Pediatric Dentistry
Oral and dental health should be taken care of from infancy onwards. In order to have healthy teeth, it is essential to have regular check-ups from infancy onwards and to protect oral and dental health with interventions when necessary. The field of dentistry that deals with oral and dental health from birth to adolescence, i.e. between the ages of 0 and 13, is defined as paediatric dentistry.
Pediatric Dentistry
Contents
When Should Children Have Their First Dental Check-up?
The first visit to the dentist should occur when the first milk tooth erupts. During the first visit, the dentist will provide information on how parents can maintain their baby’s oral hygiene. The baby’s medical and dental history is taken during the initial examination. An intraoral examination is performed during the patient’s first visit, and the patient’s susceptibility to tooth decay is assessed. The patient is guided according to their development, fluoride needs, habits outside of normal nutrition (bottle, pacifier, etc.), protection from trauma, and the effects of oral hygiene and eating habits on their teeth. The first visit to the paediatric dentist or dentist is important in terms of acquiring information that could be beneficial for the baby throughout their life. In addition, children’s dental health is important for the early diagnosis of the following procedures and precautions.
- Oral and dental health check-ups
- Teeth cleaning and fluoride treatments
- Correction of dental structure abnormalities
- Correction of improper bite behaviour
- Root canal treatment
- Baby bottle tooth decay treatment
- Fissure sealant applications
- Root Canal Treatment
How Many Baby Teeth Are There and When Do They Fall Out?
A total of 20 teeth erupt during infancy. The timing and duration of the eruption of these 20 teeth vary. The timing of the eruption of the same teeth in the upper and lower jaws may differ. The first milk teeth to erupt in babies are usually the central/middle incisors, defined as the middle front teeth in the lower jaw. These teeth are followed by the lateral incisors, which also erupt in the lower jaw. After that, the upper incisors appear. Although teething in babies usually begins around the 6th month, delays may occur in some cases. It is generally correct to express this period as between 6 and 12 months. All milk teeth are expected to have erupted by the 33rd month.
Baby teeth usually begin to appear around the 6th month after birth. All baby teeth will have appeared by the age of 2.5–3 years. The complete shedding of baby teeth continues until the age of 12. The first baby tooth usually falls out around the age of 6, and adult teeth begin to appear. After the first baby tooth falls out, the baby teeth fall out one by one and are replaced by permanent teeth. Between the ages of 6 and 12, both baby teeth and permanent teeth are present in the mouth. In some children, the first permanent teeth to appear are the molars, while in others, the incisors appear first. By the age of 13, most of the 28 permanent teeth should have erupted. The four third molars, known as wisdom teeth, erupt between the ages of 17 and 21, bringing the total number of teeth to 32. There may be delays and problems with the eruption of wisdom teeth.
Why Do Baby Teeth Fall Out?
Baby teeth act as space maintainers. This is fundamentally due to the structure of the jaw. Baby teeth act as space maintainers and make room in the jaw for permanent teeth. Baby teeth in humans usually begin to fall out around the age of 6, but not all teeth fall out at the same time. When the teeth we refer to as permanent teeth are ready to erupt, the root of the baby tooth begins to dissolve and the tooth falls out. This makes room for the permanent tooth.
Should Baby Teeth Be Treated?
Baby teeth are often neglected because they are temporary, but this is absolutely, absolutely not the right thing to do. Healthy baby teeth are very important for the structure of the mouth and jaw. In addition, healthy baby teeth are also very important for infant and child development. Baby teeth hold the place for permanent teeth, so if they are not cared for and treated, their loss can lead to malformations in adult teeth. Furthermore, baby teeth are very important for chewing and speaking. For children to avoid speech disorders and developmental problems related to chewing difficulties, it is essential that their baby teeth are healthy.
What are Dental Diseases in Children?
