Pediatric
Dentistry

Pediatric dentistry is a branch of science that examines and provides solutions to oral and dental health problems in the period from birth to the end of adolescence. It is defined as pedodontics in dentistry. With the emergence of children’s milk teeth, the dental system goes through different periods until the permanent teeth appear.

Treatment of problems in children’s oral and dental health

Treatment of decays in primary(deciduous) and permanent teeth, placing crowns in cases of excessive material loss, Root canal treatment in primary and permanent teeth, Tooth extraction, Placeholder application to prevent loss of space due to early primary tooth extraction, Treatment of fractures caused by trauma such as crash and accidents, Elimination of discoloration on teeth.

Avoiding dental and oral problems with preventive and non-operative treatments

Oral hygiene training, Informing and training parents, Information about healthy diet, Fluoride varnish application, Fissure sealant applications, Protective and stopping orthodontic treatments, Application of night plaques used to prevent teeth grinding and clenching (bruxism), Application of dental protectors used during sports matche

At What Age The First Dentist Visit Must Be Done?

Your child should be under the control of the dentist when the first teeth start to emerge in order to prevent problems in their teeth, jaw and facial development and to be detected early. Meeting the dentist before your child’s teeth develop decay brings many advantages. As simple and short term preventive methods, get information about correct brushing and nutrition from your dentist will prevent the dental problems before they occur. As the child gets used to going to the dentist, there will be no dentist fear. In addition, dental problems that may occur in your child are detected by your dentist at an early stage that you cannot detect. In this way, delay in the treatment to be applied is prevented. Generally, 6-month checkups are recommended, but your dentist will determine how often your visits should take into account your child’s oral and dental health.

DO NOT FORGET THE FIRST TOOTH, FIRST EXAMINATION!

What Should You Do If Your Child Has Dental Trauma?

In children, the front teeth are exposed to trauma in cases such as falls and collisions. In cases where the front teeth (or back teeth) are broken, if there is no sign of a serious problem with the general health of the child, you should immediately contact the dentist. The sooner the intervention time is in the teeth damaged as a result of trauma, the higher the success of the treatment.

If you can find the broken piece of tooth, put it in clean water and take it to the dentist, if possible. In cases where the broken piece is suitable, your dentist can stick this piece back to the tooth. Adhering the broken piece back to the tooth provides more aesthetic results. However, in cases where the broken piece cannot be found or it cannot be bonded due to multiple fractures, the desired aesthetics and function can be restored with composite resin fillings suitable for tooth color.

The Importance Of Nutrition For Children

Nutrition is of primary importance in the formation of caries. First of all, it should not be forgotten that all types of food, including breast milk, cause tooth decay if the teeth are not brushed. However, especially when feeding babies at night, adding sweeteners such as sugar, honey and molasses to the feeding bottle, and sweetening the pacifier will increase the possibility of tooth decay in your baby and the speed of these decay’s formation. This improper diet causes the teeth of children to decay rapidly at an early age and to form the early childhood caries (bottle caries). For this reason, it is necessary to avoid sweetening the milk with sugar that is given with feeding bottle in infancy. Night feeding (night-time feeding after the age of 1 or sleeping with a bottle) is one of the most common reason of caries.

The Points To Be Considered In Nutrition In Childhood

The points to be considered in nutrition in childhood as follows:
Sugary, sticky chocolate-like or acidic foods and beverages should be reduced as much as possible. However, since these foods cannot be completely restricted, it is important to give them after the main meals and to brush the teeth right after. However, it should not be forgotten that not all food that causes the decays does not taste SWEET. Each food with high carbohydrate content causes the formation of caries.

Processed foods rich in starch; Prepackaged foods such as crackers, chips, cornflakes, non-whole grain breads, processed dairy products (fruit yoghurt and milks) can cause the decays.

When Should Start Tooth Brushing In Children?

