Definition and Overview

Paediatric dentistry is a dental specialty that focuses on providing dental care for children, from birth to adolescence. Dental follow-up sessions aim to promote optimum oral and dental health, and can involve procedures to achieve this objective.

Follow-up sessions for paediatric dentistry are spaced six or twelve months apart (depending on the child's circumstances). The first consultation session should occur six months after the first tooth has broken out, or by the time the child is about one year old. Regular follow-up consultations will then be scheduled to establish a good relationship between the dentist and the patient. The paediatric dentist will monitor the patient’s oral and dental health as well as provide risk detection and early diagnosis of possible problems.

The paediatric dentist will also provide information on how unhealthy oral and dental habits can be corrected. Treatment during the sessions will be provided as needed, but preventative home care habits, such as regular brushing and flossing, will be reinforced with every visit. Diet counseling and nutritional requirements can also be discussed with the patients and their parents in each session.

Who Should Undergo and Expected Results

As mentioned earlier, parents should start bringing their children to the dentist six months after the first tooth has broken out. Follow-up consultations should then be scheduled every six months so the dentist can ensure the health of the teeth and can check their alignment as they erupt. The expected result of regular follow-up consultations with a paediatric dentist is optimum oral and dental health, as well as aligned, clean teeth.

How is the Procedure Performed?

Regular paediatric dentistry follow-up consultations are similar to the sessions with a primary healthcare provider. The dentist typically asks general questions about the patient’s teeth and possible concerns of the parents to begin each session. Then, the patient will be asked to sit in a dental chair for a visual inspection of the teeth, tongue, gums and other parts of the mouth. This is a preliminary check of the patient’s oral and dental structures.

Younger patients need to undergo regular dental x-rays to determine the condition of dental structures not easily visible to the naked eye. A dental x-ray can confirm the presence of cavities, infection and root-related problems. The dental structures of younger patients change rapidly, which makes it important for the paediatric dentist to monitor if the teeth are forming properly and are absorbing the right minerals. Dental x-rays can show weaknesses in the patient’s dental structure. As recommended by the American Academy of Paediatric Dentistry, patients with high risk of tooth decay will require one dental x-ray every six months, while children with low tooth decay risk can undergo the procedure once a year. Dental x-ray equipment found in paediatric dental offices typically has lower radiation levels than the ones used for adults.

Prophylaxis or dental cleaning is typically performed on a regular basis. Plaque and hard calculus deposits (commonly known as tartar) will be removed to prevent them from causing gum disease and cavities. The tongue and other hard to reach parts of the mouth will also be cleaned. The dentist or the hygienist will then apply fluoride to the surface of the teeth to strengthen and protect them from decay. For children with good oral and dental health, prophylaxis will be performed every six months, otherwise, dental cleaning will be recommended more often.

Other procedures that can be performed during a paediatric dental follow-up include the following:

  • Cavity repair, where the dentist applies tooth-colored fillings into the cavities. If the damage is extensive, the dentist may perform a pulpotomy nerve treatment or install a stainless steel crown.

  • Early orthodontic care, which involves early intervention procedures to correct crowded or crooked teeth. This can save the patient and the parents from expensive and extensive orthodontic work later in life.

  • Tooth extractions might be performed, but only in cases where there is nothing that can be done to repair the damage, and in cases where tooth decay affects the overall oral and dental health of the patient.

  • Installation of space maintainers for younger patients. This device is installed when primary teeth fall out before permanent teeth break out, or if teeth were extracted. Space maintainers essentially hold space for the permanent teeth, which are still developing, to prevent crooked teeth in the future.

  • Sealant application to prevent tooth decay.

Possible Risks and Complications

Paediatric dentistry follow-up consultations and preventive procedures are safe. However, tooth extractions and root canal treatment, among others, can cause infection if the patient or the parents fail to follow the aftercare instructions provided by the dentist.

References:

  • American Academy of Pediatric Dentistry
  • Canadian Academy of Pediatric Dentistry
  • British Society of Paediatric Dentistry
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