What is Paediatric Dentistry?
Paediatric dentistry involves the dental care of children from birth to adolescence, including those with complex treatment needs. Here at Orthosmile, our dentists can monitor your child’s oral and dental health and development and provide treatment to help maintain a healthy mouth and smile.
Our children’s dentists may offer a variety of treatment options for your child, including thorough oral health assessment at their first visit to ascertain their individual needs and a range of preventative care, identifying and addressing dental issues at an early stage while they are easy to manage.
Your Child’s First Visit
When your child visits us for the first time, it is of paramount importance that they have a positive dental experience right from the start in order to ease them into the dental environment.
We will listen carefully to your concerns and conduct a thorough assessment and examination of your child’s oral health at this first visit, whilst also acclimatising them to the clinic environment. When the examination is complete, we will plan the treatment most appropriate for your child’s individual needs and take you through each step of the decision-making process, giving you opportunities to ask questions.
Preventative Care and Oral Health Monitoring for Children
The paediatric dentist will review your child’s health at regular intervals to ensure optimal oral health.
We may also offer regular cleaning, application of fluoride at intervals to reduce the risk of decay, provide bespoke advice on how to maintain good oral hygiene, and promote good dietary habits from an early age to ensure optimal dental health for your child.
Our children’s dentists also work closely with our orthodontic team to monitor the dental growth and development of your child, to provide the best advice on any developing issues with the bite and discuss how these may be prevented or treated in a timely manner.
Dental Treatment for Children
Here is a list of some of the most common children’s dental procedures that we offer…
The pits and grooves of back teeth often trap food and bacteria, which can contribute to dental decay, or caries, if not managed.
Fissure sealants are a plastic coating that can be painted in these deep grooves and fissures help as a protective layer to help prevent dental decay.
This treatment is quick, easy and pain free! The dentist will first clean the tooth, prepare it with a special solution and then apply a thin layer of sealant material in the deep fissures, setting it with a blue light.
These can last a long time, however, may need replacing or topping up at intervals to make sure they remain effective.
This is a gel that can be applied onto children's teeth at regular appointments by the dentist to provide extra protection against tooth decay in addition to brushing with a fluoride toothpaste. It is easy to apply, painless, sets quickly and has a pleasant taste and smell!
There is good scientific evidence to show that fluoride varnish treatment is a safe and effective means of reducing decay. Some children are more susceptible to decay than others, and your dentist will advise you on whether fluoride varnish is recommended for your child and how often it is necessary to have it applied.
Who may require more fluoride varnish?
- Children who are at a high risk of tooth decay with a history of frequent cavities and multiple restorations
- Children with orthodontic appliances or fixed braces
Here at Orthosmile, we want to instil good oral hygiene habits from a young age. Your child’s dentist may recommend hygiene and prevention appointments for your child to help maintain a happy and healthy mouth.
Your child’s dentist will investigate your child’s current oral hygiene habits, give the best current recommendations on how your child can clean their teeth at home, and also assess any areas of your child’s diet which requires improvement.
Our dentists also conduct painless, stress-free, professional cleaning for your child, using a special coloured solution called a plaque-disclosing agent which shows all the areas your child is currently missing.
We may also suggest the application of a Fluoride varnish, a gel that can be applied to the surfaces of the teeth that can give some extra protection against tooth decay.
It is really important that children with braces are monitored closely and maintain optimal oral hygiene as it can be sometimes more difficult and time-consuming to keep teeth clean with braces in place. Your dentist will give specific advice on how best to brush if your child has braces.
If your child has dental decay and cavities are detected early enough, the dentist may recommend the removal of the decay and placing a filling to protect the tooth.
We use the most minimally invasive, conservative and gentle techniques to fill the tooth, using white or tooth coloured filling materials such as composite, and drilling as little natural tooth structure as possible, ensuring the safest and most pleasant experience for your child.
In some situations, where a cavity is too large or decay is too extensive to place a simple filling in your child’s baby tooth, the dentist may recommend the placement of a crown. This is a cap that covers and protects the tooth surface, ensuring the baby (primary) tooth is maintained until the adult tooth replaces it. It is also a method of restoring a tooth following root canal therapy.
