PEDODONTICS
(Oral and dental health in children)
Pediatric dentistry is a branch of dentistry that aims to protect the oral and dental health of children ages 0-13 and address problems arising from decay, trauma, and genetic causes. Dentakademi Kids, a prominent pediatric dentistry hospital in Istanbul, offers state-of-the-art medical equipment and expert pediatric dentistry to address all children's oral and dental concerns in Istanbul.
By the time a baby is 3 years old, they have 20 well-spaced baby teeth in their mouth. The spaces between baby teeth become important during tooth replacement. These spaces create sufficient space for the larger permanent teeth to emerge. These spaces also make it easier for the child to clean their teeth.
A newborn's teeth are hidden beneath the gums. By the baby's sixth month, they begin to erupt and become visible above the gums. This process can vary from baby to baby. The first teeth to appear are the two front teeth in the lower jaw. This is followed by four teeth from the front of the upper jaw and two more from the lower jaw.
Why are milk teeth important?
Primary teeth are crucial for children's growth and development. Primary teeth facilitate the transition from a milk-based diet to a more diverse and solid diet at the beginning of life. Primary teeth are considered essential for preparing food for digestion during the early years.
· Milk teeth protect the permanent teeth germs underneath them against minor traumas that are very common in children and ensure their normal development, away from harmful external factors.
If the upper and lower milk teeth have a normal closing, they help the lower jaw to take a normal position and ensure the optimal eruption of the six-year-old teeth.
· Primary teeth guide the permanent teeth. The healthier the primary teeth, the healthier the permanent teeth that will emerge. The periodic shedding of primary teeth allows the permanent teeth to take their place in the jaw and participate in the occlusion.
The primary set of teeth, by fulfilling the chewing function, indirectly contributes to jaw development. The functioning of the chewing muscles ensures proportionate jaw development.
· Primary teeth also affect speech and phonation. When the front primary teeth are missing, the pronunciation of some vowels is impaired.
· Baby teeth are also very important for aesthetic reasons. School-age children, in particular, often make fun of each other when they are missing teeth.
Until your child reaches 6-8 years of age, they'll need your help with brushing. You should help your child brush at least twice a day: once in the morning and once just before bed. Be careful to keep food particles off the teeth (especially the molars). The grooves and ridges on the molars provide surfaces where debris can cling.
When do milk teeth appear, how many are there, and when do they fall out?
The first primary teeth begin to appear around 6 months. This process can vary from baby to baby (ranging from 3 to 12 months). Primary teeth are completed around 2.5-3 years of age. There are 20 primary teeth in total, 10 in each upper and lower jaw. The mixed dentition begins at age 6. The process of change begins around 5-5.5 years with the loosening of the lower incisors. Because these first front teeth become loose and fall out, parents often assume that the remaining primary teeth will come in a few months or years. However, the average age for primary molars to come in is around 10-11 years. The age at which primary teeth fall out can vary from child to child.
When Should You See a Doctor?
The first dental checkup should be done within six months of the first tooth appearing. This first dental checkup is important because it teaches families how to properly clean their baby's teeth and how to properly care for them. Early childhood cavities (baby bottle tooth decay) can develop as a result of poor eating habits and the belief that baby teeth will eventually fall out. Regular checkups after the first checkup can help prevent this.
Baby Tooth Decay
There are many risk factors for decay in milk teeth.
Nighttime feeding: Continuing breastfeeding, especially at night, after 18 months poses the greatest risk to baby teeth. While breast milk offers many protective properties, breastfeeding at night, once baby teeth emerge, can lead to early childhood cavities. This is because saliva flow, which cleans teeth during the day, decreases at night, allowing breast milk to remain on the surface for extended periods. This results in early cavities , starting with a chalky white appearance in baby teeth and progressing to fractures.
Letting the child brush: Considering that motor function is achieved around age 8-9, it's unlikely that a child will be able to brush their own teeth. Self-brushing criteria include being able to tie their shoes and groom their own hair. Parental brushing before bed is especially important. They can be given the opportunity to do it themselves in the morning.
After brushing, drink milk before going to bed: Mouth inhalers used for allergic asthma etc.: Since these orally administered medications contain a certain amount of sugar, the mouth must be rinsed with water to prevent decay.
The quantity and frequency of snacks: Substituting pure chocolate for wafers and encouraging saliva flow by chewing gum can reduce molar decay. Nuts and dried fruit can be preferred as snacks. Snacking frequency can be reduced.
What to do when there is a cavity?
Tooth decay is one of the most common oral health problems in children. Tooth decay in primary teeth is a preventable and reversible infection. However, if left untreated, it can lead to pain, abscesses, malnutrition, decreased growth and development, speech disorders, premature tooth loss, and, unfortunately, social exclusion from some peers. Therefore, preventive measures are crucial in combating tooth decay, a preventable disease.
