Preventive dental approaches and treatments for children consist of the following topics:
» Brushing
» Monitoring tooth development
» Establishing the habit of using dental floss
» Informing the family
» Proper nutrition
» Identifying and preventing bad habits
» Fluoride applications
» Fissure sealant applications
» Space maintainer applications
» Ensuring protection from trauma and impacts
What is the importance of preventive dentistry?
Preventive dentistry ensures a healthy and beautiful smile for your child. Children with healthy mouths chew more comfortably and easily; they receive the nutritional values of foods fully and effectively. They grasp speech more quickly and understandably. Since there is no disease in their mouths that threatens other parts of the body, their overall health is also better. Because a healthy mouth looks good, the child has more confidence in themselves and their appearance. In addition, preventive dentistry is a less tiring and cheaper treatment approach.
When should preventive dentistry begin?
Preventive dentistry begins from the eruption of the first teeth in the mouth. See your dentist as soon as your child's first tooth erupts. This way, you can also be informed about protecting oral health. The earlier your dental visits begin, the higher your child's chances of protecting against dental diseases, you will be able to take precautions before cavities form, and you will be able to raise a generation that is cavity-free and healthy.
What is the family's role in preventive dentistry?
After your child's dental health is fully ensured, your dentist provides information to your child on brushing, flossing, and to the family on diet and, if necessary, fluoride use, so that they can maintain this health themselves at home. You also help your child gain these habits for life by monitoring and controlling the applications.
What is the dentist's contribution to preventive treatment?
Brushing teeth, flossing, and fluoride applications are all practices aimed at protecting your child's dental health. But there are also other treatments that are applied. For example, fissure sealants, etc., are methods frequently used by dentists.
Fluoride applications:
Fluoride is a substance the body needs in appropriate amounts. Fluoride intake should begin when a child is 0 years old and continue until they are 8 years old.
There are 2 ways for fluoride to enter the body:
The first way is systemically, through drinking water, fruit juices, fluoride in foods, and fluoride-containing tablets or syrups. Systemically taken fluoride is stored on the surfaces during tooth development and has a long-lasting effect. It also adheres to dental plaque, helping with remineralization, which is the restoration of the substance loss caused by decay in the tooth structure.
The second way of fluoride intake is topically or locally. Locally taken fluoride strengthens existing teeth in the mouth and increases resistance to decay by adhering to tooth surfaces. Toothpastes, mouthwashes, and fluoride gels and pastes applied by dentists are examples of topical fluoride.
The anti-caries effect of fluoride is explained by researchers through 3 mechanisms:
By converting hydroxyapatites in the tooth structure into soluble fluorapatite, it reduces the acid solubility of the enamel, which is the uppermost and thinnest layer of the tooth.
It helps repair and heal the enamel layer of the tooth, which has been damaged by acids.
It directly affects the plaque that accumulates on the tooth, preventing it from producing acid.
To benefit from this caries-reducing effect of fluoride to the maximum extent, it is recommended to use it systemically until the age of 8, when tooth formation is complete, and then topically until the eruption of permanent teeth. The ideal amount of fluoride determined by the American Dental Association is 0.7-1.2 mg/L (ppm). When the amount of fluoride in drinking water is less than these doses, fluoride supplementation is needed. The doses to be used will be determined by your pediatrician.
Professionally applied topical fluorides by your dentist are fluoride-containing gels applied to the mouth with plastic spoons. It is a very comfortable and easy fluoride application that is repeated every 3 or 6 months, depending on the dosage used.
Fissure sealant applications:
Fissure sealants are aesthetic, transparent substances used to seal the chewing surfaces of teeth before cavities form, in order to cut off the relationship between bacterial plaque and the areas of the teeth most prone to decay.
Even if your child can effectively brush their teeth twice a day (morning and before going to bed), it is difficult to clean very indented areas. Thanks to fissure sealants, these areas are isolated and protected from food and plaque accumulation, and therefore from the risk of cavity formation. The 6-year molars and 12-year molars, which are the first permanent teeth to erupt in the mouth, are very important and are the teeth most at risk for food accumulation and cavity development. For this reason, it is of great importance and necessity to apply fissure sealants, especially to these teeth.
Fissure sealant is a single-session, easily applicable method. First, the tooth is cleaned, a chemical agent is applied and dried. After the fissure sealant, which is a fluid, transparent substance, is applied to the tooth, it is hardened with a light-curing device. There is no harm in the child eating after the application. Fissure sealant applications are both much cheaper than cavity treatment and, since no procedure is performed on the tooth, it is a trouble-free procedure for your child. The child should continue oral care in the same way after the fissure sealant is applied. The applied fissure sealant should be checked every 6 months. If necessary, an addition or renewal can be made.
Space maintainer application:
Baby teeth either fall out due to the pressure applied by the permanent tooth underneath or have to be extracted due to trauma or deep cavities that cannot be treated, resulting in early tooth and space loss.
As a result, the adjacent teeth may shift into the space created, and the permanent teeth underneath may not find space to erupt or may erupt in a different location. This leads to orthodontic problems. Therefore, by placing plastic or metal appliances called space maintainers, we prevent these disorders that will cause problems in the future.
There are two types of space maintainers:
» Removable (the child can take it out and put it back in themselves)
» Fixed space maintainers
Fixed Removable space maintainers are types that are made in the laboratory from an acrylic-based material, compatible with the child's mouth, by taking measurements from the child's mouth in the clinic. We prefer this type of space maintainer when there are multiple missing teeth on both sides of the jaw. The child only removes the appliance while eating, wearing it all day long. In the case of a single missing tooth on one side, especially if the child is young, we prefer to use a fixed space maintainer. Fixed space maintainers are made by the doctor in a single session in the clinic.
When should a space maintainer be made?
The interproximal surfaces of baby teeth are very prone to decay. Because young children cannot brush effectively and cannot clean their back teeth well, these teeth decay quickly, and early extractions occur when caries progression is not treated and prevented. Adjacent teeth, which tend to shift towards the space created by extractions or deep cavities on the surfaces of the teeth, or the permanent tooth erupting from underneath, leads to space loss, crowding, and serious orthodontic problems in the future.
Therefore, space maintainers should be made, especially in the early loss of baby molars. The most significant space loss occurs in the lower or upper jaw when the primary first or second molar is lost early before the 6-year molar has erupted. The wide space needed by the 6-year molar can be closed by the adjacent teeth shifting into this area of the early fallen or extracted tooth. Therefore, space maintainers are particularly important in these areas.
What are the benefits of space maintainers?
Space maintainers prevent the closure of tooth gaps. They prevent the movement of existing baby teeth in the mouth until the permanent tooth takes its place in the jaw. Since it does not apply any force to the teeth and therefore remains passive, it is an easier form of treatment for your child to tolerate compared to an orthodontic treatment that will need to be applied in the future.
What should be considered when using a space maintainer?
» Sticky candies and chewing gum should be avoided.
» The space maintainer should always be worn, except when eating.
» In order to prevent the space maintainer from breaking, do not apply too much force when putting it on and taking it off, and always store it in its special case.
» After brushing the teeth, the space maintainer must be brushed and cleaned before being placed in the mouth.
» Visit the dentist for regular check-ups (once a month).
