Paediatric dentistry involves the care of children between six months and 18 years, and is an area of dentistry closely related to paediatrics. In dealing with children, we often resort to the basics of psychology.
What every parent should know
Parents should be aware of the importance of caring for their child’s development, including the condition of the oral cavity and its organs, beginning during pregnancy (in cooperation with the gynaecologist). Most important is that the mother-to-be eats appropriately and avoids stimulants and certain drugs, etc. Women in the last trimester of pregnancy need to know how to take care of oral cavity hygiene immediately after the child’s birth (appropriate rinsing and massaging gums, protecting against thrush, etc). Mothers should be cautioned against some bad habits, such as sweetening milk and feeding the child such milk before bedtime, or feeding a baby with another child’s spoon (transfer of cariogenic bacteria), which can lead to the spread of dental caries.
Other bad habits include inappropriate sleeping positions, allowing a child to suck a pacifier after the age of one year, etc., which can lead to hypertrophy of the bones of the lower and upper jaws and to various types of malocclusion. Early consultation with a paediatric dentist is very important to provide comprehensive prophylaxis to an infant (in cooperation with a paediatrician).
From the first meeting with the parents, the paediatric dentist underlines the importance of treating first teeth, emphasising at the same time that leaving these teeth untreated can lead to the development of various kinds of inflammation, starting from pulpitis, through periostitis, and ending with perignathic inflammation (inflammation spreads from the tooth canal to the periodontium, the dental process bone and periostium, and subsequently to soft tissues in the interfascial spaces of the face as well as to perignathic and perimandibular spaces).
Most importantly, these processes spread very rapidly, much more so than in adults, due to the different bone structure in children. Complications may include even thrombotic inflammation of the pterygoid plexus and secondary meningitis. Untreated first molar teeth and their preterm loss are associated with abnormal growth and development of maxillar bones as well as with various tooth abnormalities and malocclusions resulting, for example, from abnormal growth and positioning of adult teeth.
First visit to a paediatric dentist
At the first meeting with the parents, the paediatric dentist assesses the condition of the oral cavity (if teeth have yet to come through, he recommends appropriate hygiene of the oral cavity, draws the parents’ attention to bad habits, instructs them to come back to him when the first teeth appear, and discusses the baby’s diet). He maintains close contact with the paediatrician, providing dental care to the young patient. If necessary, in the case of a high genetic predisposition to caries, following consultation with the treating paediatrician, he introduces endogenous prophylaxis (these are most often drops/tablets containing fluorine of an appropriate concentration). Important factors are continuous and systematic inspections of the child’s oral cavity and the introduction of many other methods of exogenous prophylaxis (contact fluoridation and tooth fissure sealing, etc., and potentially increasing or decreasing the dose of drugs prescribed).
First visit to an orthodontist
A consultation visit to a paediatric dentist is often the introduction to orthodontic treatment. The dentist, assessing the occlusion, detects a first-tooth abnormality or malocclusion, and proposes appropriate exercises in preparation for wearing braces. Quite often, the early diagnosis of an abnormality and eliminating its cause may limit the duration of orthodontic treatment, which can take many years. The causes of abnormalities in the masticatory organ includes:
- dysfunctions, for example, the dysfunctional ingestion of food, artificial feeding, unwillingness to chew hard food, abnormal breathing through the mouth and abnormal speech, as well as inappropriate positioning of the lower jaw at rest
- parafunctions, which are bad habits such as sucking a pacifier, a finger or thumb, the tongue or lips, nail biting, teeth grinding, etc. Early indentification and rectification of these habits can protect the patient from developing a number of impairments in the masticatory organ. In the case of acquired weak defects, identifying the cause and eliminating it at an early stage often leads to self-healing, and therefore the rapid intervention of the paediatric dentist is paramount
- dental caries
- traumas
- systemic diseases, e.g. rickets or sialoadenitis.
By assessing the condition of mucosa, the paediatric dentist is able to discover the first beginnings of an infectious childhood disease and other systemic diseases.
Early symptoms of changes in the oral cavity may occur in the following disorders:
- blood disorders,
- kidneys disorders,
- gastrointestinal-tract disorders,
- allergies,
- metabolic disorders.
In cooperation with a radiologist, the paediatric dentist can detects all abnormalities concerning the position and number of teeth etc, at an early stage. In cooperation with an orthodontist, plans for the further treatment of the patient are made. When assessing the abnormalities of tooth development with a paediatrician, the paediatric dentist attempts to find the systemic causes of the problem.
Dental phobia
The importance of the psychological aspect of the doctor-patient (child) relationship is also worth emphasising. Many children and adults suffer from dental phobia and dentist-phobia. These conditions are unfortunately associated with childhood traumas and the fear of pain. The introduction of such materials as Carisolv or HealOzone used in Medicover is a very effective solution to encourage these patients to use dental services. An important fact from the point of view of a paediatric dentist is that it is a painless procedure with a very short duration (each item of work inside the patient’s oral cavity takes only 10 to 40 seconds), which gives very good results.