The primary goal of pedodontics is to establish healthy and interactive communication. Children’s dentistry; the first sessions end with an informative conversation about introduction and oral care. In the following sessions, the treatment of paediatric patients is continued with materials and personnel adapted to the child’s psychology and the technique of say-show-apply in space. Our pedodontist can perform all dental treatments such as periodontal treatment, filling and tooth extraction according to the treatment needs of children.All oral health problems and preventive treatments are performed by pedodontists during the period from infancy to young adulthood.
Preventive treatment of children’s dentistry
Preventive treatment is very important in children’s dentistry as in all areas. Having your child under the care of a regular doctor and developing good tooth brushing and eating habits ensures that they will have healthy teeth throughout their lives. Milk teeth are also important for dental health. Milk teeth that are not well preserved cause decay and pain. When they are lost early, they make the permanent teeth confused. For this reason, it is best to start checking from the time your child’s milk teeth come out. Dental caries can be prevented by protective methods such as fluoride application and fissure sealants (insulating fillings). At the same time, orthodontic problems that affect the appearance of the mouth and face can be easily resolved with early intervention, helping to ensure that your child is a confident and happy individual.
New therapeutic approaches aim to prevent these diseases before they occur and to treat existing diseases.
Such as ; Good Eating Habits through good home care, it is possible to prevent certain diseases before they occur.
Thanks to preventive dentistry ;
- Will receive shorter and simpler treatments,
- It will cost less.
- Preventive dentistry starts at an early age, so it is more of an initiative for children.
Fluoride applications: With topical fluoride applications applied clinically by the dentist, there is a substantial reduction in dental caries. These applications are possible with fluoride-containing gels, solutions and certain dental materials.
Periodic check-ups: With the computerised monitoring system, check-up appointments for registered patients can be easily made without any interruption. Through these routine checks (usually once every 6 months), oral hygiene can be monitored and potential problems can be detected early on. The latest development in early caries diagnosis is laser caries detection. This device, which has the ability to distinguish even caries that cannot be monitored by X-rays or cannot be seen by the eye, is very effective compared to conventional examination methods. In addition, panoramic X-rays taken at the first appointment prior to the examination also contribute greatly to early diagnosis.
Fissure sealants: Fissure sealants are a preventive treatment to protect the tooth from decay before decay develops. Studies show that 90% of cavities develop on the chewing surfaces of molars. Large molars are not fully calcified in the first months of their appearance in the mouth (they are not hardened) and are susceptible to decay. Fissure sealants are used to fill the indentations on the chewing surfaces of these teeth to prevent the accumulation of food and thus the risk of caries development. These treatments are considered very necessary, especially for people who are prone to cavities in their family.
Spacers: Movable or fixed appliances designed to protect the sites of deciduous teeth that are lost prematurely for whatever reason are called spacers. Early loss of primary teeth causes developmental, functional and aesthetic problems.
Milk teeth guide the permanent teeth which will erupt, if lost prematurely, the permanent teeth will erupt randomly and there will be crowding. For this reason, the development and monitoring of caries should be very close in primary school children in the mixed dentition period without neglecting periodic checks.
Balanced diet: A balanced diet has a direct relationship with caries. A balanced diet means taking the foods necessary for growth and development. So what should be the type and frequency of food consumption? Children’s eating habits should be monitored and it should be determined how often and what the child eats.
Eating carbohydrate-rich foods with main meals and not eating such foods (cake, potato, crisps, chocolate, sugar, biscuits) in snacks will provide a very significant benefit in terms of caries development. For example; it is less harmful to eat a whole packet after lunch instead of eating a packet of chocolate at 5 intervals.
Oral health recommendations for children :
- 0-6 years: Deciduous period:
Although deciduous teeth can be variable, they begin to last, often starting in the lower anterior region after an average of 6 months, and end at the age of about 3 years, although this may change again. During this period, a total of 20 deciduous teeth (10 in the lower jaw and 10 in the upper jaw) are placed symmetrically,
- 6-12 years: mixed dentition period:
This is the age range in which the baby molars and incisors are visible in the mouth at the same time. In time, the baby molars give way to the small molars, and they move into the permanent dentition period,
- 12 years and beyond: Period of continuous dentition:
This is the period when the milk teeth fall out completely and the permanent teeth take their place in the mouth and when the balance and contacts between the teeth occur. In order to have healthy teeth from infancy, it is necessary to follow good nutritional patterns and to be protected from the particular type of decay called “baby bottle tooth decay”. Milk teeth are important in the vocal function that will begin during this period, in terms of the correct elimination of sounds and letters, as well as the functions of appearance, biting and eating. Milk teeth also serve as a reserve space in the jaws and determine the direction of drive of the permanent teeth that will replace them. For this reason, tooth extraction during the primary set of teeth should be a treatment alternative that should be considered as a last resort.
