CHILDREN’S DENTISTRY (PEDODONTY)

MILK TEETH;

  • Provides chewing function.
  • It is important for digestive function.
  • It contributes to growth and development.
  • It acts as a space saver for the permanent teeth that will be replaced.

WHAT HAPPENS WHEN MILK TEETH REMOVE, WHAT TO DO?

What Happens When Teeth Come Out?

Teething symptoms may appear two to three months before the teeth themselves. These symptoms vary from child to child, and in fact, opinions on what they are and how painful they are also vary from doctor to doctor. However, it is generally accepted that a teething baby may experience the following:
Drooling:Many babies drool starting around two and a half to three months old. Teething increases this more in some babies than in others.
Redness of the chin or face: In a drooling baby, it is not surprising that redness or cracks occur on the skin due to the irritation caused by the constant contact of saliva on the chin and around the mouth. To prevent this, gently wipe the saliva periodically throughout the day, and place a towel under the bed sheet to absorb the saliva while your baby is sleeping. When the skin becomes dry, keep the area constantly moist with a soft skin cream.
Mild cough: Excessive saliva can cause the baby to choke and cough from time to time. If your baby is not showing signs of a cold, flu or allergy, there is nothing to worry about. It is common for infants to continue coughing to gain attention or enrich their vocal repertoire.
Bite: A bite in this case is not a sign of hostility. A teething baby tries to soothe his gums by putting anything he can get into his mouth, whether it’s his own hand, his mother’s breast, a stranger’s finger.
Pain: Under the pressure of an erupting tooth, inflammation develops in the gingiva. While this may cause unbearable pain in some babies, it may not cause any problems in others. The first teeth and molars are the teeth that cause the most trouble when they come out.
Unrest: As the inflammation increases and the sharp tooth approaches the surface, the pain in the baby’s gums may become constant. Like anyone with chronic pain, he can be distressed and distracted from his normal self. This restlessness can sometimes last for weeks.
Refusal to feed: A teething baby may refuse to feed. A baby who has started solid foods may lose interest in these foods for a while. However, this should not worry you. Because your baby gets the necessary nutrients from liquid foods and his appetite will come back after the tooth comes out.
Diarrhea: The relevance of this to teething is very doubtful. Some mothers say their baby has diarrhea every time they teethe. Some doctors think there is a correlation between teething and bowel movements, most likely due to increased salivation. Some doctors do not want to admit that there is such a correlation ; perhaps because mothers fear that by attributing every diarrhea to teething, significant gastrointestinal disorders may be overlooked. Know that your baby’s stool may be watery during teething, but be sure to report diarrhea that lasts longer than two stools.
Fire: Fever, like diarrhea, is a symptom that doctors are hesitant to be associated with teething. A fever below 38°C may accompany teething due to swelling of the gums. However, if your baby has a fever, do what you do at other times, and let your doctor know if it doesn’t subside in two days.
Insomnia: Even babies who sleep soundly through the night may begin to wake up at night while teething. In this case, do not try to feed him immediately. Instead, make him go back to sleep by himself. Waking up at night, like other problems, is more common when the first tooth and molars are erupting.
Gingival Hematoma: Sometimes an erupted tooth can cause bleeding in the gums, which is seen as a bluish stain. There is no need to worry about these hematomas and they resolve on their own without medical intervention. A cold compress can reduce pain and speed healing.
Ear Pulling, Cheek Scratching: Pain in the gums may radiate to the ear and cheek along the nerve pathways. It is important to remember that babies also pull their ears when they have an ear infection. Consult your doctor if you suspect an ear infection, even if your baby is teething.

What to Do When Teeth Appear?
There are dozens of tried-and-true treatments. Some work, some don’t. You can try some of the following.

