PEDODONTICS

Pediatric dentistry, also known as pedodontics, deals with the oral and dental health of children in the 0-15 age group. It includes the toothless period of children, the period in which the milk teeth erupt, the period when the milk teeth are completed in the mouth, the mixed dentition process in which the teeth start to erupt, and the period in which permanent teeth are completed.

Milk teeth start to erupt from the 6th month. When the child is 2.5 years old, teeth are complete. However, due to genetic factors, it may be possible to get them later or earlier.

WHAT ARE THE SYMPTOMS OF TEETHING?

  • Redness, itching, swelling of the gums
  • Increase in saliva flow
  • Desire to bite hard objects
  • Lack of appetite, restlessness

WHAT SHOULD BE DONE WHEN A BABY IS TEETHING?

The mother and father should do the following and show affection to the baby;

  • Cleaning the baby’s gums with a cold washcloth
  • Giving the baby cold teether
  • To use pain relieving pomades under the control of the dentist.

Use of a teether: You can keep the plastic and paint-free teether in the refrigerator for a while and give it to your baby to scratch the gums. It is a big mistake to neglect the care of milk teeth with the thought of replacing them with new ones.

The teether should not be kept in the freezer. Otherwise, it may stick to your baby’s tongue, cheeks and lips.

Giving cold foods: By giving cold fruit purees and water to your baby going through loss of appetite, you will both relieve the pain and prevent the lack of food and water.

Use of medications to reduce pain: Syrups containing paracetamol or ibuprofen may be helpful in reducing pain.

WHY IS THE HEALTH OF MILK TEETH IMPORTANT?

It is important for several reasons including the following:

  • Proper nutrition of the child
  • Smooth development of speech
  • Child’s psychology, self-confidence and respect
  • It is very important to clean it because it acts as a placeholder for the permanent tooth that will replace it.

WHEN SHOULD CHILDREN START BRUSHING THEIR TEETH?

When the baby’s first milk teeth start to come out; the parent should clean the teeth after feeding with a clean cheesecloth or gauze. Also in this period, baby toothbrushes that the parent can put on their finger to clean baby teeth are also available in markets. When they reach the age of 1 or 2, the child should get a tooth brushing habit under parental control with a small brush. Care should be taken that the bristles of the brush are not hard and the brushing process is not too harsh.

WHAT IS BABY BOTTLE TOOTH DECAY? HOW CAN IT BE AVOIDED?

Brown stains, which we call “baby bottle decay”, can be seen on babies’ teeth. It is common in babies who sleep with a bottle at night. To prevent baby bottle decay;

  • Baby’s habit of sleeping with a bottle should be prevented.
  • Baby should drink water after feeding.
  • Sugar, honey and molasses should not be added to the milk in the bottle.

IS THUMBSUCKING HARMFUL IN CHILDREN? WHEN SHOULD IT END?

Finger sucking is an innate reflex.

Finger sucking and using false pacifiers can last up to the age of 2 or 2.5. However, finger sucking habit that continues after this age causes orthodontic problems. Finger sucking should be stopped at the age of 4.5 at the latest.

WHAT IS FISSURE COVER? WHAT DOES IT DO?

When the milk tooth row is completed, there are 20 deciduous teeth consisting of 8 incisors, 4 canines and 8 molars. At the age of 6, permanent teeth begin to emerge behind the milk teeth. We call the teeth that precede the milk teeth “6th-year teeth”; these will fall on top of the following teeth and they are not noticed by children or their parents because they remain behind and are prone to decay because they can not be adequately cleaned.

The indentations and protrusions on these teeth are covered by the dentist by applying a “fissure sealent” and the adhesion of decaying factors to the tooth is prevented. In addition, with topical fluoride application, the teeth are made resistant to decay.

WHAT ARE SOME MEASURES THAT CAN BE TAKEN AGAINST DECAYS?

It is in our hands to have healthy and beautiful teeth with the habit of brushing teeth gained in childhood and preventive treatments applied by dentists. Milk teeth contain more organic matter than normal teeth, so they are more prone to decay, they decay more easily and quickly.

Children cannot interpret the early signs of decay such as cold-hot sensitivity and mild pain in a timely manner. They realize the event only when there is unbearable pain, which may be too late.

Children cannot pay attention to oral care as much as adults. The child’s dexterity, curiosity and parent’s attitude determine the brushing habits.

One mistake that parents often do is dipping the pacifier or bottle in sugar, jam, etc. They are given to children by putting them in foods such as milk, sugar milk, fruit juice, etc. Thus, the teeth become susceptible to decay due to nutritional irregularities.

A vaccine or medicine that can completely prevent decay has not been developed yet. However, some materials are used today to reduce the number of decayed teeth, one of them is the material we call the “fissure sealant”.

Tooth decays usually start in the grooves called “fissures” on the chewing sides of molars and small molars. With the material mentioned, the grooves are covered and germs, food residues and so on so the leakage of the caries is prevented. This procedure can also be applied to permanent molar and small molar teeth from the age of 6.

Another way to prevent decay is to increase the resistance of teeth to caries. This resistance is gained by applying superficial fluoride to the teeth.

