Turkey, Izmir Children Dentistry- Pedodontist
What is Pediatric Dentistry (Pedodontics)?
In all healthy or infected, degenerated teeth, there are rooms in the form of a closed basin, which we call pulp chambers, where the blood and nerve package that feeds our teeth are located. Root canal treatment has become inevitable if unbearable hot and cold sensitivity or pain in the teeth occur due to tooth decay, trauma and similar reasons.Pediatric dentistry is a department of dentistry that deals with teeth and dental surrounding tissues in the age range from the time your baby is born to the age of 14. In pediatric dentistry;
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Protective procedures to prevent decay of milk and permanent teeth,
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Treatment of caries in milk and permanent teeth,
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Follow-up of jaw and facial development,
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Treatment of dental traumas,
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Detection of the relationship of systemic disorders with teeth, if any,
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Preventive dental treatments of mentally handicapped children is done.
How Are Teething Periods in Children?
In babies, the first teeth come out when they are 6-8 months old, and the eruption of milk teeth is about 3 years old. When the milk dentition period is over, your child will have 20 teeth in his mouth. The situation called the mixed dentition period occurs when the milk teeth shake and fall out on their own and the permanent teeth come instead. This period begins at the age of 6 and continues until the age of 12. At the age of 12 and after, there are no deciduous teeth in the mouth, and by the age of 13-14, a total of 28 teeth play a role in chewing and speaking.
Bottle Bruises
Baby bottle caries are caries that develop due to the use of baby food and sugary foods in baby bottles and children who have had their first tooth. Because of the bottle, the teeth are more exposed to sugary foods and this causes the milk teeth to decay faster.
Even if children use a bottle, it is the duty of parents to develop the habit of brushing their teeth. Regular dentist and pedodontist visits also prevent possible caries by taking preventive actions.
Thumb Sucking
Thumb sucking is a common habit in babies and children. The habit of thumb sucking in the period until the upper and lower permanent teeth erupt does not cause permanent damage to the jawbones and teeth. However, the habit of thumb sucking, which continues at the age of 6 and beyond, both causes skeletal deformations in the jaws and causes the teeth to protrude from their proper positions. A reward and punishment system can be used to discourage children with thumb sucking habits. However, if children cannot be discouraged from this habit, they should definitely get help from our dentists and pedodontists.
If possible, the first visit to the dentist in children should be made by the parents at the age of 3, when 20 milk teeth are in the mouth. The most important procedures in children are fluoride applications, which we call preventive dentistry, and fissure sealing procedures. These two applications, which we will talk about in our article, are procedures that are applied when there is no caries in the teeth and that make the hard tissue of the teeth more robust. Restorative procedures and placeholder procedures in primary and permanent teeth are more interventional applications.
Fluorine Applications
Fluoride, or fluorine, is an element in the periodic table that makes tooth enamel much stronger. This element, which contributes to the support of healthy tooth enamel, prevents caries-causing bacteria on the tooth surface from damaging the tooth enamel. Fluorine applications are definitely beneficial for the little ones with high caries rate.
Although there have been statements about fluorine in the past that it is harmful, none of them is evidence-based. For this reason, both FDI (World Dental Association), ADA (American Dental Association) and Turkish Dental Association stated that superficial fluoride application does not cause any harm to human health and can be applied safely.
What is Fluorine Varnish?
Fluorine varnish are dark gel-form structures that contain fluorine in a much higher concentration than the amount of fluoride found in toothpastes. The most important reason for applying fluorine varnish is that tooth enamel provides better defense against caries. Even if fluoride varnish plays a very good role in preventing caries, it provides us with much better results when sugary foods that we can classify as caries are not consumed together with regular tooth brushing.
Before starting the fluorine varnish treatment, it is recommended to be applied at certain intervals according to the age and amount of caries.
Fluorine varnish is a process that is applied to the tooth surface with a 5-minute process. It can be said that it is the most fun operation that children can easily do. After the fluorine varnish process, in order for the fluorine to be more effective from the tooth surface to the inner surface; We do not want our little one to consume any food, including water, for 30 minutes.
When is Fluoride Application Made in Children?
It is important for children to gain the habit of brushing after the first milk tooth erupts in the mouth. Superficial fluoride applications can be made after 3 years of age. If we, the dentists, deem it necessary after a routine dental check-up, we recommend the application of fluoride to the families.
Is Fluorine Application Harmful?
As we mentioned at the beginning of our article, superficial fluoride application is never a harmful process. On the contrary, fluorine is our building block that protects our tooth enamel. Associations such as FDI, ADA and TDB have made statements that surface applications of fluorine will not cause harmful systemic effects and should be used. In many academic studies, it has been proven that superficial fluoride application prevents caries formation.
Fissure Sealant
In children and adults, the chewing surfaces of the molars are more indented and protruding. We clinicians call these indentations and protrusions fit and fissures. Pits and fissures are the most suitable areas for the accumulation of food residues. If we consider pits and fissures as small pits, it is possible for food residues to enter these areas and cause tooth decay with the effect of bacteria due to inadequate oral hygiene. Often the ends of the bristle bundles of the toothbrush may be insufficient to clean these recesses and protrusions. Thanks to fissure sealants, these grooves and small pits are made shallower and caries formation is prevented.
What is Fissure Sealant Application?
Fissure sealant is the process of covering the chewing surface of non-carious molars with a fluid consistency filling material. In this way, the chewing surfaces of the teeth are completely protected against tooth decay.
What is the Purpose of Fissure Sealant Application?