  • Giving Something To Chew: Here, it is aimed to relieve the pressure on the gums rather than the nutritional value. Therefore, if the chewed thing is cold, its benefit increases. A frozen donut, a cold banana, or carrot, a piece of ice wrapped in cheesecloth, a rubber tooth ring. Whatever you give your baby to chew, always be with him and ensure that he is in a sitting position.
  • Things He May Scratch His Teeth: Some babies may object because of the initial pain. But after a while, the pain gives way to relief.
  • Cold drinks: Give your baby a bottle of cold water. If she refuses the bottle, try giving it with a glass. In this way, you will also meet your baby’s water needs and replace the fluid lost with diarrhea or increased salivation.
  • Cold Foods:Refrigerated peach puree, applesauce, yogurt may appeal to your baby more than room temperature food.
  • Something to Relieve Pain: If nothing else works, paracetamol will make your job easier. Consult your doctor for dose adjustment. Do not apply anything else to your baby’s gums unless your doctor recommends it. This includes alcoholic beverages.

ORAL CARE IN CHILDREN

RECOMMENDATIONS FOR BRINGING YOUR BABY AND CHILDREN TO THE HABITS OF BRUSHING:

Brush your own teeth with a separate toothbrush while brushing your teeth,
Get him some toothbrushes. Let these brushes be of different colors and with different comic book characters. Have him choose a different brush each time. This choice will increase his tooth brushing desire and motivation.
Make sure to create a toothbrushing board at home and mark on the board after each brushing.
Let him brush his teeth first, then let him brush yours and then yours.
Place an hourglass in the bathroom and keep time by turning the hourglass upside down each time you brush. About 2 minutes of brushing will suffice.
Remember that your baby or child has no knowledge of tooth decay. Feed him a sticky candy, chocolate or biscuit and show him how it sticks to his teeth in the mirror. Then brush her teeth and show her in the mirror how beautiful, clean and white her teeth are.
In addition, after the first milk tooth erupts, you can (6-9 months) Taking it to the dentist will provide you with more detailed information about your child’s oral hygiene. If the pediatric dentist brushes your child’s teeth during regular dental check-ups later, or other children brushing their teeth in the clinic environment will definitely increase his motivation.
It should not be forgotten that regular brushing will play a big role in preventing your child’s future dental problems.

PROTECTIVE PRACTICES IN CHILDREN

Protective practices help your child to have healthy teeth and jaw structure in the coming years. These; regulation of dietary habits, fluoride applications, fissure sealant applications and placeholder applications.

Pay attention to these to prevent tooth decay;

  • Do not give your baby sugary foods at the last feeding of the night.
  • After drinking milk with a bottle, drink water for mouth cleaning.
  • Never dip the pacifier in sugar, honey or molasses.
  • Do not put your child’s spoon in your mouth during feeding, do not take the bites out of your mouth and give them to your child.
  • Do not give sugary, sticky caries between main meals.
  • After each feeding, make your child drink water to clean the mouth.
  • From the age of two, brush your teeth twice a day with a suitable sized brush under your control.
  • When you are sure that your child does not swallow the toothpaste, brush them using a pea-sized amount of children’s paste.
  • Make use of preservative fluoride treatments.
  • If you have caries in milk teeth, make sure to have them treated.
  • Have fissure sealant applied to the 6-year-old teeth that come out from the back of the milk teeth at the age of 6 and must remain in our mouth for life, and if there is caries, have it treated.
  • Have your child’s teeth checked by the dentist every 6 months.

ORAL AND EXTERNAL PROBLEMS IN CHILDREN

1. OUTER ROOT

  • Reasons:Inadequate oral hygiene, wrong eating habits, tooth structure
  • Symptoms: Sensitivity and pain to heat and cold, Child refrains from brushing and using decayed teeth
  • Treatment: Glass-ionomer/glass-carbomer/compomer/composite restorations according to the depth of caries; root canal treatment; stainless steel veneers or tooth extraction can be done.

2. EXTERIOR GRINDING

  • Reasons:Stress, aggressive, obsessive or shy personalities, children whose parents grind their teeth are more prone to this habit.
  • Symptoms:Wear on the teeth, grinding noises while sleeping, pain in the facial muscles, problems in the jaw joint, headache, wobbly and sensitivity in the teeth.
  • Treatment:First of all, it is tried to eliminate the psychological factors that cause teeth grinding.