It has been found in research that if adequate oral hygiene procedures are not provided in children with dental caries early in the period, the risk of caries is higher during the period of continued dentition in later life. Early tooth extraction can lead to nutritional disorders and weight loss in the child. However, it may alter the eruption periods of the permanent teeth and prevent them from setting properly. Therefore, “replacement appliances” should be applied to protect the areas required for the permanent teeth to continue after early extraction of deciduous teeth. During the period of growth and development, especially in children with any systemic disease (heart disease, asthma, kidney disease, bleeding problems etc), oral health is more important and any decay that may occur is due to cavities in the mouth. It should be borne in mind that infection can be vital in these situations. Nutrition in childhood is of great importance in terms of growth and development from infancy.
Instead of these foods, feeding only milk or water from a bottle will be a more protective approach in terms of caries formation. Due to the use of such sugar-containing foods to facilitate sleep before sleep, this carbohydrate content during the sleep period can accelerate caries formation by creating acid attacks in the oral environment.
In this period, the main points to consider in terms of oral health are the concept of “balanced nutrition” and “dental care”. For a balanced diet, it is necessary to benefit equally from all food groups and in particular carbohydrate foods, known to be carious, should not be consumed frequently except for main meals. Sugary foods that are nibbled on between meals or starchy nutrients such as crisps, crackers and sticking to the teeth contribute to the preparation of the caries causing environment by metabolising until our child brushes their teeth.
Not giving the baby a bottle of fruit juice, milk with honey, biscuit milk or any other liquid containing carbohydrates (especially during sleep) during bottle-feeding periods will also ensure that our baby is protected from bottle decay during this period. Finally, it is necessary to brush the teeth with the help of the mother before sleeping, at least to clean the surfaces of the teeth with a clean cheesecloth or compress, and if this cannot be done, water should be given last.
One of the protective measures against tooth decay is the application of fluoride. Fluoride chemically and physically modifies the structure of enamel by entering the enamel structure during the germ formation phase of the tooth and, as a result, the dissolution of enamel in an acidic environment is reduced. For this reason, it has been thought that fluoride should be taken systemically along with vitamins and minerals during development.
However, it is argued that fluoride is more important and effective in terms of a local effect called the “topical effect” after tooth eruption and in adults.
The greatest risk of using fluoride tablets is yellow-brown stains on the enamel depending on the amount of fluoride taken, called “dental fluorosis”. Studies have shown that children of mothers who took fluoride tablets during pregnancy showed no difference in caries resistance.
Nowadays, fluoride applications, which are more frequently applied by dentists in clinics and practices and/or by individuals at home, have become more widely used. These applications can be made with agents such as toothpastes, gels, mouthwashes, solutions, varnishes and foams. The aim of these applications is to prevent the development of caries and to reverse the process. It is reported that the frequency of caries decreases mainly with fluoride gel applications and that the frequency of caries decreases with applications made twice a year.
Fluoride mouthwashes and toothpastes that individuals can apply themselves at home are also ideal methods of applying preservatives. Fluoride toothpastes should be used with caution as they can be swallowed by children. It is suggested that standard toothpaste concentrations (1000 ppm and above) are suitable for children in high risk groups. In the period between 6 months and 2 years, toothpastes with a concentration below 500 ppm should be preferred. Particular attention should be paid to brushing with the help of parents or under the supervision of young children.
Tooth brushing techniques
What is important in tooth brushing is the effective cleaning of the areas where bacterial plaque and food residues are concentrated. To do this, the toothbrush should be brought close to the tooth at a 45° angle and follow a circular line with oval movements on the front of the tooth. This movement should be applied to all front surfaces of the upper and lower teeth. Next, the pits (chewing surfaces) of the small and large molars with a chewing surface should be completely swept free of food residue. Since the inner surfaces of the teeth, especially the front areas, are narrow, the upper and lower regions should be brushed perpendicularly.
Make sure this process is easy and quick by approaching your child correctly while brushing. Supporting the child’s head, retracting the tongue with your fingers, your visual position and your dexterity are important when brushing the teeth. In the chair: by moving behind the chair, supporting the child’s head with your arms or trunk, the child’s teeth should be brushed. While the child is sitting on a chair, parents can also perform the same procedure by sitting on a chair at the back.
Sitting: While the child is sitting on the floor, parents can sit on a chair behind the child and brush their teeth so that the child’s head is lightly pressed against your lap. Meanwhile, a pillow to place under the child’s head will also make the procedure easier.
The harmonious relationship and cooperation between the child, the parents and the dentist is important to ensure oral health in childhood. This becomes even more important for children with disabilities, chronic diseases or special needs. Nowadays, measures are taken to protect oral health with the protective approaches developed in dentistry.
Fissure sealants and fluoride applications applied by dentists and caries prevention are carried out effectively and protective applications are tried to be widespread.