Infant and Child Dental Care – Pediatric Dentistry

Important dental care information parents need to know for their children between 6 months old and 15 years

What is a tooth decay (cavity)? What are the reasons for cavities?

Today tooth decays are considered as bacterial infection in the human body.
It is a general health problem and effects mouth and general health care.

At what age do cavities start and why?

There is a very high risk when honey or sugar based substances are mixed in the baby bottle and the dummy is dipped inside honey. Even in the presence of one single tooth, the infant’s tooth should be brushed after each meal. After breast feeding period, at the time the infant starts to eat regular food, a proper mouth care and dental hygiene is needed. Otherwise, dental decay will occur quickly. In the first year after the first tooth eruption the infant should be taken to a dentist, and regular 6 months check-ups should start. These precautions and check-ups are important to prevent dental cavities and to provide the child’s motivation to take good care of his/her oral health. Generally, 3-12 year old age group is the high risk group. At this age children cannot brush their teeth properly, and do not visit the dentist for routine check-ups. Brain’s manipulative ability develops at age 10. That is why until age 10, before going to bed after the child’s brushing, parents should brush the teeth again. The parents should also be educated in terms of oral health care, and dental first aid of the dental traumas.

Sugar is not only present in cakes and chocolate! Milk, rice, vegetables and fruits contain sugar. Saliva and mechanical movement of lips and cheeks clean off some of the food remains in the teeth. However, the rest which is not cleaned, sticks onto the surfaces of the teeth which collides with bacteria forming acid that causes dental cavities. If possible after each meal, but especially before going to bed teeth must be very well cleaned as a precaution to avoid dental cavities. Soft tooth brushes and tooth pastes specific to children’s age should be used. Drinks containing acid and sugar are not advised to be consumed.

At what age do teeth erupt?

Between 4 months and 3 years 20 of the primary teeth eruption is complete. While teeth are erupting pain, increase in saliva and fever may be seen. Massaging the gums over the erupting teeth can comfort the child. If there is an increase of the fever, it is best to go and see a pediatric doctor, and according to doctor’s advice paracetamol syrup may be used to reduce fever and pain. Dental gels containing anesthetics can be bought at the pharmacies and may be applied for short term pain relief. Note that these gels are generally swallowed by the child or washed out with the saliva.

In general between the ages 6 and 14 the 28 permanent teeth eruption is complete. The first permanent teeth (first molars) erupt at the age of 6 behind the primary molars .Following this; the primary incisors are replaced with permanent ones. It is recommended to have the dentist apply fissure sealants to the occlusal surfaces of the permanent molars as protection and twice a year fluoride gel treatment to all teeth.

How can dental cavities be prevented?

Dentist should examine each patient’ s personal caries risk factor degree. By doing this the dentist can correlate the dental cavity risk of the children and their parents. Children’s oral bacterial formation takes place until the age of 2 and is influenced very much by their parents.

Topical fluoride usage is well known to prevent dental cavities and should be a part of the treatment protocol twice a year. This element is included in various amounts and forms inside toothpastes. However, excess of fluoride can cause fluorosis in bones and teeth which is characterised by discolouration of the related tissues. Fluoride-free toothpaste should be chosen until the child can rinse and spit out well, otherwise the tooth paste will be swallowed. Fuoride should be applied by the dentist in the dental office.

At what age can the dental cavities be treated with fillings?

In general children do not stay calm and steady during treatments until the age of 5-6. There is also a risk of allergy to local anesthesics which is why young children should be treated at professional hospitals under sedation or general anaesthetics.

If cavities are taken care of by the dentist at an early stage, they can be easily stopped by applying high concentrations of flouride. Parents should help children to take good care of their teeth and give them a proper diet and hygienic help.

Primary teeth are place holders for permanent teeth. In the presence of cavities primary teeth loose their volume and consequently the place is lost for the permanent teeth to erupt, which will cause crowding or eruption problems of permanent teeth.

When is the right time for the first orthodontic consultation?

Between the age of 3 to 5 it is important to detect skeletal and developmental anomalies, and to take precautions to prevent malocclusions. If the child is showing a normal function and skeletal jaw relations, there is no need for an early orthodontic treatment until the total eruption of the all permanent teeth has been completed, which will be between the age of 12 – 14. Until this time 3-6 months recalls for orthodontic controls are helpful and necessary. If relatives and/or one of the parents have a very small mandible or opposite excessively big prominent mandible, routine controls until the end of growth period are very important even if the child has a normal bite.

Tongue thrust and bad habits such as biting finger nails, chewing on pencils and sucking thumbs create open-bite. If needed children should get professional help to stop these habits.

At the ages of 7,8 and 9 primary incisors are replaced with permanent incisors. Especially after permanent incisor eruption, custom dentist made mouthguards should be used during practicing any kind of contact sports including basketball, cycling, hockey, football, rugby, soccer etc

We should take good care of permanent teeth, and never forget that these teeth will not be replaced for the third time.