Tooth Discoloration
My Child's Teeth Are Colored!
Tooth discoloration can occur in both permanent and primary teeth. Discoloration, particularly in the front teeth, can cause aesthetic concerns in both parents and children. The increasing visual perception of children and adolescents can sometimes negatively impact their psychology, leading to a lack of self-confidence and social isolation.
These discolorations can appear brown-black, yellow-orange, or green-gray. These discolorations can sometimes be mistaken for caries, and a pediatric dentist should be consulted as soon as possible to determine the cause, treat it, and take the necessary precautions.
What Causes Discoloration in Teeth?
Although there may be many reasons for discoloration, the most common reasons are inadequate oral hygiene, use of iron medications, and the increase of some color-causing bacteria in the mouth.
What Causes Black and Brown Coloration?
These are the most common discolorations in children. Studies conducted in Turkey on children aged 5 to 13 have calculated the prevalence of this type of discoloration to be approximately 17%. This means that this condition is observed in approximately one in every five school-aged children. It generally appears in spots or bands near the gums, parallel to the gums. It is most often seen on the upper front teeth, which do not benefit from the rinsing effect of saliva. It is caused by an increase in the amount of color-producing bacteria in the mouth. These bacteria are called chromogenic bacteria. This type of discoloration occurs when the chemicals produced by chromogenic bacteria combine with the iron in saliva or gingival fluid. Therefore, the use of iron-containing medications increases the likelihood of discoloration.
What Causes Gray-Green Colors?
This type of tooth discoloration, which can appear gray, brown, or green, is usually found in the upper front primary teeth. This type of discoloration, which is twice as common in boys as in girls, is caused by tissue residue left on the tooth surfaces during the eruption of primary teeth. If this membrane, called Nasmyth's membrane, which surrounds the tooth surfaces, does not break down completely and remove itself over time, this type of discoloration occurs as a result of the proliferation of chromogenic bacteria in the area.
What Causes Yellow-Orange Colors?
This type of discoloration is seen in areas near the gums in cases of inadequate oral hygiene. It is more common in the upper or lower front teeth. This type of discoloration is often seen in children with malnutrition.
Discoloration or Rot?
These two conditions can often be confused, especially when there are dark discolorations. If you experience sensitivity or pain, you should consult a pediatric dentist as soon as possible. Treatment for decay may be necessary.
So, What Should Be Done About Discolorations Inside the Teeth?
In addition to the external discolorations mentioned above, we can sometimes observe other discolorations within the internal structure of the tooth. These discolorations can develop due to medication (especially tetracycline), high fluoride intake, genetic disorders, or other causes. A detailed examination is necessary for diagnosis and treatment .
General Anesthesia in Children
How is General Anesthesia Performed in Children?
General anesthesia is one of the methods used for dental treatment. General anesthesia is performed in a hospital setting through a teamwork between a dentist and an anesthesiologist. Before general anesthesia, the child is examined by the anesthesiologist, and the results of the tests are evaluated. The anesthesiologist determines the child's suitability for general anesthesia after the examination.
How is Anesthetized Dental Treatment Performed in Children?
The anesthesiologist and their team prepare the child for the procedure, put them into sleep, monitor them during the procedure, wake them up after the procedure, and manage their recovery. Dental treatments are completed by the dentist and their team while the child is asleep. All necessary dental treatments and protection are performed during general anesthesia. The goal is to completely treat stains, decay, and infections in the mouth.
It is very important for children who undergo dental treatment under general anesthesia to attend regular checkups at the doctor's discretion and maintain oral hygiene and a healthy diet. During follow-up examinations, which should be conducted at least three times a year, the dentist evaluates the child's diet and oral hygiene. Simple procedures are also used to help the child adapt to dental care and overcome anxiety about dental treatment. Easily implemented preventative measures are also implemented to prevent new cavities and recurrence of similar conditions. Anxiety often subsides spontaneously in children who see their teeth being treated and no longer problematic after general anesthesia. They sit in the dentist's chair with greater confidence and comfort. Another common problem encountered in children treated for dental caries after general anesthesia is a rapid increase in appetite and weight gain as their teeth begin to function.
Who Can Benefit from Anesthetized Dental Treatment?
This method is used for children who are unable to demonstrate the necessary compliance with dental treatments in a clinical setting (in the dentist's chair), who fail to respond positively to the behavioral guidance techniques the dentist uses from the initial examination, who are unable to overcome a pre-existing dentist phobia, and who are too old and unwilling to tolerate the severity of their cavities and the intensity of the treatment required. General anesthesia is also used in children with chronic systemic conditions that make clinical treatment risky, those with a gag reflex, or those whose syndromes (autism, Down syndrome, etc.) make dental treatment in an in-office setting unfeasible.
