pediatric dental care

The first set of teeth may eventually fall off; however, it doesn’t mean that you don’t take good care of them. The health of a child’s permanent teeth solely depends on the health care of the primary teeth. It is a fact because primary teeth act as a guide for continuous tooth eruption. Usually, new parents are unaware of the significance of maintaining good oral hygiene. As a result, their child starts to develop tooth decay in one or more teeth.

It is essential to understand that child oral health care begins right after the birth of the baby. Cleaning the gum pads with a soft clean washcloth can help to ease the process of teething. The child’s first dental visit should be scheduled within the first year. This helps to keep a check on the growth and development of baby’s oral tissues.

Tooth decay, gum disease, development of oral habits like tongue-thrusting and thumb-sucking are certain things that need to be looked after. Pediatric dentistry specializes in treating such conditions for children. A Pedodontist is the best dental professional to consult for any dental problems related to kids. Today’s article will highlight some of the conventional pediatric dental care and treatments.

What is pediatric dentistry?

Pediatric dentistry is a popular branch of dentistry that specializes in providing excellent dental care to children right from birth through adolescence. Additionally, pediatric dentistry is a great source to educate new parents about the importance of their child’s oral health. (1)

Pediatric dentistry trains dental professionals in establishing a comprehensive and positive relationship with the child patient. There are a wide variety of dental treatments that come under this branch of dentistry. Some of them include tooth filling, pulpectomy, sealant placement, orthodontic interventions, stainless steel crown placement, and behavior modifications.

Who is a Pedodontist?

Pedodontist also is known as the Pediatric dentist, is a dental professional who specializes in child oral health care and needs. These dental specialists are trained vigorously to have the knowledge and experience in behavior management and to build a good rapport with the children. (2)

Pediatric dentists mainly look after the dental health of the teeth, gums, mouth, and associated oral habits or problems to ensure proper growth and development of the oral cavity and jaws. Typically, a pediatric dentist undergoes training in a professional dental school for two years, where they learn about child psychology, development, patient management, and care.

Often kids are apprehensive and anxious before a dental visit. The two most crucial techniques that a pediatric dentist follows in providing a positive dental experience to the child patient are –

  • Tell show and do method – the dentist informs the child about each step, shows him the step outside the mouth, and performs the technique inside the mouth. (3)
  • Positive reinforcement – this includes praising the child for behaving well throughout the dental procedure. This technique boosts up patient co-operation.

What is the importance of the first dental visit?

First dental visit typically involves the technique of familiarizing the child with the dental office, staff, and surroundings in a positive and friendly way. To build a good rapport and provide comfort to the child, the dentist may ask the parent to sit on the dental chair and hold the child for an oral examination.

Behavior management techniques change according to the type of patient. Usually, during an oral examination, the dentist thoroughly inspects the oral tissues, including the teeth, gums, tongue, lips, and inner cheeks. All the signs of tooth decay, gum disease, malocclusions, tongue thrusting, or oral infectious lesions is checked to ensure the proper oral health of the child.

Tooth cleaning is the best and simple way of familiarizing the child with dental tools and procedures. Moreover, tooth cleaning ensures thorough removal of the plaque and tartar from the mouth. A second part of the first dental visit includes a radiographic study. Dental x-rays are usually taken when the dentist raises suspicion of tooth decay. A periodic x-ray study within every six months helps to keep a check on the oral health status of the child.

What are the standard pediatric dental procedures?

Several dental treatments are performed to restore and prevent tooth decay and gum disease in children. Some of the standard pediatric dental procedures include –

Fluoride treatments

Fluoride treatments are essential for children as they help to remineralize the tooth enamel and prevent tooth decay. Water fluoridation has taken a significant step in providing fluoride to the people of the community. However, the fluoride from drinking water may not be sufficient to protect the primary teeth from dental decay. (4)

Typically, fluoride treatments are done by using gel formulations, foam, or even paint. The dentist puts a calculated amount of fluoride in a dental tray. The tray is placed on the teeth for a few minutes to allow absorption of the fluoride.

Tooth cleaning

Professional tooth cleaning is an effective dental procedure that removes dental plaque and bacteria from the tooth and gums. Moreover, tooth cleaning is also used as a standard step to familiarize the child patient with different dental instruments.

During this procedure, the dentist uses an ultrasonic scaler to scrape the plaque and tartar from the tooth surface. This step is followed by finishing and polishing of the tooth surface. It is essential to get tooth cleaning done twice in a year with a time interval of six months.

Tooth filling

Tooth decay is one of the most progressive dental diseases that children with poor oral hygiene experience. Tooth decay is caused by the weakening of enamel by an acid attack from the harmful oral bacteria. (5)

Often, tooth decay is ignored by the parents, which allow further progression of the lesion. Such conditions can quickly turn into a painful experience. A tooth filling is performed for tooth decay that has not involved the pulp tissue. Glass ionomer tooth material is usually used in restoring baby teeth.

