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Children's Dentistry

Children’s dentistry, also known as pediatric dentistry, treats children from birth to puberty. Pediatric dentists are trained to treat special dental problems that children may experience and support the early development of healthy oral hygiene habits.

Table of Contents

1. Why is children’s dentistry important?

Children’s dentistry is crucial for several reasons, encompassing health and socio-economic aspects. Here are the key points:

1.1. Health Benefits

Prevention and Early Intervention

– Early dental care can prevent the development of caries and other oral health issues. Studies have shown that early intervention, such as establishing a dental home, can significantly reduce the incidence of caries in children[8].

– Preventive measures, such as fluoride treatments and dental sealants, are essential in maintaining oral health from a young age.

Impact on Quality of Life

Oral health significantly affects the quality of life of children and their families. The Early Childhood Oral Health Impact Scale (ECOHIS) has been used to measure this impact, showing that children with better oral health have a higher quality of life[3][7].

Behavioral and Psychological Aspects

– Managing dental anxiety is a critical component of pediatric dentistry. Techniques such as animal-assisted therapy (AAT) have been shown to reduce anxiety and improve the overall dental experience for children[2].

Long-term Health Outcomes

Establishing good oral hygiene practices early in life can lead to better oral health in adulthood. This includes regular dental visits, proper brushing techniques, and a healthy diet[6].

Children's Dentistry

1.2. Socio-Economic Importance

Economic Impact

Investing in children’s dentistry can bring significant economic benefits by reducing the need for more extensive and expensive treatments later in life. Early preventive care is cost-effective and can save on future healthcare costs[1][4].

Access to Care

Teledentistry has emerged as a vital tool in improving access to dental care, especially in underserved areas. It allows for remote consultations, diagnosis, and monitoring, which can particularly benefit children in rural or low-income areas[5].

Educational Programs

Dental health education is essential in preventing oral health problems. Programs to educate children and their parents about proper oral hygiene practices have improved dental health outcomes[6].

Policy and Insurance

Policies such as including pediatric dental care in the Affordable Care Act (ACA) have increased dental insurance coverage for children. However, ensuring this translates into increased dental visits and care utilization remains challenging.

2. Dentistry for children in the baby teeth stage

Dentistry for children, particularly during the baby teeth stage, is critical to overall health and well-being. The importance of dental care in this stage is multifaceted, addressing prevention, early detection, and treatment of dental issues. 

Children's Dentistry

2.1.  Prevention and Early Intervention

Preventive Measures: Dental decay is the most common infectious disease in young children and is largely preventable through low-cost measures. Early visits to a dentist, dental care as part of prenatal care, and interdisciplinary collaboration are recommended for prevention.

  • Fluoride Supplementation: For regions without water fluoridation, fluoride supplementation for pregnant women may be an effective way to increase fluoride intake during pregnancy, potentially preventing dental caries in their children[11].
  • Parental Knowledge and Behavior: Parental knowledge and behavior are crucial in maintaining children’s dental health. Early educational actions focusing on establishing healthy nutritional habits and correct oral hygiene practices are essential.

2.2.  Early Dental Visits

– Age of First Visit: The study on when and why parents seek dental care for children under 36 months found that orientation/prevention was the most prevalent reason for dental visits up to 30 months. However, caries treatment becomes the most pervasive reason at 30-36 months[9].

– Importance of Early Visits: Another study emphasizes that preventive interventions for premature tooth decay should start before age 2, as waiting until then may be too late for effective prevention.

2.3.  Challenges and Solutions

– Dental Trauma: Early childhood dental trauma, especially to the upper central incisor, highlights the importance of prompt treatment and follow-up to reduce the risk of both short and long-term adverse outcomes.

– Socioeconomic Inequalities: Socioeconomic inequalities play a significant role in the use of dental care services during early childhood. Higher family income is associated with greater use of dental services, indicating the presence of inequalities.

