“A woman has two smiles that an angel might envy, the smile that accepts a lover before words are uttered, and the smile that lights on the first born babe, and assures it of a mother’s love.” Thomas Chandler Haliburt
A Child’s smile costs a lot.You being a mother or father is responsible to keep it well lifelong.Like the great Osho had put in anyone can become a father or mother,even animals can; but to become a great mom and dad is a bit different because parenting is an art.It sometimes needs a bit of extra efforts ,extra edge of knowledge what to do for your little charm what not to,when to do,why that is necessary and so on.The umpteen needs have to be addressed amidst the pandemonium created by the little champion.Most parents often neglect child’s dental care thinking milk teeth don’t need much care as they will be soon replaced by permanent teeth.It is a misconception.A healthy set of milk teeth is needed for a strong healthy set of permanent teeth.
Science has provided a clear understanding that tooth decay is an infectious, transmissible, destructive disease caused by acid-forming bacteria acquired by toddlers from their mothers shortly after their first teeth erupt (generally around six months of age). In its early stages, the effects of dental caries are largely reversible through existing interventions (e.g., fluorides) that promote replacement of lost minerals from the outer layer of the tooth (enamel). These findings, combined with epidemiological data on the occurrence of tooth decay in infants and young children, suggest that true primary prevention must begin in the first to second year of life. This evidence also suggests that particular attention should be paid to the oral health of expectant and new mothers.In early childhood there is tremendous growth and development of the face and mouth, with dentition-associated disturbances that may require the attention of dental professionals. Other common oral conditions of childhood (in addition to tooth decay) include: gingivitis and mucosal (soft tissue) infections; accidental and intentional trauma; developmental disturbances associated with teething or tooth formation; poor alignment of teeth or jaws; and craniofacial abnormalities (including clefts of the lip and/or palate). Additionally, parents frequently request information on a diverse array of concerns including: sucking habits; fluoride usage; tooth alignment; timing and order of tooth eruption; and discolored teeth.
INFANT ORAL HEALTH CARE
Infant oral health care begins ideally with prenatal oral health counseling for parents, a service that should be provided by knowledgeable health care providers such as obstetricians, family physicians, pediatricians and nurse practitioners, as well as dental providers. Actual infant oral health care visits focusing on relevant history taking, clinical examination of oral structures, risk assessment, counseling, anticipatory guidance and necessary follow-up interventions should begin early, ideally before dental diseases are established. This early involvement is viewed as the foundation on which a lifetime of positive oral health and dental care experiences can be built, thus minimizing costs associated with treatment of dental diseases.
FIRST DENTAL VISIT
Despite growing recognition of the above, a discrepancy exists between dental and public health organizations’ versus the American Academy of Pediatrics’ recommended age for a first dental visit. American Academy of Pediatric Dentistry (AAPD) policy, as reflected in its “Periodicity of Examination, Preventive Dental Services, and Oral Treatment for Children,” recommends that children be seen by a dentist following the eruption of the first tooth, but not later than 12 months of age. The AAPD recommendation is embraced by the Bright Futures consortium of 28 child health organizations and is consistent with the policies of the dental and public health groups including the American Dental Association, American Dental Hygienists Association and the American Public Health Association. In contrast, the American Academy of Pediatrics (AAP) recommends that every child should begin to receive oral health risk assessments by 6 months of age from a pediatrician or a qualified pediatric health care professional, and that infants identified as having significant risk of caries or being in a high-risk group should be entered into an aggressive anticipatory guidance and intervention program provided by a dentist between 6 and 12 months of age
“DENTAL HOME” CONCEPT
Primary pediatric oral health care is best delivered in a “dental home” where competent oral health care practitioners provide continuous and comprehensive services. Ideally a dental home should be established at a young age (i.e., by 12 months of age in most high-risk populations) while caries and other disease processes can be effectively managed with minimal or no restorative or surgical treatment. An adequate dental home should be expected to provide children and their parents with:
- An accurate examination and risk assessment for dental diseases
- An individualized preventive dental health program based upon the examination and risk assessment
- Anticipatory guidance about growth and developmental issues (e.g., teething, thumb or pacifier habits)
- Advice for injury prevention and a plan for dealing with dental emergencies
- Information about proper care of the child’s teeth and supporting structures
- Information about proper diet and nutrition practices
- Pit and fissure sealants
- A continuing care provider that accomplishes restorative and surgical dental care when necessary in a manner consistent with the parents’ and child’s psychological needs
- Interceptive orthodontic care for children with developing malocclusions
- A place for the child and parent to establish a positive attitude about dental health
- Referrals to dental specialists such as endodontists, oral surgeons, orthodontists, pediatricdentistsandperiodontists when care cannot be directly provided within the dental home and
- Coordination of care with the infant/child’s primary care medical provider.