These can be metal, or tooth coloured, and the dentist will discuss the options most appropriate for your child.
In cases of extensive tooth decay that has spread to and infected the nerve inside the tooth, the dentist may recommend children’s root canal therapy or pulpotomy if the tooth can be saved, avoiding the need for dental extraction.
Such therapy can be an instant relief for children in pain in cases where the nerve has been infected, and with gentle techniques available to numb the tooth with local anaesthetic, the treatment can be almost pain-free.
Although our dentists always try their utmost to try and save every tooth possible, sometimes it may be necessary to remove a tooth, for example to create space for orthodontic treatment, or in circumstances where a tooth is decayed beyond restoration.
Where this is necessary, we provide expert and careful treatment to ensure this is as stress-free and relaxed a procedure as possible for your child, taking precautions and paying close attention to make sure any treatment done is painlessly.
Your child may need a space maintainer if they lose any of their primary/baby teeth earlier than expected (for instance due to injury or infection), to maintain the space in the mouth for the permanent or adult tooth to come through, before the space naturally closes. If this is the case, the paediatric dentist may recommend fitting of a space maintainer for your child. Space maintainers are not always necessary, and the dentist will be able to advise whether your child would benefit from one at their assessment visit.
Space maintainers come in various types and varieties and are custom-made to fit your child’s mouth. They can either be fixed or removable.
Fixed space maintainers are more common and are usually recommended in most cases – they involve a band which is fitted/cemented onto a tooth, normally a molar tooth, which remains there until the permanent tooth has come through.
Removable space maintainers are much like retainers and are removable appliances which should be worn for most of the day but can be removed for cleaning. Some of these can have a false tooth added to them if necessary, as an aesthetic solution.
Space maintainers are not painful but require just little time getting used to and some attention is needed to take care of these appliances, especially in terms of cleaning. The dentist will go through all the instructions in detail to ensure the best outcome.
Contact sports and physical activities may pose a risk to your child’s teeth, with a significant proportion of traumatic dental injuries being sports related. Injuries can include dislodgement, chipping or fracturing of teeth or damage to the lips and gums surrounding them.
Therefore, protecting the teeth and gums by using some form of mouthguard or gumshield to reduce this risk is very important, and extra care needs to be taken by patients with braces, to protect against injury to themselves and others during sports.
Mouthguards for patients with braces can be designed so that both upper and lower teeth are protected and should have enough space to accommodate for the braces. They should be made with appropriate thickness to support and protect the teeth against impact that can be encountered during physical activities.
Your dentist will discuss the various options available to you, such as custom-made mouthguards which are made using impressions, providing a close fit.
If your child has had an accident involving their teeth, it is important to get in touch and arrange an emergency appointment during our opening hours, where the dentist can assess the injury and ensure your child receives the care they need.
Our paediatric dentist will assess and manage injuries involving your child’s baby (primary) or adult (permanent) teeth such as chipped or fractured teeth, loosened teeth or displaced teeth, or those that have been knocked out (or avulsed).
What should you do in the event that your child has had an injury to their teeth?
Chipped Tooth: Treatment will differ based on whether a primary or permanent tooth has been affected. If a piece of a permanent tooth has been chipped, if this piece can be found, we recommend storing it in milk, saliva or salty water and attending the dentist. The dentist may then reattach this piece if possible.
Displaced tooth: If your child’s teeth become loose or displaced from its usual position following an injury or accident, we recommend attending the dentist immediately who will be able to assess the injury. Your dentist may then recommend repositioning the tooth, followed by placing a small temporary wire, like a brace, to hold the tooth in place with the adjacent teeth.
Knocked-out tooth or complete loss of tooth: Time is the most critical factor here and it is important to see the dentist immediately. It is important to establish whether your child’s baby/primary tooth has been affected or adult/permanent tooth, since the ways in which injuries to these teeth are managed are different. If you are unsure, we recommend storing the tooth in saliva, milk or salty water and coming straight to the dentist who will advise.