Bottle Rot
Early childhood caries, also known as nursing caries or bottle syndrome, occurs when baby teeth are frequently exposed to sugary drinks and sugar. When breastfed babies fall asleep with milk in their mouths or hold onto the milk, the risk of tooth decay arises. Preventing bottle tooth decay involves paying attention to the consumption of sugary foods and ensuring that the baby drinks some water after breastfeeding and feeding. Decay of milk teeth can lead to tooth abscesses and the spread of infection to different parts of the body.
Early Tooth Loss
Early tooth loss may occur due to decay or trauma. Early tooth loss in primary teeth can cause problems with the alignment of permanent teeth. Teeth that erupt crooked, misaligned, or improperly positioned can cause chewing problems and temporomandibular joint problems, in addition to malocclusion. Therefore, early tooth loss must be monitored. To prevent problems that may arise in cases of early tooth loss, space maintainer treatment can be applied. This treatment preserves the space occupied by the lost tooth. This ensures that no problems arise in the alignment of other teeth, while also preserving the space for the adult tooth that will replace the lost baby tooth.
Thumb Sucking – Lip Sucking
It is normal and healthy for babies to suck their fingers, toys and dummies. However, continued thumb sucking beyond a certain age can cause problems with the alignment of permanent teeth. Depending on the frequency and duration of sucking, problems with tooth alignment, excessive biting behaviour and speech problems may arise.
Tongue Pushing
The behaviour of pushing the upper part of the tongue towards the lips is called tongue thrusting. This causes pressure on the front teeth and makes them more prominent. Tongue thrusting is a condition that must be treated as it can cause speech and biting problems.
Retention in Milk Teeth
In some cases, the milk tooth does not loosen and the permanent tooth underneath begins to emerge from the same place. The retention of the milk tooth may occur due to the presence of two teeth in the same area or the absence of the permanent tooth.
What are the signs of teething in babies?
Babies normally start teething at 6 months. However, just as every baby develops at a different pace in terms of walking or talking, it is natural for there to be variations in the timing of teething. A baby who gets their first teeth at 5 months is just as healthy as one who gets them at 8 months; there is no cause for concern. During this time, you can observe your baby’s symptoms and, if they are experiencing teething discomfort, apply methods to soothe them.
The following symptoms may be observed in babies who are teething:
- Increased saliva
- Putting hands in mouth
- Chewing on foreign objects
- Pulling at ears
- High fever
- Redness on cheeks
- Diarrhoea
- Restlessness
- Disturbed sleep pattern
Teething is one of the problems that families struggle with as much as babies do. It is extremely important for parents to remain calm when trying to comfort a baby who is crying because of teething. There are several ways to comfort a teething baby:
Teething and chewing: When teething, babies love to put whatever they find in their mouths to rub their gums. The pressure and rubbing motion applied to sore gums is very soothing for babies. Special teething toys produced for this purpose greatly comfort babies who are teething.
Cold application: Teething toys designed especially for babies, particularly those filled with liquid or gel, can be cooled in the refrigerator and given to the baby. This numbs the gums, which the baby will find very soothing. If you place these toys in the freezer compartment of the refrigerator, they may become excessively cold and could damage the cheeks or gums. Therefore, you should ensure they are cooled in the refrigerator compartment and supervise the baby’s use of the teething toy.
Cold foods: If your baby has started eating solid foods, they will prefer cold foods over hot ones. Yoghurt is both nutritious and refreshing, and can be a lifesaver for teething babies! Apples, pears and carrots placed in a mesh feeder also have a very soothing effect. Did you know that babies teething also love the core of fresh pineapple sold in supermarkets? Please ensure that every food you give is age-appropriate for your baby and that they consume it under your supervision.
Pain reliever: Pain-relieving gels applied to the gums are no longer approved by the FDA as of 2018. Studies suggest that the active ingredient ‘benzocaine’ in these gels may cause serious problems by reducing the oxygen-carrying capacity of red blood cells. They were not particularly effective anyway. If none of the methods mentioned above are helpful, then you may need to give your baby a fever reducer-pain reliever as recommended by your paediatrician.
Local medication application: Gels applied locally, such as “Calgel” or “Dentinox gel”, are massaged into the area of redness to help soothe the baby.