This cannot be achieved, the patient is made a removable night plate.

3. FINGER SUCKING

  • Reasons: Thumb sucking is a common habit at a young age. It usually goes away on its own by the age of four. The continuation of the habit at the age of permanent teeth eruption leads to structural disorders in these teeth and palate. The cause of these disorders is the pressure exerted by the finger on the front teeth and palate. The degree of impairment that occurs depends on the duration, frequency, and severity of sucking and the position of the finger during sucking.
  • Treatment: The most effective way to prevent thumb sucking is to accustom the child who tends to thumb sucking to the pacifier. The damage caused by the pacifier is less, and it can be left more easily. The timing of treatment is very important. Unless the child himself wants to get rid of this habit, it is impossible for the treatment to be successful. It is psychologically very beneficial for the child to leave before school age so that he does not suffer from environmental pressure and ridicule. The child should be guided positively by being encouraged and rewarded without being put under pressure. If, despite everything, the habit cannot be broken by the age of 6, it is necessary to seek professional help by consulting a dentist.

4. USE OF pacifier

  • For babies, sucking is the most natural way to relax and feel safe. If the baby is prone to thumb sucking, he should be directed to the pacifier immediately.
  • A pacifier is also less harmful than thumb sucking; and it can be left more easily in later ages. The pacifier should be given only when necessary, not for most of the day.
  • In order not to cause structural defects, pacifiers with natural breast structure should be chosen as much as possible.
  • The soundness of the structure of the pacifiers should be checked daily. The size of the pacifier should be suitable for the structure of the mouth.

5. BABY ROOT/ EARLY CHILDHOOD ROOT (ECC)

  • Reasons:Continued eating habits before and during sleep, situations where the child is allowed to sleep with a bottle, Frequent and long
  • There are factors such as prolonged night feeding, giving caries-causing foods to the child, using pacifiers dipped in sugar or honey.
  • Treatment: The conditions that are important in the prevention of the disease and that the physician should do are as follows: Treatment options are determined according to the caries activity. It can vary from filling to extraction. When there is a large number of tooth loss, the child’s nutrition, growth and development; Child prostheses can be made so that his psychological state and speech are not affected.

6. NON-MILK COLORS

Causes and treatments:

  • Bacterial Plaque: a yellowish or orange-colored appearance occurs in his teeth. Do not forget that; The first appearance of dental caries in babies also exhibits a white/yellowish character. It is usually controlled by brushing.
  • Black colourations: Iron preparations or multivitamin drops that you usually use for your baby can leave temporary black stains on the teeth. With regular brushing of the teeth, you can ensure that these stains do not occur at all or very little.
  • Colorations due to trauma: Especially when your baby starts to walk, they will definitely fall as a result of some curiosity and some accident. Sometimes these falls can be simple enough not to make them cry, and sometimes they can cause serious problems. If it falls on your teeth; Depending on the severity of the fall, the teeth may lose their vitality and the color of the teeth may become dull gray. In such cases, consult your dentist immediately.
  • Other Colorations: Infections due to excessive fluoride consumption in milk teeth and permanent teeth and due to high fever during pregnancy or in the first months after birth can also cause tooth discoloration. In such cases, you can get detailed information from your dentist.

Deciduous tooth traumas and emergencies

  1. Trauma
  2. Urgent

Frequently asked questions about milk teeth:

1. Why do milk teeth rot quickly?

Milk teeth contain more organic matter than normal teeth, so they are more prone to decay, they rot more easily and quickly.
Children cannot interpret signals such as hot-cold sensitivity and mild pain, which can be seen in the early period of caries, in a timely manner. They realize the event only when the pain is unbearable, in which case it may be too late.
Children cannot pay as much attention to oral care as adults. The child’s dexterity, curiosity and parent’s attitude determine the tooth brushing habit.
One of the mistakes that mothers make frequently is to use a pacifier or bottle with sugar, jam, etc. They are given to children by dipping them into foods such as sugary milk and fruit juice between sleep.
Thus, the teeth become susceptible to decay due to nutritional irregularities.

