The World Health Organization (WHO) and the American Pediatric Dentists Association recommend that the first dental examination be done between 6 months and 12 months after the first primary tooth erupts.
WHAT SHOULD BE CONSIDERED BEFORE THE FIRST DENTIST EXAMINATION IN CHILDREN?
The first dental examination in children should take place as soon as possible without facing any dental problems in order not to cause dental trauma in children. Before the first dental examination, parents prepare the children for the environment with visuals such as books, videos or cartoons before the visit, which helps to reduce the child's anxiety about the unknown. Parents' own fears or threats 'will not hurt', 'don't be afraid', 'injection', etc. should not be reflected to the child with discourses, but should inform the child with constructive, short and concise explanations as much as possible. Before the appointments, parents should not promise their children about the procedures to be performed, and it should be emphasized that this decision is a joint decision between us, the doctors and the child.
Unless your dentist tells you otherwise, children should not come to the appoinment hungry.
WHAT IS DONE AT THE FIRST DENT EXAMINATION?
In the first dental examination, the teeth are examined using only a mirror and light, with an approach that will be appropriate for the age of our pediatric patient. During this examination, existing anomalies in the teeth, jaw and facial development, lack of space, the presence of missing or excess teeth can be detected, it is determined in the early period, and necessary planning and routine follow-ups can be made. Parents are informed about the procedural or preventive treatment approach for the early or late intraoral findings of early childhood (formerly baby bottle caries) caries. We also inform you, the families, about how the teeth should be taken care of and how the diet should be.
WHAT ARE THE ERUPTION AND SHEDDING (FALLING OUT) TIMES OF MILK TEETH?
The first milk tooth begins to emerge between 6-12 months. Since the development of each child will be different, the eruption times of milk teeth vary in children. There are 20 milk teeth. They are completed around the age of 3 on average. The falling out processes of the primary teeth begin with the fall of the lower anterior incisors around the age of 6, and although it varies from child to child, it is completed around the age of 12-13.
WHY ARE MILK TEETH IMPORTANT?
Milk teeth have a very important place in nutrition in the period when the child is most active in terms of growth and development. The presence of healthy milk teeth is important in fulfilling the chewing function and, accordingly, in providing a balanced diet for children. In addition, by ensuring the active use of the jaw and facial muscles, the formation of facial asymmetry can be prevented by positively affecting the development of the jaw and face. Primary teeth are also important in terms of phonation (speech). The milk teeth guide the permanent teeth located under them in the jawbone. With deep caries in milk teeth or early loss of milk teeth (extraction), it cannot guide the underlying permanent teeth and may cause late or cross eruption of permanent teeth with deviation in the eruption path.
WHEN AND HOW SHOULD THE MILK TEETH BE BRUSHED FIRST?
With the eruption of the milk tooth, the teeth should be brushed regularly. If the milk teeth have not erupted yet and breastfeeding continues, the tissues in the mouth should be cleaned with a clean cheesecloth or gauze moistened with water after breastfeeding. Since tooth brushing requires fine motor skills, it is recommended to brush twice a day, in the morning and in the evening, with the parents until the age of 9-10. With the development of the spit reflex, the use of toothpaste containing fluoride is recommended. It is recommended to use fluoride-free toothpaste in young children where the spit reflex is not developed. Which toothpaste and how much it should be used is determined by the pediatric dentist according to the child's caries risk group.
WHAT ARE EARLY CHILDHOOD CARIES?
Early childhood caries, formerly known as bottle caries, is the presence of 1 or more cavities on the primary teeth of children younger than 6 years old. The most important reason for this situation, which we frequently encounter in our country, is the inadequacy of night feeding and oral hygiene. In babies, milk taken directly from the bottle or from the mother's breast accumulates on the front surface of the milk teeth. The formation of caries in milk teeth is inevitable due to the low salivary flow rate at night, the inability to remove food from the teeth, and the presence of caries-causing microorganisms in the environment. It begins primarily on the anterior surface of the upper milk teeth.
