What Is Pedodontics? What You Need to Know About Pediatric Dentistry

Children's tooth structure is different from that of adults, and the developmental processes in this period require specialist expertise. Pedodontics (pediatric dentistry) is the branch of dentistry that aims to protect the health of the primary (baby) and permanent teeth of children aged 0–15, treat the problems that arise and help children develop oral care habits.

Why Is Pediatric Dentistry Important?

Many parents may neglect this period, thinking "the baby teeth will fall out anyway". However, baby teeth do not only make chewing possible; they also act as space holders for the permanent teeth and support the child's speech development. Early loss of baby teeth can lead to orthodontic problems (crowded teeth) in the future.

The Role of Pediatric Dentists (Pedodontists)

Pedodontists are specialists trained in child psychology. Their main goal is to prevent children from developing a fear of the dentist (dental phobia) and to carry out treatments with a playmate-like approach.

When Should the First Dental Examination Take Place?

The World Health Organization (WHO) and the American Academy of Pediatric Dentistry recommend that the first dental examination take place after the first tooth erupts (usually between 6 months and 1 year of age). During this examination, the dentist:

Checks the pattern of tooth eruption.

Educates parents on nutrition and tooth brushing.

Takes precautions against early problems such as "baby bottle tooth decay".

How Can Children Overcome Fear of the Dentist?

You can follow these steps to help your child feel at ease with the dentist:

Be Honest: Instead of definitive statements like "It won't hurt at all", talk about the fun aspects of the process.

Don't Project Your Own Fears: If your own experiences of dental treatment have been negative, avoid talking about them in front of your child.

Introduce Them Early: Visiting the clinic for a check-up when there is no pain at all helps the child get to know the environment.

Summary: Pediatric Dentistry for Healthy Smiles

Pediatric dentistry is not just a treatment process; it is a follow-up process. Regular check-ups every 6 months help your child have healthy teeth for life. With the right tooth brushing habits and the support of a specialist pedodontist, you can make the greatest investment in your child's future.

What Is Fluoride Application and What Does It Do?

In the body, fluoride ions accumulate mostly in hard tissues such as bones and teeth. By increasing the calcification of tooth enamel, fluoride strengthens the tooth against the acids that cause decay. This creates a decay-preventing effect. It is a topical method, meaning it is applied to the tooth surface. Fluoride is applied to the teeth using gels, fluoride varnishes, fluoride mouthwashes and fluoride-containing toothpastes. To appeal to children, the forms applied by dentists are flavored with various aromas. Depending on the caries risk assessment made during the dental examination, this procedure should be repeated every 3–6 months.

What Is a Pit and Fissure Sealant?

The grooves on tooth surfaces are called pits and fissures. These areas are very favorable for bacteria to settle in and for food to get trapped. As a result, they are prone to decay. By sealing these areas before decay develops, the formation of cavities is prevented. Because it is a preventive treatment, it can be applied to everyone.

What Is a Space Maintainer?

When baby teeth are lost early for any reason, the removable or fixed appliances made to preserve their space so that the permanent teeth can erupt in their normal positions are called space maintainers. If the space of an extracted baby tooth is not preserved, the teeth in front of and behind the gap will fill it. The new permanent tooth will not be able to erupt in its proper position, and the teeth will become crowded. The permanent tooth may even remain impacted.

• If the permanent tooth is very close to erupting,
• If there is more space than necessary for the permanent tooth to erupt,
• If there is not enough space for the permanent tooth to erupt,
• If, for orthodontic purposes, it is desired that the space of the lost tooth be filled by the neighboring teeth,
• If there is any pathology in the eruption path of the permanent tooth, a space maintainer is not needed.

What Should Parents Pay Attention to in Order to Prevent Early Childhood Tooth Decay?

