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left;">世界卫生组织对口腔健康提出的目标是：到80岁还有20颗功能牙?？墒亲钚驴谇涣餍胁⊙菹允?，我国3岁儿童有一半已出现蛀牙，5岁儿童乳牙?；悸蚀?0.9%。而12岁儿童已经有1/3的人恒牙出现了蛀牙。想和口腔里二三十个“小伙伴”健健康康地相伴到老，似乎不是一件很容易的事。</p><p style="text-indent: 2em; text-align: left;">日前，广州日报健康有约名医大讲堂微课邀请到广州市妇女儿童医疗中心口腔科主任医师叶金梅、副主任医师龙宝军，详解家长们关心的口腔健康问题，聊聊作为家长，我们可以怎么做帮助宝宝拥有一口好牙。</p><p style="text-indent: 2em; text-align: left;"><strong>乳牙三问</strong></p><p style="text-indent: 2em; text-align: left;"><strong>为什么孩子出牙换牙比别人晚？</strong></p><p style="text-indent: 2em; text-align: left;">“为什么我的宝宝九个月了都还没长牙？”“班上很多同学都开始换牙了，我孩子还没有动静，正常吗？”乳牙萌出、换牙时间的早晚，让不少家长焦虑。</p><p style="text-indent: 2em; text-align: left;">“出牙、换牙的早晚，最主要还是遗传因素，和营养没有太大关系，不用刻意补钙?！币督鹈分赋觯檠烂瘸龅钠骄奔涫?个月左右，4个月~1岁左右都是正常的。20颗乳牙全部萌出的平均年龄是2岁半，早的接近2岁，晚的接近3岁。只要婴儿常规体检正常，出牙稍微晚几个月也不需过分焦虑。宝宝出牙期间可能会低热，但如果高烧到38℃、39℃，则更可能是感染性发烧。出牙的主要不适是牙龈可能会发痒、发胀，孩子喜欢咬东西，可以给孩子提供磨牙棒缓解症状。</p><p style="text-indent: 2em; text-align: left;">至于替牙时间，平均在6岁左右，早的可能4岁半、5岁开始，迟的可能七八岁。男孩子换牙时间一般都比女孩子晚一两年。一般持续6年，到12岁左右，恒牙就基本出齐了，出齐的年龄相差一到两年也很正常。</p><p style="text-indent: 2em; text-align: left;">龙宝军表示，如果乳牙有一点松，恒牙尚未萌出，只要没有影响饮食，就不主张干预，也不要用手去摇松乳牙，顺其自然就好。但如果乳牙太松，即便没有恒牙萌出，也容易导致发炎，可以拔掉。恒牙已经萌出的话，一般都要拔掉对应的乳牙。</p><p style="text-indent: 2em; text-align: left;"><strong>为什么认真刷牙了，牙齿还会变黄？</strong></p><p style="text-indent: 2em; text-align: left;">叶金梅指出，龋齿风险有遗传因素，更主要是后天养护的过程中，和生活习惯、喂养方式有很大的关系。比如每晚两三次以上夜奶，牙齿腐蚀风险大大增加；酸的、甜的、黏的食物，吃完后不注意清洁牙齿，也容易被腐蚀?！坝新杪杷担何乙估锸乔孜鼓溉椋裁幢Ρσ不岬谩唐咳！科涫?，无论母乳还是牛奶，只要孩子是含着一口奶睡觉，牙齿腐蚀风险都大增?！彼ㄒ?，要尽量避免夜奶，孩子夜间哭闹未必是饥饿，而可能是一种习惯，可以尝试在孩子迷迷糊糊的时候喂些清水，慢慢过渡到不需要夜奶。</p><p style="text-indent: 2em; text-align: left;">有家长提出，为何每天认真刷牙，宝宝牙齿还是会变黄？龙宝军介绍，牙齿的邻面，用牙刷刷不干净，建议每天至少用一次牙线清洁牙缝，可以选择带手柄的牙线，更加便于使用。有的孩子会出现牙齿变黄或变黑，可能是龋齿，也可能仅仅是色素沉着，需要牙医进行判断。色素沉着主要是由于刷牙没刷干净、唾液里一些成分比较高、吃了含色素重的食物后没有及时清洁牙齿等原因引起。“色素一旦沉积，靠刷牙刷不掉，如果影响到孩子外表、自尊心，可以到医院里面由专业的医生用打磨、抛光等方式洁牙?！?/p><p style="text-indent: 2em; text-align: left;"><strong>快换牙了，乳牙烂了还要处理吗？</strong></p><p style="text-indent: 2em; text-align: left;">孩子5岁，发现乳牙有蛀牙，还需要补吗？叶金梅介绍，乳牙的硬度比较小，加上孩子的食物中往往有甜、黏的特点，一旦发生龋齿，发展速度很快。