2.Can caries formation be prevented?

A vaccine or drug that can completely prevent caries has not been developed yet. However, some materials are used today to reduce the number of caries, one of them is; “fissure sealant” called material. Dental caries is usually found on the chewing surfaces of molars and premolars. “fissure” It starts in grooves called grooves. With fissure sealants, the grooves are covered and microbes, food residues, etc. By preventing the leakage of the cavities, the onset of caries is prevented. This procedure can also be applied to permanent molars and premolars that erupt from the age of 6 years.
Another way to prevent caries is to increase the resistance of teeth to caries. This resistance is gained by applying superficial fluoride to the teeth.
Should caries in milk teeth be treated?
Untreated milk tooth decay causes pain, bad smell, difficulty in chewing, malnutrition and ugly appearance. Untreated dental disorders in this period can cause tooth decay, jaw development disorder and general health problems in the future. (from rheumatism to heart ailments) may cause. Therefore, caries in milk teeth, “new ones will come in their place anyway”should be treated without error.

For a caries-free mouth in children;

  • Regular dental check-up
  • Oral care
  • Balanced diet
  • Fluor and Sealant application is required.

3. What should be done to overcome the fear of dentist in children?

If you explain to your child that dental treatment is nothing to be afraid of, you can easily take him to the dentist. But often parents turn going to the dentist into an element of fear. Because:

Taking the child to the dentist should not be a punishment. On the contrary, an environment should be created for the child to go to the dentist with pleasure.
Another issue to be considered is not to evoke an association between going to the dentist and the pain event that the child will be exposed to. However, the child “Your tooth will never hurt” deceive him by saying; makes future treatments more difficult.
Having a good dialogue with the dentist is a factor that helps the child overcome his fear. For this, let the child answer the questions asked by the dentist himself.

Dental Treatment with Sedation
What is sedation and how is it done?

It is a state of sleep that can be adjusted with depth controlled by preserving all the reflexes of the patient with sedative drugs used. It is a method applied by an anesthesiologist.
Anesthesiologist-Dentist cooperation is required in the application of dental treatment with sedation in children. First of all, after the patient is examined and evaluated by the anesthesiologist and dentist, a sedated dental treatment appointment is scheduled.
The patient should stop eating and drinking 3 hours before the start of the procedure. Sedation begins with intravenous access and administration of the solution. In children who are not psychologically and mentally ready for vascular access (underage, mental retardation, hyperactive etc.) Sedation is started by nasal drip, then the vascular access is opened and the procedure is started. The patient’s (your child) When the sedation reaches a sufficient depth, dental treatment begins. Patient’s vital signs (Pulse, respiration, oxygen saturation, blood pressure, body temperature) While being monitored and watched by an anesthesiologist, the pedodontist continues the dental treatment. After the completion of the treatment, the sedation is terminated by superficialization. The most important feature of the system is that the duration and depth of sedation can be adjusted with the sedative drugs used.
Since nothing is remembered after the application, including the opening of the vascular access, the negativities that may occur with fear in the dental treatments that the children will have later on their own will disappear.

What is Conscious Sedation? How is it applied?

Conscious Sedation is the state of suppressing the level of consciousness and giving appropriate responses to physical and verbal stimuli, allowing the patient to continue breathing independently. Conscious Sedation can be achieved by administering appropriate anesthetic drugs through the vascular access, nasal mucosa, and gas sniffing. Naturally, the child’s age, medical history, and cooperative approach to the applied method are also important in the selection of the method.

Eating After Sedation Dental Treatment?

Standard procedures apply in terms of dental treatment. So there is no need to wait for the fillings, after the bleeding is under control for the extraction, she can eat something 2 hours later. In terms of sedation, the patient should not have swallowing problems and should be controlled for bleeding in the mouth after surgery or tooth extraction.

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