Pedodontics is a dentistry department that provides healthy development and protection of primary teeth and permanent teeth of children between the ages of 0 and 14. It is also described as pediatric dentistry.
In children, the first tooth appears in the middle of 6-7 months. However, sometimes the first tooth emerges early in the third month, sometimes it may sag to the twelfth month or even later. Teeth usually come out in hereditary order, so if you or your partner’s teeth come out early, it is likely that your baby will have the same pattern. It is completed as 10 (20) teeth in the lower and upper jaws around 2.5-3 years of age.
Teething symptoms may occur 2-3 months before the teeth themselves. Although these symptoms vary from child to child, they can be seen as an increase in the amount of saliva, redness or cracks on the skin due to the irritation caused by constant saliva contact in the jaw and around the mouth, cough, restlessness, fever, insomnia, refusal to feed, itching of the gums.
Teeth Grinding Habit is a common condition in children. Stress, aggressive, obsessive or bored personality structures, and children whose parents grind teeth are more prone to this habit. Wear in the teeth, grinding sounds while sleeping, pain in the face muscles, problems in the jaw joint, headache, swaying and sensitivity in the teeth may be symptoms of tooth grinding disorder. In order to solve this problem, first of all, the factors that lead to grinding teeth psychologically are tried to be eliminated. It is useful to act together with pedagogues and school guidance teachers. If this is not achieved, a soft overnight plaque that can be inserted and removed at regular intervals can be made to the patient.
Finger Sucking Habit is a common habit at an early age. Usually, if left until the age of four, the open closure in the teeth disappears spontaneously. The fact that the habit continues at the same age as the teeth, leads to structural disorders in these teeth and palate. The reason for these disorders is the pressure applied by the finger to the anterior teeth and palate. The degree of the resulting disorder depends on the duration, frequency, severity of the suction and the position of the finger during suction.
Unless the child himself/herself wants to get rid of this habit, it is difficult for the treatment to succeed. It is psychologically very beneficial for the child to quit before school age in order not to be subjected to environmental pressure and to be mocked. The child should be encouraged and rewarded positively without being repressed. If the habit has not disappeared by the age of 6 despite everything, professional help should be obtained by consulting the dentist.
Pacifier Habit For babies, sucking is the most natural way to relax and feel safe. The pacifier should only be given when necessary, not for most of the day.
In order for this habit not to lead to structural disorders, pacifiers with natural breast structure should be selected as much as possible. The structure of the pacifiers should be checked every day. The size of the pacifier should be suitable for the structure of the mouth.
Primary teeth should be treated just like permanent teeth. Untreated dental disorders in this period may cause tooth crookedness, chin development disorder and general health problems in the future.
Early childhood caries, or bottle caries, is a common type of caries that starts in the upper incisors of babies and affects all teeth in a short time.
Milk accumulated in the mouth by babies suckling breast milk before bed or during sleep or drinking cow’s milk with a bottle creates a suitable environment for rapid growth of bacteria. Decreased salivation during sleep facilitates the dissolution of enamel because of the acid produced by bacteria. For this reason, care should be taken to clean the primary teeth, especially after night feeding.
For the early diagnosis of bottle caries, be sure to take your child to a pedodontist before the age of one. Do not allow him/her to feed in his/her sleep from the age of one. Clean your baby’s teeth regularly with a wet cheesecloth or toothbrush after each feeding. After feeding, make them drink water in cases where your baby’s teeth cannot be cleaned. Do not add high sugar foods such as honey, jam, molasses to your baby’s milk.
Caries cause tooth damage and result in an abscess that causes pain and infection if left untreated. The dentist fills the tooth with tooth-colored fillers after removing the caries and weakened parts of the tooth. With filling, the teeth become able to function again, the aesthetic disorder caused by decayed teeth disappears, and the child’s nutrition becomes easier. By ensuring that the filled deciduous tooth functions until the time of replacement, the location of the permanent tooth that will come from the bottom is preserved and therefore, tooth crowding that may occur can be prevented.
After removal of the caries and weakened parts of the tooth, capping can be applied to preserve the pulp tissue and maintain the tooth’s vitality in cases where it is very close to the pulp (in some cases, a special filler is temporarily placed on the tooth and permanent filling can be done within 3 weeks-6 months or later).
It is a form of treatment that aims to remove the crown pulp tissue of the tooth with special tools and to maintain the root pulp of the tooth in a healthy way.
Canal treatment is a treatment associated with the tissues in the root part of the tooth in order to prevent tooth loss. It is aimed to remove the infected tissue within the root canals and fill them with intra-canal drugs compatible with the physiological root erosion of the canals.
If the tooth extraction infection in the tooth is too advanced to be treated, the best way to prevent further spread of the infection is often tooth extraction. As a result of not extracting a tooth that requires tooth extraction, these teeth can cause pain, swelling, and even bone loss in the jaws, and infected primary teeth that are not extracted can also damage the permanent teeth that come from below.
Apexogenesis or apexification treatments are applied to young continuous teeth without a closed root end, where the living tissue of the tooth is damaged due to caries infection or trauma.
The root development of the tooth continues naturally by preserving the vitality of the tooth nerve with apexogenesis treatment. This treatment continues until root development is completed with clinical and radiographic examinations to be performed in periodic controls. The sensitivity of the patient to heat and cold decreases and disappears during apexogenesis treatment. In line with the child’s response to treatment, the treatment plan may turn into apexification treatment.