HOW DO THE HEALTH OF THE MILK TEETH AFFECT THE HEALTH OF THE PERMANENT TEEHT?

There are 20 milk teeth in total. It is normal for milk teeth to be open. The reason for this is to provide a place for permanent teeth to replace them. Decays may also occur in milk teeth. These bruises must be treated. If milk teeth are inflamed, root canal treatment should be tried first, if not possible, the tooth should be extracted. If the decaying teeth are pulled out prematurely, there is no space for the permanent tooth coming from the bottom and space is limited. Therefore, decays in the milk teeth should be treated, you should not make the mistake of thinking “new ones will replace anyway”.

At what age should children start visiting their dentists?

Your child should be under the control of a dentist when their first teeth start to come out in order to prevent problems in their teeth and jaw facial development and to be detected early. Going to the dentist before your child’s teeth develop cavities brings many advantages.

The American Association of Pediatric Dentists states that a dental examination is required from the age of 1 or at the latest with the eruption of the first milk tooth.

Which toothpaste to use and when?

Use of fluoride-containing paste before the age of 3 is not recommended due to the risk of the baby swallowing it. However, there are pastes suitable for babies that do not contain fluorine, do not foam and contain completely digestible enzymes. After the age of 3, fluoride-containing toothpaste for children can be used. It is important to use child toothpastes only up to the age of 12.

Since the mechanical cleaning of the teeth is important, using more paste does not mean better cleaning. Pastes should be used in amounts that are equal to the lentil grain. In addition, since the paste will foam with saliva, it is not necessary to wet the paste put on the brush under water.

Dental Injuries in Children

Accidents where children injure their teeth should be cared for without wasting time. Dental injuries in children can sometimes cause the permanent tooth to completely separate from its socket.

In this case, you should go to your dentist immediately with the tooth that came our. Meanwhile, the tooth should be kept in a glass of milk, if milk is not available, in clean water.

Oral Care in Babies

Feeding babies with breast milk for at least the first four months will ensure the normal development of soft tissue and muscle functions around the mouth. In cases where breast milk is insufficient, the use of a bottle with a physiological cap (palate, cut end) is required.

Babies should be accustomed to feeding with a glass and spoon from the age of 1.

Bottle feeding can continue until the age of 2 at most. Habits such as thumb sucking and using a dummy pacifier can be allowed until the age of 2 – 2.5. If there is a thumb sucking habit, the reason for this should be investigated and this habit should be eliminated between the ages of 3 and 6.

Respiratory problems have a negative effect on jaw development. If there is breathing only from the mouth and not through the nose (this is better understood during sleep), the otolaryngologist should definitely be consulted.

When should children start brushing their teeth?

Cleaning should begin when the baby is 6-8 months old (that is, when the first teeth appear in the mouth). After breakfast and before going to bed at night, it is advisable to wipe the teeth (at least the chewing surfaces) by soaking a clean cloth or gauze.

It is appropriate to start using a toothbrush after the child’s posterior teeth appear (average 2.5 or 3 years old).

My baby’s teeth decayed as soon as they erupted. What could be the reason?

Brown spots sometimes appear on babies’ teeth as soon as they erupt or these teeth are broken and lost. In fact, these stains are dental issues are due to caries.

The reason for the formation of tooth decay in such an early period is baby bottle decays. Breast milk or cow’s milk, which are the most important nutrients in baby nutrition, naturally contains sugar.

WHAT IS THE EFFECT OF EATING AT NIGHTS ON DENTAL HEALTH?

If the baby is fed breast milk or a given a bottle before going to bed at night or during sleep, the milk accumulates in the mouth and creates a favorable environment for microbes for tooth decay. Therefore, teeth should be thoroughly cleaned, especially after night feeding.

  • Prevent your baby’s habit of sleeping with a bottle in mouth at night.
  • Try to put the baby to sleep after feeding.
  • Do not add sweeteners such as sugar, honey or molasses to the milk in the bottle.
  • Make sure to give water after the baby is fed.
  • With the eruption of the first teeth, clean their teeth with a clean, wet cloth after night and morning feeding.

Is baby bottle tooth decay important?

If the teeth with bottle decay are not treated, they cause pain and become inflamed. Inflamed or aching teeth cause the baby to become restless and to deteriorate the diet. Inflammation also affects the permanent teeth that will come from the bottom and causes them to be deformed.

What are the oral habits that can impair the chin development of children?

  • Thumb Sucking
  • Baby Bottles, Pacifier Sucking
  • Nail Biting
  • Object Biting
  • Keeping Food in the Mouth
  • Mouth Breathing
  • Teeth Grinding-Squeezing,

Thumb Sucking

In most children, thumb sucking stops between the ages of two and four. However, if the habit continues after the main teeth are in the mouth, it can drastically change the growth pattern of the jaw and cause serious misalignment of the teeth.

Children’s jaws, whose growth and development continue rapidly, are relatively soft and flexible, especially in those under the age of eight. Therefore, it is not difficult for the constant upper pressure of the thumb to deform the soft bone around the lower and upper front teeth. Strong thumb sucking is more likely to alter the growth pattern of children’s teeth and jaws.