What Treatments Are Used in Paediatric Dentistry?
Fluoride Treatment: Fluoride is a mineral used to strengthen the enamel of children’s or adults’ teeth. It is applied to milk teeth because their enamel is thinner than that of permanent teeth. Fluoride treatments are performed to strengthen the structure of teeth due to the high susceptibility of children’s teeth to decay. Fluoride gel is applied to the teeth and the fluoride accumulated in the mouth is spat out after approximately 4 minutes. The application is suitable for children aged 4 years and older.
Fissure Sealant Treatment: Fissures are grooves on the tooth surface that are difficult to clean, leading to bacterial accumulation. Fissure sealant application is performed by covering the grooves on the tooth surface, called fissures, with a gel.
Space Maintainers: Space maintainers can be used to prevent changes in the alignment of surrounding teeth and to ensure that the permanent tooth expected to erupt does not experience space issues when baby teeth are lost prematurely. Space maintainers are used to protect the space that the lost tooth should occupy. Depending on the number of lost teeth and the condition of the teeth, the maintainer can be designed to be fixed or removable.
Filling: Filling treatment for milk teeth is preferred to protect both the milk tooth and the space for the permanent tooth. The belief that milk teeth do not require treatment is incorrect, and failure to treat them can lead to serious problems in the long term. Therefore, filling milk teeth carefully, with priority given to avoiding damage to other teeth during the procedure, is a treatment that should not be neglected.
Amputation: Unlike root canal treatment, this procedure involves removing the infected, inflamed, or decayed portion of the pulp and leaving the remaining portion behind. If amputation treatment is ineffective in children, root canal treatment or tooth extraction may be considered.
Root Canal Treatment: Root canal treatment is a type of treatment that can be performed to save primary teeth in children. Treatment can be performed with the aim of preventing primary tooth loss. (12) Root canal treatment must be performed very carefully. As the roots of primary teeth are much more sensitive and shorter than those of permanent teeth, the treatment must be performed with great care.
What is the Purpose of the Flor Application?
One of the methods frequently used by dentists is a procedure called fluoride treatment. The main purpose of this procedure is to strengthen and maintain the enamel, which is the outer visible structure of the tooth. It helps make the tooth more resistant to decay and also strengthens the tooth surface, which is the most frequently used part. It is extremely easy to apply for every individual and tooth type requested. The procedure takes only 5 minutes to complete. After the procedure, it is recommended that the patient refrain from eating for approximately 1 hour. This will ensure that the effects of the procedure last longer. Depending on the individual, tooth structure, or usage, the procedure provides protection for 4 to 6 months.
Which Teeth Are Treated with Fluoride?
Although it varies depending on the structure or treatment of the teeth, this type of application is generally used to strengthen the white part of the tooth, i.e. the enamel. For this reason, it is widely used on teeth that need to be strong against decay, especially in children but also in adults. There are no restrictions for those who wish to have it done. It can be applied to all types of teeth. It is sufficient for the patient to request it and for the dentist to deem it appropriate. This makes the teeth stronger. The purpose of the application is to help the tooth store the substance called fluoride, which it needs. As the application is effective for up to 4 or 6 months, it does not need to be applied frequently. For this, the dentist must be consulted.
Is Flor gel a chemical? Does it have any side effects?
This procedure can be summarised as applying a substance called fluoride to the teeth and allowing the teeth to absorb it. The use of this substance is not harmful to health and does not cause any side effects. Although this may vary depending on the dentist performing the procedure, there will be no problems if it is done correctly. As the effect lasts for 4 to 6 months, it does not need to be performed frequently. This procedure, which can be easily performed on children and causes no pain, is generally harmless. As it is a method recommended by dentists to protect teeth and make them stronger, you should definitely consult your dentist for information before having it done.
What should be considered after applying Flor gel?