If the young person who has not completed root development loses his/her vitality due to continuous tooth, caries, infection or trauma, apexification treatment is applied in order to complete root development. In this treatment, tooth and tissue-friendly substances are sent to the root canals and root development is ensured to continue. Complaints such as pain and swelling in the teeth disappear after apexification treatments. During these treatments, local anesthesia is applied to the teeth. Apexification treatments are treatments that require regular control for a long time. In these control sessions, if necessary, the substances placed in the tooth are renewed. Pain and swelling may occur. If necessary, medications such as painkillers and antibiotics can be prescribed. Disinfectant drugs can be used during treatment. As a result of the dressings, root canal treatment is applied to the tooth that completes the root tip development.
Fluoride is an element that prevents the decay of the teeth and strengthens the structure of the teeth. Fluoride is found in toothpastes as well as in some nutrients. However, since children often neglect to brush their teeth, they do not receive enough fluoride to make their teeth resistant to caries. In order to prevent this situation, “superficial fluoride” applications are applied.
Superficial fluoride application is especially applied in children whose teeth are prone to decay. In this way, sufficient amount of fluoride is stored on the teeth and the structure of the teeth is strengthened and resistant to caries.
The chewing surfaces of the teeth are recessed. These pits and peaks are called pits and fissures. These areas are quite narrow and are usually where caries begin because the tightness of the food cannot be cleaned. A special flowable filling material is used to prevent the accumulation of food and microorganisms in these areas and accordingly caries. First of all, this area is completely cleaned and the flowable filling, which we call fissure filling, is applied to this area. It is hardened with light and its excess is corrected and polished.
Thanks to this process, it is possible to protect from chewing surface caries. Although it can be used for many years under normal conditions, it is beneficial to check it frequently, especially in those with habits such as chewing ice or grinding teeth.
The period when the first permanent teeth emerge in the mouth is ideal for application. This is around the age of 6. It is also applied to others during the eruption of other molars.
Although it can be applied in adults without caries, its use is more beneficial and important in children.
The parimary teeth fall as a result of the melting of the roots under the pressure of the permanent teeth coming from the bottom. However, sometimes primary teeth may be lost prematurely due to extraction due to an impact or caries. When the primary tooth is lost prematurely, the teeth on both sides tilt towards the extraction space, the teeth on the opposite jaw extend towards this space. Thus, as a result of the early loss of the primary tooth, the necessary distance for the permanent tooth coming from the bottom is lost, and crowding occurs in the permanent teeth.
In early primary tooth losses, appliances called space maintainers are used to protect the place of the permanent tooth to come from the bottom. The placeholders prevent the adjacent teeth from moving into the extraction space, allowing them to remain stationary. Thus, crowding of permanent teeth is prevented. Placeholders are passive apparatus, they do not apply force to teeth.
Placeholders are applied in two ways as fixed and movable. Fixed placeholders are used in the absence of a single tooth. As can be understood from the name, they are fixed and cannot remove patients. Moving placeholders are used in the absence of more than one deciduous tooth. The patient can insert and remove the apparatus.
Children often fall or crash. As a result, a simple mouthpiece, which they will be uncomfortable for years by damaging their front teeth, prevents the damage caused by a trauma to the lower part of the face. Especially in children who do sports such as football, boxing, skiing, basketball, cycling, skating, surfing, skateboarding, dental traumas, fractures or lip, tongue bites and tears are prevented as a result of the pillow effect of a silicone transparent mouthpiece attached to the upper jaw teeth.
If the entire tooth is dislodged, it should be kept without touching the root of the tooth and washed under clean, flowing water. The ideal environment for delivering the falling tooth to the physician is the oral cavity. However, this method is not recommended because the child can easily swallow the tooth. If the falling tooth is not in milk, it should be delivered to the physician as soon as possible in clean water. When you deliver the tooth, your physician will decide whether the tooth will be repositioned depending on whether the falling tooth is primary or permanent, the degree to which the tooth sink and the tooth are affected by the trauma.
Try to find the broken pieces and contact your dentist immediately. In the meantime, it is important to keep the parts moist. The physiological saline solution and even saliva are ideal for this. These parts are bonded to their places with very strong tools.
If the fractured part is small, a white (composite) filling is made in the same color and form as the tooth. Intraoral durability of composite fillers is limited. They change color by being stained with foods such as tea, coffee, and cola.
If the fracture is large and covers half or more of the tooth, porcelain laminate veneers are applied. Porcelain laminate veneers are durable and aesthetic. They can be explained as porcelain leaves that adhere to the front surface of the tooth and cover the broken part.
Since tooth and jaw development is not completed in those under the age of 17, it is not correct to apply porcelain laminate veneers. Again, composite laminates are made that cover the entire front surface of the tooth and the fracture section.
For the oral and dental health of children:
The use of pacifiers should be stopped around one, one and a half years of age.
The child should meet the dentist between the ages of first and second.
Meeting the dentist early and without problems creates a positive image in the child.
As soon as the teeth come out, they should be brushed.
Proper nutrition is also one of the basic elements of dental health.
These days, the most important task of dentists is to direct them towards a caries-free future with preventive treatments to be applied to children. For this purpose, Fluorine and Fissure sealant fillers can be considered as protective against caries.
Children aged 6-9 years should be examined orthodontically.
The location of a prematurely extracted primary tooth should be maintained until the permanent tooth arrives.
In addition to the bottle, another reason for bottle caries is that the pacifiers are dipped in sweeteners such as honey, molasses and jam in order to silence crying babies. In addition, carbohydrate-sugar foods given to the baby’s hand to linger after the teeth are erupted also cause tooth decay. Instead of such foods, it is necessary to direct the child to foods with high nutritional value such as apples and carrots; foods that help dental cleaning.