Sealant placement

Sealants are a preventive dental therapy that requires placement of white plastic coating on the permanent molars. These filings are thin, flowable, and do not require drilling of the tooth surface. Sealants are used to cover deep pits and grooves of permanent molar teeth that tend to trap food and undergo tooth decay. Typically, sealants should be places as soon as the first permanent molars erupt in the mouth. Typically, sealants last for 5-10 years with proper care and maintenance. (6)

Pulpectomy

A pulpectomy is a pediatric dental procedure which is performed to remove the infected pulp from the tooth roots. Pulp infection happens when tooth decay extends deep involving the dentin and the pulp. Other causes of a pulp infection include traumatic tooth injury that may fracture the tooth through the pulp tissue.

A pulpectomy is similar to root canal treatment in adults. It is usually performed in baby teeth to avoid the incidence of tooth extraction. Moreover, it contributes to maintaining natural growth and development of the permanent tooth. (7)

Stainless steel crown placement

Usually, after pulp therapy, the baby tooth is covered by a stainless-steel crown to maintain the strength of the tooth. Stainless steel crown for primary teeth restoration usually come in a pre-formed package. Additionally, they have a wide range of sizes.

Sometimes, badly broken teeth or extensive tooth decay that do not support tooth filling can be treated by a stainless steel crown. The crown is checked for the correct fit. In some cases, the dentist may also contour the crown to make it ideal for the patient’s tooth form. Once the fit is checked, the crown is cemented to the tooth. Often stainless-steel crown comes out with the tooth while they exfoliate out of the mouth.

Tooth removal

Tooth removal is a procedure performed for teeth with a hopeless prognosis, for example, extensive tooth decay with weak tooth structure, vertical root fractures, a traumatic injury that cannot be restored by any other therapeutic therapy.

Some orthodontic interventions may also require tooth extraction to create space for proper teeth alignment in the jaw. During this, procedure, the dentist numbs the concerned area using conscious sedation technique or local anesthesia. The tooth is luxated using an elevator and removed with extraction forceps.

Space maintenance

Space maintainers are specialized dental appliances that are used to hold the space for the developing permanent tooth. Space maintainers are advised during premature extraction or exfoliation of the primary tooth. Primary teeth typically act as a guide and a driving force for the underlying permanent teeth. Removal of the primary tooth without space maintenance can lead to misalignment of the permanent tooth.

This is because of drift in the adjacent tooth position, which occupies the space and blocks the natural eruption path of a permanent tooth. In most cases, it causes severe crowding or spacing between the teeth.

Orthodontic intervention

Malocclusion is a widespread dental problem that most of the children suffer from. Some of the factors that may influence the misalignment of teeth in children to include –

  • The discrepancy between the jaw and tooth size
  • Failure to maintain space (8)
  • Misaligned jaw
  • Parafunctional habits like tongue-thrusting and thumb sucking

Orthodontic interception in children helps to keep a check on the status of malocclusion and make an immediate treatment plan to align the permanent teeth properly. Some of the common malocclusions include –

  • Open bite
  • Crowding or spacing between the teeth
  • Crossbite
  • Excessive overjet and overbite
  • Forwardly placed upper front teeth

Such conditions can severely impact the self-esteem and confidence of the child. Interceptive orthodontic treatment usually involves early assessment of the misalignment or malocclusion, correction of the bite and jaw alignment evaluation.

For children with parafunctional habits, a habit break appliance is recommended to eliminate habits like tongue-thrusting and thumb sucking. A regular follow up is usually recommended once in every month to check the progress of the orthodontic therapy. Moreover, the dentist can determine further corrections that may be required.

A note on special needs dentistry

Special needs dentistry is an exclusive branch of dentistry that trains dental professionals to manage and work with children with special needs and care. Often such kids are challenging to work with because of their physical, mental, and sensory impairments. Some of the common conditions that children with special needs experience are –

  • Autism
  • Down’s syndrome
  • Cerebral palsy
  • Muscular dystrophy
  • Visual and hearing impairments (9)
  • Depression

Children with special needs require constant care and attention. Moreover, an empathic approach is usually necessary to comfort them and reduce their anxiety. This is the reason why special care dentistry is crucial in training dental professionals to provide the best care to such children.

Usually, the dental treatments for such children include routine tooth cleaning, tooth filling, and preventive care approach. Orthodontic therapy may be planned with precaution as it is challenging to maintain good oral hygiene in children with a physical disability.

Children with orofacial disorders may require medically specialized dental attention and care. Particular emphasis on maintaining good oral hygiene is made to keep the health and longevity of the teeth and gums.

Take away message

The first step towards child oral health care is to take proper care of their oral hygiene. It builds a healthy foundation for the kids. Moreover, children watch, learn, and incorporate healthy oral habits early in their life. Teething is a process of tooth eruption that every child experience in life. Gum care is significant during this time, as a healthy oral environment can do wonders in easing out the pain and discomfort of the child from teething.

Most often, children are prone to tooth decay, gum disease, and malocclusions. There are several dental treatments like sealant placement, tooth filling, pulpectomy, and stainless-steel crown placement. Every dental problem can be effectively taken care of by a pediatric dental specialist. Pediatric dentists are well trained in handling the tantrums and fears of the children. Moreover, they can effectively communicate and provide a positive dental experience to kids. Therefore, it is necessary to select the dental professional for your child carefully.