Pedodontics (Pediatric Dentistry)

What is Pediatric Dentistry?

Pedodontics (Pediatric Dentistry), is a field of dentistry which begins with preventive dentistry applications on children aged 0-15, followed by the treatment of milk and permanent teeth of all kinds, teeth traumas and treatment. Pediatric treatment requires special attention. Knowing the child psychology well, familiarizing them to the dentist chair without scaring them, informing them about oral hygiene and assuring that they live with healthy teeth and gums throughout their lives are necessary practices of Pediatric Dentistry.

The Significance of Milk Teeth in Children

Primary function of milk teeth is facilitating a proper diet. Besides, proper speech ability development depends on the presence of milk teeth. Parents ignore the importance of milk teeth because of the fact that they are temporary. This leads to negligence of their oral hygiene, causing tooth decay. It should not be forgotten that untreated milk tooth decay causes pain, bad odor, trouble with mastication, malnutrition and unesthetic image. Untreated teeth malformations may lead to crowding, jawbone anomalies and general health conditions in the future.

  • There are 20 milk teeth.
  • It is normal for milk teeth to have space between them in order to provide space for permanent teeth.
  • Tooth decay can occur on milk teeth. It is essential to treat tooth decay.
  • If the milk teeth are inflamed, root canal treatment should be employed. The tooth has to be extracted if the tooth is nonresponsive to root canal treatment.
  • If the milk teeth are extracted before their time, permanent teeth won't have enough space to fit in.

When Do the Milk Teeth Erupt ? When Do They Fall Off?

The first milk teeth on children begin erupting between 6th-8th months and the eruption is completed around the 30th month. Permanent tooth eruption and milk teeth fall-off begins at the age of 6 and continues until the age of 13. Milk molars in the back of the mouth will stay till the ages 10-12 and provide masticatory ability. Due to this fact, it is important treat and preserve them.

Is It Necessary For My Child To be Examined by a Pedodontist?

The first dental experience of your child is a beginning which will have a life-time effect of how he or she will feel about dentistry. A negative introduction will bring fear and insecurity and as a result, it will affect the following dental visits in the future. Therefore, the dentist who will take care of your child's dental health must be a specialized pedodontist who excels at communicating with children. The first visit should be planned right after the first tooth erupts.

All the necessary treatments for children are applied by the pedodontists. Maintaining good oral and dental hygiene is possible by keeping a regular schedule of appointments every 6 months. During these follow-ups, all kinds of problems affecting oral and dental hygiene can be found. The key point here is early diagnosis and treatment. Early diagnosis will have a positive impact on the child's physical and emotional development.

How Shall I Prepare My Child For His/Her First Exam?

Before bringing your child to the clinic, he or she should be briefly informed about why this visit is going to take place. Parents' worried and uneasy attitude and the sharing of their own negative experiences near the child will pose as a negative example for the child. In addition, it is extremely wrong to make the child fearful of the terms 'doctor' and 'needle'. Observing as their parents receive dental treatments will encourage the children.

How Is The Pedodontic Exam Performed For a Child?

First examination on a child patient begins with communication between the dental professional and the child along with their parents. After the initial meeting, patient's medical and dental history is taken. Afterwards, clinical and radiographical examination is performed. Following the examination, the patient and their family are informed about the diagnosis and treatment plan. Pedodontists implement various methods in order to protect milk and permanent teeth from several dental conditions such as tooth decay and periodontal diseases. These methods include; teaching the concept of oral hygiene, get the child to adopt the habit of brushing, systemic and topical flouride applications, application of fissure sealants.

Flouride Applications

Considered as the most effective form of treatment in preventive dentistry, flouride applications can be employed on healthy individuals, patients who are prone to tooth decay, for sensitivity and erosion treatment and on patients who need special care because of their systemic conditions. Treatment's frequency and doses may vary according to the patient's age and risk of tooth decay.

Fissure Sealants

Recesses and grooves on molar teeth's biting surfaces create regions for food to stick and stay in. Tooth decay starts in these regions which are hard to clean up.

The fissure sealant provides a surface that's easy to brush and also forms a shield which keeps food and bacteria from getting into the grooves in the teeth and causing tooth decay. Following the clinical applications, it is reported that tooth decay is decreased by 70%-80%.

