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Pediatric Dentistry


Kids Dentistry What is the importance of deciduous (Milk) teeth?

Majority of people underestimate their milk teeth thinking that they will be replaced. However, these 20 milk teeth continue to exist to perform their duty.

The primary task of milk teeth is to ensure that food is prepared for digestion. Milk teeth reserve the place for the permanent teeth to arrive subsequently and guide them while such permanent teeth take their place. Especially, they protect the underlying continuous tooth germ against external factors such as traumas that are frequently observed in children. Additionally, milk teeth play an important role on the phonation. The proper development of speech is much dependent on the health of milk teeth. Moreover, milk teeth also have a cosmetic function. Since your child will see the loss of anterior teeth at the ages of 6-7, she/he will deem it normal, however early losses might cause psychological traumas.

What happens during teething?

While such indicators vary from children to children, they are generally observed 1-2 months before the teething.
Drooling: The amount of drooling increases in baby or child and there might be rush and cracks around the mouth.
Biting: A teething baby will try to relax his/her gingiva by trying to bite everything around.
Pain: The pressure on the gingiva during teething causes inflammation with associated pain. It causes uneasiness in the baby if the pain increases and continues. In addition, there might be loss of appetite, insomnia, diarrhea and fever.

In order to relieve the symptoms of teething:

Cold food can be given to the baby that he/she can chew. Cold food and drinks will attract their attention more compared to those served in room temperature.
Teethers can be provided.
If these are not enough, you can take certain medication by consulting your physician.

Why do the teeth of children decay?

The thickness of dentins of milk teeth is almost half of the permanent teeth. Moreover, their inorganic content is much less compared to permanent teeth. Consequently, they are prone to decaying more compared to permanent teeth.

Furthermore, children can not take of their mouth as much as the adults. The parents should educate their children for establishing proper behaviors and habits in respect of oral care.

The growth and development of the baby is much important for parents at early ages. Parents give milk or baby food to the baby by adding sugar or honey between the sleeps. It is very wrong to dip the baby bottle or pacifier into honey or jam. Such habits cause formation of baby bottle caries at early ages.

Should milk tooth caries be treated?

Even the surficial caries on milk teeth threat the adjacent teeth. The caries in milk teeth progress and reach the nerves causing inflammation on root tip bringing pain in child and causing development anomalies by affecting the permanent teeth under the milk teeth.
If milk teeth are not treated and pulled out early, then the adjacent teeth will be leaning to the missing teeth and cause reduction of the gap which will cause the permanent teeth not being able to come out or to come out in a crowding form

Caries also cause the child not to use that side for chewing with malodor.Such conditions cause the child to experience pain very early and formation of phobia in future.

When should the first dentist visit be scheduled in children?

The first dentist visit is an important stage in the life of a child. It was a common belief in the past that the first visit should be done at the ages of around 2.5-3 after all milk teeth have settled. However, according to new data from the literature, the first visit should be scheduled at the age of 1 in order to early diagnose possible complications and also because baby bottle caries can be seen at very early ages. Thus, the child will not develop white coat phobia and also useful information will be provided to the parents about the oral and dental health of the child.

Is it possible to prevent caries formation?

The first procedure to reduce caries and protect the dentin from caries is application of fluorine. Fluorine application has two forms as local and systemic. While local fluorine can be applied by the dentist, the individual can use fluorine containing toothpaste and mouthwash. The systemic use of fluorine can be through use of fluorine tablets or drinking fluorine added water. Please consult your physician.

Another practice to reduce formation of caries is fissure covering (sealant). There are fissures on chewing surfaces of teeth. Such fissures might not be sufficiently cleaned with brushing. In order to prevent such disadvantage, fissures can be covered with sealants and caries formation can be prevented. Such application is extremely important in respect of dentistry.

What is baby bottle caries?

Breast milk and baby food naturally contain sugar. In such period, parents add honey and sugar to milk or baby food thinking that the baby will be better nourished since it is more important for parents that the baby grows and develops better. If such addition is given between sleeps or before sleeping at night, then the milk or baby food stays in contact with teeth longer and caries might be formed due to the sugar contained. Oral care should be taken into account especially before sleeping. It is also important to give water after feeding.

In order to prevent baby bottle caries:

  • Do not dip bottle or pacifier into honey or sugar.
  • Do not add sugar to baby food or milk.
  • Prevent the habit of sleeping with baby bottle at night.
  • Wipe the baby’s mouth with a wet cloth after eating and give water.

