What is pediatric dentistry (pedodontics)?
Dentists who carry out all kinds of treatment and preventive
dentistry procedures for children and who have received special training on
this subject are called pedodontists (pediatric dentists), and this branch of
dentistry is called pedodontics.
Pedodontics is basically divided into 2 parts.
A- Treating the problems that have occurred
It is possible to prevent cavities in children with a
careful diet (avoiding sticky and sugary foods as much as possible, following
healthy eating rules) and applying correct tooth brushing techniques. When a
caries occurs, the cause should be tried to be determined and the health of the
child's other teeth should be protected. Children should be taken to the
dentist from a very young age (6 months - 1 year), so that the child can come
to this environment without fear, and parents should learn what to do to keep
their children's dental health at the highest level.
1- Bruise
The decayed part of the tooth is cleaned and treated with
permanent or temporary filling depending on the situation. In some cases, the
tooth is too damaged to be treated with a filling. Such teeth can sometimes be
kept in the mouth for a while by covering them with specially prepared 'caps'
instead of being pulled out. In recent years, colored fillings have been
produced to make children love the dentist and going to the dentist. Thanks to
these materials, which are also used in our clinic, getting a filling becomes a
game.
2- Broken
Children often fall or crash. As a result of these, they
encounter problems that will damage their front teeth and make them
uncomfortable for years or require frequent visits to the dentist. A simple
mouthpiece prepared by your dentist will prevent the damage caused by trauma to
the lower part of the face. Especially in children who play sports such as
football, boxing, skiing, basketball, cycling, rollerblade, surfing,
skateboarding, dental traumas, fractures or lip, tongue biting and tearing are
prevented as a result of the cushioning effect of a silicone transparent
mouthpiece placed on the upper jaw teeth.
Dental injuries are the most common of these injuries. The
tooth of a child who does not have a mouthguard and who gets a blow to his
front teeth either falls out completely or breaks, or the pulp, which is the
living part of the tooth, is damaged in various degrees, depending on the force
of the blow. If this damage causes the death of the pulp, the color of the
tooth is discolored and a color ranging from light brown to dark gray occurs.
Please protect the dental health of your child, especially who plays sports,
with a mouthpiece prepared by your dentist.
3- Impact
Go to your dentist immediately by placing the tooth between
a clean gauze pad and wetting it with saliva. If you cannot reach your dentist
immediately, moisten the gauze with saline from the pharmacy and try to reach
your dentist as soon as possible. The ideal is to start the treatment within 1
hour. If conditions are suitable, your dentist will replace the erupted tooth
(reimplantation). With meticulous application and good care, the tooth will
stay in your child's mouth for years.
If one or more of your front teeth is broken:
If you couldn't find the parts:
- If the broken part is small, a white (composite) filling is made in the same color and form as the tooth. Intraoral durability of composite fillings is limited. They change color by being dyed with foods such as tea, coffee, cola. These need to be renewed at certain times depending on their eating habits and oral hygiene.
- If the fracture is large and covers half or more of the tooth, porcelain laminate veneers are applied to those older than 17 years of age. Porcelain laminate veneers are both very durable and very aesthetic. They can be explained as porcelain leaves that adhere to the front surface of the tooth and cover the fractured part.
It is not correct to apply porcelain laminate veneers in
children younger than 17 years of age, since the development of teeth and jaws
is not completed. Again, composite laminates that cover the entire front
surface of the tooth and the fractured part are made. However, there are
problems caused by the material, they may become colored, so they may need to
be renewed after a while.
If there is no problem after the impact:
A detailed examination should be made by the dentist and
x-ray should be taken from the relevant area. Even if there is no finding after
examination and x-ray, periapical x-rays are taken at regular intervals and
compared with old films. The aim here is to determine whether there is a
long-term problem in the living part of the tooth. The tooth loses its vitality
by changing color even after years. If such a situation is detected,
complications that may lead to tooth loss are prevented by applying root canal
treatment.
4- Tooth extraction
In some cases, the caries progresses to the living
(nerve-pulp) part of the tooth. An inflammatory condition occurs that reaches
the jawbone from the roots of the tooth. The child's face swells, there is
severe pain, and it is not right for the child's health to keep this tooth in
the mouth. In this case, the tooth is extracted from here. Especially if this
is a milk tooth and the eruption time of the permanent tooth coming from below
is very close, it is a procedure that does not have any drawbacks. If the
eruption time of the permanent tooth is not close, a space-holding appliance
should be made instead of the extracted tooth.
In a permanent tooth, this decision should be reviewed many
times before the extraction process and extraction should be considered in
cases where there is really nothing to be done. After the permanent teeth are
extracted, if the child's age is appropriate, orthodontic treatment should be
started immediately and this gap should be closed with other teeth and a
correct closing relationship should be ensured between the lower and upper
teeth. When an extracted permanent tooth is left standing, the adjacent teeth
bend towards this space. The tooth opposite the space protrudes into the space
and the whole balance of the mouth can be disturbed by a tooth.