The risk of decay starts when the first tooth erupts in babies. Contrary to popular belief, breast milk does not protect the child from tooth decay. Microorganisms that cause caries also use the sugar contained in breast milk. For this reason, parents should start cleaning their baby’s teeth in this period, as soon as the first tooth erupts. Primary teeth are less resistant to decay since their mineral ratio is lower than adult teeth. Therefore, decay is formed easily and decay progresses rapidly in primary teeth. Although feeding is very frequent during infancy, an effective cleaning done twice a day is
important in preventing the formation of caries. In older ages, it is necessary to brush twice a day for at least two minutes. Especially, brushing teeth before going to bed at night (as saliva flow decreases at night) is of great importance. After brushing teeth at night, beverage and food consumption has to be stopped.

What Is Tooth Decay?

Tooth decay is a disease caused by bacteria living in the oral environment. These bacteria produces acid by using food residues accumulated on tooth surface. These acids also cause tooth material loss, called tooth decay, by melting the tooth surface. Caries is one of the most common diseases in the world and progresses rapidly. 90% of 6-year-old children have caries. If tooth decay is not treated, it causes infection in the teeth and surrounding tissues and has negative effects on general human health. It should not be forgotten; caries is a preventable dental problem. The way to become a person
with a healthy mouth and teeth is start to have since childhood a good oral hygenie habit. Here are 6 magic formulas for the protection of oral and dental health during childhood;

  • Training of mother and father,
  • Gaining good mouth-teeth cleaning habit,
  • Healthy diets,
  • Regular dentist visits,
  • Protective applications such as fissure sealant and fluorine

Which Patient Groups Are Treated Under Sedation And General Anesthesia?

Generally, it is not possible to do dental treatment by persuasion in children under 5 years old, while in some children, regardless of age, the dentist fear cannot be prevented despite all kinds of professional approaches. In these cases, forcibly intervening in the dental caries of the child causes the child’s fear of a dentist to reach a level that cannot be overcome. In addition, the lack of treatment causes the progress of caries and serious damage to the oral and
dental health of the child. For this reason, we prefer sedation and general anesthesia methods for children who cannot help them overcome their fear during 2-3 trial appointments or who cannot be treated because of their age. Another patient group in which sedation and general anesthesia are frequently preferred are mentally disabled people. In general, poor oral care of these people causes caries and gum disorders. By ignoring the problems instead of treating them, the tooth loss of these people increases and their life quality decreases seriously due to pain in the teeth, infection and nutritional problems.

In addition to all these patient groups, these methods are preferred in adult patients who cannot overcome the the dentist phobia or who cannot have their dental treatment under normal conditions due to serious systemic diseases such as high blood pressure.

What Is Pedodontics, Who Is A Pedodontist?

Pedodonti is the branch of dentistry which specialized on child dental and oral care. Pedodontist is the specialist that study on child oral and dental health 3 years, after 5 years dentistry faculty. Pedodontists aim solving or preventing dental and oral problems related children from babyhood to puberty. Moreover the pedodontists are specially educated to treat dental problems of the children and in all ages disabled people under general anesthesia.

What Should You Do To Prevent Your Child Have The Phobia Of Dentist?

Children’s brains are very good at capturing and recording all kinds of information. A negative memory you tell about your dental treatment experiences may effect his / her and cause this fear to occur. When you decide to take your child to the dentist, you should tell him / her about this 1-2 days in advance. It is recommended not to say too early, as it will cause your child to have a long time to increase their anxiety. It would be ideal for you to give simple and general answers to your child’s questions about what to do in dentist’s office. Regarding the treatments to be done, answering such as “I don’t know too, the dentist will tell us what to do when we go” will prevent them from imagining wrong and feary things.Like all human beings, children are
afraid of the unknown and of suffering. Informing your child by a pediatric dentist, who had educated on psychological approach to children, provides
healthier results. It is very important to perform dental treatment after the child’s love and trust has been gained without creating anxiety and fear.For this reason, the first encounter between the dentist and the child has great importance. In the first encounter, it is aimed for the child to love the doctor
and the environment. The dentist introduces himself/herself, the environment and the devices and instruments he/she will use to the child and prevents the fears he will have in his mind. In playful atmosphere the child is told why he/she should receive dental treatment and what to do during the treatment process, in a language that he/she can understand. Then, treatment begins with the tooth that requires the simplest application. The child gets used to these treatments over time by moving from easier treatments to difficult ones. When the child sees that not hurt and has fun during dental treatment, her/his the dentist fear disappears completely.