– Oral Health in Special Populations: Children with primary nephrotic syndrome (PNS) show significantly higher scores of dental caries and developmental defects of enamel (DDE) than controls, underscoring the need for a periodic dental protocol for PNS patients[10].

3. Dentistry for children in the period of tooth replacement (permanent teeth growth)

Dentistry for children during tooth replacement, when permanent teeth begin to grow, is a critical phase that requires careful attention to ensure proper dental health and development. This period typically involves transitioning from primary (baby) teeth to permanent teeth, which can present unique challenges and opportunities for preventive care and early intervention. 

Children's Dentistry

3.1. Importance of Parental Knowledge and Involvement

Parental Knowledge

Parents’ understanding of dental growth and maintaining oral hygiene is crucial. Studies have shown that while many parents understand dental health well, they often lack specific knowledge about the growth and development of children’s teeth and the prevention of caries.

Practical parental guidance can significantly influence children’s oral hygiene habits, which is essential during the transition to permanent teeth.

Educational Interventions

Educational materials, such as pocketbooks about dental growth and care, can help parents better understand the stages of tooth development and the importance of maintaining both primary and permanent teeth.

3.2. Preventive Measures and Early Interventions

Dental Sealants

– Dental sealants are highly effective in preventing caries in the pits and fissures of occlusal surfaces of permanent teeth. They act as a barrier to protect enamel from plaque and acids[13].

– Despite their effectiveness, not all children at elevated risk for caries receive sealants, highlighting the need for increased awareness and utilization of this preventive measure[13].

Regular Dental Visits

Regular and timely dental visits are essential for the early detection and treatment of dental issues. The first visit should ideally occur by age one, and regular check-ups should continue throughout tooth replacement.

Early visits allow for preventive and corrective interventions, which can help manage issues such as caries and malocclusions before they become severe.

3.3. Common Dental Issues During Tooth Replacement

Caries and Tooth Loss

– Caries remain a significant problem during the transition to permanent teeth. The first permanent molars are particularly susceptible to caries due to their anatomical shape, which can harbor bacteria.

– Early loss of primary teeth can affect the dental arch length, leading to crowding or impaction of permanent teeth, which can have long-term implications for oral health.

Malocclusions

Malocclusions, such as anterior crossbite, are expected during the mixed dentition phase. Early treatment is recommended to correct these issues and ensure proper occlusal development.

3.4.  Special Considerations

Children with Special Needs

– Children with special needs may require tailored dental care approaches. Studies have shown that these children often use more rigid bristles and may have different needs regarding toothbrush maintenance and oral hygiene practices.

– Preventive measures and dental care protocols must be adapted to meet the specific needs of children with conditions such as oligophrenia.

Impact of Socioeconomic Factors

Socioeconomic status significantly influences access to dental care and the prevalence of dental issues. Children from lower socioeconomic backgrounds are likelier to have unmet dental needs and higher caries rates[12].

4. Children’s dental problems are expected at the age of teeth replacement

When permanent teeth begin to grow, children’s dental problems during tooth replacement are common and can have significant implications for their oral health.

4.1. Common Dental Problems

Caries and Tooth Decay

– Caries remain a prevalent issue during the mixed dentition phase. The presence of caries in primary teeth is strongly associated with the development of caries in permanent teeth. A study found that caries in the second deciduous molar correlate with the development of caries in the adjacent first permanent molar.

– The prevalence of caries in permanent teeth among children aged 7-18 years was found to be high, with a significant percentage of children experiencing complicated caries that require extensive treatment and rehabilitation.

Malocclusions

– Malocclusions, such as anterior crossbite and other alignment issues, are expected during the mixed dentition phase. These issues can be exacerbated by early loss of deciduous teeth, which affects the dental arch length and can lead to crowding or impaction of permanent teeth[14].

– Early orthodontic intervention is often necessary to address these issues and ensure proper occlusal development. Parental motivation and awareness of the importance of orthodontic consultations during this phase are crucial for timely intervention.