SERVICES BY A DENTIST
Dental care includes diagnostic services, preventive services, therapeutic services and emergency services for dental disease which, if left untreated, may become acute dental problems or may cause irreversible damage to the teeth or supporting structures. The dental diseases and conditions of primary concern during childhood include dental caries (tooth decay) and problems or anomalies related to disturbances of growth and development. Periodontal diseases and other conditions affecting so-called soft tissues within the mouth and underlying bone, often related to systemic health problems, also affect oral health in a smaller percentage of children.
Because children remain at varying levels of risk for dental diseases and developmental disturbances, and because the best outcomes are achieved when these conditions are detected and treated early, periodic examinations at intervals commensurate with levels of risk are recommendedfor all children starting at an early age and continuing throughout childhood and adolescence. The often insidious onset of dental diseases require that practitioners responsible for children’s oral health understand underlying disease processes and have the training, experience, and equipment necessary to accurately diagnose and manage common dental diseases and, when necessary, provide a range of therapeutic services to restore damaged structures.
PREVENTIVE SERVICESBY THE DENTIST
1.Dietary fluoride supplements
3.Professional topical fluoride application
4.Oral hygiene counselling
5.Topical antimicrobial agents
6.Pit and fissure sealants
- Space maintenance and habit discontinuation appliances
- Combination interventions for primary caries prevention or for reversing or arresting the progression of carious lesions
- Protective mouth and face guards for children engaged in sports activities
DIAGNOSTIC SERVICES BY THE DENTIST
Accurate and early diagnosis is an essential prerequisite for successful control and treatment of dental diseases and developmental disturbances. When a general screening examination indicates the need for further evaluation of an individual’s health, a referral for diagnostic studies is to be provided without delay. However, the relatively high prevalence of dental diseases and abnormalities in infants and children and the limited sensitivity of current screening procedures provide strong clinical justification for children receiving diagnostic examinations by a dentist beginning at an early age.
TREATMENT SERVICES BY THE DENTIST
Oral diseases are progressive and cumulative and, if left untreated, become more complex and difficult to manage over time. The dental therapeutic services must include dental care, at as early an age as necessary, needed for relief of pain and infections, restoration of teeth, and maintenance of dental health. A partial list of dental treatment services includes:
- Pulp therapy for permanent and primary teeth – e.g., root canal treatments;
- Restoration of carious (decayed) permanent and primary teeth with materials and techniques that meet current accepted practices – e.g., plastic and metal fillings and stainless steel crowns;
- Scaling to control gingival and periodontal diseases;
- Maintenance of space for missing posterior primary and permanent teeth to prevent or minimize problems in eruption of permanent teeth – e.g., fixed and removable space maintainers;
- Provision of removable prosthesis (partial and complete dentures) when masticatory (chewing) function is impaired, when an existing prosthesis is unserviceable or when the condition interferes with employment training or social development and
- Orthodontic treatment when medically necessary to correct handicapping and other malocclusions.
EMERGENCY SERVICES BY THE DENTIST
Emergency dental services include:
- procedures necessary to control bleeding, relieve pain, or eliminate acute infection – e.g., starting root canal treatment on infected teeth, draining abscesses and infected areas, treating soft tissue swellings associated with erupting teeth, palliative care for oral soft tissue infections such as herpes;
- procedures that are required to prevent “pulpal death” (infection of the nerves and blood vessels inside the tooth) and the imminent loss of teeth – e.g., decay removal, application of medications, temporary fillings; and
- treatment of injuries to the teeth or supporting structures (bone or soft tissues that surround the teeth) – e.g., temporary fillings for fractured teeth, stabilizing loose teeth and supporting bone, cleaning and suturing traumatic wounds; and palliative therapy for pericoronitis (swollen, inflamed tissues associated with impacted or erupting teeth) – e.g., irrigation of swellings, removing debris from infected areas, relieving trauma caused by opposing teeth
Let your eyes and ears be more focused and sharp to see the changes happening in your child’s mouth as well as to hear the language by which he or she communicates his or her dental dilemma.I would love to end this piece of information by wondering at the greatness of being a child.Going by the words of the awesome writer Paulo Coelho
“A child can teach an adult three things: to be happy for no reason, to always be busy with something, and to know how to demand with all his might that which he desires”
Dr. Manikandan.G. R
Junior Resident, Government Dental College
Trivandrum, Kerala. PH:9496815829