5- Cleaning
If the bacterial plaque (whitish, sticky layer consisting of
food residues and microorganisms) formed on the teeth has accumulated so much
that it cannot be removed by normal brushing, it should be cleaned and removed
by the dentist. This process will prevent the formation of problems such as
dental calculus and caries, which will be caused by bacterial plaques in the
long term. In the same session, the child is also informed about tooth brushing
training and prevention of caries and is called for control again.
B- Preventive dentistry applied to prevent problems from
occurring
Today, preventive medicine, which we can call stopping the
problem before it occurs, has gained importance in dentistry as in every field
of medicine. Preventive dentistry is of great importance, especially in
children. It is preferred that the first encounter of children with the dentist
is related to preventive dentistry, as there are effortless, inexpensive and
painless applications.
1- Hygiene training
Complete oral and dental care is only possible with complete
information. Hygiene education, which includes teaching tooth brushing and
flossing, reviewing nutritional habits and explaining the importance of oral
and dental health, ensures that there is no missing information. This education
is as important for adults as it is for children.
2- Superficial fluoride application
Fluoride is a natural mineral that we can get from water or
many of the foods we eat. It has been noticed that people living in regions
with high fluoride content in their waters have faced less dental caries for a
long time, and when the reason was investigated, it was determined that
fluoride made the enamel of the teeth resistant to caries. At first, the
optimal dose of fluoridation of city waters was considered and applied in some
regions, then this dose was reduced due to some side effects.
Recent studies have shown that superficial fluoride
applications are more important. It has been found that the effect of fluorine
tablets taken by the mother during pregnancy or given to the child from the 6th
month is much less than expected. The crystal structure that makes up the
enamel becomes more acid-resistant with the effect of fluoride applied to the
surface. Thus, it is more difficult to roughen and the formation of caries becomes
more difficult.
Superficial fluoride applications are a simple, painless
procedure that can be started from the age of 3 and should be repeated every 6
months. It is ideal for the child's first encounter with the dentist and for a
check-up every 6 months. After this process, which takes a few minutes, the
fluoride stored on the surface of your child's teeth will make the teeth much
healthier and stronger.
3- Fissure Sealent
The chewing surfaces of the teeth are indented. These pits
and mounds are called pits and fissures. These areas are very narrow and are
often where cavities start due to the inability to clear the jam. A special
fluid filling material is used in order to prevent food and microorganism
accumulation in these areas and accordingly caries.
First of all, this area is completely cleaned and the fluid
filling, which we call fissur sealant, is applied to this area. It is hardened
by light and polished by correcting the excess. Thanks to this process, it is
possible to be protected from chewing surface caries, which constitutes
approximately 70% of all caries. Although it can be used for many years under
normal conditions, it is useful to check it frequently, especially in those who
have habits such as ice chewing or teeth grinding.
The period when the first permanent teeth appear in the
mouth is ideal for application. This is around 6 years old. It is also applied
to the others during the eruption of other molars. An important point is that
it will be better to have permanent teeth done shortly after they start to
erupt (within 1-2 years). Because the longer the time, the more likely it is to
develop cavities and it may be necessary to fill instead of fissure sealant.
Although it can be applied to adults without caries, its use
in children is more beneficial and important. It is an absolutely painless and
very easy procedure.
How is Fissure Sealent done?
Before starting this painless process, it is necessary to make
sure that the indentations on the surface where the sealant will be applied are
completely clean and that the bacteria have been removed. For this purpose,
your teeth are cleaned and dried by brushing with a special solution. The
enamel layer on the top of the tooth is roughened with the help of a gel and
bonding is applied, after it is hardened with light, the fissure sealent is
allowed to fill the recesses with the help of a brush, and it is hardened with
light again. It is checked whether there is a height and a protective varnish
is applied on it. Very simple, cheap. It is a painless and effective preventive
procedure.
4- Placeholder
The milk tooth is lost early due to various reasons
(cavities or accidents). In such cases, until the permanent tooth from below is
ready and erupts, the adjacent teeth may bend and turn, covering the area that
the lost primary tooth should protect for the permanent tooth. In fact, the
tooth in the opposite jaw of the cavity begins to elongate. If the development
is left to itself after the early primary tooth extraction, these movements
will cause no room for the next permanent tooth. Thus, the permanent tooth will
either not grow at all or will develop out of its normal place.
Problems caused by losing even just one primary tooth
prematurely
- As the teeth will be displaced, crowding will occur, these areas will not be cleaned easily and the tendency to decay will increase.
- Chewing will be difficult.
- More serious orthodontic problems will arise.
Some milk teeth should stay in the mouth until the age of
12. However, at this age, the permanent teeth are ready and the milk teeth
change. It is very difficult for teeth that came out as a baby and that have
not been carefully preserved until this age without any problems. This small
metal appliance called a placeholder is specially prepared for the child's
mouth, and in cases where the primary tooth is lost early, it preserves this
place until the permanent tooth comes in. They are prepared as fixed or
protruding (according to the location of the lost tooth). It is a very simple
but very important appliance for the foundation of the child's future oral and
dental health.
Care and maintenance of the placeholder
- Avoid sticky foods and chewing gum.
- Do not try to push and bend the placeholder with your tongue or fingers.
- Keep it clean using a regular brush and string.
- Make sure to go for a check-up every 6 months.