If the thumb sucking habit continues, it can cause the upper front teeth to protrude and the lower ones to move back and in. It can also inhibit the growth of the lower jaw while causing the upper jaw to be pushed forward. This can cause teeth misalignment, open bite in the anterior region (where the front teeth do not close together), collapse of the upper jaw, and cross bite. Therefore, it is important to stop the behavior at an appropriate time before damage occurs.

Breathing Through Mouth

Respiratory problems have a negative effect on jaw development. If there is breathing only through the mouth and not through the nose (this is better understood during sleep), an otolaryngologist should be consulted.

Mouth breathing can be caused by:

  • A long narrow face
  • Narrow mouth
  • High palate
  • Crooked teeth (upper or lower)

Other symptoms of mouth breathing:

  • Swollen tonsils
  • Dry mouth in the morning
  • Breathing with mouth open during sleep
  • Snoring

What are the Preventive Measures in Pedodontics?

  • Oral hygiene training,
  • Informing and training parents,
  • Information about healthy eating,
  • Fluorine applications,
  • 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 in sports matches.

What is fluorine?

Fluorine is a trace element found in air, water and rocks. It has a protective effect on the teeth and increases resistance to tooth decay, so it is put into toothpaste in small amounts.

Professional applications where the amount of fluorine and its anti-caries are higher are applied by your dentist in the form of fluorine polish or fluorine gel in intervals of 3-6-12 months.

What is a placeholder?

When deciduous teeth are lost early, neighboring teeth slide into the empty 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 from below. For this purpose, appliances with movable and fixed types called placeholders are used.

What should you do if your child’s front tooth is broken?

In cases where the front teeth are broken, if there is no serious problem with the general health of the child, you should immediately contact the dentist.

If you can find the broken piece of tooth, take it to the dentist, in cases where the broken piece is still fit for attachment, your dentist can stick this piece back to the tooth.

What should you do if the anterior tooth is dislocated?

Hold the dislocated tooth without touching its root and rinse under clean running water. However, while washing, never do anything that will damage the living tissues of the root such as brushing or soaping. If you can replace it, try to place the tooth where it comes out. If you cannot, put the tooth in milk and contact your dentist immediately. Since time is very important in repositioning the dislocated teeth, consulting the dentist as soon as possible increases the success of the treatment.

Preventing the fear of dentists in your child

Frightening children by having a tooth extracted, having an injection, or going to the dentist later causes fears that are difficult to overcome. For this reason, do not talk about your own negative experiences with your child and never scare your child this way.

When you decide to take your child to the dentist, you should tell them that 1 or 2 days in advance. It is not recommended to say more than 1 week in advance, as it will cause your child to have a long time to increase their anxiety. It would be ideal for you to answer your child’s questions about what to do at the dentist as simply and generally as possible.

It is very important to perform dental treatments after the child has gained love and trust without creating anxiety and fear. For this reason, the first encounter between the physician and the child is of great importance. In the first encounter, it is aimed for the child to love the doctor and the environment. The dentist introduces themselves, the environment and the devices and instruments he will use to the child and prevents the fears they will have in their minds. Then, the child is told why they should receive dental treatment and what to do, in a language that they can understand, giving a playful atmosphere. Then, the treatment of the tooth that requires a simple treatment in your child’s mouth begins. The child gets used to these treatments over time by moving from easier treatments to difficult ones. The fear of the dentist disappears completely as the child sees that the dentist does not hurt and has fun while having dental treatment.

What should be done when teeth decay?

Since decayed 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 inability to eat 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 negatively affected.

Is it important for the milk teeth to come out on time?

Although it is considered normal for milk teeth to come out at the age of 6 to 8 months, this time may vary from child to child depending on genetic factors. While there are problems or delays in teething, early changes seen in 1 or 2 months longer seen as the continuation of tooth eruption it can lead to various problems.

What is sedation practice?

Sedation is a state of sleep that can be adjusted in depth, in which the patient can preserve swallowing, coughing and respiratory reflexes with sedative (numbing) drugs administered under the control of an anesthesiologist. With sedation, the patient’s fears and anxieties and the psychological gag reflex are suppressed and the patient is relaxed throughout the procedure. Unlike general anesthesia, the patient responds to commands. Shortly after the procedure is over, they regain themselves and returns to their normal lives. However, they do not recall any procedures.

Under what conditions and to whom is sedation applied?

In some children, despite the professional approach of the dentist, fear of the dentist cannot be overcome. 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 treatments applied this way cannot be made in the desired quality. In addition, the lack of treatment causes the progress of caries and serious damage to the oral and dental health of the child.

The patient can be put to sleep by sedation in the treatment of children who cannot overcome the fear of dentists, in the treatment of disabled children and adults, and even in adult patients who cannot overcome the fear of dentists or have serious systemic diseases such as high blood pressure.

The sedation method allows the patient to be treated awake but calm, depending on the dosage of the drug with various drugs administered intravenously. However, this procedure should definitely be performed by an experienced dentist, an anesthesiologist and an experienced team. Likewise, it is important to have all the necessary equipment ready in the environment where this process will be performed.