BilimDent Kids

What Is Pedodontics?

Pedodontics, or paediatric dentistry, is the branch of dentistry concerned with protecting both the primary and permanent teeth of children aged 0-13 and treating problems such as decay and trauma. Starting from infancy, monitoring, treating and preventing issues in children's oral-dental health and jaw-facial development make up the field of pedodontics.

Children's First Dental Check-up

Following the eruption of the first primary tooth, an examination by a specialist paediatric dentist is recommended. The timing of the first check-up and the dentist performing it matter a great deal so that dental fear does not develop in children. Regular six-monthly check-ups allow the development of the teeth, oral hygiene status and any decay to be diagnosed early.

Teething in Infants

Primary teeth begin to appear between the 4th and 7th months. By age 2.5-3 there are a total of 20 primary teeth in the mouth. The teething process differs from baby to baby. Common signs include fever, diarrhoea, increased fussiness, waking at night, increased drooling, crying spells, loss of appetite, rashes around the mouth, biting the hands, mild coughing and a desire to put everything in the mouth.

Although primary teeth are commonly seen as "temporary," they function in the mouth for around 10-12 years and play an important role in the proper development of the permanent teeth. Healthy primary teeth are necessary for a child's nutrition and correct speech. A dental check should be done as soon as the teeth appear, and oral hygiene should be maintained.

Primary Tooth Treatments

Treating very young children is not easy. When a child cannot cooperate, treatment may take place under general anaesthesia. Given these challenges, oral and dental care should be taken seriously from the eruption of the very first primary tooth.

Early loss of a primary tooth can cause neighbouring teeth to drift and close the gap, which may later prevent the permanent tooth from erupting properly (leaving it impacted) or cause it to erupt out of position, leading to a faulty bite. In such cases, future orthodontic treatment becomes unavoidable. If an early primary-tooth extraction is unavoidable, fixed or removable space-maintainer appliances should be made to keep neighbouring teeth from drifting into the gap.

Causes of Tooth Decay in Children

Primary teeth contain more organic material than permanent teeth and are more prone to decay. Children are often unable to interpret early warning signs of decay, such as hot-cold sensitivity and mild pain, in time.

A child's manual dexterity, curiosity and the parents' attitude shape brushing habits. Teeth should be brushed with parental supervision and help. Because saliva flow decreases during sleep, teeth decay more easily overnight — teeth should be brushed before bed, and nothing but water should be consumed afterwards.

Dipping a pacifier or bottle in sugar or jam, or letting a child fall asleep with sugary milk or juice between naps, can cause early-childhood decay.

No vaccine or medicine has yet been developed that fully prevents decay. However, materials such as "fissure sealants" are used to reduce the number of cavities. Fissure sealants close the grooves on the chewing surfaces of molars and premolars, preventing decay from starting; they can also be applied to permanent teeth from age 6 onward. Surface fluoride application also builds resistance to decay.

Broken Teeth in Children

If a tooth is broken, stay calm. If there is bleeding, apply pressure to the wound with a clean piece of gauze. It is important to find the broken fragment and keep it moist — saline solution, cold milk or the child's own saliva are ideal for this. The broken fragment must not be allowed to dry out, or it cannot be bonded back. See a dentist as soon as possible.

Broken fragments are reattached with bonding and can be successfully restored to look like the natural tooth. If the fragment cannot be found, today's composite or ceramic systems can still restore the tooth very successfully.

Even when no fracture is visible after an oral-dental injury, the child should still be taken to the dentist so the tooth's vitality can be monitored. If a traumatised tooth loses vitality, its colour gradually darkens and cystic lesions may develop at the root tip; in that case root canal treatment is needed. A traumatised tooth is separately assessed at the six-monthly routine check-ups.

Tooth Discolouration in Children

Tooth discolouration can negatively affect a child's social life and psychology, leading to loss of self-confidence. Discolouration generally stems from three different causes.

Medication-related discolouration: Iron supplements, which many infants receive, can cause tooth staining as a side effect. To prevent this, drop-form medicines should be placed directly toward the back of the tongue for swallowing, without contacting the teeth.

Chromogenic staining: Certain bacteria in the mouth act on the outermost clear film of the teeth and cause discolouration. Usually affecting all teeth, this staining can be cleaned by polishing, though it can recur and requires six-monthly checks; it tends to decrease with age.

Tooth decay: Early-stage decay, especially on the front teeth, can be mistaken for discolouration — making regular check-ups important for correct diagnosis and follow-up.

Clear Aligners for Children

Wireless orthodontics for children is a paediatric treatment method that does not use braces; certain problems affecting the mouth and jaw are corrected using aligners, also known as clear-aligner treatment.

There is no single fixed age for every patient — each child's development, growth and tooth-eruption timing differs. A certain number of teeth must be present in the mouth for the aligners to sit correctly, and having both primary and permanent teeth present at the same time is not a problem for this treatment. An orthodontic specialist determines whether the child is suitable, how long treatment will take, and the best age to begin.

Fissure Sealants and Fluoride Applications

What is a fissure? The grooved, indented surfaces of the teeth — developmental pits and fissures — are called fissures.

What is a fissure sealant? A material that covers these pits and grooves on the tooth surface, sometimes described as a kind of "vaccine for the tooth." It is an easy, painless procedure for preventing decay, making it an ideal treatment for children who fear the dentist or are visiting for the first time.

At what age should sealants be applied? Usually applied to the first permanent molars ("6-year molars"), though it is not mandatory and can also be applied to primary and premolar teeth. These areas are ideal spots for food to collect, and decay can develop easily without good oral hygiene — sealants help protect teeth from decay. Six-monthly routine checks are recommended afterward; sealants can be reapplied if they wear away over time. The main goal is to protect the more decay-prone molars until around age 9-10, when children can brush effectively on their own.

What is fluoride application? Simply put, it strengthens the building blocks of tooth enamel with fluoride supplementation, making the tooth structure more resistant to decay. It can be applied to children of any age; a paediatric dentist assesses the need based on the child's decay risk.

General Anaesthesia and Sedation

For very young children who cannot cooperate, children with mental, physical or medical impairments, children or adolescents who are extremely uncooperative, fearful, anxious or unable to communicate, or when urgent, extensive dental treatment is needed, general anaesthesia and sedation may be used to provide quality dental care. Procedures are carried out in operating-theatre conditions by a team of an anaesthesiologist, anaesthesia technician, dentist and assistant — allowing all necessary treatment in the mouth to be completed in a single session.