</p><p style="text-indent: 2em; text-align: left;">一些家长根据自己经验，认为反正孩子都要换牙，不需要补了?！捌涫等绻檠乐?，长出来的恒牙的位置、颜色、形态、质地，都会打折扣。比如，乳牙蛀牙不处理，烂到牙髓里、根尖发炎，而恒牙胚就在乳牙牙根分叉下，周围环境发生变化，会污染恒牙胚，还会使恒牙胚远离原本位置，发生错乱。”叶金梅说。</p><p style="text-indent: 2em; text-align: left;">另外，乳牙伴随生长发育重要阶段，乳牙不好，对颌骨、面形、饮食都有影响。因此，建议发现龋齿要马上进行处理，防微杜渐，“充填龋齿没有痛感，治疗效果好，否则等烂得很大了，就要花更多时间、精力、费用去处理”。</p><p style="text-indent: 2em; text-align: left;"><strong>从第一颗牙起做好这三件事</strong></p><p style="text-indent: 2em; text-align: left;">1. 早晚认真刷牙：</p><p style="text-indent: 2em; text-align: left;">从长第一颗牙齿开始，家长就应该在早餐后、晚上最后一顿奶之后给宝宝认真刷牙。牙齿颗数还不多的时候，可以用指套牙刷，刷牙较软、对牙龈刺激少。随着年龄增大、牙齿数目增多，则儿童牙刷的清洁力度更大。</p><p style="text-indent: 2em; text-align: left;">刚开始给孩子刷牙时，可以只用清水，也可以选择一些可吞咽的儿童牙膏，等到孩子三四岁可以自行吐出，改用普通儿童牙膏就可以。至于是否需要含氟牙膏，美国牙医协会的指南明确，孩子从第一颗牙就可以用含氟牙膏，但要注意用量：3岁以内每次牙膏是米粒大小，3岁~6岁大概豌豆大小，哪怕宝宝少量吞咽，与氟中毒剂量相比还相距甚远。3岁前是否用过含氟牙膏，对5岁时是否患龋有明显差异，最好选择可吞咽的儿童低氟牙膏。</p><p style="text-indent: 2em; text-align: left;">有的宝宝对刷牙很抗拒，家长可以用表情、语言以及相关动画片、绘本让宝宝知道，刷牙是愉快的，和吃饭睡觉一样是生活中必不可少的一部分，把习惯建立起来就好办了。</p><p style="text-indent: 2em; text-align: left;">2. 定期涂氟：</p><p style="text-indent: 2em; text-align: left;">涂氟可以促进牙齿牙釉质再矿化，健康的牙齿6个月左右涂一次，已经发生蛀牙的3个月涂一次。以往建议两岁半开始涂氟，现在已经放宽至出第一颗牙开始就可以涂氟。</p><p style="text-indent: 2em; text-align: left;">3. 定期看牙医：</p><p style="text-indent: 2em; text-align: left;">从出第一颗牙开始，家长还应该带孩子定期看牙医，及早发现龋齿、颌骨发育畸形等异常情况，及早干预才能获得更好的效果。（记者伍仞通讯员易灵敏、周密）</p></div> </div> <p class="Editor">编辑：赵彦 </p> <div id="i2i2jyu4k" class="Paging"> </div> <p class="Keyword">关键词：牙医 ?；と檠?#32;攻略</p> <h1 class="pv_title_2 mt_15"><a href="/index.shtml" target="_blank" class="more mtb_14">更多</a><span id="i2i2jyu4k" class="t" id="a3"><a href="/index.shtml"><img src="/images/xg_t1.jpg" /></a></span></h1> <div id="i2i2jyu4k" class="pa_0_5_0_10"> <ul class="Related_ul bh_150"> <li><a target="_blank" href="/c/2018-07-03/2101635.shtml">暑假到了牙齿正畸了解下</a></li> </ul> </div>  <div id="i2i2jyu4k" class="advContent"><div style="height:40px"></div><script charset="gbk" 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