If a permanent tooth is affected, and the tooth has been lost in the last 5 minutes, hold the tooth by the crown or the top and not the root. Rinse gently with water without scrubbing the root and, if you can, replant the tooth within the socket before coming to the dentist. If you cannot replant the tooth, store it in saliva, milk or salty water and make your way to the dentist immediately. The likelihood the tooth survives decreases the longer it spends outside the socket.
It is vital, that baby/primary teeth are not replanted in the socket to prevent damage to the adult/permanent teeth, so if you are unsure, we highly recommend attending the dentist immediately who will advise further.
Emergency dental pain
In the event that your child is in any dental pain, for instance toothache, we may be able to offer an emergency appointment within working hours to assess the cause and discuss management options with you in a timely manner.
Here at Orthosmile, we have the facilities to provide sedation for those children who feel anxious about treatment with the dentist – to help ensure their experience with us is as calm and relaxed as can be. It can also be an invaluable and safe way of easing nervous patients into the dental environment.
We offer inhalation sedation, a mixture of nitrous oxide and oxygen gas, commonly known as ‘laughing gas’, which is delivered through a small mask which sits over the nose and allows your child to relax and reduces pain during treatment. This is a type of conscious sedation, which means that your child will be awake and able to follow verbal instructions throughout.
Our dentist will do a thorough assessment to ensure that this type of treatment is suitable for your child and will talk you through every step of the process in detail at the initial visit, ensuring to answer any questions or queries you may have.
If the dentist advises any dental treatment such as fillings or root canal therapy for your child, it may be the case that they suggest carrying out the treatment with local anaesthesia to ensure that it is absolutely pain free.
Our dentists are trained to give these numbing injections in an atraumatic and almost painless manner, using a combination of distraction techniques and a topical anaesthetic gel which can be used before the injection, to reduce any discomfort – ensuring a stress-free experience. Our practice is also equipped with The Wand®, a cutting-edge computer assisted system which allows the dentist to give gentle and painless injections providing increased comfort throughout.
In cases where your child is particularly anxious, we may recommend inhalation sedation too, which may ease the delivery of anaesthetic, relaxing your child beforehand to prevent anxiety.
What causes white spots on teeth?
White spots are very common and can be caused by a range of factors including:
- Trauma/illness – any trauma or illness experience as a child may lead to white spots on adult teeth.
- Fluorosis - Consuming too much fluoride as a child when the permanent teeth are being formed can lead to fluorosis, resulting in discolouration or enamel spots.
- Decalcification of the enamel – this is the loss of minerals from the enamel. This can occur due to poor brushing which results in build-up of plaque acids on the enamel structure, which If left long enough starts leeching out the calcium from the enamel. Wearing braces can increase decalcification due to the difficulty in brushing under and around the brackets. Dry mouth may also cause areas of decalcification.
- Molar-Incisor hypomineralisation - this is a developmental condition that affects enamel
- Problems and illness during pregnancy and premature birth can sometimes cause white spots on a child’s teeth.
Sometimes teeth have either brown or white stains which are not amenable to whitening alone. These stains are normally caused by a decalcification process of some sort (white stains) or by a defect created during tooth formation, such as fluorosis, which is too much fluoride intake during tooth development. Fluorosis can cause severe brown stains which are within the enamel layer of the tooth. Often these types of stains lighten significantly with whitening but are not eliminated without further treatment.
Micro-abrasion uses a mixture of hydrochloric acid and pumice, which is an abrasive agent. This mixture is rubbed onto the tooth surface repeatedly until the outer layers of enamel containing the stains are abraded away. If the stains are in the outer layers of enamel, they can be successfully removed, leaving a smooth, glassy enamel surface as the finishing result. The surface has been demonstrated to be more resistant to tooth decay (or caries) than the original surface.
- The teeth are isolated using a rubber dam in order to protect the lips and gums from coming into contact with the acid.
- A slurry of pumice and acid is applied to the teeth surfaces and rubbed in.
- The slurry is rinsed with water and the results evaluated.
- The process is repeated until the stain has disappeared or is stopped if the enamel is getting too thin or if the tooth is becoming sensitive.
- The teeth are covered with fluoride gel to reduce post-operative sensitivity.
- This technique can be used alone or in adults in combination with tooth whitening or dental bonding; this is where a tooth coloured filling material is applied to the tooth afterwards.