Preventive Dentistry Approach and Treatments for Children:
Preventive dentistry in children includes the following key areas:
- Brushing
- Monitoring tooth development
- Establishing the habit of flossing
- Educating the family
- Proper nutrition
- Identifying and preventing bad habits
- Fluoride treatments
- Fissure sealants
- Space maintainers
- Preventing trauma and injury
What is the Importance of Preventive Dentistry?
Preventive dentistry ensures a healthy and beautiful smile for your child. Children with healthy mouths chew more easily and effectively, obtaining the full nutritional value from their food. They also learn to speak more clearly and quickly. A healthy mouth means fewer risks for diseases that could affect other parts of the body, contributing to overall better health. Furthermore, a healthy mouth not only looks good but boosts a child's self-confidence. In addition to these benefits, preventive dentistry is less tiring and more cost-effective compared to restorative treatments.
When Should Preventive Dentistry Begin?
Preventive dentistry should start as soon as the first tooth emerges. Once your child’s first tooth appears, it’s important to visit a dentist. This allows you to gain information on how to protect your child's oral health. The earlier your child visits the dentist, the higher the chances of preventing dental problems. By taking preventive measures early, you can help ensure a future without cavities and promote a generation with healthy teeth.
What is the Family’s Role in Preventive Dentistry?
Once your child’s dental health is established, your dentist will guide your child on how to maintain this health at home. This includes brushing, flossing, and providing information to the family on nutrition and, if necessary, fluoride use. By monitoring and supporting your child's oral care, you help them develop lifelong habits that will protect their dental health.
What is the Dentist’s Contribution to Preventive Treatment?
Brushing, flossing, and fluoride treatments are essential components of your child’s oral care routine. In addition to these, other treatments such as fissure sealants are often applied by the dentist to help prevent cavities and maintain oral health.
Fluoride Treatments:
Fluoride is an essential substance for the body when consumed in the right amounts. Fluoride intake should begin when the child is 0 years old and continue until the age of 8.
There are two main ways fluoride can enter the body:
Systemic fluoride: This is consumed through drinking water, fruit juices, foods, and fluoride-containing tablets or syrups. Fluoride taken systemically is stored on the surfaces of developing teeth and provides long-term protection. It also adheres to dental plaque, assisting with remineralization (replenishing the minerals lost from the enamel due to decay).
Topical fluoride: Applied directly to the teeth, topical fluoride strengthens the enamel and helps prevent cavities by forming a protective layer on the tooth surface. Toothpastes, mouth rinses, and fluoride gels applied by dentists are examples of topical fluoride.
Researchers have identified three mechanisms through which fluoride prevents cavities:
Fluoride converts the hydroxyapatite in the tooth structure into a more resistant form (fluorapatite), reducing the solubility of the enamel in acid.
Fluoride aids in the repair and remineralization of the tooth enamel damaged by acids.
Fluoride directly interferes with plaque buildup, preventing acid production that leads to decay.
To take full advantage of fluoride’s cavity-prevention effects, it is recommended that fluoride be used systemically until the age of 8 and topically thereafter until the permanent teeth fully emerge. The ideal fluoride concentration in drinking water, according to the American Dental Association, is between 0.7–1.2 mg/L (ppm). If the fluoride concentration in drinking water is lower than this, supplemental fluoride may be needed. Your pediatrician will determine the proper dosage.
Fluoride treatments applied professionally by your dentist involve fluoride gels that are applied to the teeth with plastic trays. Depending on the dosage, fluoride treatment is typically repeated every 3 to 6 months, and it is an easy and effective procedure.
Fissure Sealants:
Fissure sealants are aesthetic, transparent materials used to seal the chewing surfaces of the teeth, preventing bacteria from entering the grooves that are most susceptible to decay.
Even if your child brushes their teeth twice a day (morning and evening), it can be difficult to clean the deep grooves on the chewing surfaces effectively. Fissure sealants isolate these areas, protecting them from food and plaque buildup, thus reducing the risk of cavities. The 6-year molars and 12-year molars, which are the first permanent teeth to emerge, are particularly vulnerable to decay. Therefore, applying fissure sealants to these teeth is essential.
Fissure sealants are easy to apply in a single session. First, the tooth is cleaned, a chemical agent is applied and dried, and then the fluid, transparent fissure sealant is applied. It is then hardened with a light curing device. After application, the child can eat immediately. Fissure sealants are not only cost-effective but also a non-invasive procedure for your child. After applying fissure sealants, the child should continue with regular oral hygiene and have the sealants checked every 6 months. If necessary, the sealant can be repaired or replaced.
Space Maintainers:
Space maintainers are appliances used to maintain the space left by prematurely lost primary (baby) teeth until the permanent teeth emerge. Early tooth loss can occur due to trauma or deep decay that cannot be treated. If a primary tooth is lost early, neighboring teeth may drift into the gap, preventing the eruption of the permanent tooth. This can lead to orthodontic problems.
There are two types of space maintainers:
- Removable space maintainers (the child can insert and remove them themselves).
- Fixed space maintainers (cemented in place).
Fixed space maintainers are made in the dental clinic by taking impressions and fabricating a custom appliance in the lab. These are generally used when multiple teeth are missing, or both sides of the jaw are affected. The child wears the appliance throughout the day, removing it only while eating. For a single missing tooth, especially in younger children, a fixed space maintainer is preferred. Fixed space maintainers are placed in a single visit by the dentist.
When Should a Space Maintainer be Used?
Primary molars are highly susceptible to decay. Because young children cannot brush effectively, these teeth decay quickly and may need to be extracted if decay is left untreated. If a tooth is extracted or loses significant structure due to decay, the neighboring teeth may shift toward the gap, causing alignment issues and potentially leading to serious orthodontic problems.
In cases of early loss of primary molars (especially before the eruption of the 6-year molars), a space maintainer is necessary to preserve the space for the permanent teeth.
Benefits of Space Maintainers:
Space maintainers prevent adjacent teeth from moving into the gap left by an early lost tooth. They keep the space open until the permanent tooth erupts. Because space maintainers do not apply pressure to the teeth, they are easy for children to tolerate and are a less invasive option than orthodontic treatments.
Precautions When Using a Space Maintainer:
- Avoid sticky sweets and chewing gum.
- The space maintainer should be worn at all times except during meals.
- To prevent damage, do not apply excessive force when inserting or removing the appliance, and store it in a special container when not in use.
- Clean the space maintainer after brushing the teeth before placing it back in the mouth.
- Regular dental checkups (at least once a month) are necessary to ensure the space maintainer is functioning properly.
