Fundamentally in their training Post Graduate Specific in the child and adolescent being, the care and needs that this entails for a correct oral health in the future.
The Dentistry is the dentist or medicor dentist that like the pediatrician in medicine, is in charge of the care and maintenance of a correct oral health in the childhood and adolescence of the human being. This requires extensive specialized training covering all aspects of treatment possibilities, deep knowledge of the growth and development of the oral area in This So important stage of life.
All this must be done considering that the child retains throughout the rest of his life an image of his first experiences, therefore The Dentistry It seeks to strengthen by means of a positive motivation, the always pleasing image towards a correct oral health, that will certainly have an impact on the smile of the adult future.
On average, we should not wait more than six months between visit and visit. The pediatric dentist, knowing the problems that can arise in each age, and know the previous illness or problems that the child has suffered, will indicate the frequency of visits, as in some cases these should be more frequent.
The beginning of the milk dentition is approximately 6 months, when the lower central incisors come out.
The teeth of milk can suffer cavities, as well as those of the adult. But because of the characteristics of the teeth of milk, once the caries starts, it has a faster advancement and affects the nerve tissue of the tooth faster than in the adult, so it is advisable to go to the specialist as soon as possible.
Obviously a trauma to the teeth is painful, the children have different ways of manifesting the pain.
In infants may manifest as impossibility of suction or rejection of food.
When removing enamel, dentin and especially when the nerve is exposed, there is increased sensitivity to cold, heat and rubbing of food. Treatment of the lesion improves the symptomatology.
In addition to the relevant hygienic measures, the association of antibiotics and analgesics is sometimes necessary. In addition to the recommendation of soft diet during the days after the coup.
In any Case That there is a blow to the teeth, it is essential to urgently attend the pediatric dentist, any injury although apparently no damage or discomfort may trigger sequels in the future, the dentist will take care of the review and follow-up of the case to minimize the consequences.
It is widely demonstrated that the presence of habits such as prolonged use of the bottle (beyond the Year of life) or, worse, thumb sucking or other fingers, it may cause alterations in the normal growth of the maxillary bones. The elimination of these habits should be done as early as possible, so that a spontaneous normalization of their growth can be produced. If this is not possible, it would be necessary to go to other means (normally apparatus) to rectify the alterations caused.
It should not be forgotten that other habits such as breathing through the mouth can also cause alterations in the growth of the maxillary bones. It is necessary in these cases, to go to the ENT specialist to diagnose and treat in a convenient way the cause of this type of breathing.
Other customs such as biting nails, biting objects, the presence of teeth grindings (conscious or unconscious), etc., can also be elements that potentially cause alterations or pathology of the development of the articulation of the Jaw and teeth injuries.
Given the presence already established of any of these problems, there is not a single way to treat them, because the causes can be multiple. The pediatric dentist It will assess in each particular case the most suitable means of minimizing the consequences that may arise, always bearing in mind that the treatment should be carried out as soon as possible to prevent serious alterations in the development of the older child.
Teaching the child the correct self-care in dental health is the best way to avoid problems in the future. It is therefore beneficial for parents to educate the child in prevention and conservation of dental health. An important part of this education is that referred to the diet, which basically focuses on not being abundant in refined sugars, avoiding foods of soft and sticky consistency. The worst time for ingesting these foods is, without a doubt, the night. Hence the importance of a Good brushing before you go to sleep. This should be done in swings or circular movements and always from the gum to the tooth, not forgetting to brush the tongue. It is advisable to do so with a suitable brush for each dentition stage, which will be changed every month and a half.
As to whether it can be done by the little solo, since the child does not have a manual dexterity enough to make an effective brushing up to eight years (according to dentists, some adults never get to do it correctly) should do so Accompanied.
It is important to create in the child a positive attitude towards their oral health at home and through visits to the dentist, it is the best way to Prevent, and to generate in the future adult the self-care necessary to maintain a correct oral health.
In this sense, parents should encourage a positive attitude towards visits to the pediatric dentist, to minimize what has been termed “dental phobia.”
