CHILDREN’S DENTISTRY

Some parents wonder whether treating milk teeth of their children is worthwhile.

Dear Parents – it is!!!

The consequences of failure to treat milk teeth is their loss, which not only discourages children from visiting a dentist in the future, but also develops bad habits and is responsible for the formation of bite abnormalities.

We need to take care of our children’s teeth all the time, at every stage. This is our parental responsibility.

We therefore treat carious cavities in primary teeth through painless cleaning of the cavities and application of fillings. If necessary, we use sedation to spare children the stress related to injections.

Depending on the clinical indications and the patient’s preferences, we offer various filling materials. Our small patients can select theTwinky star filling, which is available in seven fanciful colours. Young patients allowed to choose the colour of their filling are more enthusiastic about the treatment.

If indicated, we also perform root canal treatment of milk teeth to prevent premature tooth loss, and thus bite abnormalities. In cases where tooth extraction is the only option, we rub the mucous membrane with an numbing, fruit-flavoured gel before the anaesthetic injection in order to make it painless.

Young Patients who have bad experiences and are not willing to cooperateare offered the option of having the procedures performed under sedation. (see -> our clinic is pain-free)

Undeveloped permanent teeth are treated similarly to those completely developed, but bearing in mind a slightly different anatomical structure of the former. Early diagnosis of any pathology is of crucial importance, as due to poor mineralisation the carious process progresses much faster than in completely developed teeth.

This is why regular dental check-ups with a children’s dentist are so important for children during the period of mixed dentition.

Our clinic offers preventive procedures to our patients, such as pit and fissure sealing, which consists in the protection of spaces particularly susceptible to dental caries using special resins. Our offer also includes tooth varnishing with fluorine-based preparations, which strengthen dental enamel and make it less susceptible to caries.(see -> prevention)

Prevention starts much earlier, almost right after birth.

In order to prevent the development of dental caries in our children, we need to remember that children:

• should not be fed in their sleep,
• should not be given liquids at night (especially liquids containing sugar, i.e. puree juices)
• should not be put to sleep with a bottle.

This leads to the development of baby bottle caries. The source of this type of caries are sweet glutinous foods (baby cereal, juices, sweetened milk), which cling to the surface of teeth. Caries bacteria convert sugars found in these foods into acids. Teeth exposed to an acidic environment for a longer time (the entire night) undergo demineralization. The night-time drop in saliva production, which has antacid properties, significantly increases the risk of caries development.

Baby bottle caries is a particularly aggressive type of caries.

In a short period of time it can lead to a complete damage of large surfaces of milk teeth. Therefore, the following rules should be observed:

• introduce spoon feeding and cup drinking as soon as possible,
• avoid sweets (or alternatively serve them once a week),
• parents should avoid licking dummies and spoons (superinfection with caries bacteria),
• avoid kissing the baby on the lips (superinfection with caries bacteria),
• introduce coarse-grained products to the diet and avoid pulpy food,
• take care of an infant’s oral hygiene from birth (in infants before teeth eruption – wipe infant’s oral cavity with a camomile infused gauze wrapped around your finger after each natural and artificial meal, at least twice a day),
• in infants after teeth eruption – removing dental plaque with the use of a silicone finger toothbrush. It is also recommended to use it to massage the infant’s gums in areas where the teeth have not yet erupted, as a support in the process of teething,
• introduce the habit of tooth brushing to children as soon as possible,
• introduce the technique of rinsing the oral cavity with an antibacterial mouthwash and using additional aids, such as dental floss,
• make sure brushing lasts at least 3 minutes.

Treating milk teeth and preventing their premature loss is a very significant method of prevention of bite (occlusion) abnormalities.

However, if our young patient has lost his or her tooth, we use space retainers that prevent undesired tooth migration, and thus the development of bite abnormalities.

A great method that we offer to children and that minimizes the discomfort caused during the administration of local anaesthesia is a gel applied on the mucous membrane. The gel anaesthetizes the mucous membrane and as a result the patient does not feel the insertion of the needle.

Another method used at Villa Nova Dental Clinic is a device called The Wand. With the Wand, the application of the anaesthetic is safe and painless. The Wand resembles a “magic wand” (its tip does not look like a syringe) which does not cause any discomfort duringthe administration of anaesthesia. This is especially important to our little patients.

Dental care anxiety or fear experienced by some children can be managed by mild premedication (administering a mild sedative agentin a dose adjusted to the child’s age one hour before the procedure).

In case of more extensive procedures, in children having particularly bad experiences from the past or in a situation when the young patient is uncooperative and performing treatment procedures under local anaesthesia is impossible, dental procedures may be performed under sedation.

Sedationinvolves inhaling an odourless gas through a face mask – it is a combination of nitrous oxide and oxygen, also known as a laughing gas. This friendly and extremely safe method of dealing with fear is particularly recommended for children, as they show decreased tolerance to stress and pain. At the same time, they react to nitrous oxide in a charming way – they dream of fairy-tale adventures, flying or drifting in water, in the air, in the clouds or in space. The metamorphosis the uncooperative child undergoes is hard to believe: most patients are no longer afraid of subsequent dental appointments!

Missing teeth occur not only in adults, but also in children and young people. The most common cause of tooth loss at the developmental age is caries or mechanical injury. Congenital absence of both milk and permanent tooth buds can also occur.

Tooth loss in children and young people leads to deterioration of appearance, speech development disorders, hindered biting and chewing, as well as complications of existing bite abnormalities or creation of new disorders.