Healthy Refreshment Recommendations For Children

It is appropriate to consume foods such as eggs, meat, cheese, milk, fresh vegetables and fruits for snacks. It is ideal to brush the teeth after eating
something everytime. You can ask your daycare center or babysitter to help and lead your child to take care of brushing. However, if you do not have the
opportunity to brush, at least you can advise your child to rinse his mouth with water and chew sugar-free gum. When your child wants to have a snack, offer him / her healthy, non-starch, nonacidic nutritious options;

  1. Cheese, plain milk or yoghurt, buttermilk, kefir
  2. Raw vegetables or fruit
  3. Nuts (walnuts, almonds, hazelnuts, dried fruits)
  4. Sandwiches made with vegetables such as whole grain bread, protein group
    (cheese, meat, chicken) and lettuce.

What Are The Protective Applications To Prevent A Tooth Decay?

1. FISSURE SEALANT


Fissure sealants is a kind of fluid filling material that covers the chewing surfaces of teeth. This material, which is applied to the tooth without abrasion on the tooth, covers the chewing surface of the tooth and prevents the food accumulation which causes caries in this area. Especially newly erupted permanent teeth are more sensitive to decay since their mineralization is not complete. Therefore, it should be applied especially to these teeth.

2. FLUORIDE VARNISH

Fluorine is an element found in air, water and rocks. It has a protective effect
on the teeth and increases the resistance of the tooth to decay, so it is put into
toothpaste in small amounts. Professional applications where the amount of
fluorine and its anti-caries effect is higher are applied by your dentist in the
form of fluoride varnish or fluoride gel at intervals of 3-6-12 months. However,
your dentist should decide on the frequency of these applications and which
type of application to choose by preparing a special program for your child.

What Kind Of Brush And Tooth Paste Should Be Used?

Parents could clean the baby’s first teeth with a clean gauze pad. During this period, baby toothbrushes that the mother can put on her finger to clean baby teeth are also available on the market. After the baby has more teeth, brushing should be continued by switching to brushes suitable for the age. Care should be taken that the bristles of the brush are not too hard or soft and that the brushing process is not too harsh. The use of paste containing fluoride before the age of 3 is not recommended due to the risk of swallowing the baby. However, there are pastes suitable for babies that do not contain fluoride,
do not foam and contain completely digestible enzymes. After the age of 3, fluoride-containing child paste can be used. It is important to use only child paste up to the age of 12. Since the mechanical cleaning of the teeth is important, using more paste does not mean a better cleaning. In addition, since the paste will foam with saliva, it is not necessary to wet the paste on the brush under water.

What Are Sedation And General Anesthesia Applications?

In the sedation application, it is possible to treat the patient awake but calm or completely deep sleep, depending on the dose of the drug with various medications given intravenously or with the sedative gas. Although the patient is suppressed in the sedation process, reflexes such as breathing, coughing and swallowing continue. After sedation, patients recover more quickly than general anesthesia. In the general anesthesia method, various drug combinations are used to ensure that the patient sleeps completely in a stable way for a longer period of time. Since the patient does not have any reflexes, respiration is provided a method called intubation; through pipes, one end of which is connected to the lungs and the other to the devices that blow air. General anesthesia is a safer method in procedures such as long-term dental treatments with water in the mouth (since reflexes such as coughing and swallowing in the sedation method are suppressed).

What Should You Do If The Front Tooth Is Come Out Of Its Place Because Of Trauma?