When is General Anesthesia Used?
General anesthesia is generally not a method immediately decided upon after the initial examination, which takes place in a clinic setting, where the child and doctor meet. The doctor first assesses the child's ability to sit in a chair. This assessment may take several sessions. When deciding on general anesthesia, the doctor considers the child's anxiety level and the psychological pressure it creates, whether the caries are manageable and manageable, the gag reflex, and any systemic conditions or syndromes that could pose a risk during clinical treatment. This process, which should be conducted in collaboration with the family, is crucial for the family to comply with the doctor's recommended intervals and to be patient. Following the evaluation, which may take several sessions, general anesthesia is used in children whose treatment in the dental chair is not possible.
Teeth Grinding
What is Teeth Grinding (Bruxism)?
Teeth Grinding
What is Bruxism?
Teeth grinding, medically known as bruxism, is the unconscious clenching or grinding of teeth, usually during sleep. Children grinding their teeth during sleep, and sometimes even during the day, can be a cause for concern for parents.
What Causes Teeth Grinding in Children?
It's normal for children to grind their teeth at a moderate level when their primary teeth fall out and their permanent teeth erupt. Light abrasions on the chewing surfaces of primary canines and molars, in particular, are important as the jaw grows, making room for the new permanent teeth. Furthermore, the pressure on the gums during the eruption of permanent teeth stimulates nerve endings and chewing muscles in the surrounding tissues. This type of teeth grinding usually disappears once all permanent teeth have erupted.
Could There Be Another Reason I Hear My Child Grinding Their Teeth?
Other factors that cause teeth grinding include conditions related to the child's general health and psychology.
Digestive disorders such as reflux and intestinal parasites, and respiratory problems such as sinusitis, allergic bronchitis, and asthma, can also trigger teeth grinding. These are often thought to be the causes of teeth grinding observed between the ages of 1 and 3. In older children, factors that may cause emotional stress (e.g., the arrival of a new sibling, disagreements between parents, problems at school) can also trigger teeth grinding. These factors can be considered in children who exhibit intense and loud teeth grinding. Especially when psychological problems persist, bruxism can lead to jaw joint problems and facial, head, and neck pain later in life.
Is There a Treatment for Teeth Grinding in Children?
Simply put, when the factors that trigger teeth grinding in children are eliminated, teeth grinding significantly disappears. In this regard, obtaining detailed information about the frequency and severity of the child's teeth grinding, the presence of any diagnosed health problems, and any medications they are taking is crucial for identifying the cause. If elevated fillings are detected during an oral examination, these fillings should be corrected first.
If it is thought that teeth grinding may be related to an existing health problem, this problem should be treated first. Treatment will also reduce teeth grinding.
It is important to remember that teeth grinding can also have an emotional origin. While families often recognize the psychological cause of this condition, in severe cases, the family, psychological counselor, and dentist may need to work together as a team. A temporary appliance (palatal brace) will be prepared during this time to prevent teeth grinding.
The application of fluoride agents to the tooth surfaces prone to wear due to teeth grinding provides protection.
Regular dental checkups and early preventative measures can help prevent teeth grinding and the joint disorders it can cause later in life.
Fluoride Application
What is Topical Fluoride (Fluoride) Application?
Fluoride is a natural compound that strengthens tooth enamel, destroys the structure of decay-causing bacteria, and prevents mineral loss from enamel against acid attacks that occur after meals. Topical fluoride application is a preventative treatment, involving the application of a high-fluoride gel-like preparation to the tooth surfaces with a brush.
Does My Child Need Fluoride Application?
During a pediatric dentist's examination, the necessity of fluoride treatment and its frequency are determined by considering factors such as the patient's age, the number of cavities and the risk of new cavities, and their diet.
Is Fluoride Application Safe?
Fluoride application performed regularly in the office is completely safe and has been scientifically proven to be protective.
What is the Purpose of Fluoride Application?
The goal is to strengthen the enamel, the building block of tooth enamel, with fluoride, making the tooth structure more resistant to decay.
Which Teeth Can Be Fluorinated?
Fluorinated gel is applied to all surfaces of all teeth.
Is Fluorinated Gel Chemical? Does It Have Side Effects?
When applied correctly, there are no side effects.
How Long Is Fluorinated Gel Effective?
Fluorinated gel is effective for 4 to 6 months, depending on your child's decay risk group. It should be repeated after this period. This way, each new set of teeth will receive the necessary amount of fluoride after a certain period.
How Is Fluorinated Gel Applied?
During Fluorinated gel application, specially prepared fluoride preparations are applied to saliva-free tooth surfaces using a special toothbrush.
How Long Does Fluorinated Gel Applied?
Fluorinated gel is a very simple preventative treatment that takes approximately 5 minutes.