Fortunately, there are more and more consultations adapted to the needs of the child (with toys, children’s books, prizes at the end of visits, etc.). The pediatric dentist, you know the right techniques to help your child become familiar with dental consultations and treatments. Starting visits when the child is small helps you make contact with this environment, y Especially, taking into account that the implantation of preventive measures (dental cleaning, topical application of fluorine) are not annoying, which affects a pleasant feeling and, of course, positive motivation towards the next control visit.
If dental treatment with anesthesia is necessary, the pediatric dentist He knows the appropriate techniques for this procedure to be practically painless, then performing the planned treatment and also being a feeling of positive motivation for successive visits.
The treatment of injuries depends on each case, the age and type of dentition in which it occurs.
When the blow occurs in a permanent tooth that has just come out, the fundamental thing is to follow the case over time until the complete maturation or growth of the permanent tooth.
When the trauma occurs in the milk tooth, the first thing we have to keep in mind is that the permanent tooth in the formation phase is intimately attached to the root of the milk tooth and therefore a blow, as minimal as it may seem, can produce a Alteration in the correct formation of the definitive tooth. The sequels we will be able to show when their exit occurs.
When the milk tooth as a result of the blow comes out completely from the bone, it is not advisable to put it in place again as it may have consequences on the permanent teeth in formation.
In these cases, the tooth or teeth lost must be replenished by a prosthesis or apparatus with the aim of the child recovering the functions of phonation, chewing and the aesthetics appropriate to his Age. The pediatric dentist will advise you on the opportune time for the placement of the prosthesis in each case.
The beginning of dental replacement is at age six. Key age of increasing prevention to get a healthy mouth for the rest of the child’s life.
Cavities may appear from the moment the teeth appear in the child’s mouth, i.e., at six months of life. There is unfortunately a special type of caries that appears at a very young age which is called early childhood caries, bottle cavities that produce a rapid and aggressive deterioration of the teeth around twenty to twenty-four months of life.
They are produced by adding sugars (sweetened cereals) or honey to the child’s bottle or pacifier, and it remains for a long time in the baby’s mouth (the worst time is the night). Also, frequent consumption of fruit juices can to cause a serious dental deterioration, especially if they are kept in a prolonged way in the mouth of the child, because in these products they contain the ingredients that most favor the tooth demineralization, and therefore the formation of cavities, which are sugar and acids.
At present it can be said in a nutshell that decay decreases, and dental injuries increase in the consultation of pediatric dentist.
The statistics stipulate that children with milk teeth, 50% of them will have suffered trauma before the end of the primary studies.
The prevalence in definitive teeth has been increasing over the years from 20-30% in the years 1995, to 20-58% in the year 2003.
The causes of the blows or injuries are very diverse and would have to differentiate between the blows in the teeth of milk and the blows in the permanent teeth.
The teeth of milk are more frequently subjected to blows at the time when the child begins his autonomous life and begins to walk. They are the result of their motor incoordination. The ages in which they occur are very early (around the year of life) so the treatment is also complicated because of the special circumstances of behavior management in children of such young age.
It is always necessary to visit the specialist to evaluate the lesion as early as possible, perform the treatment and follow-up of the injured area.
The sequels by the blow may appear not only in the milk tooth (change of color, mobility, Phlegmon….) but also in the permanent tooth in formation, intimately attached to the milk tooth from birth. These sequelae are varied (change of color, thinning or loss of enamel… and will appear at the time of the exit of the permanent tooth (around the seven years.)
In the permanent teeth, the causes are fundamentally violent sports and games. Road traffic injuries have been declining with the safety measures needed to transport children.
Unfortunately there is a factor that must be taken into account as a possible cause of trauma in the child, mainly of young age, is the ill-treatment of childhood. The dentist must also be a channel of complaints when these facts are suspected.
The milk teeth are formed during the mother’s pregnancy. For this reason, the food needed for proper development should be known and ingested properly during this stage of life. The necessary amounts of calcium phosphorus, vitamins, etc., will help form the correct dental structures. Similarly, problems related to a complicated pregnancy and/or premature delivery can potentially create abnormalities of growth and dental development.
For all the foregoing, it can be deduced that visits to the pediatric dentist, for proper education, should begin during the mother’s pregnancy.