Traumatic Injuries

Traumatic dental injuries, such as tooth fractures, intrusions, extrusions, and avulsions, are common in children, especially in the early teenage years. Avulsion, in particular, is a severe injury that can lead to space loss and require orthodontic correction and long-term therapeutic procedures.

Developmental Anomalies

Developmental enamel defects and dental anomalies in the number and size of teeth can occur in children with conditions such as growth hormone deficiency. These anomalies can affect the overall dental health and require specialized care.

4.2. Preventive Measures and Interventions

Regular Dental Visits

Regular dental check-ups are essential for early detection and management of dental issues. These visits allow for preventive measures, such as applying dental sealants, which effectively prevent caries in the pits and fissures of permanent teeth.

Parental Involvement and Education

– Parental knowledge and behavior significantly influence children’s oral health. Studies have shown that parents’ understanding of the growth period of deciduous and permanent teeth is often lacking, which can impact the effectiveness of preventive measures and early interventions.

– Educational interventions to improve parental knowledge and encourage proactive dental care practices are essential for maintaining children’s oral health during tooth replacement [14].

Orthodontic Interventions

Early orthodontic treatment during the mixed dentition phase can address skeletal and dental issues, reducing the need for more extensive treatments later. This phase is optimal for interventions that modify the skeletal system rather than just the dental system.

Management of Dental Anxiety:

Dental anxiety is a common issue among children and can hinder effective dental care. Techniques such as instrumental music therapy and other anxiety-reducing interventions can help manage dental anxiety and improve the overall dental experience for children.

5. The importance of regular dental check-ups for your baby

Regular dental check-ups for babies cannot be overstated, as they play a crucial role in ensuring the early detection and prevention of dental issues, promoting healthy oral hygiene habits, and establishing a foundation for lifelong dental health. The sources provided offer a wealth of information supporting the significance of early and regular dental visits for infants. 

Children's Dentistry

5.1. Early Detection and Prevention

Preventive Dental Visits: It is highly recommended that preventive dental care be initiated within the first year of a child’s life. Professional intervention directed at factors affecting the oral cavity helps reduce dental caries. Early screenings offer an opportunity to educate parents about the benefits of preventive care over restorative care, which may be more effective in reducing early childhood caries.

Referral from Well-Child Care Clinics: A study found that active or passive referral by well-child care (WCC) physician for a first preventive dental visit leads to earlier initiation of dental care. Specifically, an active referral, where parents receive a scheduled appointment at the dental practice, had a more significant effect than a passive referral, significantly increasing the percentage of children who had their first preventive dental visit in their first year[15].

5.2. Establishing Healthy Oral Hygiene Habits

– Role of Caregivers: Caregivers play a vital role in establishing healthy oral hygiene habits for children. The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participants reported higher caregiver-reported preventive dental care visits and services, highlighting the importance of caregiver involvement in facilitating access to dental care[16].

– Guidelines on Periodicity of Examination: Best practice guidelines emphasize the importance of early professional intervention and continuity of care based on the child’s individualized needs. These guidelines recommend a comprehensive oral examination, assessment of caries risk, and professional preventive procedures, among other services for infants, children, and adolescents.

5.3. Education and Counseling

Anticipatory Guidance/Counseling: Anticipatory guidance and counseling are essential components of the dental visit. They provide parents with the necessary knowledge and tools to care for their child’s oral health. This includes advice on diet, oral hygiene practices, and fluoride toothpaste[17].

Importance of Parental Education: Studies have shown that despite understanding the importance of maintaining oral hygiene in children, many postpartum women have medium-low overall knowledge of oral health. Raising awareness among obstetricians and other healthcare providers about the importance of oral health education for expecting and new mothers may be an effective way to improve this.