If the dislocated tooth is milk tooth due to trauma, no intervention is made, but it is necessary to apply to the dentist urgently to evaluate the possible damage to the surrounding tissues and to prevent the risk of infection. If the removed tooth is a permanent tooth; It should be washed under clean running water without touching its root. However, while washing, absolutely no operation such as brushing or soaping should be done that will damage the living tissues of the root. If it can be placed in its place, placing the tooth where it comes out gives the best result. However, if the parent cannot do this, they should put the tooth in plain milk and contact your dentist immediately. Since the time is very important in repositioning the dislocated teeth, applying to the dentist as soon as possible increases the success of the treatment. Your dentist will evaluate the condition of the tooth, ensure that the tooth is re-attached with the fixation method called splinting, and will make the necessary treatment planning according to the life stage of the tooth.

Is It Enough The Children To Brush Their Own Teeth For Sufficient Dental Hygenie?

Since the motor functions of children are not fully developed until the age of 9, they should not be expected to brush their teeth effectively alone. Just as a child before the age of 9 cannot take a bath on his own, he cannot brush his teeth. Of course, the child should be allowed to brush his / her own first, but then definitely the parents should do the actual effective brushing. Only toothbrush movement is not enough for effective brushing. Ask your dentist to show you the correct brushing technique to for yourself and your child. People gain their habits at an early age. In order to give your child the habit of brushing teeth, you should set an example for them as brushing your own teeth.

Which Method Is Preferred In Which Case? What Is The Difference Between The Two Methods?

Which method to choose depends on the health condition of the patient, the severity of the dental problems and the dentist’s preference. In general, sedation method is preferred for simple procedures that take as short as half an hour, while general anesthesia is preferred for longer and complicated procedures. In the sedation process, attention should be paid to the short duration in order to avoid the use of high doses of medication. Likewise, the recovery period of the patient is faster in sedation than general anesthesia. However, for procedures longer than half an hour, it will be safer to prefer general anesthesia to prevent complications that may occur.

What Should Be Done If Primary Teeth Decays? What Happens Decay Is Not Treated?

Since decayed tooth and surrounding tissues contain too many microorganisms, the presence of decayed teeth in the child’s mouth causes an environment that is constantly open to infection. In cases where the decay is not treated, problems such as pain and eating disabilities and bad breath occur in children depending on the progress. In cases where the decay progresses further, serious infections such as tooth abscess and swelling of the face may occur, as well as the general health of the child may be affected. When primary teeth decays, they should be treated to prevent their early loss. Since primary teeth are in the mouth during the most active period of the individual’s growth, a healthy diet and a healthy growth are very important for development. In cases of early tooth loss, the child’s nutrition will be negatively affected since the child cannot chew properly.
The primary teeth are of great importance in learning the speech correctly, problems may occur in the child’s speech in case of early loss. Primary teeth guide the permanent teeth that will come after, cross teeth problems, orthodontic problems and crowds occur in the early tooth losses.
Aesthetically deficiencies can cause psychological problems in children.

What Are The Advantages Of These Methods?

First of all, it should not be forgotten that these methods are not “luxury”, they are essentially applied to people who cannot have dental treatment in any other way and therefore are actually a salvation point. The most important advantages are treating all problems in the patient’s mouth in one session.
In patient groups who often refuse to be treated, forced extraction of the unhealthy tooth may be required because it cannot be treated. In such cases, with the help of sedation, instead of tooth extraction, treatment and oral health are provided without straining the patient. The quality of the work done by the dentist is also higher because he can work more comfortably. In addition, the patient does not feel any pain and does not remember the procedure,
preventing the fear of the dentist. Especially in pediatric patients, it is ensured that they establish an emotional bond with the dentist with regular post-operative controls. During these controls, small tooth decays that are noticed in the future are treated more easily in the clinical environment.

What Should Be Done If Milk Teeth Lost Due To Decay Before It’s Time?

The most common orthodontic treatment (braces treatment) requirement depends on early primary teeth loss. When deciduous teeth are lost early, neighboring teeth slide into the extraction space. As a result of the narrowing of the extraction gap, the permanent tooth that will emerge in this area in the future remains buried or the teeth become crowded. In order to prevent these crowding, the place of the milk tooth lost early should be preserved for the permanent tooth coming after. For this purpose, it is aimed to prevent crowding that will cause orthodontic treatment in the future by using appliances, which are movable and fixed types and called as PLACE HOLDER.