After birth, long before the child has teeth, a child’s gums should be cleaned after each intake of milk. It is the best way to prevent early caries in the future teeth, to do so, uses a moistened gauze, cleaning, not only the gums, but also the tongue, dragging the remains of milk or any other food. This operation should be carried out ideally after each shot, or at least once a day, preferably after the last shot.
From the very moment of the eruption of the first teeth, you can find in the market different options for the correct brushing these, from the silicone or latex thimbles to the small size brushes and very soft filaments that, no doubt, are Real caresses for the child.
We should know that germs in the oral cavity of adults next to the child can be transmitted to their mouth through saliva (kisses, exchange of spoons, food test and, above all, through a very common gesture, the cleaning of the pacifier or teat with the Saliv Adult a). The precautions, therefore, should be similar to those you have when the adult has the flu and wants to prevent the child from getting infected.
It is advisable to brush the teeth after each ingestion to remove leftover food that may remain in the oral cavity. The brushing should be done by an adult because, until the age of eight, the child does not have sufficient manual dexterity to perform an effective brushing. (Some adults do not manage to do it correctly.)
On many occasions, it is advisable for the child to rinse with some mouthwash that prescribes his pediatric dentist, the specialist will recommend the most suitable to the age of the child and according to the benefits that are desired.
In general, research in the correct use of fluorine as a preventive element for teething, recommends its use at a topical level (Pasta Toothpastes and mouthwashes) at low doses and high frequency, so that the more times the enamel has contact with fluorine, the greater preventive capacity against caries.
Fluoride drugs in the form of tablets and drops recommended a few years ago, are currently in disuse, recatándose only in very specific cases.
There are sports federations that require participants to use a mouth protector.
Ideally, every child who practises a violent sport uses a protector, especially in cases where there are predisposing factors (breathing primarily by mouth, profusion of teeth, lack of lip closure) to suffer trauma Dental.
There are different types of protectors in the market, it is best to use those that allow to conform to the individual shape of each mouth.
Ideally they are performed in the dental consultation, after taking some moulds of the patient’s teeth, individualizing in each case and according to specific requirements of each child as type of respiration, and bite, joint use with orthodontic appliances… In order to adequately protect each and every one of the teeth in the face of a violent blow.
Dentistry is changing and we are more and more dentists who firmly believe that it is better to prevent than cure, and to achieve this goal we must start very early.
The first thing to clarify is that all these considerations are made exclusively for the impact on permanent teeth and not on milk teeth.
The important thing is to keep the tooth as well as possible during the time they are out of place in the mouth.
There is a very important structure that is the ligament that surrounds the tooth at the height of the root and serves to hold it to the bone, logically their cells are damaged and broken by abruptly leaving the tooth of the mouth.
The collection and manipulation of the tooth should never be done by the root area, the washing will be done with whey or milk trying to reposition the tooth in the dental alveolus and go immediately to pediatric dentist. If this is not possible or we feel able to do so, the transfer of this tooth must be made urgently to pediatric dentist, keeping in humid medium (whey, milk, and even, placed in the mouth under the tongue) never dry (napkins, handkerchiefs…).
The specialist will be responsible for implementing the necessary measures to reduce the consequences of such a coup.
From the first hour of the tooth situation out of the mouth the prognosis gets worse, as the ligament cells begin to deteriorate.
The work of reconstruction of a tooth is very laborious because it is to imitate the best possible the nature, shape and color of the broken teeth.
Logically the use, frequent repetition injuries and coloring by food, among other factors, can lead to different repositions of the material. Changes in teething parameters, bite, can also cause new reconstructions.
If the hit affected the nerve, root or ligament of the tooth, the prognosis is obviously worse.
There are international studies that demonstrate the high cost of dental trauma, because in many cases involve the placement of various procedures or treatments during the life of the child and teenager, but also involve sequels of Life in the adult. More important if we consider that in most cases it affects the area in front of the mouth, which is the most impact on the aesthetics of the smile.
Our recommendations about cavities are:
• If you notice that your baby has any pigmentation or “white spot” on the outside of the upper incisors, consult immediately with a pediatric dentist To stop the infectious process and to tell you how to reverse the risk factors that caused the disease.