What Should You Keep in Mind After Fluorinated Gel Application?
Do not eat or drink for 1 hour after application. Do not consume milk or dairy products, including ice cream and chocolate, for 24 hours.
What Happens If Dairy Products Are Consumed?
The effectiveness of the treatment will be weakened. It will not harm your child.
What Happens If We Don't Apply Fluoride?
The child will be deprived of a decay-protective and tooth-strengthening treatment.
Fissure Sealant
What Does Fissure Mean?
The grooves and grooves on the chewing surfaces of our primary teeth and permanent molars are called "fissures." These areas are the most prone to decay because they are the back teeth and are difficult to clean and prone to food accumulation.
What is Fissure Sealant?
This process involves filling these grooves and grooves, which we call fissures, with a gel-like material and hardening them with a special light. It is a type of filling. It is considered a preventative treatment.
Which Teeth Can Be Applied?
It can be applied to primary molars, permanent premolars, and molars.
At What Age Can It Be Applied?
It can be applied from the age of 3 (the age when all primary teeth have erupted).
How Long Does It Last? Is It Necessary to Have It Done Again?
Sealants applied to primary teeth remain in place until the teeth fall out. Sealants applied to permanent teeth can be used indefinitely, except for minor abrasions and minor fractures. During regular checkups, any abrasions, minor fractures, or dislocations are repaired or replaced by the dentist.
Is the treatment difficult? How tolerable is it for children?
Because it's painless and often doesn't even involve mechanical abrasion of the teeth, it's a relatively easy treatment. The procedure takes a short time and can be easily applied even to young children.
Are Fissure Sealants an Expensive Treatment?
Fissure sealants are less expensive than traditional fillings. Because they are a preventative treatment, they can prevent future dental problems, making them a cost-effective treatment option.
Frequently Asked Questions (FAQ) About Pedodontics (Pediatric Dentistry)
Q: When should I bring my child to the dentist for the first time? A: We recommend that your child's first dental visit begin when their first tooth emerges (usually between 6 months and 1 year of age). This first visit focuses on getting to know each other and helps your child get used to their environment while also providing you with important information about nutrition and preventative care.
Q: Why is it important to see a pediatric dentist? Can't a regular dentist provide care? A: Pedodontists are physicians with specialized training in pediatric dentistry. They manage not only dental treatment but also your child's psychological well-being, growth, and development. They understand children's fears, establish a personal connection with them, and focus on preventing future dental phobia (dentophobia).
Q: Baby teeth will change anyway, so if they decay, isn't it better to remove them rather than treat them? A: This is the most common, yet most dangerous, misconception among parents. Baby teeth are essential for your child to eat properly, speak, and smile. More importantly, they act as "space maintainers" for the permanent teeth that will emerge. If a baby tooth is removed prematurely, the space closes, leaving the permanent tooth either impacted or crooked. This can lead to the need for expensive and lengthy orthodontic treatment (braces) in the future.
Q: What is Fissure Sealant (Dental Graft)? Is it necessary? A: Fissure sealant is a protective, fluid-filled filling material applied to the deep grooves (fissures) on the chewing surfaces of newly erupted permanent molars (6-year-old teeth). These grooves are too deep for a toothbrush to reach, and this is where decay usually begins. Fissure sealant protects teeth against decay by up to 80% by sealing these areas without causing any damage. It is an absolutely essential preventative treatment.
Q: What is fluoride application? Is it harmful to my child? A: Fluoride is a mineral that strengthens tooth enamel, making it resistant to decay. Topical fluoride application, which we use in our clinic, involves applying a highly concentrated yet safe amount of fluoride to teeth under the supervision of a dentist. This treatment provides far more protection than the fluoride found in toothpaste. When performed under professional supervision, it has no proven harm to your child; on the contrary, it is one of the most effective methods for preventing decay.
Q: My child is terrified of the dentist. How will you handle their treatment? A: Our priority at our clinic is always to gain your child's trust. Our pediatric dentists provide personalized attention, using games and a language they can understand to explain what will be done (the "tell-show-do" technique). If your child's anxiety is very high and they can't be persuaded, we also offer sedation or general anesthesia to ensure comfortable and safe treatment.
Q: When should I start brushing my child's teeth? A: You should start brushing as soon as the first tooth appears. You can use a finger brush or a soft, clean piece of muslin for the first teeth. Starting at age 1, you can use a soft-bristled toothbrush appropriate for your child's age.
Q: Which toothpaste should be used for children? A: Swallowable or fluoride-free toothpastes are recommended for children up to age 3. However, the American Association of Pediatric Dentists (AAPD) recommends using a pea-sized amount of fluoride toothpaste starting at age 3. The most important thing is the amount of toothpaste and ensuring the child spits it out after brushing. Our dentists will provide you with the most accurate information on this matter.