6. Children’s dental treatments

Children’s dental treatments encompass a wide range of procedures to maintain optimal oral health and address various dental issues that may arise during childhood. Here is a detailed overview of common dental treatments for children:

6.1.  Preventive Treatments

  1. Dental Cleanings and Examinations: Regular professional cleanings and examinations are crucial for removing plaque and tartar buildup, detecting any dental problems early, and monitoring the development of the teeth and jaws.
  1. Fluoride Treatments: Topical fluoride applications, such as varnishes or gels, help strengthen the enamel and prevent tooth decay.
  1. Dental Sealants: Sealants are thin, protective coatings applied to the chewing surfaces of the back teeth (molars) to prevent cavities from forming in the deep grooves and pits.
  1. Oral Hygiene Education: Dentists and hygienists guide proper brushing and flossing techniques, dietary recommendations, and other preventive measures to promote good oral health habits.

6.2.  Restorative Treatments

  1. Fillings: Dental fillings restore teeth affected by cavities or caries. Common filling materials include composite resins, amalgam (silver fillings), and glass ionomer cement.
  1. Crowns: Crowns, also known as caps, cover and protect severely damaged or decayed teeth. Stainless steel crowns are commonly used for primary (baby) teeth, while zirconia or ceramic crowns may be used for permanent teeth.
  1. Pulp Therapy: In cases of deep decay or trauma, pulp therapy (pulpotomy or pulpectomy) may be necessary to remove the infected or inflamed pulp (nerve) from the tooth and preserve it.
  1. Space Maintainers: When a primary tooth is lost prematurely, space maintainers prevent the surrounding teeth from shifting and maintain the proper space for the permanent tooth to erupt.

6.3.  Orthodontic Treatments

  1. Interceptive Orthodontics: Early orthodontic interventions, such as palatal expanders or removable appliances, can help guide the proper growth and development of the jaws and teeth, potentially reducing the need for more extensive treatment later.
  1. Braces: Traditional metal braces or clear aligners (e.g., Invisalign) may be recommended to correct misaligned teeth, overbites, underbites, or other malocclusions.

6.4.  Surgical Treatments

  1. Extractions: In cases of severe decay, trauma, or overcrowding, tooth extraction may be necessary.
  1. Frenectomy: This procedure involves removing or repositioning the frenum (the tissue connecting the lip or tongue to the gums) to improve tongue mobility or prevent gum recession.
  1. Exposure of Impacted Teeth: In some cases, surgical exposure may be required to assist in the eruption of impacted or partially erupted teeth.

6.5.  Management of Dental Anxiety and Special Needs

  1. Behavior Management Techniques: Dentists employ various techniques, such as tell-show-do, positive reinforcement, and distraction methods, to help children feel more comfortable and cooperative during dental procedures.
  1. Sedation Dentistry: For children with severe anxiety or special needs, conscious sedation or general anesthesia may be recommended to facilitate dental treatment safely and effectively.

Children's Dentistry

It’s important to note that the specific dental treatments recommended for a child will depend on their individual needs, dental history, and overall oral health status. Regular dental check-ups and preventive care are essential for maintaining good oral health and identifying potential issues early on.

[1] https://pubmed.ncbi.nlm.nih.gov/18869500
[2] https://journals.lww.com/armh/fulltext/2023/11020
[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10569180
[4] https://pubmed.ncbi.nlm.nih.gov/2518142
[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10880874
[6] http://sakuradental.vn/sakurasource9.pdf
[7] http://sakuradental.vn/sakurasource10.pdf
[8] http://www.jksdh.or.kr/article/?num=N0220230603
[9] https://pubmed.ncbi.nlm.nih.gov/24155615
[10] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8229337
[11] https://pubmed.ncbi.nlm.nih.gov/29059464
[12] https://pubmed.ncbi.nlm.nih.gov/7480934
[13] https://pubmed.ncbi.nlm.nih.gov/35708460
[14] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9507017
[15] https://pubmed.ncbi.nlm.nih.gov/37747061
[16] https://pubmed.ncbi.nlm.nih.gov/34859436
[17] https://pubmed.ncbi.nlm.nih.gov/27931451