PEDRIATIC DENTISTRY

Prenatal Dental Care

The hormonal changes during pregnancy can directly affect the oral cavity of the pregnant woman, who may present, for example, a predisposition to gum disease and the development of cavities and erosion (acidity that causes tooth enamel wear) due to frequent throwing-up episodes. Hence, the importance of periodic cleaning and the application of fluoride during this period. Moms are made aware of the importance of breastfeeding and receive all the guidance on the choice of pacifiers, types of nipples, bottles, teethers and accessories for baby hygiene, such as finger cots and specific toothpastes. As they are going through a moment of great awareness in their life due to the magic that surrounds maternity, it is an ideal phase to educate the moms.

The Age of the 1st Consultation

With the eruption of the first teeth, at around the age of 6 months, THE FIRST VISIT TO THE PEDIATRIC DENTIST is already recommended. Towards prevention, every effort is made to avoid cavities and other ailments or cure them at an early stage, preventing major damage to the teeth, which justifies the importance of an early approach, where our goal is ZERO DECAY, i.e., to offer all conditions for the development of a healthy dentition reaching adulthood without a history of cavities. This contact from early on is important from the point of view of oral health and the psychological aspect, because the sooner the child gets familiarized with the dentistry environment, the greater its acceptance of and cooperation with the consultations. Why wait for a situation of pain to arise, where this first contact will cause the child to associate the dentist to suffering, leaving traumas that will accompany it into adulthood?

Dentist Fear

Going to the dentist always appears among the strongest fears of the population. A fact that is currently no longer acceptable, but quite understandable when we look at the procedures of the past. As in all areas / professions, so also in dentistry, current techniques, efficiency of anesthetics and modern equipment among other improvements, provide for comfort in the dentist's chair. However, getting to change these outdated ideas and competing with the media that daily insists on associating the dentist to suffering, is a constant struggle. It is up to the practitioner to care about his patient's well-being and always offer the best treatment options. To control this phobia and improve patient’s cooperation providing the much-desired experience of comfort, we have some special methods and techniques available.

Chromogenic Bacteria

Extrinsic tooth staining of blackish pigmentation is often related to the use of drugs containing iron, cariostatics or tobacco.   However, chromogenic bacteria, such as those of the melaninogenic Prevotella species, have been related to the black pigmentation of the dental biofilm. Apart from the cosmetics, the removal of these stains is aimed at maintaining the oral health as this bacterial species presents significant collagenolytic activity.Clinically, children with black stains, resulting from the activity of these chromogenic microorganisms, present low prevalence of cavities.   The pigment responsible for the black coloration is a insoluble ferric compound, as a result of the interaction between bacterial products and saliva. This pigmentation is difficult to remove with brushing at home alone, it is necessary to see a dentist to perform professional prophylaxis using mechanical methods such as scraping, ultrasound or bicarbonate jet for its removal. There is a concern about excessive wear of the enamel as there is a tendency for recurrence.   It is suggested that the dentist be visited for cleaning every 3 months or when the pigmentations begin to appear.

Finger Sucking

Since its intrauterine life, from the fetal period onwards, the human being instinctively sucks the tongue, the lips and the fingers so that, at the moment of birth, the suction function is fully developed.   The oral organ, by way of sucking, is extremely important to the newly born child. It is through the mouth that the child survives, nourishing itself and interacting with the environment around him, satisfying itself emotionally. Children suck their fingers under various circumstances: when falling asleep, while sleeping, when cross or frustrated, and also when hungry, during stressful situations or when they are in a bad mood, restless and know that they need to calm down, or even when they are not satisfied after breastfeeding.

Dental Trauma


  • WHAT TO DO WHEN YOUR CHILD SUFFERS A DENTAL TRAUMA?


During childhood it is common for children, who take thousands of falls learning to walk, running, playing and riding bikes, end up banging their teeth. It is therefore important that parents know how to proceed in case of an accident, to manage to “save“ the tooth or, at least, to mitigate the damage caused. Many are the several types of trauma that can happen to the teeth, soft tissues (lips, tongue, cheek), the bone and support tissue. For each situation there is an indication of treatment and control.     The main complications from traumas, both to the primary or milk teeth and the permanent teeth, come from lack of immediate attention, care and control performed at the practice by the professional.

  • What parents need to know:


1-That the milk tooth has a root and that in its interior there is a canal through which run nerves and blood vessels (pulp).   And also, that the permanent tooth is in formation very close to that root since the child’s birth. Thus, depending on the type of trauma, there exists a risk of some type of sequel to the permanent tooth in development. 2-That every tooth suffering from trauma must have clinical and radiographic follow-up at the practice for at least one year and a half for milk teeth and five years for permanent teeth, as complications may develop during this period from the trauma to the tooth. 3-That not always the trauma affected tooth does present a color change. And should this happen, it doesn’t necessarily indicate loss of vitality of the tooth and the consequent need for treatment. It is up to the practitioner to assess whether there will be indication for any treatment or just the continuity of periodic monitoring. 4-That even the "small" traumas to milk teeth, where there is only a slight bleeding, need attention.

  • How to proceed in the case of dental trauma:


1-Whenever possible, contact your dentist immediately, at any time for proper guidance. In some cases, proper guidance over the phone will do, helping parents cope adequately with the situation. 2-If there is a lot of bleeding, try to stop it with gauze, a towel, handkerchief or ice to see where the blood is coming from. 3-In cases with bleeding and / or increased mobility of the tooth, a root fracture may have occurred and professional care should be given as soon as possible. An x-ray may be required to see whether there is a fracture or not. 4-When the tooth is partially pushed from its position (extrusion or dislocation), the faster it is put back into position the greater are the chances of being recovered. 5-When the permanent tooth is fully dislodged coming out completely (dental avulsion), the faster it is replanted, the better the chances of success. If you can manage, reposition the tooth back into its original position (without touching the root, taking the tooth by its crown) and immediately see the dentist.   Else, place the tooth in a container with physiological saline, milk or saliva and leave it to the dentist to replant.   Should this happen to a milk tooth, replantation is not recommended because of the minimal chance of success.   However, it is very important that the child is as quickly as possible examined by the dentist. 6-If the tooth "vanished" and could not be found, it is possible that it has suffered a total intrusion, that is, it has been pushed completely into the alveolar bone. The dentist will X-ray the area and determine the treatment.   Sometimes this intrusion (tooth push-in) is partial. 7-In case a fragment breaks off the tooth and it is found, place it in physiological saline, milk or saliva and get to the dentist, as according to the size of the fragment, it is possible to cement it back on, aesthetically recovering the tooth.

  • How can dental traumatisms be prevented?


“With kids all the care is never enough”. There are of course unexpected situations and in a matter of seconds the trauma happens. But it is always a good idea to: - avoid risk situations such as the use of baby walkers - be more cautious with a child that is in its first walking steps - use the swimming pool ladder when entering and leaving the pool - never run barefooted on a wet floor - use mouthguards when practicing extreme sports - never walk around or run with objects in the mouth (feeding bottle, cup, pens, toys) - always use the safety belt when in a car