Pedodontics

WHY DO CHILDREN’S TEETH DECAY?

The thickness of the enamel and dentin layers of primary teeth is equal to half the thickness of the enamel and dentin layers of permanent teeth. In addition, milk teeth contain more organic matter than permanent teeth. For this reason, milk teeth are more prone to decay.

Children cannot pay as much attention to oral care as adults. For a young child, it is especially difficult to clean the back teeth. Parents should educate their children about the protection and improvement of oral and dental health, the necessary practices to prevent diseases that may occur, and the establishment of appropriate behaviors and habits for this purpose.

Children cannot detect symptoms such as hot and cold sensitivity and mild pain that can be seen in the early stages of caries formation. However, when very severe pain occurs, they realize that it may be too late.

The child is fed mostly breast milk and formula at an early age. At that time, the growth and development of the baby is more important for the family.

With the thought that the baby will be fed better, the parents add sugar or honey to the milk, food during or between sleep and give it to the baby. In addition, a pacifier or a bottle is dipped in honey or jam and given to the baby. These and similar practices cause bottle tooth decay in the child.

Is it possible to prevent the formation of caries?

Today, a vaccine or drug that can prevent caries formation has not been developed yet. However, there are applications aimed at reducing the formation of caries and protecting the tooth surface from decay. The first of these is to strengthen the tooth surface by adding fluorine. Fluoride can be added to the structure of enamel during the formation period of the tooth. In this way, enamel becomes more resistant to acids.

There are two ways to intake fluorine. The first is the local application of fluoride. Local application can be in two ways.

Professional Practice: It is the practice of the dentist himself. It takes place by applying certain fluorine-containing substances to the teeth.

Personal Application: Toothpastes and mouthwashes containing fluorine can be used.

Another way for fluorine uptake is by systemic administration of fluorine. It takes place using fluorine tablets or drinking fluorinated water. The dentist or pediatrician should be consulted for systemic fluoride use.

Other applications to reduce the formation of caries in teeth are sealants-fissure sealants. There are indented protrusions called fissures on the chewing surfaces of the teeth. Tooth brushing is not effective enough in fissures of the teeth. Decay formation can be prevented by covering the fissures by applying special substances that we call fissure sealants. Although bacteria produce acid, they will not be able to reach the tooth through the fissure sealant.

WHAT IS THE IMPORTANCE OF MILK TEETH?

Many people do not care about milk teeth, thinking that they will change anyway. Milk teeth, a total of 20, continue to perform some tasks until the child is 12-13 years old.

The primary task of milk teeth is to prepare food for digestion. They help the development of the jaws by performing the chewing function. The proportional development of the jaws is achieved by the work of the chewing muscles.
Deciduous teeth protect the underlying permanent tooth germ against external factors such as trauma, which is frequently seen in children.
They are effective on speech and phonation. The proper development of speech depends on the presence of milk teeth.
Milk teeth protect the area they occupy for the permanent tooth that will come after them and guide it while the permanent teeth are erupting.
Finally, milk teeth have an aesthetic function. Teeth contribute greatly to a person’s appearance. When the child is 6-7 years old, losing his front teeth is normal because he sees it in his other friends. However, psychological problems may occur in early tooth loss.

SHOULD MILK TEETH BE TREATED?

The period of deciduous teeth and the subsequent mixed tooth period (milk teeth-permanent teeth) coincide with the period when development is most active. Determination of the adult body takes place in this period. For this reason, milk teeth are equally important in these early stages of development as long as a permanent tooth row is necessary for adolescents and adults.

If milk teeth are not treated, many problems will occur.

Even superficial caries threaten neighboring teeth with the risk of decay.
If the decay progresses and reaches the nerve of the tooth and causes inflammation over time, it may cause various disorders by affecting the permanent teeth that will come from below.
If the milk teeth are extracted early, the extraction gap is closed in such a way that the permanent tooth coming from below cannot be placed, and a perplexity occurs.
Decayed teeth cause bad breath and the child’s inability to chew on the side of the decayed tooth.
It may cause the child to be acquainted with pain at an early age and to develop some phobias in the future.

WHAT IS PEPPER COT?

Breast milk or artificial milk and formulas, which are the most important nutrients in baby nutrition, naturally contain sugar. In addition, since the development of the baby is at the forefront for the family at that time, sugar or honey is added to the milk or formula with the thought that it will be fed better. If the baby sucks breast milk or a bottle before going to bed at night, the milk or formula accumulates in the mouth and remains in contact with the teeth for a long time. Due to the sugar in its content, this long-term contact creates a suitable environment for decay. Particular attention should be paid to the baby’s oral hygiene after feeding before sleep. It will be appropriate to drink water after feeding.

To prevent the formation of baby bottle decay;

Prevent your baby’s habit of sleeping with a bottle at night.
Do not add sweeteners such as honey or sugar to the formula or artificial milk. Also, do not give the pacifier to the baby by dipping it in honey or jam.
After feeding your baby, clean his mouth with a clean cheesecloth.
Drink water after the baby is fed.
To reduce tooth decay in your child;

Help him brush his teeth. Teeth should be brushed under the supervision of an adult twice a day, after breakfast and before going to bed.
Bring your child to the dentist at an early age, have a fissure sealant applied to his teeth.
Pay attention to the use of baby bottles to prevent the formation of baby bottle decay.
Have your child take fluoride. Make use of available sources, drinking water, fluorine tablets, fluoride toothpastes and mouthwashes and fluoride applications by the dentist. However, because overuse of fluoride is harmful, consult your dentist or pediatrician about this.
Children often enjoy eating junk food between meals. Sugar and starch taken in these snacks feed the bacteria that cause caries. For this reason, you should make sure that your child’s meals are regular.

