Paediatric dentistry is the field of dentistry concerned with children’s teeth. It involves routine dental checkups, prevention of premature loss of teeth and unwanted tooth movement. Proper tooth eruption sequence and the mixed dentition stage are also monitored.
A child is born without any teeth. There are rare cases in which a child is born with teeth which are called prenatal teeth. Prenatal teeth are supernumerary teeth that are attached to the child’s gingiva. It must be removed to prevent aspiration by the child and injury to the child’s soft tissues.
It is advised that after feeding, a washcloth is used to wipe the gums. This would prevent gum infections from occurring.
The first baby teeth to erupt would be the lower front teeth. It erupts when the baby is 6 to 10 months. A complete eruption of the baby dentition or milk teeth would be until 2 to 3 years old. There are 20 baby teeth, 10 on the upper arch and 10 on the lower arch. It is normal that the baby dentition has spaces in between teeth. These spaces would later compensate the eruption of the permanent dentition.
During this time, proper oral hygiene must be done. Tooth brushing must be done by an adult. Use a baby toothbrush with a pea-sized amount of 500ppm fluoridated toothpaste. Toothpaste must not be swallowed. Dental visits must be done every 6 months.The child must not sleep with a baby bottle inside their mouth; this can cause baby bottle tooth decay. It causes pain and discomfort to the child; tooth decay on the baby teeth can spread to the permanent dentition. Premature loss of baby teeth can cause disruption on the eruption sequence of the permanent teeth. It can also cause drifting of the erupting permanent teeth towards the vacant space that may cause crowding.
There are a total of 32 permanent teeth, 10 of which would replace baby teeth. It starts to erupt when the child is 6 years old. The first teeth to erupt would be the back teeth. This is sometimes confused as a baby tooth because it does not replace any baby teeth. If this tooth is neglected it can cause premature loss, tooth crowding, and movement.
There would be a transition period called the “ugly duckling stage” in which baby teeth and permanent teeth are both present in the oral cavity. This would be from 6 years old to 12 years old. It is a must to reassure the child that this is a normal phase of tooth development.
Oral habits such as thumb sucking, nail biting, and pencil biting must be discouraged. These habits can cause tooth flaring and malocclusions.
The child is taught proper toothbrushing by the age of 4 or when the child could understand. Only a pea-sized amount of toothpaste is used with the supervision of an adult. This is done until the child is capable of performing proper oral hygiene on their own. The child must be taught not to ingest toothpaste. As the child grows older, a higher concentration of fluoride toothpaste could be used. Routine dental checkups are done every six months.