KIDS DENTISTRY

A) Pit and fissure sealants The chewing surfaces of teeth are never flat. They have in fact certain depressions called Pit and Fissures which serve as potential traps for food and bacteria making the teeth susceptible for decay. Pit and fissure sealant seals the fissure of milk teeth thereby prevents penetration of fermentable sugars and the bacteria which lead to tooth decay. The safety and effectiveness of pit and fissure sealants as a decay preventive measure has been confirmed by the American Dental Association. B) Oral prophylaxis (cleaning) - Recommended once in every 6 months. C) Fluoride application : A child’s teeth are more prone to decay due to lack of proper dexterity of brushing. Application of fluoride varnishes at regular intervals strengthens the tooth structure by incorporating fluoride ions into the structure making them more prone to acid dissolution. Not only do the permanent but also milk teeth benefit from fluoride treatment.

In cases where tooth decay extends deep into the nerve portion of the tooth it might be necessary to perform a root canal as described for the permanent tooth. It might still be considered as a better alternative to tooth extraction as saving milk tooth will not only improve chewing but also milk teeth serve as space maintainers for proper spacing and alignment of the permanent teeth.

1. Parent Counseling
a) Prenatal counseling – It involves educating the expecting mother about proper oral hygiene maintenance, nutrition intake and genetic counseling.

b) Post natal counseling-It involves educating the mother about proper oral care and nursing, teething problems, when to stop bottle feeding and the use of physiologic nipples in cases of bottle feeding babies . The mother is also advised against the prolonged use of pacifiers and sweetening solutions in bottles.

2. Space maintainers

A space maintainer is a removable or fixed appliance designed to maintain an existing space. Space maintainers are usually fitted in children when they have lost baby teeth early. The gap left from losing this tooth needs to be held open for the permanent tooth to erupt in the correct position.

3. Oral Hygiene and care of deciduous dentition.
4. Monitoring of eruption sequence.
5. Caries control and restoration of decayed teeth
 

• Oral Habit breaking therapy:

Some of the common oral habits found in children are- thumb sucking habit , lip biting habit , nail biting habit , mouth breathing habit, tongue thrusting, digit sucking etc . There treatment varies according to the duration, intensity, frequency of the habit.

a) Psychological approach for breaking the oral habits: it is generally said that children lacking parental care, love and affection resort to this habit. Thus the parents should provide the child with adequate love and affection. Also the child’s attention should be diverted to other things such as games and toys. The dentist and the parents should together work to motivate the child to discontinue the habit.

    b) Mechanical Aids for breaking the oral habits: They are basically reminding appliances that assist the child who is willing to quit the habit but is not able to do so as the habit has entered the subconscious level. They may be removable or fixed appliances.

• Interception of developing cross bite
• Muscle exercises/Oral physiotherapy
• Serial extraction or guided eruption