on Trial’. 2022. < ada.org.au/News-Media/News-and-Release/Media-Releases/DHW-Oral-Health-Habits-on-Trial> [accessed:15.12.2022].
This feature was originally published in the February issue of Retail Pharmacy magazine.