The fluoride application is a system that is used quite frequently and has no side effects. It is used to contribute to healthier and stronger tooth enamel. This procedure basically takes about 5 minutes to perform. After the application, eating and drinking should be avoided for approximately 1 hour. It is not recommended to consume milk and dairy products within 24 hours. The procedure can be easily performed on all patients who request it. The results are also quite satisfactory. For this, the duration of the application is extremely important. Depending on the user, this procedure can be successful for up to 6 months. The average is 4 or 6 months.
What happens if dairy products are consumed after applying Flor gel?
Fluoride is an element that plays a role in strengthening and hardening tooth structure. Scientific studies have shown that teeth have a stronger enamel layer after fluoride application. Fluoride application is a procedure that can be performed on children. Reports prepared by competent institutions have indicated that fluoride application does not reach toxic levels and that this procedure plays an important role in maintaining oral health. Fluoride application is a procedure that takes approximately 5 minutes. There are points to consider after the fluoride treatment, which is applied in a short time. It is recommended to refrain from eating and drinking for 1-2 hours after fluoride application. Additionally, it is necessary to avoid consuming milk or dairy products for 24 hours. While consuming milk does not harm the child, it may reduce the expected benefit of the application.
How Should Oral Care Be Performed in Children?
Dental care for children, as with all ages, begins with brushing teeth at least twice a day using the correct and effective method. In addition to brushing, in paediatric dentistry, it is also important to take protective measures for teeth that are prone to acid attacks at a young age. To this end, the application of fissure sealants, which cover the deep pits on the chewing surfaces of molars, is extremely effective. In addition, depending on the child’s needs, topical fluoride application to the tooth surfaces is recommended every six months or once a year. Although there have been various discussions in the press recently about fluoride application in paediatric dentistry, the benefits of this application have been demonstrated by scientific studies in international academic platforms. Unless a study to the contrary is published, it is recommended by paediatric dentistry specialists. With these methods, which can be applied from the age of 4, your child’s teeth will be protected from acid attacks and the risk of decay will be reduced.
- After meals, wipe your baby’s gums with a clean, soft cloth
- Do not allow your baby to fall asleep with a bottle
- Do not put sugary foods on babies’ pacifiers
- Pay attention to babies’ consumption of sugary foods
- Ensure that teeth are brushed twice a day from the age of 2
- Starting regular dental check-ups with the emergence of the first milk tooth, but no later than 1 year of age, is essential for maintaining oral and dental health in babies and children.
What is the Effect of Nutrition on Oral Health in Children?
Nutrition is not only a matter of paediatric dentistry and oral health, but also closely related to general health. There are many sugary foods on the market that are particularly appealing to children. Sugar, chocolate, jelly beans, cakes and similar foods are called ‘cariogenic’ or decay-causing foods for teeth. It may not always be possible to brush your child’s teeth after every meal. Consuming such ready-made foods is extremely harmful to children and even adults, first in terms of oral health and then in terms of general health. Directing children towards seasonal fruits to satisfy their sweet tooth is beneficial in terms of children’s dental health. Packaged, ready-to-eat snacks such as cakes contain additives such as sweeteners, preservatives, colourings, etc. They are not acceptable in paediatric dentistry. Instead, you can encourage your child to eat foods you prepare yourself. Instead of using refined sugar, you can sweeten foods with molasses, dried apricots, raisins, or foods such as apples, pears, and carrots to prepare healthy and nutritious meals.
Baby Teeth Will Fall Out Anyway, Is Care Important?
When cavities that form when milk teeth are not treated:
Tooth decay resulting in loss of tooth structure can lead to a variety of problems, including future orthodontic malocclusions,
progression to abscess formation in the tooth and swelling of the child’s face,
and, in cases where primary teeth are lost prematurely due to irreparable damage, eruption disorders in the permanent teeth that follow. Therefore, caring for milk teeth is extremely important in order to protect the child’s overall health and prevent orthodontic problems. If the tooth is too damaged to be treated, the child may need to have it extracted.
What Should Be Done After a Dental Injury in Children?