Fissure sealant is the process of covering the chewing surface of non-carious molars with a fluid consistency filling material. In this way, the chewing surfaces of the teeth are completely protected against tooth decay.
How is Fissure Sealant Application Made?
The tooth or teeth to which the fissure sealant will be applied are cleaned with special brushes. Afterwards, special gels are applied to ensure that the tooth surface is ready for the fissure sealant process. Since the fissure sealant is in the form of dark streams, it is applied to the tooth surface and spread on the chewing surface of the tooth. Finally, the fissure sealant is cured with a blue light source. This process takes an average of 2 minutes for each tooth.
Who Can Apply Fissure Sealant?
Fissure sealant is a procedure that can be performed on all children whose primary teeth are erupted. Especially 3 years old is the period when the milk dentition ends. With this period, 6 years of age when the adult first molar erupts and 12 years when the second molar erupts are suitable ages for fissure sealant.
Does Fissure Sealant Application Require Anesthesia?
Fissure sealant is not a painful procedure during and after the application. For this reason, anesthesia is not required. It is very important that the tooth surface is dry in fissure sealant application. For this reason, it is important that the child and we dentists and pedodontists are in full harmony during the procedure.
Are Fissure Sealers the Final Solution for Dental Caries?
Fissure sealants are a supportive treatment in the formation and prevention of dental caries. Especially when applied together with fluoride applications, the rate of caries in the oral environment will be very low. However, if daily oral hygiene is not taken care of, caries may occur on other surfaces and other teeth, even if the formation of caries does not occur on the surface of the fissure-sealing tooth. For this reason, it is very important to gain the habit of regular tooth brushing.
On Which Teeth Is Fissure Sealant Applied?
Fissure sealant application is mostly applied to milk and permanent molars. In some cases where the risk of caries is high, it can also be applied to permanent premolars.
Restorative Treatments in Milk and Permanent Teeth
When the first milk tooth starts to come out in the mouth, the little ones should be given the habit of brushing teeth and it can be ensured that caries do not occur in their later years. Until the age of 3, all of the milk teeth erupt into the oral environment. All of the milk teeth fall out at the age of 11-12 and are replaced by permanent teeth. It is very important to try to keep the milk teeth in the mouth even if they decay in the journey until the permanent teeth replace the milk teeth. Because milk teeth support jaw development and guide the eruption of permanent teeth.
Dental traumas are included in the classification of restorative treatments in primary and permanent teeth. Teeth that are displaced or avulsed as a result of falling, impact or impact are tried to be repositioned in the oral environment as they should be. Tetanus vaccination may be required after dental trauma. If the tooth is completely dislodged after trauma, that is, if it has become avulsed, it should be brought to the dentist in saline or in milk.
Pain transmission mechanism works differently in children than adults. It is not possible for them to detect a small bruise, and they do not usually complain of hot and cold sensitivity as in adults. For this reason, parents unconsciously bring their children to the dentist when tooth decay is too advanced. Often, children tell their families that they have pain after eating, and parents apply to the dentist.
If deemed necessary after the examination, x-ray film is taken and the condition of the teeth is examined radiologically. Afterwards, the decayed structure is cleaned from the tooth surface; filler is restored to health by amputation or root canal treatment. In some advanced dental caries, unfortunately alltan may require tooth extraction before the age of permanent tooth eruption.
In order to avoid the need for restorative dental treatments, the little ones should stay away from sugary foods, acidic drinks, all foods considered as junk food, and they should brush their teeth regularly.
Placeholder Treatment
One of the most important functions of milk teeth is to guide the permanent tooth in the process from the bottom to the permanent tooth and to ensure that it continues in the ideal position for the permanent tooth along with growth and development. In case the primary tooth is lost prematurely, the fact that the extraction space is not closed by other teeth facilitates the eruption of the permanent tooth in the correct position. In case of loss of space, the need for orthodontic treatment is seen more. For this reason, placeholders are of great importance in early loss of primary teeth.
What is Early Milk Tooth Loss?
Thumb sucking, long-term use of pacifiers, insufficient intake of breast milk cause damage to milk teeth. Similarly, loss of milk teeth may occur due to caries. Milk teeth that are lost due to these reasons before their time is called premature milk tooth loss. Placeholders are recommended by us, dentists and pedodontists, in order to minimize the need for orthodontic treatment in the future in early loss of primary teeth.
What is a Placeholder?
placeholder; They are fixed apparatus that are placed in the post-extraction cavities of the prematurely lost milk teeth, placed on the back tooth with a round ring, extended with small wires towards the cavity side and adhered to the inside of the mouth. These mentioned placeholders are fixed placeholders. Fixed placeholders can be easily removed with a simple operation when the permanent tooth comes from the bottom and completes its task. Moving placeholders, on the other hand, are made by taking measurements and if possible, it is requested to be used 24 hours a day. Movable placeholders are appliances that are suitable for multiple primary tooth deficiencies.
Is a Placeholder Necessary for Every Milk Tooth Loss?
It is recommended by pedodontists and dentists to replace all milk teeth that are lost prematurely. If it is observed by X-ray that there is a time close to permanent tooth development, then there is no need to make a placeholder.
What are the Considerations When Using Placeholders?
Our little ones who use fixed or movable placeholders should first of all pay attention to their oral hygiene. If good oral hygiene is not provided, the formation of new caries will be inevitable. Although not so much in moving placeholders, sometimes little ones may have painful places on their palates. When such a situation is encountered, families should immediately apply to their physician and the little ones should be relieved with a small procedure. Again, movable placeholders should be removed after meals, cleaned well, brushed and continued to be used afterwards.