Due to the constant growth of the chewing organ in children, it is necessary to replace missing teeth and initiate orthodontic treatment as soon as possible. Presently, children above 6 (and in some cases even above 3) undergo this kind of treatment.

The method of treatment depends on the child’s age and severity of tooth absence.

In case of missing teeth, we use orthodontic braces, preventive orthodontic dentures and therapeutic dentures.

We would like to emphasize that in the event of any mechanical injuries requiring immediate help, you can always count on our qualified personnel, who will provideyou and your children with specialist care, as well as make you feel safe.

Elektoralna is the only private dental clinic that offers VIDEO GLASSES, which allow children to watch cartoons in the dentist’s chair during the procedures. This additionally minimises potential stress of our little patients.

1. How can I allay the fear of my child about the visit to the dentist’s surgery?

The first contact with a dentist is an important experience for your child, which shapes the subsequent attitude of the child to further visits to the dental surgery. There are two main reasons for such fear of the dentist: the child’s painful experiences from previous visits, and the general picture given by its parents, which strengthens the belief that dental treatment is associated with pain. At this point adaptation visits and instructing the parents play an important role; parents should explain to their child the course and aim of the visit to the dentist before the first visit.

2. Why is the treatment of milk teeth so important?

As with the permanent teeth, the milk teeth may suffer from dental caries, which may lead to painful pulp inflammation and, in consequence, premature tooth loss if untreated. In turn, tooth loss results in the inhibition of bone growth and bite abnormalities (crowding or abnormal position of the teeth, impaction of a permanent tooth in the bone). Purulent inflammation is a source of infection for the whole body of the young patient, and may lead to inflammation of the kidneys, heart or joints, as well as damage to the germs (buds) of permanent teeth that are close to the roots of the milk teeth.

3. When do first milk teeth appear, and when do the permanent ones?

The first milk teeth appear around the 6th month of life (normal range is 5th to 10th month full-term babies, and from 6th to 11th month in premature babies); usually the lower medial incisors appear first; however, upper medial incisors may also appear first.

The first permanent teeth appear at approximately the 6th year of life, and they are the first molar teeth (next to the 2nd premolar milk teeth). However, more and more frequently, lower medial incisors appear as the first permanent teeth.

4. What does tooth sealing, varnishing and silver nitrate penetration consist of?

Tooth sealing is a procedure of sealing spaces (pits and fissures) particularly susceptible to dental caries with special resins. The procedure is performed after the appearance (eruption) of the first permanent teeth (molars), which do not suffer from caries; however, milk teeth are also sealed more and more frequently.

Varnishing with a small brush is done to cover tooth surfaces with a fluorine varnish to strengthen the dental enamel and reduce its susceptibility to caries.

Silver nitrate penetration is a procedure applied in the case where most of the surface of a milk tooth is damaged by caries to such an extent that filling cannot be applied. The procedure consists of saturating such a tooth with a bactericidal substance that stops the carious process.

5. What is early dental caries?

Early dental caries poses a significant problem in the dentistry of early childhood. It starts just after the eruption of the first milk teeth, being a significantly acute form of caries, which may lead in a few months to such extensive damage to tooth tissues that the only solution is tooth extraction (removal). Parents should monitor the teeth of their children closely, and note that any suspicious changes (discoloration or spotting) are indication for a possibly urgent consultation with a paediatric dentist.

6. How frequently should check-up visits take place?

The carious process develops faster in milk teeth than in permanent ones due to their poor mineralisation (thin enamel layer). Parents should take care that their children have check-up visits every three moths, unless the dentist recommends otherwise.

7. When should the first visit to the dentist take place?

When the first teeth appear, parents should take their child to the dentist (at around 6-12 months). The dentist will assess whether the development of the teeth and facial part of the skull is regular and will schedule a check-up visit.

8. When should the first hygiene procedures be applied to the child?

The answer is as early as possible. Even before the eruption of the milk teeth, the baby’s mouth should be regularly washed with a cotton roll soaked in a chamomile infusion or boiled, cold water and the gums should be gently massaged. In this way the baby becomes accustomed to toothbrushing in the future and oral hygiene is maintained. In the same manner, the milk teeth should be cleaned after each meal; note that the teeth should be cleaned from both lips and tongue side.

At approximately one year of age you should start to clean the child’s teeth with an appropriate toothbrush. Up to five years, the teeth should be brushed by a parent or by the child itself under parental supervision.

9. What oral hygiene agents should be used in a child?

The toothbrush should be selected according to the child’s mouth (a toothbrush with a small head and soft bristle). Until your baby learns how to spit out the saliva, clean the teeth with toothbrush alone, without toothpaste, and after a time introduce any toothpaste designed for children (with an appropriate fluorine content and pleasant flavour).

10. Should I allow my child to go to sleep with a bottle of sweet drink?

It is absolutely contra-indicated, as it leads to the development of so-called Baby Bottle Tooth Decay (BBTD, bottle caries). Sweet sticky meals (ready-to-use meals, juices, sweetened milk) that adhere to the tooth surface promote this type of dental carries. Cariogenic bacteria transform sugar contained in such meals into acids, and prolonged (overnight) contact of the teeth with an acidic environment causes their demineralisation. Moreover, the night-time decrease in the production of saliva, which has neutralising properties, additionally increases the risk of caries development. The bottle caries is a particularly aggressive form of caries, which leads to complete damage of extensive tooth surfaces over a short period.