• Caries in its initial stages may be stopped; Without However If you progress to the dentin and pulp (nerve) should be addressed to avoid pain, mouth and facial infections, etc.
Prolonged breastfeeding (after Year of age If it is diurnal and/or after the eruption of the first tooth of milk if it is nocturnal) and its relation with caries is a subject of great controversy.
As caries is a multifactorial infectious disease, we are convinced that there is no factor that causes caries on its own.
However, most Mothers That breastfeed on demand during the night moment of greater susceptibility to the bacterial attack because the saliva flow is almost null, they do not clean the teeth after the taking, increasing the risk of the baby by combining the absence of oral hygiene with the presence of a sustr ATO (milk) on the tooth surface.
We must add that there are also other factors that may increase the risk of cavities such as: children who wake up several times at night to eat (breast or bottle); Time the child sleeps with the fluid in his mouth; Consumption of sugary foods, insufficient exposure to fluorides presence of defects in the enamel (Hypoplasias); Early transmission of bacteria; among others.
Because each child has a different risk of developing diseases (including caries), parents should take their baby with a professional to identify the risk of individual caries and the preventive strategies needed According to Each case.
It is necessary to remember that caries is fundamentally an infectious disease, and therefore a focus of infection that we must fight as soon as possible, whatever the tooth and the age at which the Disease. But If we add that the child needs a healthy mouth to facilitate feeding and therefore its proper growth, we will be able to recognize the importance of care and repair of a milk tooth. To all this must be added that under each and every one of the milk teeth there is a permanent tooth prepared to form and leave at the appropriate age. And he is in that place from birth! Therefore, any infection or inflammation occurring in the area may affect the permanent tooth in formation, which requires that the milk tooth be healthy and remain in place until the time of replacement, since “your site “It is Kept perfectly by the milk tooth.
If the milk tooth disappears for whatever reason (cavities or traumatisms) before the time, it is necessary to put some type of apparatus that replenishes the important functions of the lost tooth, until the exit of the permanent tooth.
are predisposing factors related to the shape of the jaw arches, the lack of contact of the upper and lower lips (Children They remain with their mouths open continuously) breathers by mouth, profusion of upper and lower teeth (so-called rabbit teeth). Also children with some deficiency or disability that causes motor incoordination making them more prone to falls.
In this case it is necessary to distinguish between the temporal and the permanent tooth.
The most affected milk teeth are the upper central incisors, tending to produce more frequently the lesions in the dental ligament by the very sponginess of the tissues of the bone in the young child. The lesions can produce from increased mobility of the tooth, a lengthening of the same, an introduction of the tooth into the bone. The most serious cases a complete detachment of the tooth.
In the permanent teeth, the trauma produces more often a fracture of the enamel and the dentine, being able to remain exposed the nerve or tooth pulp. The X-rays will remove us from doubt of a possible lesion in the dental root and/or the ligament of the bone.
They are mostly damaged in the anterior upper teeth.
There are many people, including health professionals, who think that the care of the teeth of milk is of little importance because these teeth will be replaced by the permanent teeth.
Nothing farther from reality.
The milk teeth are very important so that the child can chew and swallow well, to speak properly, to maintain the space for the permanent ones and to develop a healthy self-esteem.
- Make correct oral hygiene, from the birth of your baby. Ask your pediatric dentist How you should do it According to the age of the child.
- Avoid The transmission of bacteria.
- Avoid feeding night after of the rash of his first tooth of milk.
- Avoid foods with Sugars (Biscuits, sweet bread, pastries, industrial juices, chocolate, ice cream, etc.), especially the first two years of life.
- Visit Al Dentistry During the first year of life to advise you about your child’s caries risk and apply appropriate preventative measures.
- Inquiry Al Dentistry On the benefits of topical application of fluorine in the enamel of the milk teeth and on the sealants of pits and fissures, according to the risk of caries of your child.
Begin cleaning the gums from birth once a day, taking advantage of the time of the bath. Use a damp gauze, the tip of a clean wipe moistened in water or a rubber thimble.
Mandatory: Start Oral hygiene with the eruption of the first tooth of milk (about 6 months of age), twice a day; In the morning and at night. You should clean
Teeth, gums, tongue, cheeks and palate.
