Paediatric dentists complete 3 years advanced specialty training, in addition to their 5 year dental degree, to become specialists in children’s oral health care. This training provides the skills necessary to deliver the highest quality of dental care for all children from infancy to adolescence. Paediatric dentists are specially trained in advanced treatment techniques and child behaviour management to help treat anxious children, children with special health needs and to help give every child a positive and happy dental experience.
As soon as they come into the mouth (usually around 6 months of age.) No fluoride toothpaste before age 2 years. Dr.Howley will show you techniques to make brushing easy.
Children can develop decay very early in life, even as early as when the baby teeth have just come into the mouth and some of these baby teeth will not fall out for another 8 to 9 years. Here are some reasons why decay (cavities) in baby teeth needs to be prevented or treated:
1. Baby teeth are needed for speaking and chewing food.
2. Dental decay (cavities) is the number one chronic disease of childhood. Decay is an infectious process – this means that once it starts, if left untreated and if the causative factors are not corrected, it can spread to other teeth, including adult teeth. Decay in baby teeth is the primary predictor of future decay in permanent teeth.
3. Baby teeth, like permanent teeth, have a blood supply and a nerve supply through which they are attached to the rest of the body. As a result, dental decay in a baby tooth can cause severe toothache and severe infections, including facial swellings that can require hospitalisation.
4. The permanent molar teeth develop between the roots of the baby molars. Abscesses (infection) from untreated baby teeth can sometimes spread into the underlying developing permanent tooth. This can result in damage to the permanent tooth.
5. Decay in baby teeth can spread very quickly into the nerve and blood supply of the baby tooth as the outer parts of the baby tooth (enamel and dentin) are thinner than in a permanent tooth.
6. Baby teeth are needed to hold space for the permanent teeth that are waiting to come in. The earlier a baby tooth is lost/or taken out, the more critical this space loss becomes. Sometimes permanent teeth can get blocked out and are unable to come up into the mouth –because of the space loss from the early loss of a baby tooth. Space maintainers are available to hold the space, but the baby tooth itself is the best space maintainer.
AGE 0 – 2: A non- Fluoride toothpaste should be used. Only a smear amount of toothpaste is needed.
AGE 2 – 5: A pea-sized amount of Fluoride tooth paste is all that is needed. Make sure your child does not swallow the toothpaste.
• Eat a good, well balanced diet.
• For children aged 1 to 5, you can use “Food for Young Children.” This is a booklet that can be downloaded here.
• Avoid snacking on sticky/chewy or sugary foods and drinks (e.g. biscuits, toffees, juices, chocolate milk etc.) If these types of foods are consumed, have them at meal times and not every day. These foods should ideally be reserved for “treat” days.
• Be aware that “100% fruit juice” or “No added sugar” or “Organic” juice can still contain naturally occurring sugars that can cause damage to your child’s teeth.The American Academy of Paediatrics recommends children 1-6 years of age consume no more than 120-180 mls of fruit juice per day and that this should be consumed as part of a meal.
• Sugary drinks (e.g. sports drinks, juices) should be consumed quickly and not spaced out over time. The same is true for sweets or sugary foods to reduce the amount of time they are in contact with the teeth.
• Drink water or milk, especially between meals.
• If thirsty during the night, only drink water.
• Infants should not be put to bed with a bottle at night or at nap time.
• Infants should be taught to drink from a cup instead of a bottle/sippy cup at around 12 months of age.
Irish Dental Association is: 1st visit = Age 1. High risk diets (that cause decay) can be established as early as 12 months of age, so for maximum prevention of decay, early visits are required.
Decay rates in Ireland are exceptionally high. According to the Health Research Board, one out of every three 5-year olds have experienced decay. This number rises to more than half of all 5-year olds living in areas without Fluoride in their water supply. Half of all 12-year olds and three quarters of all 15-year olds have experienced decay in their permanent teeth.
If your child is experiencing pain or has had trauma to their teeth, please contact our practice for advice. If your child has a severe medical emergency (e.g. head trauma) or a swollen face from a severe infection or trauma, please seek medical attention.
Here are some tips on how to handle some dental emergencies. Traumatised teeth should be assessed as quickly as possible by a dentist to prevent pain and infection. In some cases, a traumatised tooth may need a root canal treatment or for the tooth to be removed.
Trauma to a baby tooth can affect the development of a permanent tooth, so it is important to have injured baby
What do you do if a permanent tooth gets knocked out?
• Find the tooth.
• Only hold the tooth by the crown (see picture.) Try not to touch the root at all – as the cells on this part of the tooth are very delicate and are needed for the tooth to re-attach itself to the mouth.
• If the tooth is dirty, you can quickly rinse the tooth (less than 10 seconds) – if necessary, but do not scrub the tooth or wash it with any detergents/soaps etc. Make sure to put the plug in the sink hole, if washing it in the sink.
• The best thing to do is to put the tooth back into the socket as soon as you can and bring your child to the dentist immediately. Try to place the tooth root first – into the socket and have your child bite a handkerchief or some gauze to hold it in place.
• If you cannot put it back into the socket, place the tooth in a cup with one of the following:
In order of preference: Viaspan™, Hank’s Balanced Salt Solution, or cold milk. If these are not available you could have your child spit into a cup and bring the tooth in the cup, covered in saliva. Tap water for tooth storage is not recommended, unless all other options are not available. Water can damage the cells on the root that are needed to re-attach the tooth.
• Bring your child to the dentist immediately. The longer the tooth is out of the mouth (measured in minutes), the less likely the tooth will be able to be saved. If the tooth is out of the mouth for over an hour it may not be possible to put it back into the socket of a growing child.
• Antibiotics will be required and Tetanus status will need to be assessed.
Sources: www.dentaltraumaguide.org and www.aapd.org
X-rays are needed to examine the areas in your mouth that cannot be seen while doing a visual exam. Here are some reasons why x-rays are taken:
• To diagnose decay (cavities) between the teeth when this area cannot be visualised directly
• To assess the extent of infection within a tooth and/or the surrounding bone
• To assess the extent of damage to a tooth following a traumatic injury
• To look for abnormalities in developing teeth or the areas surrounding the teeth
At Dentistry for Kids, we only use Digital x-rays. Digital x-rays reduce radiation by up to 80% compared to the already low exposure of traditional dental x-rays. We also follow the ALARA principle (As Low As Reasonably Achievable) and use lead aprons to minimize your child’s exposure to radiation. The American Academy of Paediatric Dentistry recommends x-rays at intervals ranging from 6 to 36 months, depending on the cavity-rate and age of your child. Each child will be assessed on an individual basis to determine whether x-rays are required.
Contact your dentist immediately. If you can, find the broken tooth fragment and bring it with you to the appointment.
Find the tooth. Contact your dentist. DO NOT place a baby tooth back into the socket as baby teeth are not put back in if they fall out.
A Diplomate is a paediatric dentist who is certified by the American Board of Paediatric Dentistry. (ABPD) “The ABPD certifies paediatric dentists based on standards of excellence that lead to high quality oral health care for infants, children, adolescents, and patients with special health care needs. Certification by the ABPD provides assurance to the public that a paediatric dentist has successfully completed accredited training and a voluntary examination process designed to continually validate the knowledge, skills, and experience requisite to the delivery of quality patient care.” For more information, please see: http://www.abpd.org/Content/About.aspx