Pediatric Dentistry examines the oral and dental health of individuals from birth to the end of adolescence (0-15 years old); It is the department that applies all protective, preventive and therapeutic methods in these individuals. In the pedodontics unit of our polyclinic, many methods are applied for preventing these diseases as well as treating mouth and dental diseases in children. Some of those include;

• Treatments and restorations of decayed milk and permanent teeth,
• Tooth caries prevention procedures,
• Extraction of teeth that cannot be treated,
• Preventing the negativities that may occur with the formation of early tooth loss with some appliances, ensuring the formation of the teeth row properly,
• Diagnosis, treatment and long-term follow-up of traumatic dental and supporting tissue injuries,
• Follow-up of tooth eruption and dentition and prevention of deviations from normal,
• Protective and preventive orthodontic treatments,
• There are applications such as diagnosis, treatment and follow-up of gingival diseases seen in childhood and young individuals.

What age group does a pediatric dentist treat?

Children in the 0-15 age group enter the field of the pediatric dentist. The edentulous period covers a long period, including the period when the milk teeth begin to erupt, the period when the milk teeth are completed in the mouth, the mixed dentition period when the permanent teeth begin to erupt, and the period when the permanent teeth are completed.

When should the first visit to the pediatric dentist be made?

Children’s first dental examination should be done until the age of 1 after the eruption of the first milk tooth.

What are the common mistakes made in terms of dental caries in children’s nutrition?

Night feeding: Feeding, which starts with breastfeeding or feeding with a bottle, continues especially after the 18th month and between sleep at night, and the teeth are not cleaned over time, causing the milk teeth to decay over time.

Junk foods consumed in between meals: Consumption of sugar-containing foods such as chocolate, biscuits, cakes, ready-made fruit juices and acidic beverages frequently between meals, and not brushing the teeth are another cause of caries.

Why are the milk teeth important?

Milk teeth are extremely important for your child’s healthy growth and development. In addition to chewing, which is necessary for nutrition, milk teeth are needed for speaking and a beautiful smile. Another task of the milk teeth is to protect the permanent teeth that will come from below and to ensure that the permanent teeth come to the right place on the jaws.

What are the problems that can be experienced during teething in babies?

While it is considered normal to see irritability, temper, loss of appetite, insomnia and increased saliva flow during teething in babies, symptoms such as fever, redness, runny nose, rash and diarrhea are not related to teething and require a referral to a pediatrician. Particularly painful, reddened and swollen gingiva (swelling or bruise in gingiva) are a sign that teeth are erupting. During this period, it will be comforting for the baby to massage the gingiva with a cooled small spoon, teether (must be hard rubber, teethers containing liquids or made of breakable plastic should not be preferred) or the mother’s finger that has been washed.

How should children with fear of the dentist be approached?

Even adults are known to hesitate before routine dental checkups and treatments. So it’s understandable that children find going to the dentist quite daunting. Parents can try the following methods to help their children be less nervous about visiting the dentist:

Talk to your child about the visit, simply explain what might happen. You can tell your child that the dentist will “count” and “take a picture” of their teeth. Please don’t talk to your child about how the dentist scared you or how bad your last visit was. Do not use words that children might be afraid of, such as “needle”. It’s helpful to talk to your dentist about any concerns your child may have. Be sure to work with your dentist to help overcome the fear. Do not bribe your child to go to the dentist or take your child to the dentist as punishment.

What is early childhood caries?

It is the case of one or more tooth caries and related fillings or loss in a child before the age of six. It is a disease caused by bacteria that settle on the teeth immediately after eruption and convert the sugar taken with nutrition into acids that cause caries. It starts as a result of long-term nocturnal feeding and insufficient cleaning of the teeth, and if precautions are not taken, it progresses rapidly and intensifies.

What are the causes of early age caries?

Some acid-forming bacteria in the mouth, carbohydrates taken with nutrition, and the presence of dental hard tissues for a certain period of time lead to the formation of dental caries. These bacteria are usually passed from the mother or caregiver to the child after the teeth erupt. Especially putting the baby to bed with a bottle containing sugary drink, optional breastfeeding at night after 12 months, giving the pacifier dipped in sugary foods such as jam and honey to calm it, and not paying attention to brushing teeth are among the reasons. In addition to these, the inclusion of foods and beverages containing free sugar in the diet before the age of two may cause severe tooth decay.

What are the prevalence and causes of dental caries in children?

Although the prevalence of dental caries in children in our country varies according to age and regions, it is known to be between 80-90% in general. Wrong eating habits and not paying attention to oral hygiene are among the most important reasons.

Is tooth decay transmitted from mother to child?