• The mother should take care of her oral health from pregnancy onwards.
• To prevent bacteria from passing from mother to child, the pacifier and spoon used when feeding the baby should not come into contact with the mother's mouth.
• After the baby has been fed, water should be the last thing given.
• From the moment the first teeth erupt, they should be cleaned with a damp cloth.
• Prevent your baby from getting used to sleeping at night with a bottle in their mouth.
• Do not add foods that increase decay, such as sugar, honey or molasses, to the bottle.

The dental journey that begins with the eruption of the baby teeth at around 6 months is now a lifelong one. An attitude of "a new tooth will come in anyway to replace the baby tooth" can lead to serious problems for your child:

Waking up at night with pain, crowding of the permanent teeth, missing teeth, disorders in jaw development, etc.

Treatment methods that can be applied to baby teeth and children are:

• Fillings
• Amputation (pulpotomy)
• Root canal treatment
• Apexification
• Stainless steel crowns
• Tooth extraction
• Frenectomy

How Are Fillings Done on Baby Teeth?

After the decay in the tooth is removed, the tooth is reshaped with filling materials suitable for baby teeth.

Why Are Baby Teeth So Important?

• They help with eating.
• They help with speech.
• They hold space for the permanent teeth.
• They guide the permanent teeth as they erupt.
• They guide the growth of the dental arch in which the permanent teeth will settle.

What Do We Ask of You Before and After Your Child's Dental Treatment?

• Before treatment, do not try to motivate your child with phrases such as "don't be afraid, it won't hurt", etc. Quite contrary to the intended motivation, these phrases make your child think that this is something to be afraid of and that it might hurt.
• Before treatment, you can tell your child about your own experiences of dental treatment: what was done, how it was done and what it was for.
• When persuading your child to go to the dentist, do not use phrases that will frighten them. ("If your tooth decays, the doctor will give you an injection and pull your tooth out", etc.)
• Before going to the dentist, do not make promises to your child about what the doctor will do. ("They'll just look at your tooth.", "They won't pull your tooth out.", "They won't give you an injection.", etc.)
• Do not promise your child rewards for after the appointment. Rewards cause your child to perceive the procedure as difficult.
• Come to appointments with both parents. Your child will be better motivated.
• Unless told otherwise, make sure your child has eaten before coming to appointments.
• During treatment, do not ask questions that will undermine their motivation, such as "Are you tired?" or "Does it hurt?".
• During treatment, do not use phrases that refer to time, such as "5 more minutes" or "Count to 10". If the treatment is not finished by then, their trust will be shaken.
• Children get bored and tired of treatments quickly. The number of sessions is higher than for adults. For this reason, do not insist that the doctor carry out more procedures. Leave the decision to your child and their doctor.

When Do Teeth Come In?

The eruption of baby teeth begins at around 6 months and continues until approximately 30 months. Roughly every 6 months, a group of baby teeth erupts. Some babies may have teeth in their mouth at birth, or teeth may erupt within the first 30 days. As long as they do not bother the mother during breastfeeding, nothing needs to be done. After the age of 6, the permanent teeth begin to appear in the mouth. From this age until about the age of 13, permanent teeth and baby teeth are present in the mouth together.

What Symptoms Might You Notice During Teething?

• Increased saliva (drooling)
• Pain and restlessness
• Redness and swelling of the gums
• Redness and itching on the cheeks and chin
• Biting
• Sleeplessness
• Loss of appetite
• Ear pulling

It should be remembered that these symptoms vary from baby to baby. In some babies, fever, diarrhea and skin rashes are also observed during teething.

It has not yet been proven that these symptoms are related to teething. Since these symptoms may also be due to another illness, it is advisable to consult your doctor.

What Are the Causes of Late Eruption of Baby Teeth?

• An eruption cyst, also called an eruption hematoma, causes bleeding in the capillaries as a result of the pressure the erupting tooth exerts on the surrounding tissues. This painless, blue-purple swelling can be dispersed by massage, making it easier for the tooth to erupt.
• Premature birth
• Low birth weight
• Heredity
• Vitamin D deficiency
• Exposure of the mother or child to X-rays during pregnancy
• Systemic diseases (Down syndrome, ectodermal dysplasia, …)
• Endocrine disorders (hypothyroidism, …)

What Are the Causes of Early Loss of Baby Teeth?

