Pediatric Dentistry
Children are recommended to have a dental check-up every six month. Children’s teeth can change radically within a relatively short period of time. Such changes include shedding teeth, chronic decay of temporary and permanent teeth, or rapid tooth decay. Decayed milk teeth should be filled, since decay can spread to the neighbouring teeth or the newly erupting teeth. Healthy milk teeth are essential in order to ensure symmetrical development of the dental arch and the jaw bones. Early loss of milk teeth can lead to problems requiring orthodontic treatment.
When developing their oral hygiene habits, children follow their parents’ practices, and their attitude to regular dental check-ups reflects their parents’ attitude. In order to set a good example and create a good atmosphere at dental visits, we have introduced a family dentistry model. We make a treatment plan for the whole family and you can come to the treatments together with your children. It is also very important to teach proper oral hygiene practices when both the parents and the children are present.
When shall I start brushing my child’s teeth?
Teaching good oral hygiene habits must be started at an early age, so we would like to warn pregnant women and highlight the fact that proper nutrition starts while your baby is still in your womb, and you should start proper oral hygiene when your child is still an infant. When you breastfeed your baby, clean the gum after feeding with a soft piece of cloth, and as soon as the first teeth erupt, you should start brushing them. There is a wide variety of tooth brushes, our dental hygienist will help you chose a tooth brush that fits your child’s age.
Learn more about proper oral hygiene for children, do not hesitate to consult our dental hygienist.
Why is it important to take my child to the dentist every six month?
It is important to find the best time for fissure sealing and to reveal the need for orthodontic treatment in time. Children who had regular visits to the dentist in their childhood are more willing to have regular check-ups as adults. If you visit us regularly, we can reveal improper brushing techniques and dental problems, so we can start treating them earlier. We can avoid drilling or it involves slight discomfort only.
What is fissure sealing? This treatment is not widely known yet…
Fissure sealing: Fissure sealing is a treatment to form a barrier on permanent back teeth. Since the efficacy of tooth brushing is not perfect in early childhood, plaque can accumulate on the rough chewing surfaces of molar teeth causing tooth decay in the grooves. Fissure sealing involves applying light cured fluoride varnish to the chewing surfaces of newly erupted healthy permanent teeth to fill the grooves. The first treatment is performed at around the age of six, when the first permanent molar erupts.
Dental traumas in childhood
The children spend more time outdoors in summer. However, the number of dental traumas suffered by children also increases. Common causes of accidents in little children include ride-on toys: trikes, scooters and bicycles. Pads and helmets can protect your children and their teeth, however, it is good to know what to do if they have an accident. Consult your dentist as soon as possible. When dealing with dental trauma patients, we use the classification of dental traumas by the International Association of Dental Traumatology and follow their guidelines. If a bigger piece of the tooth is chipped, the pulp is exposed and it can cause increased sensitivity. It can even lead to the death of the tooth. If the tooth suffers a complete fracture, the pulp chamber is opened. Such fractures require immediate root canal treatment of the tooth. If front teeth are fractured as a result of a blow, the periodontal structures can also get damaged.
Such injuries are often associated with pain on biting, sensitivity or mobility of the tooth, which require prompt splinting. The splint is left on the teeth for a few weeks allowing the periodontal structures to heal, then it is removed. If your child suffers a dental trauma, visit your dentist or consult any dentist as soon as possible. Do not delay in receiving dental treatment if your child has pain on biting or chewing.
Unhealthy dental habits in childhood
One of the most common dental habits in childhood is thumb sucking, as many as 35–40% of children suck their fingers. It is a natural habit for newborn babies or infants to get acquainted with their environment by stimulating their tongue or lips. Thumb sucking can help them relax or just spend time. However, prolonged or regular thumb sucking can have an effect on the development of the teeth and the jaw bones. The type of the resulting dental abnormality depends on the length, frequency and intensity of thumb sucking. 4–6 hours of thumb sucking a day can cause the teeth to drift. The most typical abnormalities include open bite, narrowing of the upper jaw, cross bite, protrusion of the upper incisors, inclination of the lower incisors, or shifting of the lower jaw backward. Normal closure of the dental arch is disrupted and it can result in improper chewing, decreased aesthetics or speech defects.
Thumb sucking is not hygienic, it can lead to infections. If thumb sucking becomes a permanent habit, you should try and make your child to quit it before the age of 4. Children older than 4 years of age are more likely to develop a dental abnormality affecting their jaw bones or teeth, and these abnormalities will require orthodontic treatment.
Circular caries
Nowadays paediatric dentistry has been focusing on preventive treatments to reduce the risk of tooth decay. Suir Clinic recommends regular dental check-ups for children every six months. Fissure sealing and fluoride treatment are effective preventive measures, but parents should also take care to prevent tooth decay.
Milk teeth tend to decay because the thickness of their enamel is half of the thickness of permanent teeth, so it is much thinner. Children can develop tooth decay as early as 6 –12 months after the eruption of their teeth. Tooth decay can present slowly (cariessica) leaving relatively hard brownish spots on the tooth surfaces, or it can develop rapidly (carieshumida) leading to softening of the hard tissues.
Early Childhood Caries (ECC) is defined as a filled or lost tooth due to tooth decay with or without cavity formation between birth and the age of 71 months (American Dental Association). Upper incisors are most prone to tooth decay. However, back teeth (molars) can also be affected. Molar caries can be mild (presenting before the age of six) or severe (presenting before the age of 3). Tooth decay can also be classified according to its etiology, site or progression (circular caries, baby bottle caries).
Circular caries is tooth decay that develops on the external (labial) surfaces of the incisors at the gum line and spreads along the dental arch. It can appear as early as one year of age. Causes include external (exogen) factors, such as sweet drinks (tea, fruit juice, sugar containing soft drinks) or decay causing (cariogenic) foods with high acid and sugar content. Internal (endogen) factors include early birth, exudative diathesis, TB or rickets. Circular caries develops in a symmetrical pattern, and the incisor crowns usually break off before the eruption of the second molars. If circular caries is left untreated, the decay spreads to the canines and the molars as well, leading to severe damage of the whole denture by the age of 2–3 years. The saliva contains a high level of cariogenic microorganisms, such as Steptococcusmutans or Lactobacillusacidophilus. Treatment includes changing the child’s diet and cutting out decay causing foods. At an early stage adhesive techniques (fissure sealing or liquid bonding) can be effective. At an advanced stage filling, bonding or crown placement can help. However, if we cannot save the tooth, it has to be removed (extracted). In this case we should consider the effects of the extraction on the child’s speech development, and we should also secure room for the permanent teeth.
Lower front teeth appear behind the milk teeth
Parents are often afraid and come to the clinic because their child has two rows of front teeth, but that is a natural way of shedding teeth. Lower front teeth appear behind the milk teeth from the direction of the tongue. This is how a situation illustrated on the photo can occur in a 6-year-old child. Both lower front teeth have come out, and the lower milk teeth are still in the mouth. The length of time lower milk teeth are shed varies, but they usually become loose and fall out within a few weeks or months. The tongue, the muscles and the changes resulting from growing usually push the permanent teeth to their proper position in the dental arch.