Tooth decay is an infectious disease that can be easily transmitted from mother to child. When children are born, they are born sterile from caries-causing microorganisms. Due to the traditional but wrong habits of the mother, these microbes can easily be transmitted to the child. For example, habits such as feeding the baby with the spoon that the mother uses to control the temperature of the food, controlling the temperature of the food in the bottle by mouth, putting the pacifier in and out of her mouth to clean it, kissing the baby from the area very close to the mouth of the baby cause the caries-causing microorganisms in the mother’s own mouth to pass to the baby. Since these microorganisms can adhere to the tooth surface, they multiply rapidly with the eruption of the first teeth and form one of the causes of caries.

What kinds of precautions can be taken to prevent tooth decay in children?

It is important to consult a pediatric dentist and have the first examination from the period when the teeth begin to erupt until the child is 12 months old. In this first meeting, which will be held before bad habits develop and tooth decay begins, the pediatric dentist can give the family very useful information about proper nutrition, oral hygiene and tooth development.

The most effective preventive method is to introduce the habit of brushing teeth to children at an early age.  It is necessary to start brushing the teeth with fluoride toothpaste by the parents and/or the caregiver, starting from the period when the first milk tooth erupts.

Families should pay attention to their children’s eating habits and keep them away from foods that cause caries and contain free sugar. Instead, more nutritious and caries-free foods should be preferred. For example, instead of snacks such as wafers, candy, and chocolate, fruits such as carrots, apples, fibrous vegetables and nuts can be given in between meals. Sugar-free or artificial sweetener-containing xylitol chewing gums can be preferred instead of sugar gum.

What is fluoride application and how often should it be done?

It is the application of agents such as varnish, gel, solution and fluoride compounds to the surface of the teeth in order to prevent, slow down or stop dental caries in children, adolescents and young people. It is ideal to be applied by the dentist in the dental unit and in a preventive program planned for individual needs. The frequency of application is determined by the dentist according to the child’s risk of developing dental caries. In this way, it can be applied two, three or four times a year. Fluoride applications alone are not enough to prevent dental caries. It is necessary to carry out many methods such as regulation of nutrition, control of plaque accumulation in the mouth, treatment of existing caries lesions, fissure sealant applications, regular control. The most effective preventive approach is to carry out a continuous program prepared by the dentist individually according to the needs of the child.

What is fissure sealant?

The chewing surfaces of the molars in the posterior region have thin slits and pits where food can easily hold due to their anatomical structure. Since children cannot easily brush their molars regularly when they start brushing, caries usually starts from the back teeth first.

In order to protect these teeth against caries, fissure sealants are applied, which is a method that children can easily accept at any age, without removing material from the teeth.

The materials used in the fissure sealant application can be transparent or opaque white.  These materials, which do not pose any aesthetic problems, can be bonded to the tooth enamel and remain for 3-5 years. Fissure sealants can protect the chewing surfaces of the teeth from decay in this long period. Since it is a painless procedure, it requires minimal compliance and can be applied without local anesthesia.

Is there an age limit for applications that prevent tooth decay?

Both fissure sealants and local fluoride applications should ideally be done within the first 3-4 years following the eruption of the teeth. In other words, its application on caries-free teeth during the period after the eruption gives the most effective results.

What kind of health problems do dental caries cause if left untreated?

Decayed milk teeth are extremely harmful both for the child and for the development of the permanent teeth under them. After a while, an infection develops in the roots of untreated decayed milk teeth. This infection can cause permanent developmental staining of the enamel of the developing teeth under. In addition, decayed milk teeth are a serious source of infection and can be a source of infections extending to vital organs in the body. For example, the heart, kidneys, joints are organs that are easily affected by these infections. The nutrition, sleep pattern, growth, physical and social development and quality of life of the child, who is introduced to dental caries and its consequences at an early age, deteriorates. For all these reasons, it should not be neglected by saying that the decayed milk teeth will fall out after a while, and they should definitely be treated.

Should the cavity of the extracted milk tooth be preserved?

Primary teeth that are incurably infected due to caries or traumatic injury should be removed from the mouth by pulling out. Since a permanent tooth will replace the milk teeth removed from the mouth after a while, that cavity should not be closed. For this purpose, appliances called space maintainers should be applied to the cavities of the extracted milk teeth. Otherwise, the adjacent teeth will slide into the cavity of the extracted milk tooth and narrow the place where the permanent tooth will erupt. In this way, both very long and costly treatments may be required to correct the disorganized teeth row. Space loss in dental arches can be easily prevented with space maintainer appliances that can be used at a much lower cost.

In which cases and how are dentures made in children?

It is very rare for children to be born completely toothless. However, in some syndromes, complete or partial edentulism can be seen as a finding of the oral-dental system or independent of the disease. In such cases, dentures should be applied in order to provide the child with functions such as chewing, speaking and aesthetics. It is necessary to periodically renew the dentures by following the growth and development of the child.