Apart from trauma to the baby tooth or tooth decay, early loss of baby teeth usually develops due to a systemic disease. (Hypophosphatasia, Papillon-Lefèvre syndrome, Histiocytosis X group diseases, neutropenia, leukemia, diabetes, …)

Some habits acquired in childhood negatively affect the development of the mouth and jaw and the positioning of the teeth. These habits need to be broken during childhood. A dentist can also help with this.

These habits are:

• Thumb sucking
• Tongue thrusting
• Bottle and pacifier sucking
• Nail biting
• Mouth breathing
• Biting various objects
• Teeth grinding and clenching
• Holding food in the mouth without swallowing

All sucking habits are normal up to the age of two. Children usually give up these habits on their own. Habits that are not given up later lead to changes in the positions of the teeth and disorders in jaw development.

What Is Preventive Treatment in Pediatric Dentistry?

• Oral hygiene and nutrition education
• Fluoride application (a treatment that strengthens the mineral structure of the teeth)
• Pit and fissure sealants (protective fillings)
• Space maintainers. These are treatments and examinations carried out in childhood to instill oral and dental care habits so that the teeth stay healthy for many years. Because they are painless, simple procedures, they are very helpful for getting to know the dentist and overcoming dental phobia.

What Is Oral Hygiene and Nutrition Education?

It covers the importance of correct and effective tooth brushing and how to do it, as well as the use and importance of dental floss. When we acquire these habits at a young age, we have a healthy mouth throughout our lives.

As parents, it is often difficult to control our children's eating habits. Children listen more to their teachers and doctors. For this reason, the task of explaining which foods cause tooth decay and limiting their consumption also falls to the dentist.

These education sessions, held in a conversational atmosphere, will also play a positive role in helping your child get used to the dentist.

What Is Amputation (Pulpotomy)?

In baby teeth where the decay has come very close to the pulp (the part containing the nerves and blood vessels), it is the procedure of removing the pulp tissue affected by the decay while cleaning out the cavity, and leaving the healthy pulp in the root. The tooth is then filled with suitable materials.

Can Root Canal Treatment Be Done on Baby Teeth?

Root canal treatment is applied in cases where the decay is very deep, or in teeth that have lost their vitality due to trauma and become infected. Root canal treatment can also be done on baby teeth; the difference lies in the choice of filling material.

What Is Apexification?

If a permanent tooth loses pulp vitality for any reason (trauma, infection) before its root development is complete, this is the procedure of guiding the closure of the opening at the root tip together with root canal treatment. The treatment process includes dressings changed every 3 months. Complete closure occurs within 6 months to 2 years.

What Is a Frenectomy?

When the connective tissue between the front teeth is longer than it should be, a gap remains between the upper front permanent teeth after they erupt. The procedure of shortening this tissue is called a maxillary labial frenectomy. This procedure should be done after the upper permanent canine teeth have erupted (at around age 12).

After tooth decay, the most common problem we encounter in children is dental trauma. Dental trauma most often occurs due to falls, school accidents, sports injuries, traffic accidents and fights.

As a result of trauma:

• Fractures or cracks in the tooth and root
• Loosening of the tooth
• Complete displacement of the tooth from its socket
• The tooth being pushed into the gum
• A change in the position of the tooth
• Injury to the surrounding soft tissue
• Fractures or cracks in the jawbone may occur.

What Should Be Done in Cases of Dental Trauma?

• Contact a dentist without delay.
• If there are pieces of the broken tooth, keep them. It may be possible to bond these pieces back in place.
• If the tooth has been completely knocked out, find the tooth, touch the root surface as little as possible and keep it in saliva, milk or saline solution until you reach the dentist. If conditions allow, the tooth can be placed back in its socket and held in the mouth.