The structure of the mouth and tooth region, face sub-region, diseases, preventive and curative treatments of children are the subjects of "Pedodontics". The dentist educated in this field is called "pedodontist". In this article, there is information about the major oral and dental diseases starting from teething of children during normal times.
When does the tooth eruption begin?
The first tooth begins to erupt in babies at about 6 months. However, delayed or premature tooth eruption can often be observed. Delayed tooth eruption is usually related to genetic predisposition; but systemic diseases that delay tooth eruption should not be ignored. These diseases are deficiencies of thyroid, parathyroid, and growth hormone, which generally hinder growth and development.
Newborns have tooth buds. At birth, the buds (germ) of all the milk teeth and the first permanent large molar bumps (6-year-old molars) are formed.
Teeth that erupt between 4 - 8 months:
If there are slight ridges on the maxillary incisors area, this indicates that the right and left maxillary lateral incisors are erupting. Right and left maxillary and mandibular central incisors have erupted. The order of eruption; first right and left maxillary central incisors, then right and left maxillary lateral incisors, and then right and left mandibular lateral incisors.
Teeth that erupt between 8 - 11 months:
All the right and left maxillary and mandibular central and lateral teeth are erupted.
Teeth that erupt between 11 - 15 months:
All the right and left maxillary and mandibular central and lateral teeth are erupted. Right and left maxillary lateral milk incisors erupt 12 months earlier than right and left mandibular lateral milk incisors. Then, the first milk molars begin to erupt.
Teeth that erupt between 15 - 21 months:
When the child is 18 months old, milk canine teeth begin to erupt.
Teeth that erupt between one and a half - two and a half years:
Lower and upper jaw second baby molars are erupted. Root calcification of baby teeth completes one year after corona eruption. Permanent first molar erupts at the age of six. 6-years molars erupt at the age of 6 behind existing baby teeth. Parents and children confuse 6-year molars with baby teeth. The chewing sides of these teeth may stay on the very spot for months just before erupting. Accumulation of food causes tooth decay.
What are the symptoms associated with tooth eruption in children?
There are some general and regional changes in infants during the eruption of milk teeth. These are loss of appetite, loss in weight, diarrhea, anxiousness, hyper-salivation, itching and redness in gingival area. There is no cure for these symptoms. However, dental gel can be used externally in order to sustain a comfortable diet and relief of pain. In addition, some syrups can be used to get rid of itching.
When you should perform your first visit to dentist?
Children should be taken to dentist for control after first tooth eruption. After this, visit to dentist should be repeated for control every 6 months. Clinical examination of child by dentist has two stages:
1. Stage: Extra-oral Examination
The size, shape and proportions of this region are observed during head and face examination. Swelling and asymmetry are treated if there is any and maxillary and mandibular prognathism is examined in children older than 6 years. Palpation and inspection of the swelling, fixation of the softness and lymph examination should be carried out. The lower jaw joint is then examined. Pain and voices ae evaluated. Exophthalmos, blue sclera and nasal obstruction are observed if there is any in the child during eye, nose and sinus examination.
2. Stage: Intra-oral Examination
This stage includes examination of the teeth and soft tissue when the patient keeps his/her mouth open and the observations made when the teeth are closed. The examination begins by examining the lips both upside and outside. Then buccal mucosa, frenulum, hard palate, pharynx, sublingual and tongue are observed. It is checked if there is any color change, acute and chronic fistula or swelling.
What does a dentist recommend to the parents?
The parents are informed about their child's mouth and dental health. It is recommended to visit a pedodontist or dentist every six months.
What should be done if a permanent tooth erupted while baby tooth is in the mouth?
It is most frequently observed in lower incisors during intraoral examination. "Ectopic eruption" is the situation of abnormal eruption of tooth. Permanent incisor and cuspid are tend to erupt early. This situation may cause early root resorption of milk incisors. Early resorption of lateral milk incisors' back roots is another example of ectopic eruption.
Ectopic eruption is generally seen between the ages of 5 and 8. If lost milk canines or unerupted permanent molars are observed in the mouth of a seven years of child, eruption might be suspected.
Ectopic eruption in lower incisors is fixed by itself when milk incisors fall or are extracted. There are many treatment options for ectopic teeth ranging from simple braces placed between teeth to orthodontic apparatuses. Translocation power is applied to teeth in order to sustain teeth erupt from the right locations. For this purpose, the child is directed to pediatric dentistry.
When do children should start brushing their teeth?
Dental care that begins during infancy is the first step in the formation of preventative education and dental care that will be necessary throughout life. The group of microorganisms causing tooth decay is generally called "Streptococcus Mutans". It is thought that the microorganisms that cause this situation are usually passed from mother to child in a period of 9-36 months. Therefore, the dental health of a child and the dental health of a mother are very closely related. Dental care for infants should be started with the first erupted tooth.
Oral and dental cleaning should be done by parents through using a clean piece of cloth. Children can use toothbrush from the age of 1. Tooth brushing can be carried out without using toothpastes or with using low fluorine based toothpastes produced for children by taking into consideration that children might not able to rinse their mouths accurately. The toothbrush must be used by the parents since the child cannot perform effective dental cleaning. After brushing teeth, also the tongue should be brushed.
The medical and dental story of the baby is listened at the very first examination. Intra-oral examination is performed on the patient's first visit and his/her susceptibility to tooth decay is evaluated. The patient is directed in accordance to the effects of development, fluorine need, dietary habits except normal habits (feeding bottle, teat, etc.), protection from trauma; oral hygiene and dietary habits. The first visit to pedodontics or dentist is important in order to obtain information that can be useful for the infant throughout his/her life.
What are the precautions to be taken on preventing tooth decay in children?
The first step to protect children from tooth decay is to have a good oral hygiene. For this purpose, teeth should be brushed at least 3 times a day for 2 minutes. Toothpicks and mouthwashes may only be used after the age of 5 contributively to toothbrush in reference to the recommendation of the dentist. One of the proven methods of protection from tooth decay, "fluorine", should also be used.