Pediatric Dentistry (Pedodontics)

Milk teeth contain more organic matter than normal teeth, so they are more prone to decay and can decay more easily and quickly. Children do not react much in the early stages of decay. As the decay progresses, they may become sensitive to cold and sweets. Later, the decayed tooth will hurt and cause pain to the child. The pain increases especially when eating. This is because the food residues that enter the decay press on the nerves of the tooth and cause increased pain.

Children sometimes have brown spots on their teeth as soon as they erupt, or their teeth break and fall out. In fact, these stains are actually tooth decay and the teeth break because of the decay. The reason for cavities at such an early stage is so-called bottle caries. Breast milk or cow’s milk, the most important food in infant nutrition, naturally contains sugar. If the baby sucks on breast milk or a bottle at night before going to bed or during sleep, the milk accumulates in the mouth and creates a favorable environment for germs to decay the teeth.

• Prevent your baby from sleeping with a bottle in his/her mouth at night.
• Do not add sweeteners such as sugar, honey, molasses or biscuits to the milk in the bottle.
• Make sure your baby drinks water after feeding or brush your baby’s teeth if possible.
• With the eruption of the first teeth, wipe the teeth with a clean, wet cheesecloth or gauze after night and morning feedings.

Untreated decay of deciduous teeth leads to pain, bad odor, chewing difficulties, malnutrition and unsightly appearance. Untreated dental disorders in this period can lead to crooked teeth, impaired jaw development and general health problems (from rheumatism to heart disease) in the future. Therefore, decays in milk teeth should be treated without falling into the misconception that “new teeth will replace them anyway”.

Early loss of deciduous teeth causes some problems during permanent dentition, especially in the posterior molar regions. Because the permanent tooth that will be adjacent to the cavity where the tooth is lost may not erupt and remain impacted or erupt from a different place and cause malocclusion. In such cases, the need for orthodontic treatment (braces) is inevitable in the future. If an early deciduous tooth extraction has to be performed for various reasons, fixed/movable placeholder appliances should be made to prevent the space from closing as a result of shifting of the teeth next to the extraction cavity.

Cleaning should begin when the baby is 6-8 months old (i.e. when the first teeth appear in the mouth). After breakfast in the morning and before going to bed at night, it is a good idea to wipe and clean the teeth (at least the chewing surfaces) by wetting a clean cheesecloth or gauze.

It is appropriate to start using a toothbrush after the child’s back teeth erupt (at an average age of 2.5 – 3 years).

It is very difficult to get preschool children to apply a technique for brushing their teeth. The important thing at this age is to give the child the habit of brushing teeth. When children brush their teeth, they often brush the visible or easily accessible sides of the teeth. However, in order to prevent cavities, it is necessary to clean the interfaces and chewing surfaces of the teeth much better. For this reason, it would be good to check with the parents after brushing.

Toothbrushes made of soft nylon bristles suitable for the size of the child’s mouth should be used. Hard brushes are not suitable for use as they will abrade the teeth. Just as sweeping cannot be done with an old broom, teeth cannot be brushed with an old brush. Brush bristles should be replaced as soon as they wear out (average 6 months).

Just three minutes of effective brushing after breakfast in the morning and before going to bed at night is enough. Like any good habit, the habit of brushing your teeth should be developed during childhood.

A vaccine or medicine that can completely prevent caries has not yet been developed. However, some materials are currently used to reduce the number of caries, one of which is a material called “fissure sealant”. Dental caries usually starts in the grooves called “fissures” on the chewing surfaces of molars and premolars.

By covering the grooves with the material we mentioned, germs, food residues, etc. are prevented from leaking into that area and the onset of caries is prevented. This procedure can also be applied to permanent molars and premolars that erupt from the age of 6.

Another way of preventing decay is to increase the resistance of teeth against decay. This resistance is achieved by applying superficial fluoride to the teeth.

In accidents where teeth are damaged in children, intervention should be carried out immediately. It is very important to make the correct diagnosis. For this, your doctor will ask you when and where the accident happened, from which side the impact came, whether there was fainting, vomiting, memory loss, etc. after the accident. The most appropriate treatment can be applied in line with the information provided.

Dental injuries in children can sometimes cause the permanent tooth to completely detach from its socket. In this case, you should visit your dentist immediately with the extracted tooth. In the meantime, the tooth should be kept in a glass of milk or, if milk is not available, in clean water.

Sıklıkla kesici dişlerde ve köpek dişlerinde görülen bu durum, süt dişlerinin geç düşmesine neden olabilir. Bu durumda süt dişlerinin çekilmesi gerekebilir. Bazı durumlarda özellikle üst köpek dişlerinin daha önden ve yukarıdan sürdüğü durumlarda ortodontik tedavi( tel tedavisi) ile sürekli dişin olması gereken pozisyona getirilmesi gerekebilir.

Milk teeth are typically spaced apart. Due to the size difference between permanent teeth and baby teeth, these gaps help to give the permanent teeth enough space during eruption. These gaps between teeth also make it easier for your child to clean their teeth.

The first orthodontic check-ups of your child should be done around the age of 7-8, when the permanent teeth begin to erupt. Thus, possible problems can be diagnosed early. Early diagnosis will increase success in orthodontic treatment as in every treatment

Gingival diseases in children usually occur as mild inflammation of the gums around the newly erupting teeth or when brushing is inadequate. During this period, the gums are red, swollen and prone to bleeding. Similarly, mouth breathing and finger sucking habits also negatively affect gingival health. Except for more severe cases that occur due to systemic diseases, only oral hygiene and dental cleaning when necessary will be sufficient in terms of treatment.

Sucking a finger or a pacifier is normal in children. Most children stop this habit before they reach the age of 4 years, which is a period of time during which the teeth are not harmed. Children who continue the habit beyond the age of four should be examined by a pediatric dentist (pedodontist) or orthodontist. In most children, however, there is no need to worry about the sucking habit until the age of 6, when the front teeth erupt.

Translated with DeepL.com (free version)

Altı yaşında olmasına karşın hala uzun süreli ve kalıcı emme alışkanlığı devam eden bir çocuğun üst ön dişleri dışa itilir, alt dişleri içe eğilir, alt ve üst çene uyumu bozulur ve damak bölgesi daralır.

When your child reaches his/her first year of life, he/she should have his/her first experience with a dentist. In this way, he/she will feel comfortable in the dentist’s chair at a later age and at the same time gain the habit of regular and quality oral and dental care.

Decayed deciduous teeth should be treated like permanent teeth. The pulp (dental nerve), which is located inside the deciduous teeth and carries pain receptors, covers a large part of the clinical crown of the deciduous tooth seen in the mouth. This can cause severe pain when the nerve of the tooth is affected by bacteria in the decay cavity and becomes inflamed.

Bacteria seeping into the pulp from the decay cavity cause the pulp to die as a result of inflammation. As a result, necrotic tissue residues formed along the crown and root canal of the tooth cause abscess formation at the root end of the work. The way to remove this abscess is to perform root canal treatment for the milk tooth.

Milk teeth should be kept in the mouth until the permanent tooth that will erupt under them, and a placeholder should be applied in cases where early extraction is mandatory.