As children are constantly on the move, dental injuries in children are a common occurrence in paediatric dentistry. As a result of an impact to the tooth, loosening of the tooth, a broken baby tooth, a broken tooth root, or the tooth being knocked out entirely may be observed. In this case, if the child has no other pressing health issues, they should be taken to a paediatric dentist without delay. The tooth may be broken after the trauma. If the broken piece is found and brought to the dentist under appropriate conditions, it may be possible to reattach it. To do this, you must place the broken piece in a container filled with saliva as soon as possible, under conditions as close to the oral environment as possible. If the tooth has been completely knocked out, it should be washed with clean water without touching the root surface and brought to the dentist as soon as possible in a container filled with saliva.
Kartal Paediatric Dentist – Paediatric Dentistry
We offer treatments specifically for children, including milk tooth fillings, space maintainers and trauma management. We aim to provide a safe experience through communication that reduces anxiety and approaches that minimise pain.
What is a fissure sealant? Should it be applied to every tooth?
The grooved and indented surfaces of teeth are called fissures. A fissure sealant is a material used to cover these grooved and indented surfaces of teeth. The process of covering these surfaces with a fissure sealant is called fissure sealing. Fissure sealing is used to prevent cavities. The fissure sealing procedure is quite simple and painless. It is particularly ideal for people with teeth that have many pits and grooves.
Should all children have fissure sealants?
Children are prone to dental problems due to their developmental stage and their fondness for sugary foods. At the same time, it takes a certain amount of training and time for children to develop the habit of brushing their teeth. For this reason, although it is not mandatory for every child, the prevailing view is that dental vaccination is beneficial. Your dentist will provide definitive information on this matter. As the application is suitable for children of all ages and yields highly successful results, there is no issue with its implementation. The application, which means your children’s teeth will be more durable and protected against decay, has no harmful effects.
Is fissure sealant or fluoride more important?
Fissure sealants and fluoride treatments are procedures used in preventive dentistry for children. These procedures are not substitutes for one another; rather, they complement each other.
What does a fissure sealant do?
Fissure sealants are a method used in dental treatment. They are applied to protect the surfaces of molars. The grooves and pits that appear on molars are covered with a filling material called a fissure sealant. This significantly prevents the formation of cavities. This filling material has a fluid consistency. It is a highly successful treatment method for preventing decay. It is frequently used in children. It is essential to pay close attention to dental health in children. It is important to apply fissure sealant treatment to children to counteract the risk of decay. The procedure is completed in a very short time and is checked every six months to make the treatment more permanent.
How can tooth enamel be strengthened?
The hard structure on the outer surface of the tooth is called enamel. Over time, this enamel layer wears away and, if neglected, damages the inner structure of the tooth and causes tooth decay. Failure to take proper care of the enamel leads to tooth loss.
What happens if we don't have fluoride treatment?
One of the important factors for dental health is fluoride application. Fluoride application, which is also frequently used in children, includes measures to prevent tooth decay. If not applied, an acceleration in the formation of tooth decay may be observed. Tooth enamel is damaged and rapid progression of tooth decay is seen. The tooth structure cannot strengthen and gum problems may occur. Teeth become vulnerable to acid and bacteria. Crooked teeth are common in children and can disrupt the structure of the mouth. Orthodontic treatment may be required due to factors such as lack of fluoride application and inadequate tooth brushing. Bad breath is unpleasant and embarrassing for both the individual and those around them. Inadequate brushing and fluoride application can cause bad breath.
How is Fluoride Treatment Applied?
To make the white parts of the teeth, namely the enamel structure, more durable, a process called fluoride treatment is applied. This treatment essentially enables patients’ teeth to be more resistant to decay. It can be applied to any type of tooth. There are no circumstances that prevent its application. For the application, the front surfaces of the teeth must be cleaned of saliva. It is a simple procedure. The entire surface of the tooth is then coated with the substance called fluoride. The substance is liquid, fluid and quite easy to apply. The entire procedure takes an average of 5 to 10 minutes. The patient then resumes their normal life. The application and results may vary depending on the skill of the dentist performing the procedure.