WHEN SHOULD THE FIRST DENTIST EXAMINATION BE DONE IN A CHILD?

Since the first dental examination is the child’s first encounter with the dentist, it constitutes a step in his life. Previously, it was thought that the first dentist examination should be done after all the deciduous teeth erupt, ie at the age of 2.5-3. However, according to the new literature information, it has been accepted that the first dentist examination will be performed around the age of 1 year, since children can have bottle caries at a very early age will prevent complications that may occur later. In this way, both the white coat phobia does not occur in the child, and the parents can be given useful information about the oral and dental health and nutrition of the child.

Advice That Can Be Given To Parents

The child should be brought to the dentist at an early age so that he can meet the dentist without problems.
The dentist should not be used for criminal purposes.
Bribe should not be given when bringing the child to the dentist.
For the dentist’s procedure, the child should not be promised that it will not be done before.
The child should not be teased in order to overcome his fear.
Parents should not show their fears in front of the child.
The procedures to be done a few days before going to the dentist can be explained to the child.

FISHING SEALANTS – FISHING SEALANTS

There are indentations and protrusions called fissures on the chewing surfaces of the teeth. The places where bruises begin are usually fissures. Fissure sealants are transparent or white fluid materials applied to fissures to prevent the formation of caries.

How Does Fissure Sealant Prevent Caries Formation?

Although your child regularly carries out oral care every day, the indentations and protrusions on the teeth cannot be completely cleaned. Food residues and bacteria settle in these narrow spaces, threatening the tooth with the risk of caries. Since the fissure sealants are fluid, they reach the deepest point of these indentations and block these areas. Thus, bacteria cannot reach these areas.

Who and Which Teeth Is Fissure Sealant Applied?

The fissure sealant can be applied to any tooth with fissure on it, there is no problem. Fissure bruises occur more and more easily in children and young people. For this reason, fissure sealant is usually applied to large molars with the highest risk of caries in children who have recently erupted permanent teeth.

How is Fissure Sealant Applied?

Fissure sealant application is a quick and comfortable procedure. Since there is no abrasion on the tooth, it is painless and takes a short time, the procedure ends in just one session.

Is Fissure Sealant Application Expensive?

Fissure sealant fee is cheaper than filling fee. Considering that the fissure sealant will protect the tooth from caries formation, it is very economical.

How Long Does the Fissure Sealant Stay in the Mouth?

Fissure sealants are materials that can be eroded over time. However, research shows that they stay in the mouth for many years. Very hard foods and teeth grinding habit can cause the fissure sealant to break or fall off quickly. If regular dental checks are made, fractures or falls occurring in fissure sealants are detected on time and necessary.

Fissure sealant is an application only to prevent the formation of caries. If your child does not care about oral care, no method can prevent tooth decay.

SPACE HOLDERS

Milk teeth fall as a result of the melting of their roots due to the pressure of permanent teeth coming from below. However, sometimes milk teeth may be lost prematurely due to extraction as a result of an impact or decay. When the milk tooth is lost early, the teeth on both sides bend towards the extraction cavity, the teeth in the opposite jaw extend towards this space. In this case, the necessary distance for the permanent tooth will be lost from the bottom, crowding occurs in the permanent teeth.

In order to protect the place of the permanent tooth coming from the bottom in early milk tooth losses, the appliances called placeholder are used. Placeholders prevent neighboring teeth from moving into the extraction cavity, keeping them fixed. Placeholders are passive appliances, they do not apply force to the teeth in any way.

Placeholders are implemented in two ways.

Fixed Place Holders: Used in case of a single tooth missing. As the name suggests, it is fixed, the patient cannot be removed.

Movable Place Holders: They are used in the absence of more than one deciduous tooth. The patient can put on and take off the appliance.

TEETHING

The first tooth comes out on average in the 7th month. However, some children’s teeth erupt early and others late. This has no medical significance. It has been determined that hereditary factors are effective in the eruption time of the teeth. Average eruption times of deciduous teeth are shown below.

What Happens When Teeth Are Growing?

Teething symptoms may occur 1-2 months before the teeth are erupting. These symptoms vary from child to child. However, the following symptoms are usually seen during teething in babies.

Drooling: Salivation increases in the baby during the teething period. Redness and cracks can be seen in the chin or around the mouth due to the irritation caused by saliva contact.

Biting: A teething baby tries to soothe their gums by putting everything they can in their mouth.

Pain: Inflammation develops in the gum due to the pressure that occurs during the eruption of the tooth. This can cause pain in some babies. As the inflammation increases, the pain becomes constant and causes the baby to show discomfort.

In addition to these, symptoms such as refusal to feed, insomnia, diarrhea and fever can be seen in the baby.

To reduce teething symptoms;

You can give the baby cold things to chew on. Its purpose is to relieve the pressure on the gums.
The baby can be given things that he can scratch his teeth. Cold foods and drinks will attract more attention to your baby than those at room temperature.
If these applications are not sufficient, you can use an appropriate medication in consultation with your doctor.