At what age is it time to introduce your child to the dentist? Why do even three-year-olds get tooth decay? Why treat milk teeth, because they will fall out anyway? Wday.ru asked the most popular questions from parents to the best pediatric dentist in Russia.
Gold medalist of the competition “Pediatric Dentistry” of the Russian Dental Excellence Championship 2017, head of the pediatric dental department of AGF Kinder
1. When should the child be seen for the first time to the dentist?
The first visit with the baby is best done at the age of 9 months to 1 year, when the first teeth begin to come out. The doctor will examine the frenum of the tongue and lips, check the first teeth. This will make it possible to notice and prevent or correct bite pathology, speech defects, and aesthetic disorders in time. Further, it is better to visit a pediatric dentist for prevention once a quarter.
2. How to teach a child to brush his teeth? What is more important – a brush or a paste?
With the appearance of the first tooth, you can already teach your baby to hygiene. It is worth starting with a soft silicone finger brush and boiled water. Gradually switch to a baby toothbrush with water. If there is no indication for toothpaste, you can brush your teeth with water for up to one and a half years. After that, switch to toothpastes. Choosing between a paste and a brush is not entirely correct. For a certain age, a brush is more important, for certain cases – a paste. For example, if the child has a predisposition to tooth decay, the doctor will prescribe a fluoride paste or firming therapy. And the European Academy of Pediatric Dentistry recommends the use of fluoride pastes from the very first tooth.
3. Why is silvering of children’s teeth still used? They turn black, this is unaesthetic, the child is worried.
Silvering teeth is not a method of treating milk teeth, but only the preservation of infection (stopping caries), since silver has a good antiseptic property. Silvering of teeth is effective when the process is shallow, within the enamel. If the process is extensive and involves tooth structures such as dentin, the effectiveness of the silvering method will be very low. The method of silvering is chosen when, for some reason, there is no possibility of a full-fledged treatment.
4. Daughter is 3 years old. The doctor suggested treating 3 teeth at a time in a medication sleep. But after all, anesthesia is dangerous to health and shortens life, has a number of consequences! Especially for a child.
The doctor proposes to treat the teeth in sedation (dull consciousness) or under general anesthesia (anesthesia, medication sleep) to parents of young patients, because, unfortunately, at the age of 3-4 years, more than 50% of children already suffer from caries. And the concentration of attention in babies is small, the time spent in a chair is about 30 minutes. They get tired, naughty and cry. This time is not enough for high-quality work with a large volume of work. Earlier in medicine, not completely safe drugs for anesthesia were really used. There were also undesirable reactions: vomiting, feeling short of breath, headache, prolonged weakness. But now the treatment is carried out under general anesthesia using the drug sevoran (sevoflurane) under the supervision of a team of anesthesiologists and a pediatrician. It is the safest inhalation anesthetic. It was developed in an American corporation and has been successfully used for more than 10 years in the USA, Japan and Western Europe. Sevoran acts quickly (the patient falls asleep after the first breaths), does not cause allergic reactions. The patient easily wakes up 15 minutes after turning off the sevoran supply, the drug is quickly and without consequences excreted from the body, does not harm any organs and systems. Also, there are no contraindications for the use of sevoran in patients suffering from such serious diseases as epilepsy, cerebral palsy, heart defects, liver and kidney damage.
More than 50% of children aged 3-4 years already suffer from tooth decay. By the age of 6, decay of deciduous teeth is detected in 84% of young patients
5. The doctor recommended that the preschool child be given fluoridation, fissure sealing, remineralization. What it is? Is it just prevention or cure? Why is fissure sealing possible only immediately after eruption, and not long after?
After eruption, permanent teeth are not yet fully formed, their enamel is not mineralized, and there is a very high risk of infection. Fissures are natural pits in the teeth. Sealing helps seal the pits so that soft food plaque does not accumulate in them, which is difficult to remove during daily hygiene. Caries of permanent sixth teeth in 80% of cases occurs in the first year, therefore, it is more effective to seal it immediately after eruption. Remineralization therapy is a coating with fluoride or calcium drugs. All procedures are aimed at strengthening teeth and preventing caries.
6. Daughter is afraid of the dentist (once painfully put a filling). How to find a doctor to help you overcome your fear?
It can take a long time for a child to adapt to a dentist’s appointment. Proceed gradually, tell your child why you want to go to the doctor, how it will go. In the clinic, in no case should the child be forced to do anything. During the first visits, the little patient may not even sit in a chair, but he will get to know the doctor, talk to him. After several trips, you can gradually increase the manipulation of the chair. If the fear is not overcome at all, for the peace of mind of the child and parents, it may make sense to opt for treatment under sedation or general anesthesia.
7. Why treat caries on baby teeth? It comes out expensive, but they still fall out.
Not treating baby teeth just because they will fall out is absolutely wrong approach. A child needs healthy baby teeth to chew food thoroughly and learn to speak correctly. Yes, the front milk teeth fall out quickly, but the chewing group of teeth individually lasts up to 10-12 years. And these baby teeth are in contact with permanent ones. By the age of 6, decay of deciduous teeth is detected in 84% of young patients. Just at this age, the first permanent chewing teeth, “sixes”, begin to erupt. And statistics confirm that caries of permanent sixth teeth in 80% of cases occurs in the first year. Tooth decay is an infection that multiplies and damages more and more dental hard tissues. It reaches the nerve of the tooth, pulpitis occurs, the teeth begin to ache. When the infection goes even deeper, the rudiment of a permanent tooth can also be involved in the inflammatory process, after which it can come out with an already altered enamel structure or lead to the death of the rudiment.
8. In a daughter (8 years old) molars come out crooked. Our doctor says that while only plates can be put on, it is too early to install braces. And her 12-year-old friend has already got braces. What is the difference between plates and braces? How to understand – the child’s permanent teeth are still straightening or is it time to run to correct the bite?
During the active phase of the eruption of permanent teeth (5,5 – 7 years), it all depends on whether there is enough space in the jaw for new teeth. If it is enough, then even the crooked permanent teeth that come out will stand up evenly later. If there is not enough space, then you cannot do without correcting the occlusion with any orthodontic constructions. The plate is a removable device that is made individually. Plates are used when a complete change of milk teeth has not occurred, and there are still growth zones in the jaw. Under the influence of the plates, the growth of the jaw is stimulated, and there is a place for permanent teeth. And braces are used with a complete change of milk to permanent teeth. This is a non-removable device in which special fixing devices (braces) are glued to the tooth and, with the help of an arc, are connected into a single chain like beads. When the teeth begin to change, it is better to go for a consultation with an orthodontist and assess the situation. The sooner you start correcting the occlusion, the easier this process will be and the faster the result will be achieved.