It also occurs in other teeth over time. Although the treatment of these caries is difficult in young children, it can be performed with the help of pediatric dentists and families. The fact that cavities are common and numerous in the mouth and the child's cooperation cannot be ensured makes it necessary to carry out the treatments under general anesthesia.
In the prevention of early childhood caries;
The baby should not be allowed to sleep with a bottle in his mouth.
After drinking milk from a bottle, it should be ensured that he drinks water.
Teeth should be cleaned with a moistened cheesecloth wrapped around the index finger.
From the age of 1, the baby should be taken to the dentist regularly for examination.
Instead of a carbohydrate-based diet that sticks on the teeth, fruit and vegetable-based fibrous foods should be preferred.
Since the swallowing reflex cannot be controlled until the age of 2-3 years, the teeth should be brushed twice a day by the mother or father with a fluoride-free toothpaste and a small-headed, soft-bristled toothbrush.
WHAT IS FISSURE SEALING APPLICATION?
The recesses and grooves on the chewing surfaces of milk and permanent teeth are called 'fissures'. The process of covering (coating) these fissures with a fluid filling material is called fissure sealaning. With the fissure sealant application, the accumulation of food residues, plaque and microorganisms can be prevented, and a smoother and easier-to-clean tooth surface is formed. No intervention is made to the tooth during the fissure sealaning process. This is a protective procedure applied to milk and permanent teeth to prevent tooth decay.
WHAT IS A LOCAL FLUORIDE APPLICATION?
Fluoride is a compound that strengthens the structure of the tooth, disrupts the effect of caries-causing microorganisms, and balances the acid attacks that occur with nutrition during the day. It has a gel consistency and can be applied to the teeth with a brush or spoon. It is an easy-to-apply, short and protective procedure that prevents tooth decay. It should be repeated at intervals of 3,4 and 6 months, depending on the child's diet, age, needs and requirements. There is no harm as long as it is applied under appropriate conditions. Its effectiveness against caries has been scientifically proven.
WHAT IS A PLACEHOLDER?
It is an appliance bonded to the tooth that protects the place of the lost milk teeth for various reasons until the permanent tooth below comes. It can be designed in different ways according to the number of missing teeth in the mouth. Depending on the number of missing teeth and the adaptation of the child, there are two types: fixed (not removable by the child, removable by the doctor) or moveable. The placeholder remains in the mouth until the permanent tooth erupts.
IN WHICH SITUATIONS DO THE CROWNS APPLY TO CHILDREN?
They are veneers that are made for extremely deteriorated, rotten milk teeth that cannot be saved with filling, are attached to the milk teeth like a hat, and have no connection with the permanent tooth below. With the fall of the milk tooth, it falls out with it, as it is attached to it. It is available in varieties such as stainless steel or zirconium crowns. It is made by gluing ready-made crowns on the tooth without the need for any measurement process. Made from tissue-friendly materials. There is no harm for the child. Since it is an application that surrounds the tooth, in the presence of good oral hygiene, it can protect against caries by staying in the mouth until the tooth falls out.
WHAT SHOULD WE DO WHEN CHILDREN HAVE GRINDING TEETH?
Teeth grinding, also known as bruxism, is an action that is usually done by rubbing or squeezing the teeth in the lower and upper jaws together during sleep. In some children, the severity is quite high during sleep, a loud noise that can wake the parents who are sleeping in the next room, causing anxiety in the parents. Teeth grinding is a physiological condition that is desired for the teeth to be eroded and settled a little, in the process until all the primary teeth fall out and all permanent teeth come out. As a result of an examination by pediatric dentists, there is no need to worry as long as there is no wear on the teeth. It's not just physiological. Stress, reflux, presence of intestinal parasites, allergic asthma, bronchitis or sinusitis also trigger teeth grinding. In physiological conditions, no treatment is performed unless there is a defect in the teeth. If teeth grinding associated with a different health problem is observed, it is necessary to treat the problem and eliminate the cause.