Children of one year or more: Perform oral hygiene with a toothbrush the size of your mouth. If your baby does not wake up to eat at night or eat candy, you can do the brushing only with water. If not, use fluoride 1000ppm toothpaste in a quantity of “Rice granite”.
If your Molars: Pass The floss between the contact areas between the molars before sleeping. You can use a dental floss with wax or if you see it complicated, use thread positioners (Flossers).
See Al Dentistry About the need to apply topical fluorides according to your child’s caries risk.
The use of toothpaste Flúoradas it’s the best way to prevent cavities. Once your child has learned to spit, it is essential that you do the brushing with fluoride 1000ppm toothpaste in the amount of “rice granite.”
Toothbrushing in children is effective only if it is done by an adult. We recommend letting the baby and/or child play without However We suggest that the adult perform hygiene until the child has the proper motor skills (at about 8 years). From that moment, supervise the night brushing until adolescence.
Remember that oral hygiene is done both to establish good oral habits and to protect your teeth from milk. By getting your baby accustomed to gentle dental cleaning and flossing, you will create a pattern of oral care that accompanies you for the rest of your life.
- Intense pain
- Hospitalizations and emergency visits
- Decreased physical development
- Decreased quality of life
- High cost of treatment.
However, perhaps the most important factor for the care of the teeth of milk is the close relationship that exists between the cavities in the teeth of milk and the permanent ones. In other words, a child with cavities in his or her teeth will probably be a child with cavities in the permanent teeth y Therefore, an adult with multiple dental treatments, with the economic, physical, psychological and emotional consequences that this implies.
Tooth decay in the milk teeth advances very quickly because the enamel of these teeth is thinner than the permanent ones and the nerve is closer to the surface.
The first stage of early caries is usually the appearance of “white spots” in the enamel of the upper anterior teeth, usually in the area bordering the gingiva.
In young children this decalcification progresses rapidly into a cavity, causing pain, difficulty eating, loss of school days, oral infections, facial cellulite, emergency visits and hospitalizations, etc.
Caries is currently the most frequent chronic infectious disease in childhood, five times more common than asthma and seven times more common than allergic rhinitis. It is a serious public health problem that can have serious repercussions on the child’s overall health.
Caries is a multifactorial infectious disease, with which there are several factors involved in its emergence. Among the most prominent during childhood we have:
Late visits to the dentist: The sooner you visit the Pediatric dentist (Before the Year of life), more possibilities and tools you will have to prevent oral illnesses in your child.
Insufficient oral hygiene: It is perhaps the most notable factor for the appearance of cavities. The oral cleaning is obligatory from the appearance of the first tooth of milk, as well as the use of the dental floss when the molars have made contact.
Dental characteristics: A small number of children have defects in the enamel of their milk teeth (hypoplasias) caused by some alteration during their formation (intrauterine), whose surfaces are more susceptible to caries.
Early transmission of bacteria: there are certain risk behaviors that increase the likelihood of early infection of bacteria in the mother/father’s saliva that increase the risk of baby decay.
Nocturnal feeding: During sleep, the salivary flow is almost null, which is the time most susceptible to the attack of bacteria. Therefore, after the appearance of the First Milk tooth, night feeding is not recommended, especially in a bottle. If you continue to breastfeed or bottle, you should try to clean the teeth after the night-taking.
Incorrect eating habits: a highly caryogenic diet, especially between meals, multiplies the possibility of developing early caries. Enamel Hypoplasias – In the same way, there are particular dental anatomy that favors food retention and increases the risk of caries. For this type of dental anatomy, the sealants of pits and fissures are an excellent preventive measure to avoid the retention of food and caries.
Insufficient exposure to fluorides: the use of topical fluorine has proved to be very effective in increasing tooth resistance to the attack of bacteria, especially in high-risk patients. The pediatric dentist It should indicate the amount of fluoride According to Your child’s age and individual caries risk.
Children with prolonged medication: Many pediatric medications (antibiotics, analgesics, flu pills, corticosteroids, etc.) have a high sugar content, so Which medicated children are high-risk caries patients and should be monitored more frequently.
