WHAT IS PEDODONTICS?
Pedodontics, in other words, pediatric dentistry, is a branch of dentistry that works to ensure the healthy preservation of both primary and permanent teeth and to eliminate problems caused by decays, trauma, hereditary or similar factors for children between the ages of 0 and 13. Starting from infancy, the monitoring, treatment and preventive measures related to oral-dental health of children and the development of the maxillofacial area constitute the field of study of pedodontics.
THE FIRST DENTAL EXAMINATION IN CHILDREN
It is recommended that the first dental examination in children be performed by a specialist pediatric dentist after the first primary tooth erupts. In order for the “Fear of Dentists” that we encounter in many adults today not to develop in your child, the time when the first dentist examination is performed and the dentist who performs it are of great importance. Thanks to regular examinations every six months, children's dental development, oral hygiene status and decays that may exist on the teeth can be diagnosed, and carious teeth diagnosed at an early stage can be treated and the risk of caries can be prevented. Examination Process Before the first examination, the family should not inform the children about the procedure. Dentists will give information about the procedure in a way that they can understand. Words such as pain, pain, needle should not be used by families during the first examination, which is performed together with families. Although families expect some procedures to be performed at the first examination, the priority for the doctors should be the children and their psychological condition. First of all, it is necessary to prepare the child. When the child sees that there is nothing to be afraid of, he/she helps with the treatment in cooperation with the doctor. These approaches and treatments should be performed by the most suitable pedodontics specialist (Pediatric Dentist) for your child.
TOOTH ERUPTION PERIOD IN INFANTS
Deciduous teeth that complete the development process in the bone begin to appear in the mouth by moving towards the face of the gum between the 4th and 7th months. 4. There is a total of 20 deciduous teeth in the mouth at the age of 2.5 - 3. Of these teeth, 10 are in the lower jaw and 10 are in the upper jaw. Tooth eruption process in infants proceeds differently in every baby due to the fact that it is associated with very different factors such as the infant's characteristics, genetic structure, family history and nutritional level. Since the development of each baby is not the same, there are differences in the eruption period.
The most common signs of eruption in infants are the following;
* Fever and diarrhea,
* Increased moodiness,
* Night waking and crying,
* Increased salivation and saliva,
* Bouts of restlessness and crying,
* Loss of appetite and refusal to eat,
* Rashes around the mouth,
* Hand biting,
* Mild coughing,
* Desire to take everything into the mouth.
In society, deciduous teeth are regarded to be temporary teeth. However, it should be remembered that deciduous teeth function in the mouth for about 10-12 years and play a very important role in the proper development of permanent teeth and protect the location of permanent teeth. Deciduous teeth are of great importance for eating and making sounds accurately during speech. At the same time, it is important for deciduous teeth to remain in the mouth until the period of falling off to achieve an aesthetic appearance. For this reason, as soon as teeth appear in the mouth in infants, it is important to see a dentist and maintain oral hygiene in line with the doctor’s recommendations.
PRIMARY TOOTH TREATMENTS
Primary teeth contain more organic matter than normal teeth, so they are more prone to carries and can decay more easily and quickly. Children do not react much in early stages of caries. As the decay progresses, sensitivity to cold and sweet may start. Later, the decayed tooth will cause pain to the child. It is not very easy to put children, especially at a young age, in the dentist's chair and perform treatment. Sometimes even pediatric dentists (pedodontics specialists) cannot perform the treatment of these aching teeth on the couch because the child does not cooperate, and the treatment has to be performed under general anesthesia. Taking into account all these difficulties, great attention should be paid to oral and dental care from the eruption of the first primary teeth. Premature loss of primary teeth causes some problems during permanent dentition, especially in the posterior molar regions because, over time, the neighboring teeth may move towards the cavity where the tooth was lost, causing this place to close. This, in turn, causes the permanent tooth that will be replaced in the future to remain buried or leads to incorrect closures by erupting from a different place. In such cases, it is inevitable that orthodontic treatment (dental brace treatment) be required in the future. If an early primary tooth extraction has to be performed for various reasons, fixed / movable placeholder devices should be made to prevent the place from closing as a result of movements of the teeth next to the extraction cavity.
CAUSES OF TOOTH DECAY IN CHILDREN
Primary teeth contain more organic matter than permanent teeth, so they are more prone to decay. They decay more easily, and decays can progress very quickly. Children are not able to interpret signals which can be observed in the early period of decays such as cold-hot sensitivity and mild pain in a timely manner. They only realize the situation when there is unbearable pain, in which case it may have been too late. Children cannot pay as much attention to oral care as adults. The child's dexterity, curiosity and the parent's attitude determine the habit of brushing teeth. Teeth should be brushed with parental accompaniment and parental help until children's hand skills develop. Especially at night, teeth can decay more easily because saliva flow will decrease during sleep. For this reason, teeth should be brushed before going to sleep, and nothing other than water should be consumed. A mistake that mothers in particular often make is to put a pacifier or bottle into foods such as candy or jam or get their children used to foods such as sweetened milk and fruit juice between sessions of sleep. These eating habits can cause early childhood decays. Can the formation of decays be prevented? A vaccine or drug that can completely prevent decays has not yet been developed. However, some materials are used today to reduce the number of decays, one of which is the material called "fissure sealant." Dental decays usually begin in the grooves called "fissures" located on the chewing faces of the molars and premolars. By covering the grooves with fissure sealants, decays are prevented by preventing bacteria and nutrient residue from leaking into this area. This procedure can also be applied to permanent molars and premolars that come out from the age of 6. Another way to prevent decays is to increase the resistance of teeth to decays. This resistance is achieved by applying superficial fluoride onto the teeth.