WHAT SHOULD BE DONE IF PERMANENT TEETH ERUPT WHEN THERE ARE STILL MILK TEETH IN THE MOUTH?
It is a common condition in pediatric patients. Contrary to popular belief, the presence of permanent teeth coming from behind before the milk teeth fall out is not something to worry about. It is mostly seen in the teeth in the lower anterior region. If the milk teeth fall out, if there is no problem of space in the lower jaw, the current situation will improve with the growth and expansion of the lower jaw and the thrust of the tongue. However, in cases where it is delayed, orthodontic treatment may be required. In such a case, it will be sufficient to apply to us pediatric dentists before it is too late.
IS IT POSSIBLE FOR CHILDREN TO BE BORN WITH TOOTH?
Teeth that are in the mouth at birth are called 'natal teeth', and teeth that erupt within the first 30 days after birth are called 'neonatal teeth'. Natal and neonatal teeth are mostly milk teeth, but they can rarely erupt as extra teeth. It is frequently encountered in the lower anterior incisor region. The root development of these teeth is not fully developed and they are attached to the gingiva in the mouth. In the oral examination, if the tooth is wobbly, affects sucking, harms the baby's tongue, and there is a risk of escaping into the respiratory tract, it is decided to extract the tooth by discussing it with the pediatrician. If it is determined that this erupted tooth is an early erupted milk tooth, if it does not wobble, if there is no harm to the baby, it does not need to be extracted.
WHAT ARE BLACK COLORS IN CHILDREN?
Tooth discoloration can be seen in both primary and permanent teeth. These discolorations can often be confused with dental caries and this causes concern in families. The known causes of black discoloration are the use of iron medication, inadequate oral hygiene and the increase in the presence of black discoloration bacteria in the mouth. Today, the increase in aesthetic concerns in children and adolescents can cause loss of self-confidence in the presence of these colorations and cause them to be isolated from the social environment. It is necessary to consult a pediatric dentist in order to determine the cause of the existing discoloration, to treat it and to take the necessary precautions to prevent its formation.
WHAT SHOULD WE DO IF THE CHILDREN'S TEETH IS BROKEN AND DISPLACED?
The first thing to do in case of tooth fractures in primary or permanent teeth in children or in cases of teeth eruption (avulsion) is to determine whether there is any damage to the extra-oral tissues without panicking. If there is a foreign body in the trauma area, it should be removed, if there is bleeding, a clean gauze pad should be applied to control the bleeding. The nearest pediatric dentist should be consulted by finding the broken or protruding tooth and placing it in the milk without holding the root. In such injuries, it will be beneficial for you to contact us as soon as possible, as the extraoral dryness of the displaced tooth and the open time of the nerve tissue in broken teeth are of great importance in the course of the treatment. If you reach us pediatric dentists, the necessary dental treatments are carried out in line with the age and needs of the child without wasting time.
WHEN SHOULD DENTAL TREATMENT BE PREFERRED UNDER GENERAL ANESTHESIA?
Dental treatment under general anesthesia is the completion of dental treatments in one go by putting the child to sleep completely. It is needed in children with fear of the dentist, in children who have tried behavioral guidance methods on the couch but not responded to, in children who need a lot of dental treatment at a young age, in babies and children with early childhood caries, and in children with physical and mental disabilities. General anesthesia is performed in a hospital environment with an anesthesiologist and his team, and dental treatments are performed by a pediatric dentist. It is usually discharged on the same day. After the procedures, the child's nutrition and brushing habits are also checked with regular controls to prevent the recurrence of this situation, and prevent caries with preventive and preventive treatments. One of the most important purposes of regular check-ups is to ensure that children who have difficulties in sitting in the chair in the clinic and having a procedure are adjusted to the chair.