In some cases, if the number of milk teeth lost number is high, these placeholders can also be prepared as child prosthesis(place holder with teeth), in
order to protect the chewing function of the child.

What Should The Patient / Patient’s Legal Guardians Consider Who Prefer To Be Treated Under General Anesthesia/sedation?

These methods require dentists and anesthesiologists to work as a team. It is very important that the team that will make this treatment method is
expert and experienced in their field. Pedodontists (pediatric oral and dental health specialists) train specially in applying dental treatment with these
methods in children and mentally disabled people. In addition, it is very important that all the necessary equipment is ready in the environment
where the process will be performed. It is also very important to examine the general health condition of the patient well and to perform the
necessary blood tests before general anesthesia.

Is There Any Risk Of These Methods?

Of course, any health-related operation carries more or less risk. The point is to know well which method has which risks, to choose the appropriate method for the person and to take the necessary precautions. Also it is of great importance that these operations are carried out by an expert and experienced team in a fully-fledged health center.

What Are Children’s Bad Habits And Addictions That Make Their Dental Health Worst?

Children may have some bad habits that can cause permanent or temporary damage to their teeth and oral soft tissues. Often parents either do not notice or ignore these harmful habits. However, these habits cause orthodontic problems that can lead to bigger problems in the future. These bad habits negatively affect the development of the face, teeth and jaws. These habits may have started from infancy and continue throughout life. In order to prevent these behaviors that cause orthodontic disorders, it is absolutely necessary to get help from preventive orthodontics. Habits are conditioned behaviors that always happen in the same way. These are divided into good and bad habits. It is a good habit if it does not have any physical, psychological and social harm. The opposite is called bad habits. The type, severity and duration of bad habits are very important. A dentist can recognize these bad habits at an early stage and stop them before irreversible damage occurs. Bad and harmful mouth habits that require protective and preventive treatment can be listed as follows;

  1. Thumb sucking
  2. Tongue sucking
  3. Swallowing irregularities, tongue sticking out of the mouth
  4. Pushing the teeth with the tongue or inserting the tongue between the teeth
  5. Long use of the bottle and pacifier
  6. Lip sucking and biting
  7. Cheek biting
  8. Clenching or grinding teeth
  9. Oral breathing
  10. Nail biting
  11. Nutritional disorders

Parents play an important role during the period of quitting bad habits that harm teeth in children. Parents should take their child to the dentist twice a year and have their teeth checked. Orthodontic problems, if any, will be detected early with regular checks. When the dentist sees a harmful habit that needs to be treated, he or she can refer you to the orthodontist and the pedagogue to be treated in collaboration.

When Do We Grow Permanent Teeth? What Should Be Considered In This Period?

Permanent teeth begin to appear when the child is about 6 years old. The eruption of 32 permanent teeth is completed with the eruption of wisdom teeth.
The period from 6 to 12 years old is the period that we call mixed dentition, when primary and permanent teeth are together in the mouth. If there is caries in the baby teeth during this period, the microorganisms that cause this caries infect permanent teeth just like a person with flu infects their environment. For this reason, having a healthy primary dentition prepares the ground for the child to be healthy in terms of mouth and teeth in adulthood. Since 6-year-old teeth (1st molars), which are the first permanent teeth to come out, emerge from the back of the milk teeth in the back part of the mouth, mostly parents do not notice that these teeth are erupting or they think that teeth are primary teeth. These teeth are at risk of serious decay due to the child not brushing that area well. In most of the people, these teeth are decayed, extracted, crowned or filled. That’s why it is strictly recommended that fissure sealants, which are a protective treatment, be applied to these teeth by the dentists. Early intervention in jaw space stenoses that are noticed in the period when permanent teeth are growing, detecting genetically missing permanent teeth at an early stage and drawing the appropriate treatment method accordingly will prevent the need for serious orthodontic treatment in the future. For this reason, it is very important to follow the dental check calendar determined by your physician.

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