TOOTH FRACTURE IN CHILDREN
If the tooth is broken, first of all, you should remain calm so that you don't do anything wrong. If there is bleeding, you should immediately apply compression on the wound site with a clean gauze swab. If there has been an injury to the lip, wash it with cold water and apply compression with gauze. Try to find the broken part. During this time, it is important to keep the area moisturized. Saline, cold milk and even your child's own saliva are ideal for this. Broken tooth fragments should not dry. Otherwise, they cannot be glued. Go to the dentist as soon as possible. These parts will be glued using strong agents (bonding), and they will be aesthetic and durable like any composite filler to be made. If the broken tooth fragment is not found, it is possible to restore the tooth very successfully using composite or ceramic systems, similar to a natural tooth. Even if there is no fracture in oral-dental injuries, it is necessary to take the child to the dentist to monitor the vitality of the tooth. If the tooth that has been traumatized loses its vitality, its color will become darker, and cystic lesions may develop at the root tip. If the tooth has lost its vitality, root canal treatment should be performed. Whether it is required becomes clear within a few months. Nevertheless, the traumatized tooth will be evaluated separately during routine 6-month check-ups.
TOOTH DISCOLORING IN CHILDREN
Tooth discoloration can have a bad effect on children's social life and psychology and lead to loss of self-confidence. The prominence of visuality and the sensitivity of parents to their children increase the importance of aesthetic treatments for tooth discoloration today. Discolorations on the teeth are generally caused by 3 different reasons; Drug-Induced Discolorations: Nowadays, all infants take iron supplements, and iron medications have side effects such as tooth discoloration. To prevent discoloration, medicines in the form of drops should be dripped directly on the back of the tongue so that the baby can swallow without them touching the teeth. Chromogenic Discolorations: Some bacteria in the mouth (chromogenic bacteria) affect the transparent membrane located on the outside of the teeth, causing discoloration. Discoloration, which affects all teeth in general, can be cleaned with the polishing process but it can happen again. It requires check-up every 6 months. The rate of discolorations decreases with aging. Dental Decays: Dental decays in the initial state can be confused with discoloration, especially on the teeth in the anterior region. Dental appointments are very important for the accurate diagnosis and follow-up.
CLEAR ALIGNERS FOR CHILDREN
Clear aligners for children, as the name implies, is a pediatric treatment method where braces are not used. It is a field where the procedure commonly known as dental correction can also be performed. Clears aligners for children is based on dealing with a number of problems related to the mouth and jaw using plaques. The procedure is also known as transparent plaque treatment. At What Age Is Transparent Plaque Used for Children? It is not possible to determine a single and exact age for all patients because the development, growth, tooth eruption age and dental diseases are different for each individual. However, in order for the plaques to be placed properly, there must be a certain number of teeth in the mouth. In this treatment, the presence of both primary and adult teeth in the mouth does not pose a problem. An orthodontic dentist will determine whether the child is suitable for treatment, the duration of the treatment and the optimal age to start treatment.
FISSURE SEALANT AND FLUORINE APPLICATIONS
What is a fissure? Indented and cleft-shaped surface of the teeth are called fissures. The developmentally visible pits and grooves on the surface of the teeth are called fissures. What is a fissure sealer? It is the material that covers the indentations and cavities on the tooth surface, that is, the fissures. The application of this procedure is called fissure sealant. A fissure can be defined as a kind of dental vaccine. It is a fairly easy, painless procedure to prevent formation of caries. This application is the most ideal treatment method for children who have a fear of dentists or who go to the dentist for the first time. At what age should the fissure be applied? This application is usually applied to the first molars, which are called 6-year-old teeth, that is, permanent teeth. However, this is not a mandatory condition, and it can also be applied to primary teeth and, again, to small molars in the same way. Another application may be on developmental grooves and cleft-shaped formations on the front or back teeth. These areas are ideal places for food accumulation and caries can easily occur if good oral hygiene is not maintained. In order to be a precaution in such areas, teeth can be protected from caries by applying a fissure sealant to prevent decays on the surfaces. There is no loss of natural tooth tissue in the fissure cover application. After the application, patients are called for routine check-up sessions for 6 months. Over time, the fissure sealants may wear out or disappear. In such cases, fissure closure treatment can be applied again if the physician deems it appropriate. The main goal in this application is to protect molars that decay more easily, especially until the age of 9-10, when children can brush their teeth effectively during the period when their motor functions can be fully implemented.
GENERAL ANESTHESIA AND SEDATION
It may be required to use general anesthesia and sedation to provide a quality dental treatment when immediate and extensive dental treatment is needed for young children with whom cooperation cannot be achieved, children with mental, physical or medical disabilities and extremely uncooperative, scared, anxious children and adolescents, or those who cannot be communicated. The procedures are performed in operating room conditions with a team of an anesthesiologist, an anesthesia technician, a dentist and his/her assistant. It allows all the procedures in the mouth to be performed in a single session.