Paediatric dentistry is responsible for the comprehensive care and maintenance of oral health in children and adolescents. Maintaining the dental health of primary teeth is not just important for chewing , but also to keep space for the permanent teeth forming beneath these and to enable the normal development of the muscles and jaws.
To ensure a good state of dental health, check-ups should take place every 6 months. Caries can cause infectious foci which can have long-term damage on children’s health, meaning check-ups are important.
FREQUENTLY ASKED QUESTIONS
AT WHAT AGE DO CARIES BEGIN TO APPEAR?
Caries can occur when tooth eruption begins, therefore it is advisable to begin dental cleaning when the first teeth appear, using a wet gauze pad and later children’s toothbrushes without toothpaste, and then subsequently using it. The Spanish Paediatric Dentistry Society recommends first visiting the dentist when the child turns one.
HOW CAN WE RECOGNISE CARIES?
Caries must be diagnosed by a paediatric dentistry specialist through regular check-ups every 6 months, because if the parents are the ones who see them, it may be too late because the cavitation process has already begun. Usually, the first sign of caries is the appearance of a change of colour in the tooth, which becomes whitish and opaque. At a more advanced stage, a yellowish-brown border can be seen in the area with caries, then later the loss of substance and the cavity in the enamel appear.
When we see the broken enamel, it means the process has been taking place in the mouth for several months. For temporary teeth, this process is very fast because the enamel is highly porous; therefore it’s important to act quickly when the dentist detects signs of tooth decay.
DO CARIES IN PRIMARY TEETH HURT?
Their structure is the same as that of permanent teeth, meaning when caries affect the enamel, you don’t yet feel pain, but when the lesion progresses, it reaches inside the tooth and affects the dentine, and that’s when you do feel pain. As the infection develops, it enters the tooth’s soft tissues (nerve), and boils may appear.
HOW ARE CARIES IN CHILDREN TREATED?
Depending on the tooth’s pathology, the treatment will differ:
a) If the lesion doesn’t affect the nerve, an obturation will be performed using a filling.
b) If the lesion affects the nerve, a pulpotomy or nerve treatment will be performed, and for an infection with boils, a pulpectomy will be performed, These techniques are different to those used for permanent teeth.
c) If the infection and the tooth are severely damaged, we’ll remove the primary tooth. In these cases, when the permanent tooth eruption is still a long way off, a space maintainer must be positioned to prevent the space from shifting and allow the permanent tooth to come through.
WHAT PREVENTIVE MEASURES CAN I TAKE?
The main preventive measure is daily hygiene and good dietary habits.
Fluoridation must always be performed under the dentist’s supervision. The enamel is reinforced and re-mineralisation takes place by applying fluoride. The fluoride reacts with the enamel’s hydroxyapatite crystals and turns them into fluorapatite crystals that are far more resistant to the action of acids. According to the WHO, the incidence of caries is reduced by 50%.