Today caries is a 100% disease controllable if you know the risk factors that cause them.
The new generations should not go through what their parents spent at the dentist…
Dentistry is changing and we are more and more dentists who firmly believe that it is better to prevent than cure, and to achieve this goal we must start very early.
Breastfeeding not only has huge nutritional, immunologic and emotional benefits for the baby. In addition, it favors the correct positioning of the dental arches and thus, a good dental occlusion (good bite between the upper and lower teeth).
All babies are born with a “small” jaw compared to the upper jaw.
Breast sucking helps the jaw “advance” in its position and thus obtains a better relationship between the maxilla and the mandible. Different studies indicate
What With the exercise of the masticatory and facial muscles in lactation, the indicators of malocclusions (bad bites) decrease to 50%.
Breastfeeding also facilitates the baby’s nasal respiration, helps a correct positioning of the tongue and a good development of the oral musculature, prevents abnormal swallowing patterns, promotes a correct form of the palate, increases the flow Salivary gland, among many other advantages.
The majority of pediatric dentists we agree on the great importance of breastfeeding during the first six months for the correct development of breathing, mouth, occlusion (bite) and swallowing (swallowing food) during childhood.
Remember that breast milk does not cause tooth decay on its own; but we see in the consultation many infants who present caries at an early age when the nocturnal lactation is prolonged and combined with a lack of oral hygiene; when the baby breast many times during the night; when the baby spends a lot of time with milk in his mouth; when there are complementary sugary foods; when there is not enough exposure to fluorides; when the child has enamel defects; when there is an early transmission of bacteria from the parents’ saliva; etc.
Start with oral hygiene as soon as you can, even if your baby does not have teeth. Take advantage of the moment of the bath to clean the gums with a gauze, a damp cloth or a rubber thimble.
Once the first milk tooth has erupted, gradually reduce breastfeeding at night. If you decide not to do it, it is very important that you do the dental cleaning immediately after the taking.
Take your baby to the pediatrician before his first birthday to inform him of measures to prevent the onset of tooth decay and other oral diseases.
Because many mothers can not (or decide not to) breastfeed their child, the bottle is often the tool used to feed it.
We believe it is important for mothers to be aware that the use of a bottle (of any type) does not promote the growth and development of the jaws and facial muscles such as breastfeeding.
With the bottle the child does not close the lips with such force and these adopt the shape of “O”, there is no buccal vacuum, the action of the tongue is difficult, which moves forward against the gum to regulate the excessive flow of milk and stays flat.
There is less excitation at the level of the buccal musculature and it will not favor the harmonious growth of the bones and cartilages.
The flow of milk in the bottle does not require a constant movement of the jaw and it is in a more backward (distal) position. The bottle stimulates a muscular work but of the wrong muscles (buccinators); which can generate narrow arcades and consequently lack of space for teeth and tongue. When the baby drinks a bottle, uses a pacifier or sucks the finger, the tongue does not reach its correct position on the palate. Therefore, the height and width of the palate is influenced by the object that lies between it and the tongue.
With all these factors, an atypical swallowing (incorrect) can be established early that can later cause different types of malocclusions (bad bites).
For decades, the bottle (especially the nocturnal one) has been linked to precocious caries of childhood (formerly called “bottle caries”) because the content of the bottle usually stays a long time in the mouth and causes demineralization of the tooth enamel of the milk teeth.
- Once erupted the first tooth of milk, avoid the use of the night bottle with any liquid other than water. If you do not, it is very important that you do the oral cleaning before your baby falls asleep.
- Use bottles whose outlet holes are small, most similar to the maternal breast.
- Placing the baby in a vertical position instead of horizontal will stimulate the exercise of the oral musculature.
- Never add sugar, honey, sweeteners or cereals to the bottle. Juices should be offered in coaches, cups, not bottled.
- The bottle should be limited to 12 – 18 months of age. Close to your child’s first birthday, try drinking the fluids in a trainer’s Cup.
Good oral hygiene is the most important factor in preventing tooth decay and gum disease.
The earlier you start with oral hygiene in your baby, the better as it During the first months of life, the baby is in a passive oral phase, in which he enjoys the massage and manipulation of his mouth.