Space Maintainers

Milk teeth have a vital role in your child's facial and jawbone development. Some of the milk teeth have to stay in the mouth until the age of 12. However, all milk teeth is replaced by permanent teeth at this age. It is quite difficult for milk teeth to survive upto this age if they were not protected properly. Even the loss of milk teeth may cause serious orthodontic conditions in the future. Various treatments are applied for preserving the milk teeth. Filling and root canal treatments can be applied to milk teeth just like adults. Nevertheless, the space left by prematurely lost milk teeth due to trauma or decay has to be preserved with space maintainers. When the milk teeth is lost prematurely, two conditions can be observed until the permanent teeth erupts; the teeth surrounding the extraction area may be crooked or fill the area by turning. This can lead to teeth eruption from a different spot or stay buried. Teeth in front of the extraction area may extend to this space. Space maintainers can be manufactured from metal or plastic. Fixed or removable space maintainers are prepared according to the number of prematurely lost milk teeth and their localization. After the impression is taken by the dentist, the technician prepares the space maintainer in the lab. Afterwards, the prepared space maintainer is attuned to the patient by the dentist. Patient uses the space maintainer under dental professional supervision and the maintainer is removed when the milk teeth begins erupting.

What Are The Functions Of Space Maintainers?

  • It prevents the extraction site from being concealed by other teeth and preserves this space until the permanent tooth erupts in order to facilitate the eruption in an ideal position.
  • It aids in preventing the orthodontic problems which may appear in the future.
  • Due to the fact that it keeps the teeth in their ideal positions, it prevents crowding. Thus, it provides advantages such as beautifully aligned teeth, easily brushed teeth and less interdental decay formation.

Fixed Space Maintainers

These are used in single milk tooth loss. Things to keep in mind when using are:

  • When there is a problem or the space maintainer is dislodged, it is required to inform your pedodontist.
  • Sticky food should not be chewed in the area of the space maintainer.
  • A follow-up appointment is required after 3 months.

Removable Space Maintainers

These are used in more than one milk tooth loss. These kind of space maintainers are detachable apparatus.

Things to keep in mind when using are:

  • Removing them during meals,
  • Removing them before bed and keeping them in water,
  • When brushing teeth, also brushing them with the brush.
  • Immediately letting your pedodontist know if any kind of fracture occurs on the space maintainer.
  • Going to the follow-up appointment after 3 months.

Emergencies in Pedodontics

My child has a toothache, what should I do?

Your child?s toothache is most likely due to decay. First of all, his/her teeth should be brushed to remove all the food particles and the interdental spaces should be flossed. If necessary, painkiller should be given and an appointment should be scheduled from your pedodontist as soon as possible. In these cases, random antibiotics use is wrong and this decision must be left to your pedodontist. Under no circumstances should the aching area be applied with hot compress or aspirin.

If My Child Falls and The Milk Teeth is Dislodged, What Shall I Do?

It is recommended to visit your pedodontist as soon as possible. Completely dislodged milk teeth must not be placed to their sockets again due to the fact that this may harm permanent teeth developing underneath them.

If My Child Falls and Permanent Tooth is Dislodged, What Shall I Do?

Firstly, the dislodged tooth must be found. The tooth should be held without touching the root and only be rinsed with clean water. If the tooth is preserving its integrity, it must be placed into its socket. The tooth must be prevented from dislodging by getting the child to bite on gause or clean cloth. If the tooth can not be placed, it can be carried in cold milk, water or your child's saliva. It is recommended to visit your pedodontist as soon as possible. If it's later hours, parents should head to a hospital's tooth clinic. The treatments applied 2 hours after trauma have a very high success chance.

What Shall I Do If A Fracture Forms On The Tooth As A Result Of Trauma?

It is recommended to contact your pedodontist as soon as you can. If the cracked fragment can be found, it must be preserved in cold milk or water. This fragment may be used in restoring the tooth. Treatments performed as soon as possible will prevent bigger problems from manifesting.

What Shall I Do If A Fracture Forms On My Child's Jaw Area?

Due to the fact that there may be head trauma in cases like these, emergency medical attention is required. The fractures on this area must be examined by medical doctors, followed by oral and maxillofacial surgeons and treated accordingly.

Is It Possible To Protect My Child From Dental Trauma?

If you have a toddler, plastic caps should be placed on the pointy ends of furniture which your child may bump into.

During car travel, it is a must to use child car seats buckled up with a seat belt.

Thanks to the mouthguards prepared by your dentist, children who practice sports such as basketball, football, boxing, skiing, cycling and skating can be protected from tooth fractures and soft tissue injuries.

My child's space maintainer is dislodged/broken, What Shall I Do?

If the space maintainer is loose or has a broken piece, it should be removed from the mouth if possible. If it can not be removed and causes discomfort on soft tissue, it is recommended to contact your pedodontist and protect the area with cotton wool.