In order to reduce the ratio of caries in your child:

Help him/her as he/she brushes teeth. Teeth should be brushed under the supervision of an adult at least twice a day; once after breakfast and once before sleeping at night. Introduce your child to dentist at early age. Make sure that protective measures are taken in order to prevent formation of caries. Be careful about baby bottle usage against such caries…

Make sure that your child receives sufficient amount of fluorine. Try to use fluorine containing tablets, pastes and mouthwashes as well as fluorine applications by dentist. Since too much fluorine is also harmful, consult your physician. Moreover, make sure that meals of your child are regular since snacks cause caries due to their sugar and starch content.

What is thumb sucking and is it harmful?

Generally, thumb sucking habit is not harmful for children younger than 5 years. However, the first permanent teeth will be appearing starting from 6 years and if such habit still continues then there might be maxilla development problems. Since the maxilla bone is very soft in this period, the upper anterior teeth are pushed forward with the pressure caused by the thumb and lower anterior teeth are retreated. Moreover, the upper palate will have a dome shape. The efforts to prevent thumb sucking habit should be started as early as possible. If your child can not withdraw from such habit after the age of 5 still, the first method might be carrot and stick approach however if the problem still can not be solved, then you can solve this bad habit by seeking help from physicians.

Things to be considered by parents:

  • The child should be introduced to the dentist before developing problems at early age.
  • The parents should make the child feel their own fears and the dentist shouldn’t be used as a tool for punishment or fear.
  • The child shouldn’t be bribed for visiting the dentist.
  • The child shouldn’t be promised incorrectly about operations to be performed as if they are not going to be performed. For instance, the child shouldn’t be assured that there will be no injection. The child can be told about the procedures to be followed a couple of days before the appointment.
  • Parents shouldn’t mock about the fear thinking that it would work to eliminate the fear.

Fissure Sealants

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How does Fissure Sealant eliminate caries formation?

Even if children follow their oral and teeth care regularly everyday, they may not reach the indents on the teeth absolutely. When the food residues cling to these narrow areas, suitable environments are formed for the reproduction of bacteria and the teeth face the threat of caries. Fissure sealants reach the depths of such indents and ensure an effective coverage and protect the teeth against caries.

How Is Fissure Sealant Applied?

Since there is no abrasion or minimum level of abrasion on teeth, this is a very fast and comfortable application. It is pain-free and can be completed only in one session.

How Long Does Fissure Sealant Remain in Mouth?

Fissure sealants are abraded in time. Hard food and gnashing may cause breakage or drop of such sealants. When regular controls are performed, necessary actions can be taken by timely detection. We would like to point out that fissure sealants are only protective materials. If your child is not taking care of his oral care, then no method can prevent caries.

Place Holders

pedoPlace holders are used in order to maintain the necessary space so that permanent teeth can properly take their place as well as to prevent the adjacent teeth from moving to such position. Thus, possible crowding is eliminated.
It has fixed and removable versions. Fixed place holders are used in case of a single tooth loss. Removable place holders are used in case of loss of more than one tooth.

Traumas

Children fall down or hit very frequently. As a result, they might face problems due to which they will be disturbed throughout their lives. Especially in case of sports such as boxing, football, basketball, skiing, cycling, surfing, skateboard, roller blades, etc. children are under risk. The silicon transparent mouth guard to be attached on the upper maxilla teeth will prevent tongue-lip biting and ruptures and protect the teeth by acting as a pillow.

As a result of impact;

  • If the anterior teeth are completely protruded: Put the teeth inside the milk, if this is not possible, keep it inside the mouth in saliva and consult the physician as soon as possible. Do not dry the teeth. The ideal application is to start treatment within 30 minutes. If conditions are suitable, your dentist will place the teeth and start necessary treatment.
  • If one or more of anterior teeth are broken: Try to find the broken pieces and consult your dentist. Keep the pieces humid in the meanwhile. Serum physiology, milk and even saliva is ideal for this purpose. Such pieces can be attached with very strong bonding agents.
  • If you can’t find the pieces: If the broken piece is too small, a white filling can be performed. If the fracture is too much, then laminated veneer or crowns can be an option for those older than 17 years of age. However, in case of younger children, such applications will not be suitable as they haven’t completed their maxilla and teeth development. It should be waited to complete the growth by restoring the broken part temporarily until the child grows up.
  • If there is no problem after the impact: There should be detailed examination by the dentist and x-ray images should be obtained. Even if there is no finding, the child should be kept under control against possible complications and x-ray images should be obtained at regular intervals.